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THORACIC WALL MUSCLES, MAMMARY GLANDS, CROSS-SECTION.

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Presentation on theme: "THORACIC WALL MUSCLES, MAMMARY GLANDS, CROSS-SECTION."— Presentation transcript:

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2 THORACIC WALL MUSCLES, MAMMARY GLANDS, CROSS-SECTION

3 THORACIC WALL MUSCLES

4 Surface Muscles (Anterior) Platysma Platysma Pectoralis major Pectoralis major Pectoralis minor Pectoralis minor Subclavius Subclavius Serratus anterior Serratus anterior Refer in syllabus: Refer in syllabus: Table 1, pp Figure 13, p 50

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6 Surface Muscles (Posterior) Latissimus dorsi Latissimus dorsi Trapezius Trapezius Rhomboideus major Rhomboideus major Rhomboideus minor Rhomboideus minor Refer in syllabus: Refer in syllabus: Table I; pp 47-9

7 Deltopectoral Triangle Boundaries: Boundaries: Anterior border of the deltoid. Superior border of the pectoralis major. Middle third of the clavicle.

8 Deltopectoral Triangle Contents: Contents: Cephalic vein. Deltopectoral lymph nodes. Deltoid branch of the thoracoacromial artery.

9 Clavipectoral Fascia Invests subclavius and pectoralis minor. Invests subclavius and pectoralis minor. Attached to clavicle and anterior thoracic wall. Attached to clavicle and anterior thoracic wall. Pierced by: Pierced by: Cephalic vein Thoracoacromial artery Lateral pectoral nerve Become suspensory ligament of the axilla. Become suspensory ligament of the axilla.

10 THORACIC WALL STRUCTURE (x.s.) Refer to Figure 15, p. 60 in syllabus as well as background material on pp

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12 MAMMARY GLAND

13 Mammary Glands Modified sweat glands Modified sweat glands lobes lobes Lobes separated by fibrous septa Lobes separated by fibrous septa Lactiferous duct (1 per lobe) Lactiferous duct (1 per lobe) Lactiferous sinus (ampulla): Lactiferous sinus (ampulla): Dilation as duct enters nipple

14 Mammary Glands Fibrous tela subcutanea: Fibrous tela subcutanea: Connective tissue layer surrounding the entire gland. Fatty tela subcutanea: Fatty tela subcutanea: Adipose tissue deep to fibrous layer. Suspensory ligament of Cooper: Suspensory ligament of Cooper: Bundles of collagen fibers in dermis and hypodermis.

15 Mammary Glands Breast extends from 2 nd -3 rd rib superiorly to 6 th -7 th costal cartilage inferiorly. Breast extends from 2 nd -3 rd rib superiorly to 6 th -7 th costal cartilage inferiorly. Extends from lateral border of sternum to beyond the anterior axillary fold. Extends from lateral border of sternum to beyond the anterior axillary fold.

16 Mammary Glands Retromammary space: Retromammary space: Space between the gland and the pectoralis major muscle. Sinus mammarumis: Sinus mammarumis: Space between the two glands.

17 Mammary Gland Arteries Anterior perforating arteries: Anterior perforating arteries: From internal thoracic artery To medial part of gland Medial mammary rami: Medial mammary rami: From 2 nd - 4 th anterior perforating arteries To deep medial part of gland

18 Mammary Gland Arteries Lateral mammary artery: Lateral mammary artery: From lateral thoracic artery. To inferior part of gland. Lateral mammary rami: Lateral mammary rami: From lateral cutaneous branches of intercostal arteries. To lateral part of the gland.

19 Mammary Gland Veins Superficial and deep venous plexuses drain into internal thoracic, lateral thoracic, and intercostal veins. Superficial and deep venous plexuses drain into internal thoracic, lateral thoracic, and intercostal veins.

20 Mammary Gland Nerves Lateral mammary nerve: Lateral mammary nerve:T2-T6 Anterior branch of lateral cutaneous branch of intercostal nerves. Anterior branch of lateral cutaneous branch of intercostal nerves. Medial mammary nerve: Medial mammary nerve:T2-T6 Lateral branch of anterior cutaneous branch of intercostal nerves. Lateral branch of anterior cutaneous branch of intercostal nerves.

21 Mammary Gland Lymphatics Perilobular and interlobular lymphatic vessels: Perilobular and interlobular lymphatic vessels:Into: Subareolar plexus: Subareolar plexus:Into: Lateral lymphatic trunk: Lateral lymphatic trunk: From lateral and superior gland Medial lymphatic trunk: Medial lymphatic trunk: From medial and inferior gland

22 Mammary Gland Lymphatics Lateral lymphatic trunk and Medial lymphatic trunk: Lateral lymphatic trunk and Medial lymphatic trunk:Into: Pectoral group of axillary lymph nodes: Pectoral group of axillary lymph nodes:Into: Subclavian lymphatic channels Subclavian lymphatic channels

23 Mammary Gland Lymphatics Accessory lymphatic drainage: Accessory lymphatic drainage: Periphery of gland drains into apical group of axillary nodes and follows thoracoacromial trunk. Circumareolar channels drain into sternal chain.

24 THORACIC WALL LYMPHATICS

25 Lymphatic Drainage Subareolar plexus of nodes Subareolar plexus of nodes Axillary lymph nodes: Axillary lymph nodes: Receive from: Superficial tissues, skin, breast, extrinsic limb muscles. Include: Pectoral group Lateral group Apical group Subscapular group

26 Lymphatic Drainage Infraclavicular nodes Infraclavicular nodes Parasternal nodes Parasternal nodes Abdominal nodes Abdominal nodes

27 MECHANICS OF RESPIRATION

28 Inspiration: “Bucket Handle” Involves contraction of intercostal muscles Involves contraction of intercostal muscles Results in raising of ribs Results in raising of ribs Results in an increase in the lateral dimensions of the thoracic cage. Results in an increase in the lateral dimensions of the thoracic cage.

29 Inspiration: “Pump Handle” Results from raising of sternum Results from raising of sternum Results in increase in anteroposterior dimensions of thoracic cage Results in increase in anteroposterior dimensions of thoracic cage

30 Abdominal Breathing Results from lowering of diaphragm: Results from lowering of diaphragm: Phrenic nerve Necessary when: Necessary when:Infant Costal cartilages are calcified

31 Expiration Mostly passive Mostly passive


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