the answers from page 3 till 67. From where do the lateral cutaneous branches (anterior
and posterior) of intercostal nerves arise and to where do they distribute?
<blockquote> The lateral cutaneous branches of a typical intercostal nerve arise
lateral to the angles of the ribs, divide into anterior and posterior branches,
and supply the skin of the thoracic and abdominal walls
</blockquote>
8. Is any pinkish mammary glandular tissue visible?
<blockquote> It is likely that your cadaver does not have any appreciable mammary
tissue. Most of the cadavers are elderly.</blockquote>
9. What are suspensory ligaments of the mammary glands?
<blockquote> The suspensory ligaments are fibrous condensations of the connective
tissue stroma which are prominent in the superior part of the mammary gland.
These help support the lobules of the gland and attach it to the dermis of
the overlying ski
</blockquote>
10. Consider blood supply, nerve supply, and lymphatic drainage
of the breasts.
<blockquote>
Blood: A breast's
arterial supply is derived from branches of the internal thoracic artery (including
anterior intercostals), the lateral thoracic artery, the thoracoacromial artery,
and posterior intercostal arteries. Venous drainage follows arterial supply,
primarily draining into the axillary vein, but also draining some blood
into the internal thoracic vein.
Nerves: The skin of the breast
is innervated by anterior and lateral cutaneous branches of the 2nd through
6th intercostal nerves. For example, the area around the nipple and areola
is innervated via the T4 spinal nerve.
Lymphatic drainage : Lymph passes from the
nipple,
areola, and
lobules to
the subareolar lymphatic plexus. From there:
- MOST (75%) of the lymph goes to the axillary
lymph nodes, via the pectoral lymph nodes. (It is extremely important
to consider the axillary nodes when performing a breast exam on a patient.)
- Most of the rest goes to the parasternal
lymph nodes.
- A small amount of lymph goes to the opposite breast.
- A small amount of lymph goes to the abdominal wall and downward.
Lymphatic vessels in the
skin of the breast drain into the axillary,
inferior deep cervical, infraclavicular, and parasternal lymph nodes.
Lymph from the axillary lymph nodes subsequently drains into the
subclavian
lymph trunk. Lymph from parasternal nodes enters the
bronchomediastinal
trunk. </blockquote>
11. Why are lateral pectoral
and medial pectoral nerves reversed (with respect to their names and relative
locations) from what you would expect?
<blockquote> Both of these nerves supply the pectoralis major. The "medial"
and "lateral" designations of these two nerves refers to the cords
of the brachial plexus from which they are derived. (Do not worry about this
now, but it
will haunt you later!) They are not topographic designations.
(To remember which is which, think about the
Medial pectoral nerve
being a
Major nerve which supplies
both the pectoralis
Major
and the pectoralis
Minor. The
Lateral nerve is a
Little
nerve, and only innervates pectoralis major.)
()</blockquote>
12. Where does the cephalic
vein terminate?
<blockquote> The cephalic vein passes between the deltoid and pectoralis major
muscles and empties into the termination of the axillary vein.
(Latin/Greek,
cephalicus/kephalikos = head
<blockquote>
the answers from page6to 21The axillary space is shaped like a truncated pyramid.
Its boundaries are:
- anterior wall: pectoralis major and minor
muscles. The lateral border of pectoralis major muscle forms the anterior
axillary fold.
- posterior wall: scapula, subscapularis muscle,
teres major muscle, and latissimus dorsi muscle. The teres major muscle
combines with latissimus dorsi muscle to form the posterior
axillary fold.
- medial wall: serratus anterior muscle
- lateral wall: the floor of the intertubercular
groove of the humerus.
</blockquote>
) ()</blockquote>