Important upper limb questions:
Mammary gland:
a) location and extent : 2nd to 6th rib vertically and horizontally from sternum to mid axillary line
b) what are the anatomical features of the mammary gland?
● Skin
○ Nipple
○ areola
● Parenchyma
○ 15-20 lobes arranged in radial fashion
○ Lobe divides into lobules with cluster of acini
○ Each lobe drains into lactiferous duct
○ Near its terminates duct expands into lactiferous sinus
● Stroma
○ Supporting network (fibrous and fatty)
○ Fibrous - sensory ligaments of cooper and support breast
○ Fatty - forms bulk of the breast
c) Name relations of the mammary gland?
● Pec major
● Serratus anterior
● External oblique
● Retromammary space (separated breast from pec fascia)
,d) mention breast lymphatic drainage?
There are 5 lymph nodes that the breast drains into:
● Axillary (ant, central, post and lat) drains UL and LL
● Internal mammary drains UM LM
● Apical drains axillary lymph nodes
● Supraclavicular drains apical
● Posterior intercostal lymph nodes
Superficial lymphatics drain the skin of the breast except nipple and areola.
Deep lymphatics drain parenchyma of the breast and nipple and areola. Most lymph drains into
the subareolar plexus of sappy.
● 75% lymph drains into axillary nodes
● 20% ant thoracic lymph nodes
● 5% post intercostal lymph nodes
e) mention blood supply to the breast?
● Axillary artery gives off branches called superior thoracic, acromiothoracic and lateral
thoracic arteries
● Perforating branches Internal thoracic artery
● Posterior intercostal arteries
, f) explain the microscopic features of the mammary gland?
COME BACK
g) Clinical aspects of the breast?
1. Breast cancer which arises from epi cells of lactiferous ducts
a. Common upper lateral quadrant of breast in tail of spence
b. Hard lump, nipple retraction and skin
2. Peau d orange : obstruction of sup lymphatics due to cancer
a. Loss of mobility to breast due to cancer getting into retromammary space
b. Retraction caused by infiltration of cancer to lactiferous ducts
* first tumor draining area called sentinel node
Clavipectoral fascia:
a) explain its attachments?
● Vertically : extends from clavicle above to axillary fascia below
● Medially : attached to first rib and costoclavicular ligament and blends with ext intercostal
membrane
● Laterally : attached to coracoid processes
b) name the structures that pierce the fascia?
● Lateral pec nerve
Mammary gland:
a) location and extent : 2nd to 6th rib vertically and horizontally from sternum to mid axillary line
b) what are the anatomical features of the mammary gland?
● Skin
○ Nipple
○ areola
● Parenchyma
○ 15-20 lobes arranged in radial fashion
○ Lobe divides into lobules with cluster of acini
○ Each lobe drains into lactiferous duct
○ Near its terminates duct expands into lactiferous sinus
● Stroma
○ Supporting network (fibrous and fatty)
○ Fibrous - sensory ligaments of cooper and support breast
○ Fatty - forms bulk of the breast
c) Name relations of the mammary gland?
● Pec major
● Serratus anterior
● External oblique
● Retromammary space (separated breast from pec fascia)
,d) mention breast lymphatic drainage?
There are 5 lymph nodes that the breast drains into:
● Axillary (ant, central, post and lat) drains UL and LL
● Internal mammary drains UM LM
● Apical drains axillary lymph nodes
● Supraclavicular drains apical
● Posterior intercostal lymph nodes
Superficial lymphatics drain the skin of the breast except nipple and areola.
Deep lymphatics drain parenchyma of the breast and nipple and areola. Most lymph drains into
the subareolar plexus of sappy.
● 75% lymph drains into axillary nodes
● 20% ant thoracic lymph nodes
● 5% post intercostal lymph nodes
e) mention blood supply to the breast?
● Axillary artery gives off branches called superior thoracic, acromiothoracic and lateral
thoracic arteries
● Perforating branches Internal thoracic artery
● Posterior intercostal arteries
, f) explain the microscopic features of the mammary gland?
COME BACK
g) Clinical aspects of the breast?
1. Breast cancer which arises from epi cells of lactiferous ducts
a. Common upper lateral quadrant of breast in tail of spence
b. Hard lump, nipple retraction and skin
2. Peau d orange : obstruction of sup lymphatics due to cancer
a. Loss of mobility to breast due to cancer getting into retromammary space
b. Retraction caused by infiltration of cancer to lactiferous ducts
* first tumor draining area called sentinel node
Clavipectoral fascia:
a) explain its attachments?
● Vertically : extends from clavicle above to axillary fascia below
● Medially : attached to first rib and costoclavicular ligament and blends with ext intercostal
membrane
● Laterally : attached to coracoid processes
b) name the structures that pierce the fascia?
● Lateral pec nerve
