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Lecture 5- FEMALE BREAST ANATOMY FOR NURSING STUDENT 2-1.ppt
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- 4. Naming the quadrantsfor the purpose of describing a lump 1.Upper medial quadrant 2. Upper lateral quadrant 3. Lower medial quadrant 4. Lower lateral quadrant
- 5. Breast clock andQuadrants
- 6. • Modified sweatgland- modified apocrine gland • Fat accounts for its smooth contour and most of its bulk. • The resting (non-lactating) breast, however consists mostly of fibrous & fatty tissue; variations in size are due to variations in fat content, not glandular tissue which is very sparse. • During pregnancy alveoli bud off from the smaller ducts & the organ usually enlarges significantly, & more so in preparation for lactation. • When lactation ceases there is involution of secretory tissue. • After menopause progressive atrophy of lobes & ducts takes place. • MALE BREAST • Resembles the rudimentary female breast • has NO lobules or alveoli. • The small nipple and areola lie over the 4th intercostal space
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- 8. Parts, Shape &position of the Gland • It is conical in shape. • It lies in superficial fascia of the front of chest. • It has a base, apex and tail. • Its base extends from 2nd to 6th ribs. • It extends from the sternum to the midaxillary line laterally. • It has no capsule.
- 9. SHAPE AND POSITIONOF FEMALE BREAST • 2/3 of its base lies on the pectoralis major muscle, while its inferolateral 1/3 lies on: • Serratus anterior & • External oblique muscles. • Its superolateral part sends a process into the axilla called the axillary tail or axillary process up to the 3ed rib
- 10. • Nipple: • Itis a conical eminence that projects forwards from the anterior surface of the breast. • The nipple lies opposite 4th intercostal space. • It carries 15-20 narrow pores of the lactiferous ducts. SHAPE AND POSITION OF FEMALE BREAST
- 11. SHAPE AND POSITIONOF FEMALE BREAST • Areola : • It is a dark pink brownish circular area of skin that surrounds the nipple. • Lubricated by the areolar glands of Montgomery • large, • modified sebaceous glands →may form sebaceous cysts → may infected • The subcutaneous tissues of nipple & areola are devoid of fat.
- 12. STRUCTURE OF MAMMARYGLAND • It is non capsulated gland. • It consists of lobes and lobules which are embedded in the subcutaneous fatty tissue of superficial fascia. • It has fibrous strands (ligaments of cooper) which connect the skin with deep fascia of pectoralis major. • It is separated from the deep fascia covering the underlying muscles by a layer of loose areolar tissue which forms the retromammary space. (allows the breast to move freely).
- 13. STRUCTURE OF MAMMARYGLAND • It is formed of 15-20 lobes. • Each lobe is formed of a number of lobules. • The lobes and lobules are separated by interlobar and interlobular fibrous & fatty tissue, called ligaments of Cooper. These ligaments give the breasts support by connecting the skin of the breasts to the pectoralis muscles below them. • It has from 15-20 lactiferous ducts which open by the same number of openings on the summit of the nipple.
- 14. ARTERIAL SUPPLY • 1.Perforating branches of internal thoracic (internal mammary) artery. • 2. Mammary branches of lateral thoracic artery. • 3. Mammary branches of Intercostal arteries.
- 15. VENOUS SUPPLY • Veinsare corresponding to the arteries. • Circular venous plexus are found at the base of nipple. • Finally, veins of this plexus drain into axillary & internal thoracic veins.
- 16. AXILLARY LYMPH NODES •They are arranged into 5 groups which lie in axillary fat : • Pectoral (Anterior) group : which lies on the pectoralis minor along lateral thoracic vessels. • Subscapular (Posterior) group : which lies on posterior wall of axilla on lower border of subscapularis along subscapular vessels. • Brachial (Lateral) group : lies on lateral wall of axilla along 3rd part of axillary vessels. • Central group : lies in axillary fat at the base of axilla. • Apical group : lies at apex of axilla. • Subclavian lymph trunk: • it is formed by union of efferent lymph vessels of apical group. It usually opens in subclavian vein. On the left side it usually opens into thoracic duct.
- 17. LYMPHATIC DRAINAGE • Subareolarlymphatic plexus : • Lies beneath the areola (the plexus of Sappey). • Deep lymphatic plexus: • Lies on the deep fascia covering pectoralis major. • Both plexuses radiate in many directions and drain into different lymph nodes.
- 18. LYMPHATIC DRAINAGE • Central& lateral parts of the gland (75%) drain into pectoral group of axillary lymph nodes. • Upper part of the gland drains into apical group of axillary lymph nodes. • Medial part drains into internal thoracic (parasternal) lymph nodes, forming a chain along the internal thoracic vessels. • Some lymphatics from the medial part of the gland pass across the front of sternum to anastomose with that of opposite side. • Lymphatics from the inferomedial part anastomose with lymphatics of rectus sheath & linea alba, and some vessels pass deeply to anastomose with the sub diaphragmatic lymphatics.
- 20. APPLIED ANATOMY- CANCERBREAST • It is a common surgical condition. • 60% of carcinomas of breast occur in the upper lateral quadrant. • 75% of lymph from the breast drains into the axillary lymph nodes. • In case of carcinoma of one breast, the other breast and the opposite axillary lymph nodes are affected because of the anastomosing lymphatics between both breasts. • In patients with localized cancer breast, a simple mastectomy, followed by radiotherapy to the axillary lymph nodes is the treatment of choice.
- 21. Applied Anatomy • Thelactiferous ducts are radially arranged from the nipple, so incision of the gland should be made in a radial direction to avoid cutting through the ducts. • Infiltration of the ligaments of Cooper by breast cancer leads to its shortening giving peau de’orange appearance of the breast.
- 22. Mammary ridge • Mammaryridge extends from the axilla to the inguinal region. • In human, the ridge disappears EXCEPT for a small part in the pectoral region. • In animals, several mammary glands are formed along this ridge.
- 24. • Fibrocystic Breast -Breasttissue responds to fluctuating levels of hormones, especially estrogen • Cause; -Changes in the breasts may include: • an overgrowth of cells that line the milk ducts • an increase in fibrous tissue • the formation of cyst • People who develop fibrocystic changes may be more sensitive to hormonal fluctuations during the menstrual cycle. It is common for symptoms to become more bothersome right before or during a menstrual period. • Common cause of ‘lumpy breast’
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