1. UPPER LIMB  Introduction  Organization  Function By: Dr. Mujahid Khan

5. BREAST Introduction: Breasts are specialized accessory glands Breasts are specialized accessory glands Secrete milk Secrete milk Present in both sexes Present in both sexes Similar in males and immature females Similar in males and immature females

6. Anatomy of Breast Has nipples Has nipples Surrounded by a colored area of skin “Areola” Surrounded by a colored area of skin “Areola” Consist of a system of ducts embedded in connective tissue Consist of a system of ducts embedded in connective tissue

7. At Puberty Gradually enlarge Gradually enlarge Assume their hemispherical shape Assume their hemispherical shape Under the influence of ovarian hormones Under the influence of ovarian hormones The ducts elongate in size The ducts elongate in size

8. Extension Base extends from 2 nd to the 6 th ribs Base extends from 2 nd to the 6 th ribs From lateral margin of sternum to midaxillary line From lateral margin of sternum to midaxillary line Greater part of a gland lies in superficial fascia Greater part of a gland lies in superficial fascia

9. Axillary Tail Extends upward and laterally Extends upward and laterally Pierces the deep fascia at the lower border of pectoralis major muscle Pierces the deep fascia at the lower border of pectoralis major muscle Then enters the axilla Then enters the axilla

12. Formation Each breast consists of 15-20 lobes which radiate out from the nipple Each breast consists of 15-20 lobes which radiate out from the nipple The main duct from each lobe opens separately on the summit of the nipple called Ampulla The main duct from each lobe opens separately on the summit of the nipple called Ampulla Base of nipple is surrounded by AREOLA Base of nipple is surrounded by AREOLA Tiny tubercles on the areola produced by the underlying areolar glands Tiny tubercles on the areola produced by the underlying areolar glands

14. Fibrous Septa Lobes of the glands are separated by fibrous septa Lobes of the glands are separated by fibrous septa Are well developed in the upper part of the gland Are well developed in the upper part of the gland Extend from skin to the deep fascia Extend from skin to the deep fascia Serve as a suspensory ligament Serve as a suspensory ligament

15. Retromammary Space These are the connective tissues which separate the breasts from the deep fascia covering the underlying muscles

16. Young & Old Breasts tend to protrude forward from a circular base in young women Breasts tend to protrude forward from a circular base in young women They tend to be pendulous in older women They tend to be pendulous in older women They reach their maximum size during lactation They reach their maximum size during lactation

17. Blood Supply Perforating branches of the internal thoracic artery and the intercostal arteries Perforating branches of the internal thoracic artery and the intercostal arteries Axillary artery via lateral thoracic and thoracoacromial branches Axillary artery via lateral thoracic and thoracoacromial branches

19. Lymph Drainage Important clinically because of frequent development of a cancer Important clinically because of frequent development of a cancer Subsequent dissemination of the malignant cells along the lymph vessels to the lymph nodes Subsequent dissemination of the malignant cells along the lymph vessels to the lymph nodes

20. Division Breast is divided into 4 quadrants for lymph drainage

21. The lateral quadrants of the breast drain into the anterior axillary or pectoral group of lymph nodes

22. The medial quadrants drain by means of vessels that pierce the intercostal spaces and enter the internal thoracic group of nodes The medial quadrants drain by means of vessels that pierce the intercostal spaces and enter the internal thoracic group of nodes