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G04 Ant Thorax Breast.Weyrich.Ppt.Pdf A patient suffers a puncture wound in the back just lateral to the 2nd thoracic vertebra. The puncture wound courses until it hits the erector spinae muscle group. From superficial to deep, identify the correct order of muscles hit by the protruding object. 20% 20% 20% 20% 20% A. Trapezius, latissimus dorsi, rhomboids, erector spinae m. B. Trapezius, rhomboids, serratus posterior superior, splenius ., errector spinae m. C. Trapezius, rhomboids, splenius m, erector spinae m. D. Trapezius, rhomboids, serratus posterior superior, erector spinae m. E. Trapezius, rhomboids, splenius m., serratus posterior superior, erector spinae m. Trapezius, rhomboid.. Trapezius, latissimus...Trapezius, rhomboids... Trapezius, Trapezius,rhomboids... rhomboids... Anterior Chest Wall • Anterior Chest Wall -Osteology (dry lab) -Gray’s pp. 118-126 -Gray’s Dissector pp. 49-54 -Anterior Chest Wall -Gray’s pp. 115-135; 333-336 -Gray’s Dissector pp. 55-72 1 Skin of the Anterior Chest Wall Syllabus p. 30 Lines of the Thoracic Wall Syllabus p. 30 2 Breasts Female Male Syllabus p. 31 Anatomy of the Female Breast Syllabus p. 31 3 Innervation of the Breast Blood Supply of the Breast Syllabus p. 31 4 Lymphatics of the Breast Syllabus p. 31 The Lymphatic System -Capillaries -Vessels -Nodes -Lymphocytes 5 Lymphatic Ducts -Thoracic Duct -Right Lymphatic Duct Lymphatics of the Right Breast 6 Lymphatics of the Left Breast Cancer develops in the right breast of a 34 year old woman. The woman experiences a loss of sensation in her nipple. Which nerve is likely affected by the tumor? 20% 20% 20% 20% 20% A. T1 B. T2 C. T3 D. T4 E. T5 T1 T2 T3 T4 T5 7 Lymphatic drainage to the right upper quadrant of the breast is also compromised. Which of the following lymph nodes are more greatly affected? 20% 20% 20% 20% 20% A. Axillary lymph nodes - Right lymphatic duct B. Parasternal lymph nodes - Right lymphatic duct C. Intercostal lymph nodes – Right lymphatic duct D. Axillary lymph nodes – Thoracic duct E. Intercostal lymph nodes – Thoracic duct Axillary lymph nodes.. Maxillary lymph Parasternal nodes.. Intercostal lymph n... lymph nod.. Intercostal lymph nod.. Muscles of the Thoracic Wall -Pectoralis Muscles* -Serratus Anterior Muscles* -Subclavius* -Intercostals* -Transversus Thoracis -Subcostalis -Diaphragm Syllabus pp. 32 8 Pectoralis Major and Minor Innervation of the Pectoralis Major and Minor 9 Innervation of the Pectoralis Major Serratus Anterior 10 The Lateral Thoracic Artery (Serratus Anterior) Subclavius 11 Innervation of the Subclavius A mastectomy is used to remove a cancerous tumor from a 46 year old woman. The procedure involves excision of the breast tissue to the pectoralis major muscle, associated fascia, and into the medial axillary wall. After the procedure the woman has a noticeable winged scapula. The following nerve is most likely damaged: 20% 20% 20% 20% 20% A. Spinal accessory n. B. Lateral pectoral n. C. Long thoracic n. D. Dorsal scapular n. E. Nerve to the subclavius. Long thoracic n. Lateral pectoral n. Dorsal scapular Medial n. pectoral n. Spinal accessory n. 12 Intercostal Muscles Intercostal Nerves and Vessels 13 Clinical Correlates FYI: Diaphragm will be discussed in the next lecture 14 Arteries of the Thorax Syllabus p. 33 Veins of the Thorax Syllabus p. 34 15 SCREEN 2 Trapezius 16 Trapezius, Rhomboid m., Serratus Posterior Superior, Splenius m. Trapezius, Rhomboid m., Serratus Posterior Superior, Splenius m., Deep Muscles of Back 17 Segmental Innervation of the Anterior Skin 18 The Female Breast 19 Innervation of the Breast Blood Supply of the Breast 20 Lymphatics of the Right Breast 21 Lymphatics of the Left Breast 22 Innervation of the Pectoralis Major and Minor 23 Serratus Anterior Subclavius 24 Intercostal Muscles 25 Intercostal Nerves and Vessels 26.
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