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Mammary glands (breast)
• They are specialized accessory glands.
• Site
• They extend from second to sixth rib and from the lateral margin of the sternum to the midaxillary line.
• The axillary tail.
• Structure
• The gland is formed of 15-20 lobes,
• Arterial supply
• Perforating branches of the internal thoracic artery.
• Perforating branches of the intercostal arteries.
• The lateral thoracic branch of axillary artery.
• Thoracoacromial branch of axillary artery.
• Venous drainage
• It corresponds to the arterial supply.
• Lymph drainage
• anterior axillary or pectoral lymph nodes.
• the internal thoracic artery.
• The posterior intercostal lymph nodes.
• The opposite breast and the lymph vessels of the anterior abdominal wall
The axilla
• It is a pyramidal shaped space, which lies between the upper part of the arm and
Apex:
Anteriorly: Posteriorly: Medially: Base:
Anteriorly: the lower border of pectoralis major muscle.
Posteriorly: the tendon of latissimus dorsi and teres major muscles.
Medially: chest wall.
Anterior wall: Pectoralis major, subclavius, clavipectoral fascia, pectoralis minor, and the suspensory ligament of the axilla.
Posterior wall:
• Subscapularis, latissimus dorsi and teres major muscles.
Medial wall:
• Upper four or five ribs, intercostals spaces and serratus anterior muscle.
Lateral wall:
• Coracobrachialis and biceps muscles
Base:
• Skin.
• Contents:
• Axillary artery, Axillary vein, brachial plexus of nerve, lymph vessels and lymph nodes.
Pectoralis major
• Origin:
• Insertion:
• Nerve supply:
• Action:
Pectoralis minor
Subclavius
Subscabularis
Latissimus dorsi
Teres major
Serratus anterior
Clavipectoral fascia
• It is a strong sheet of connective tissue,
• Structures piercing the clavipectoral fascia:
•
Axillary artery
• Beginning:
• As the downward continuation of the subclavian artery.
• End:
• by becoming the brachial artery.
• Relations:
• First part:
• Second part:
• Third part:
• Branches:
• First part: Highest thoracic artery.
• Second part: Thoracoacromial artery. Lateral thoracic artery.
• Third part: Subscapular artery.Anterior circumflex humeral artery. Posterior circumflex humeral artery.
Axillary vein
• Beginning: The vein is formed by the union of the venae comitantes of brachial artery and basilic vein
• Course and relations:
• End: by becoming the subclavian vein.
• Tributaries: They correspond to the branches of the axillary artery.
Brachial plexus
• Formation:
• It is formed in the posterior triangle of the neck by the union of the anterior rami of fifth, sixth, seventh and eighth cervical and the first thoracic spinal nerves.
• Relations of the cords to the axillary artery:
• The branches of the brachial plexus:
• Branches from the roots:
• Branches from the upper trunk:
• Branches from the lateral cord:
• Branches from the medial cord:
• Branches from the posterior cord.
Axillary lymph nodes
• They are formed of six groups.
• Anterior (pectoral) group.
• Posterior (subscapular) group.
• Lateral group.
• Central group.
• Infraclavicular (deltopectoral) group.
• Apical group.
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