The Breast

Breast
Located in the ant. fascia of the ant.
chest
12-20 lobes of glandular tissue
fibrous connective tissue
adipose tissue
Coopers Ligament

- 2nd or 3rd rib superiorly

- inframammary folds
6th or 7th ribs inf.
- sternum medially
- AAL or MAL laterally
and ant. Axillary fold

Breast
Blood Supply
internal mammary artery
posterior intercostal arteries
axillary arteries
highest thoracic
lateral thoracic
thoracoacromial

Breast
Venous Drainage
perforating branches of the internal
mammary vein
tributaries to the axillary vein
perforating branches of the posterior
intercostal veins
* Circulus venosus- venous anastomotic
circle around the nipple

Breast
Sensory innervation of the breast
lateral and anterior cutaneous branches
of the 2nd to 6th intercostal nerves
Anterior and medial branches of the
supraclavicular nerve

 Lymphatic Drainage
axillary lymph node groups
axillary vein group(lateral group)- 4-6 lymph
nodes that lie medial or posterior the axillary
vein
external mammary group(ant. or pectoral
group)- 4-5 lymph nodes @ the lower border
of the pectoralis minor
scapular group(posterior or subscapular
group)- 6-7 lymph nodes near the posterior
wall of the axilla

 Lymphatic drainage cont.

central group- 3-4 large nodes
embedded in the fat of the axilla
behind the pectoralis muscle
subclavicular group(apical group) 6-12
lymph nodes partially post. And
partially above the pectoralis minor
interpectoral or Rotters group- 1 to 4
nodes

Breast
Axillary nodes may be divided according to
their lateral and medial relationship to the
pectoralis minor muscle
Level I- lateral to or below the border of the
pectoralis minor (ext mammary, axillary vein
and scapular groups)
Level II- deep to or behind the pectoralis
minor(central some subclavicular )
Level III- superomedial to the upper margin of
the pectoralis minor( most of the subclavicular
group)

Autonomic Nervous System

Innervation of involuntary structures
found in the central and peripheral nervous
system
Divided into 2 parts:
Sympathetic nervous system
Parasympathetic nervous system

Sympathetic Nervous System

Prepares the body for emergency
Efferent Fibers
Cell bodies of the sympathetic neurons -Lateral
Horn of Gray matter of the spinal cord from T1
to L2

Myelinated Axons in the

Anterior Nerve Roots
White Rami
Communicantes
Paravertebral Ganglia of the Sympathetic trunk

Terminate in the ganglion

by syanapsing w/ an excitor
cell

Travel in the ST to a ganglia

in the cervical region and
synapse with an excitor cell

Greater Splanchnic Nerve

5th-9th thoracic ganglia
pierces the diaphragm and
synapses w/ excitor cells in
celiac plexus

Lesser Splanchnic Nerve

10th,11th ganglia pierces
the diaphragm and synapses with the lower portion
of the celiac plexus

Pass thru the ganglia in

the thoracic part of the
ST w/o synapsing

Lowest Splanchnic Nerve

12th thoracic ganglia
pierces the diaphragm
synapses with EC in the
renal plexus

Sympathetic
Nervous System

Parasympathetic
Nervous
System

Parasympathetic Nervous System

For conserving and restoring energy
Efferent Fibers
Connector cells are located in the brain and
sacral segments of the spinal cord
In the brain forms parts of nuclei of origin of
cranial nerves III, VII, IX, X
axons emerge from the brain contained in the
corresponding cranial nerves
Sacral connector cells are found in gray matter
of the 2nd, 3rd and 4th sacral segments of the
cord

Parasympathetic Nervous System

Myelinated axons leave the spinal cord in
the ant. nerve roots of the corresponding
spinal nerves
They then leave the sacral nerves and
form the Pelvic Splanchnic Nerves
Cranial preganglionic fibers relay in the
pterygopalatine, submandibular and otic
ganglia.
Preganglionic fibers of the pelvic
splanchnic nerve relay in the ganglia in
the pelvic plexus