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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%)
Lymphatic Drainage allows the spread of Carcinoma to which 3 locations?
In a radical Mastectomy what 7 things are removed?
- Auxillary Lymph Nodes
- Muscles both Major and Minor Pectoralis Muscles
- Medial and Lateral Nerves
- Medial and LAteral Arteries
- Minor Arteries
- Opposite Breast
Three Functions of the Thoracic Cage are?
- Protects Internal Organs
- Attachment of Muscles
- Assist in Breathing
Some Characteristics of the First Rib are?
- Boundary for Thoracic Inlet
- Groove for Subclavian Artery and Vein
What ligament givens the breast its shape?
Suspensory Ligament of Cooper
List the axilliary lymph nodes.
- 1. Apical
- 2. Central
- 3. Anterior
- 4. Lateral
- 5. Posterior
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)
What structures surround the thoracic inlet?
- 1. first rib
- 2. manubrium of the sternum
- 3. 1st thoracic vertebra
What structures are located in the thoracic inlet?
- 1. trachea
- 2. esophagus
- 3. phrenic and vagus nerves
- 4. Apex of the lung
What structures surround the thoracic outlet?
- 1. T12
- 2. Rib 12
- 3. Costal Margin (from 7th - 10th rib)
The xiphoid process is located at which level of thoracic vertebrae?
T 10 or T 11
The manubrio-sternal joint (sternal angle, angle of louis) is located at ....
What rib is the longest? The shortest?
- longest: 7
- shorters: 12 (sometimes 1)
Which ribs are typical?
List the true ribs?
- They articulate directly with the costal cartiledge of the sternum
List the False Ribs (and floating)
- - ribs 8-10
- floating: 11-12
Describe the first rib.
- 1. short and broad
- 2. Boundary for thoracic inlet
- 3. Grrove for subclavian artery and vein
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.
What are the three intercostal muscles?
- 1. external
- 2. internal
- 3. innermost
What lies between the internal and innermost intercostals?
posterior intercostal neurovascular model
The intercostal space below the 12th rib is
the subcostal space
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
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
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
List the arterial supply of the of the thorax.
- 1. Internal thoracic artery (from the subclavian artery- ANTERIOR)
- 2. Highest intercostal artery (subclavian artery)
- 3. Posterior Intercostal
- 4. Subcostal Artery
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
The azygous vein drains into the
superior vena cava.
The accessory hemiazygous and hemi-azygous cross over and drain into the
The accessory hemiazygous may drain into the