(17) Lower and upper extremity lymphatics

Humeral axillary LN
(already part of drawing; review later when you memorize)

lateral

= lymph from upper limb

Subscapular axillary LN
(already part of drawing; review later when you memorize)

posterior

skin an muscles of
= posterior neck
= thoracic wall

Pectoral axillary LN
(already part of drawing; review later when you memorize)

anterior

skin & muscle of:
- anterior + lateral thoracic walls + 85% of female breast

Central axillary LN
(already part of drawing; review later when you memorize)

recieves lymph from:
humeral (lateral)

subscapular (posterior)

pectoral (anterior)

subcalvicular axillary
(already part of drawing; review later when you memorize)

Apical
- inferior to clavicle

- deltopectoral lymph nodes (right side of arm) (superficial)S

supraclavicular LN
(already part of drawing; review later when you memorize)

cervical lymph nodes drain here

Boundaries of axilla

Anterior wall = pec major/minor

Lateral wall = humerus

Posterior wall = subscapularis

Medial wall = SA

Breast anatomy

1) superficial to fascia covering pec major + SA
- b/w ribs 2-6

2) mammary glands (milk)

3) retromammary space
- b/w breast tissue + pec major fascia

4) axillary tail

5) nipple + areola

Breast (milk secreting gland pathway)

Lobes w/ milk secreting cells
→ drain in to lactiferous ducts
→ which drain into lactiferous sinus

Lobes of glandular tissue

separated by adipose tissue

& bands of CT (suspensory ligaments of cooper)

Arterial supply of breast

Medial mammary branch = internal thoracic artery (from subclavian branch)

Lateral mammary branch:
- lateral thoracic artery (lateral aspect) (from axillary branch)
- posterior intercostal arteries (supplies deep/post)

*TLDR therefore 3 ways to metastasize

Venous drainage of breast

Same as their artery counterpounts

1) internal thoracic vein (medial)

2) lateral throacic vein (lateral)

3) posterior intercostal vein (deep/post)

Lymphatic drainage of breast

-85% is drained via
1) PECTORAL AXILLARY NODES
→ eventually drain into subclavian trunk

-15% is drained by:

2) Parasternal LN
→ follows internal thoracic artery
→ to bronchomediastinal trunk

3) LN assoc w/ posterior intercostal artery
→ to thoracic duct