Breasts have similar structures in male and female during puberty

System of ducts embedded in connectice tissue within the areola

Breast matures under the influence of ovarian hormones

Breast

Dilation near the nipple area

Produces the tubercles on the areola

Supported by suspensory ligaments

Filled with connective tissue

Layers of breast

Breast at pregnancy: Rapid increase in length and branching of duct system

Breast at pregnancy: Development of secretory alveoli at the enda of small ducts and connective tissue

Breast at pregnancy: Increase vascularity of the breast

Breast at pregnancy: Enlarging nipples and darker

Breast at pregnancy: Growth slows down

Breast at pregnancy: Still increasing size

Breast at pregnancy: Ducts filled with colostrum

Interlobular connective tissue thickens

Areola faded but never to original color

Breast decrease in size and become pendulous

Secretory aveoli disappears but ducts remain

Due to absence of ovarian estrogen and progesterone

Decrease in size

Remaining milk is absorbed

Breast and nipple return to near original sizes

Breast lymphage drainage: anterior axillary pr pectroal groyp posterior to the lower borders of pectoralis major

Breast lymphage drainage: internal thoracic group

Ribs

3 cavities of thorax

Sternal angle of Louis

Articulates with body of sternum

Articulates with manubrium sterni

Typical ribs

Parts of typical ribs

Arise from C7

Flattened from above downward

Closely associated with lower brachial plexus and the subclavian artery and vein

Occurs in 0.5% population

Free anterior end or connected to 1st rib by fibrous band

Joints of the chest wall

Connects the head to the intervertebral disc

1st rib and 3 lowest ribs have one synovial joint

Articulates with the transverse process of the corresponding vertebral body

No movement possible

No movement possible

Articulates with lateral border of the sternum by synovial joint

Articulates with one another by the small synovial joint

Embedded in the musculature

Structures tbat pass through thoracic outlet

Entire thoracic outlet is covered by what membrane?

External intercostal

Internal Intercostal

Azygos

Hemiazygous

Drains into azygos and hemiazygos

Drains into internal thoracic vein and musculophrenic vein

Intercostal nerves: Distribute to corresponding intercostal space

Intercostal nerves: Enters the costal cartilage to distribute to the abdominal wall

Intercostal nerves: Ends pass to the abdominal all

Intercostal nerves: Becomes the subcostal nerve and enters the abdominal wall directly

Intercostal nerves: Supplies the skin and the pleurac intercostal muscles, levatores costar and serratus posterior

Intercostal nerves: Supplies the abdominal skun, peritoneum, external oblique, transversys abdominus and the rectus abdominis

Most important muscle for breathing

Diaphragm: high as the upper border of the 5th rib

Diaphragm: high as the lower border of the 5th rib

Right crus

Left crus

Structures that pass through the aortic opening

Structures that pass through the esophageal opening

Structures that pass through caval opening

Accompany the terminal branches of the correspondung intercostal nerves

Enters the rectus sheath of the anterior abdominal wall and supplies the rectus muscle

Runs around the costal margin of the diaphragm and supplies the lower intercostal spaces and diaphragm

For the upper six intercostal spaces

Scapula

Spine of scapula posteriorly to the 6th rib and costal cartilage anteriorly

Line along 4th costal cartilage

Superior mediastinum contents

Inferior mediastinum contents

Covers the thoracic wall, undersudr of suprapleura membrane, thoracic side of diaphragm, lateral side of the mediastinum

Covers the lungs

Sensitive to pain, temperature, touch and pressure

Supplies by the intercostal nerves

Supplied by the phrenic nerve

Supplied over the domes by the phrenic nerve and around the perophery by the lower six intercostal nerves

Sensitive to stretch

Insensitive to pain and touch

Receives autonomic nerve supply from pulmonary plexus

Clinically detectable increased at 300 ml

Inflammation of pleura

Air in the pleural cavity causing collapse of the lungs

Increase fluid in the lungs

Pleural fluid is clinically detectable increased at how many ml?

Trachea becomes the left and right bronchus

How long is the trachea?

Trachea

Bronchus: Wider, shorter, more vertical

Bronchus: about 1 inch

Bronchus: Branches out to superior lobar bronchus, middle and inferior lobar bronchus

Bronchus: Narrower, longer, more horizontal