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Name 5 routes of Lymphatic Drainage.
- Axillary Nodes--(~75% of Lymph from Breast goes through these.
- Transpectoral (~5-10%)
- Parasternal-(internal thoracic artery)-(~5-10%)
- To Opposite Breast (~5%)
- Ligamentum Teres (to Liver)-(~5%)
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Lymphatic Drainage allows the spread of Carcinoma to which 3 locations?
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In a radical Mastectomy what 7 things are removed?
- Breast
- Auxillary Lymph Nodes
- Muscles both Major and Minor Pectoralis Muscles
- Medial and Lateral Nerves
- Medial and LAteral Arteries
- Minor Arteries
- Opposite Breast
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Three Functions of the Thoracic Cage are?
- Protects Internal Organs
- Attachment of Muscles
- Assist in Breathing
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Some Characteristics of the First Rib are?
- Short
- Broad
- Boundary for Thoracic Inlet
- Groove for Subclavian Artery and Vein
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What ligament givens the breast its shape?
Suspensory Ligament of Cooper
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List the axilliary lymph nodes.
- 1. Apical
- 2. Central
- 3. Anterior
- 4. Lateral
- 5. Posterior
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How does lymph drain from the breast?
- 1. axilliary nodes
- 2. transpectoral
- 3. to opposite breast
- 4. nodes along ligamentum teres
- 5. parasternal (internal thoracic artery)
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What structures surround the thoracic inlet?
- 1. first rib
- 2. manubrium of the sternum
- 3. 1st thoracic vertebra
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What structures are located in the thoracic inlet?
- 1. trachea
- 2. esophagus
- 3. phrenic and vagus nerves
- 4. Apex of the lung
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What structures surround the thoracic outlet?
- 1. T12
- 2. Rib 12
- 3. Costal Margin (from 7th - 10th rib)
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The xiphoid process is located at which level of thoracic vertebrae?
T 10 or T 11
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The manubrio-sternal joint (sternal angle, angle of louis) is located at ....
Tv 4
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What rib is the longest? The shortest?
- longest: 7
- shorters: 12 (sometimes 1)
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Which ribs are typical?
3-9
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List the true ribs?
- 1-7
- They articulate directly with the costal cartiledge of the sternum
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List the False Ribs (and floating)
- - ribs 8-10
- floating: 11-12
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Describe the first rib.
- 1. short and broad
- 2. Boundary for thoracic inlet
- 3. Grrove for subclavian artery and vein
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List the origin, insertion, function, and innervation of the serratus anterior.
- - origin: ribs 1-8
- - inserts on superior, inferior and medial border of the scapula
- - function: rotates scapula, abductor of arm and elevation above the horizontal plane and respiration.
- - nerve: long thoracic nerve (found in axilla)
- if the nerve is cut: winging of scapula, loss of elevation, problems with respiration.
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What are the three intercostal muscles?
- 1. external
- 2. internal
- 3. innermost
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What lies between the internal and innermost intercostals?
posterior intercostal neurovascular model
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The intercostal space below the 12th rib is
the subcostal space
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List the origin, insertion, function, and innervation of external instercostals
- 1. attachement: the lower borders of ribs 1-11 to the upper border of ribs 2-12
- 2. fibers run down and foward
- 3. at the costochrondral joint replaced by external intercostal membrane
- 4. function: elevate the rib cage (inspiration)
- 5. nerve: corresponding intercostal
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List the origin, insertion, function, and innervation of the internal intercostal muscles
- 1. fibers run down and back
- 2. attachement: lower margins of ribs, costal cartilages and costal
- 3. near the vertebra
- 4. nerve: corresponding intercostal nerves
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List the origin, insertion, function, and innervation of the innermost intercostals
- It has 3 parts:
- 1. Innermost intercostal per se:
- - few fibers between the ribs except at subcostalis muscle and sternocostalis muscle
- -IT IS MOSTLY MEMBRANE
- 2. Subcostalis muscle
- - found at the angle of the rib only
- - attachement: between the ribs posteriorly and may cross 1 or 2 ribs and attach to third rib
- - func: expiration
- 3. Sternocostalis muscle (transversus thoracis)
- - found near the sternum only
- - attachemnt: back of xiphoid process and sternum
- - inserts in costal cartilage
- nerve: corresponding intercostal nerves
- - func: expiration
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List the arterial supply of the of the thorax.
- 1. Internal thoracic artery (from the subclavian artery- ANTERIOR)
- POSTERIOR:
- 2. Highest intercostal artery (subclavian artery)
- 3. Posterior Intercostal
- 4. Subcostal Artery
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List the venous supply of the thorax.
Anterior Aspect: Internal thoracic vein drains into the brachiocephalic vein.
- Posterior Aspect:
- Right Side:
- 1st: highest intercostal vein drains into the brachiocephalic
- 2nd - 3rd: joins higher intercostal:-- drains into azygous
- 4-11: intercostal veins drain directly into the azygous
- Subcostal vein (12): drains into the azygous.
- Left Side:
- -Highest intercostal vein drains into the brachiocephalic
- -2nd, 3rd, 4rth, intercostal veins join to give to the accessory hemiazygous
- -5-11: intercostal and subcostal vein join together to give the hemiazygous vein
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The azygous vein drains into the
superior vena cava.
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The accessory hemiazygous and hemi-azygous cross over and drain into the
Azygous Vein
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The accessory hemiazygous may drain into the
brachiocephalic vein
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