Term
| where is the thorax located? |
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Definition
| between the neck and the abdomen |
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Term
| how are the inlet and outlet of the thorax defined? |
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Definition
inlet is defined by the manubrium and first ribs
outlet is defined by the diaphragm |
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Term
| breast tissue consists primarily of what? |
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Definition
| fat, it is compartmentalized between glandular and connective tissue |
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Term
| where do the suspensory ligaments of cooper run? |
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Definition
| from the deep fascia all the way to the skin |
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Term
| name the components of the female breast. |
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Definition
| nipple, areola, lactiferous ducts, lactiferous sinuses, mammary glands, suspensory ligaments, fat |
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Term
| what are areolar glands and what purpose do they serve? |
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Definition
| sebaceous glands surrounding the nipple, help to lubricate the nipple during suckling |
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Term
| true or false, the nipple and areola become more pigmented after first pregnancy? |
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Definition
|
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Term
| how is milk excreted by the mammary glands? |
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Definition
| the nipple is supplied with smooth muscle that contracts upon stimulation |
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Term
| what arteries supply the breast and where? |
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Definition
internal thoracic artery supplies the medial aspect
the lateral thoracic artery supplies the lateral aspect |
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Term
| what lymph nodes drain the breast and where? |
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Definition
| the majority of the breast (lateral portion) is drained by the axillary nodes, and the rest (medial portion) drain to the parasternal nodes, all eventually drain to subclavian lymph trunk |
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Term
| what sections are the breast divided into and what region sees higher incidence of breast cancer? |
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Definition
| superior lateral/medial and inferior lateral/medial, the superior lateral region (avoids spread to contralateral breast) |
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Term
| true or false, the majority of breast lumps are cancerous? |
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Definition
|
|
Term
| what makes up the majority of breast lumps? |
|
Definition
fibrocystic changes (40%)
followed by no disease (30%) |
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Term
| how does a breast tumor cause dimpling? |
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Definition
| the tumor impinges on the suspensory ligaments, as the breast is compressed the ligament is unable to stretch producing a dimple (sign of aggressive tumor) |
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Term
| true or false, a fibroadenoma is cancerous. |
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Definition
| false, it is a benign tumor |
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Term
| what are some signs of breast cancer? |
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Definition
| dimpling, recruitment of blood vessels, amorphous region, edema, and orange peel skin |
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Term
| what prevents large scarring in breast surgery? |
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Definition
| utilization of langer lines |
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Term
| what is involved in a mastectomy? |
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Definition
| the removal of all breast tissue down to the pectoralis major, locating the long thoracic (seratus anterior) and thoracal dorsal (latissimus dorsi) nerves prior to removal |
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Term
| what nerves innervate the seratus anterior and latissimus dorsi? |
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Definition
| the long thoracic and the thoracal dorsal, respectively |
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Term
| what is involved in a lumpectomy? |
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Definition
| removal of only tumor and surrounding area, also axillary node dissection to detect metastasis |
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|
Term
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Definition
| injection of dye in an area to locate its draining lymph nodes |
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Term
| what two surgical repair procedures are available after mastectomy and what do they involve? |
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Definition
tramp flap reconstruction - relocates the opposite rectus abdominal muscle to the affected breast, also uses skin graft from stomach to breast
latissimus dorsi flap reconstruction - relocating part of the lat dorsi around to the affected breast |
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|
Term
| how is the relocated muscle kept viable during tram flap reconstruction? |
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Definition
| only the insertion site is cut to maintain the blood supply to the muscle |
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|
Term
| what surgical procedures are available for nipple reconstruction? |
|
Definition
| CV flap and double opposing tab |
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|
Term
| what are the three main functions of the thorax? |
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Definition
| protection of vital organs, breathing, and a conduit between structures of head and abdomen |
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|
Term
| which ribs are true ribs and why? |
|
Definition
| ribs 1 through 7, they attach to the body of the sternum via their own costal cartilage |
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|
Term
| which ribs are false ribs and why? |
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Definition
| ribs 8 through 10, they attach to the costal cartilage of the rib superior to them |
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|
Term
| which ribs are floating ribs and why? |
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Definition
| ribs 11 and 12, they do not attach to the sternum only to the vertebral column |
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|
Term
| what vertebra attach to the ribs? |
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Definition
|
|
Term
| which ribs are considered typical ribs and why? |
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Definition
| ribs 3 through 10, because they have a normal rib shape |
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|
Term
| which ribs are considered atypical and why? |
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Definition
| ribs 1 and 2, they are very curved and shorter, and ribs 11 and 12, they are straighter and shorter |
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Term
| what is involved in a thoracotomy and why is it performed? |
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Definition
| cut through skin and underlying tissue, then cut through periosteum, cut out section of rib, and then cut through underlying periosteum; to gain access to the thoracic cavity |
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Term
| what hazard does cartilagenous ribs pose to children? |
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Definition
| the ribs can compress a lot possibly damaging underlying organs |
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Term
| which ribs are the least/most likely to be broken and why? |
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Definition
| rib 1 is least likely because of its shape and it is protected by the clavicle, ribs 2 through 7 are the most likely to be broken anterior to the angle (lateral portion) |
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Term
|
Definition
| caused by multiple rib fractures which causes an inward movement of the fractured rib during breathing |
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Term
| what should be considered during chest x rays in the elderly? |
|
Definition
| ossification of the costal cartilage can resemble the appearance of a tumor |
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|
Term
| what bone is commonly used for bone marrow extract due to its easy access? |
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Definition
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|
Term
| what bone fracture is associated with a 25-45% mortality rate and why? |
|
Definition
| the sternum, because it is anterior to the heart |
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Term
| name the external muscles of the thoracic wall. |
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Definition
| the pectoralis major, pectoralis minor, serratus anterior, posterior-superior serratus, trapezius, latissimus dorsi, levator scapulae, and major and minor rhomboids |
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|
Term
| name the internal muscles of the thoracic wall. |
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Definition
| external intercostals, internal intercostals, innermost intercostals, and the transversus thoracis |
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Term
| what functions do the external, internal, and innermost intercostals and the transversus thoracis perform? |
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Definition
| the externals and the innermost intercostals elevate the thorax during inspiration, and the internal intercostal and transversus thoracis depress the thorax during forced exhalation |
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Term
| where do the vascular and nervous tissue run in the thoracic wall and how are they protected? |
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Definition
| from the spinal column anteriorly between the internal and innermost intercostals, by the intercostal groove on the inferior side of the ribs |
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|
Term
| what are the collaterals and where are they located? |
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Definition
| they are the second set of arteries, veins, and nerves running through the intercostal space superior to the rib |
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|
Term
| what three diameters are expanded during inspiration? |
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Definition
| superior to inferior, anterior to posterior, and transverse |
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Term
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Definition
|
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Term
| what is the difference between deep and shallow breathing? |
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Definition
| deep is also called diaphragmatic and shallow is called costal, refers to muscles used |
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Term
| what type of breathing is increasingly used by pregnant women due to pressure on abdominal viscera? |
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Definition
| costal (or shallow) because diaphragm is impeded |
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Term
|
Definition
| forced breathing, active inspiration and exhalation |
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Term
|
Definition
| utilizing every muscle possible for breathing, dying breathe |
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Term
| what four regions make up the thorax and what land marks separate them? |
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Definition
| superior, anterior inferior, middle inferior, and posterior inferior mediastinum; the sternal angle (angle of louis) to T5 divides superior to inferior, the pericardium divides anterior, middle, and posterior |
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|
Term
| what surface feature resides at the 4th intercostal space? |
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Definition
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|
Term
| what vertebra does the suprasternal notch align with? |
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Definition
|
|
Term
| what vertebra does the xiphisternal joint align with? |
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Definition
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|
Term
| where can the apex beat of the heart be found? |
|
Definition
| 5th intercostal space, mid clavicular line (under nipple) |
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