بسم الله الرحمن الرحيم

Mammary Gland It is fully developed in adult females It is rudimentary: –In female before puberty –In males Site: in the superficial fascia of the pectoral region. Shape: it is conical or hemispherical. Extent: –upwards: 2nd rib –downwards: 6th rib –medially: lateral margin of the sternum –laterally: midaxillary line (axillary tail)

Relations: –supero-medial 2/3: rest on pectoral fascia covering pectoralis major muscle (separated by retro-mammary space. –infer- lateral 1/3: rests on the serratus anterior muscle & external oblique muscle

The skin of the breast shows: The nipple: a conical projection lying opposite to the 4 th intercostal space in males and in females before pregnancy The areola: –area of pigmented skin surrounding the nipple –it is pink in nulligravida but change to dark brown in the 2 nd month of pregnancy (permanent change) NB: - The breast has no capsule (to allow its distension during pregnancy). - No subcutaneous fat beneath the nipple and areola.

Internal structure of the breast: the mammary gland is formed of lobes. each lobe drains into a lactiferous duct. the lactiferous ducts (15-20) converge toward the nipple & dilate to form lactiferous sinuses. the lactiferous sinuses open separately on the nipple. NB: the lobes of the breast are separated by suspensory ligaments of Cooper (these are fibrous septa stretched between the skin & pectoral fascia).

Axillary Tail the supero-lateral part of the breast extends upwards and laterally along the lower border of pectoralis major pierces deep fascia to reach the axilla tail of the breast

Arterial supply: Mammary branches of internal thoracic artery. Mammary branches of intercostal arteries lateral thoracic artery (the main supply). pectoral branch of thoraco-acromial artery.

Lymph Drainage The lateral quadrants drain into the anterior (pectoral) axillary lymph nodes. The medial quadrants drain into internal thoracic lymph nodes. A few vessels drain into the posterior intercostal lymph nodes. Some vessels drain to the opposite site lymph nodes. Some vessels drain into the abdominal lymph nodes. The lateral quadrants drain into the anterior (pectoral) axillary lymph nodes. The medial quadrants drain into internal thoracic lymph nodes. A few vessels drain into the posterior intercostal lymph nodes. Some vessels drain to the opposite site lymph nodes. Some vessels drain into the abdominal lymph nodes.

Clavipectoral fascia it is a well-defined membranous fascia filling the gap between subclavius & pectoralis minor muscles. attachment: –superiorly: it splits to enclose subclavius, then attached to the lips of subclavian groove. –inferiorly: it splits to enclose pectoralis minor, then extends down as the suspensory ligament of axilla which is attached to axillary fascia  hollow of axilla. –medially: is attached to 1 st & 2 nd costal cartilages. –laterally: is attached to coracoid process. N.B.: the upper part is thickened and is called costo-coracoid ligament the upper part is thickened and is called costo-coracoid ligament structures pierce clavipectoral fascia: structures pierce clavipectoral fascia: –Cephalic vein –Lateral pectoral nerve –Thoraco-acromial artery –Lymphatic vessels

THANK YOU