8.30.11+-+Self+Study...+Pectoral+Region+and+Thoracic+Wall


 * SELF STUDY**


 * Pectoral Region and Thoracic Wall**
 * 30 August 2011**


 * READING:**
 * **COA5, pp. 83-84, 105-111, 728-730, 742-760.**
 * **COA6, pp. 76-78, 98-111, 680-683, 688-705**


 * OBJECTIVES:**


 * 1. List the bones that form the pectoral (shoulder) girdle.**


 * 2. Define the appendicular skeleton.**


 * 3. Name the bones which form the upper limb.**


 * 4. Define the axial skeleton and the bones which form it.**


 * 5. Identify the following features of the clavicle:**
 * **acromial end** - flat end articulates with acromion process
 * **sternal end -** rounded end articulates with sternum

__Resources:__ Video #1: Distinguishing the acromial end from the sternal end Video #2: Distinguishing the right clavicle from the left clavicle


 * 6. Name two joints formed by the clavicle.**
 * 1) Sternoclavicular joint
 * 2) Acromioclavicular joint


 * 7. List three functions of clavicle.**
 * 1) Serves as a crane or strut from which the scapula and limb are hung
 * 2) Protects the cervico-axillary canal for the nervous and vascular supply to the arm
 * 3) Transmits shocks from the upper limb to the axial skeleton


 * 8. List the ribs covered by the scapula**
 * Ribs 2 through 7 are (partially) covered by the scapula


 * 9. Identify the following landmarks of the scapula.**
 * **suprascapular notch**
 * **supraspinous fossa**
 * **infraspinous fossa**
 * **glenoid cavity**
 * **coracoid process**


 * 10.Identify the bony landmark which forms the “point of the shoulder.”**


 * 11.Identify and describe the following landmarks of sternum and rib cage:**
 * **manubrium**
 * **body (aka gladiolus)**
 * **xyphoid process**
 * **jugular notch**
 * **manubriosternal joint**
 * **sternal angle (of Louis)**
 * **xiphisternal joint**
 * **costal notches**
 * **costal margin**


 * 12.Name the set of costal cartilages which lie at the levels of the sternal angle and xiphisternal joint.**


 * 13.Identify the following muscles of the pectoral region. List the proximal and distal** **attachments, innervation and main actions of these muscles.**
 * **pectoralis major (****clavicular head and** **sternocostal head)**
 * **pectoralis minor**
 * **serratus anterior**
 * **subclavius (We will not dissect this muscle until later.)**


 * Muscle || Proximal attachments || Distal attachments || Innervation || Main actions || Images ||
 * Pectoralis major ||  ||   ||   ||   || [[image:http://www.rad.washington.edu/academics/academic-sections/msk/muscle-atlas/upper-body/pectoralis-major/atlasImage_large]] ||
 * Pectoralis minor ||  ||   ||   ||   || [[image:http://www.rad.washington.edu/academics/academic-sections/msk/muscle-atlas/upper-body/pectoralis-minor/atlasImage]] ||
 * Serratus anterior ||  ||   ||   ||   || [[image:http://www.rad.washington.edu/academics/academic-sections/msk/muscle-atlas/upper-body/serratus-anterior/atlasImage_large]] ||
 * Subclavius ||  ||   ||   ||   || [[image:http://i.quizlet.net/i/i1JRw_mmN6JerR51jwNeFA_m.jpg]] ||


 * 14.Define the term “winged scapula”. Describe its cause.**


 * 15.Identify the following arteries of the pectoral region:**
 * **thoracoacromial a./trunk**
 * **lateral thoracic a.**


 * 16.Identify the cephalic vein.**


 * 17.Describe the clavipectoral fascia and its relationships.**


 * 18.Identify the major parts of the breast:**
 * **fat**
 * **suspensory ligaments (of Cooper)**
 * **axillary tail (of Spence)**
 * **mammary lobule (collectively comprise mammary gland)**
 * **areola**
 * **lactiferous ducts**
 * **lactiferous sinuses**
 * **nipple**
 * **retromammary space**


 * 19. Name the following arteries that supply the breast:**
 * **internal thoracic a.** - #4 in figure
 * **lateral thoracic a.** - #2 in figure
 * **thoracoacromial a.** - #1 in figure
 * **posterior intercostal aa.** - #3 in figure




 * 20.List the chief venous drainage of breast.**

The two main veins shown in //Clinically Oriented Anatomy// that drain the breast are the:
 * 1) Lateral mammary veins
 * 2) Internal thoracic vein (and its perforating branches)


 * 21.Name and label the lymph node groups receiving lymphatic drainage from the breast:**
 * **axillary lymph nodes (lateral quadrants)**
 * **parasternal nodes (medial quadrants)**


 * 22.Define the superior, inferior, medial and lateral borders of the breast.**


 * 23.Name the intercostal nerves that supply the breast**