Fluid Circulation in the Breast

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Types of Circulations of Breast:

Take this opportunity to study a diagram of how blood leaves the heart through the aorta, then divides through large branches of it (carotid, subclavian) to reach the head, chest and upper limb. You should practice tracing blood from the aorta to a target structure such as the breast so that you know all of the possible routes. Anastomoses (look that up now if it is a strange word to you) are key to understanding how the body deals with occlusion or damage to blood vessels (and to what you might have to clamp in order to restrict flow to the structure in a surgical procedure). In general you need to be concerned about arteries more than veins since their anatomy is less variant and they have a layer of smooth muscle that keeps them open when they are cut. By comparison veins vary more in their routes and designs, and circulation through them is by passive pressure, which means that damage to them tends to be less life-threatening.

Arterial Circulation:

• Richly supplied from four sources.

• Internal thoracic artery sends perforating branches to supply medial breast.

• Lateral thoracic artery supplies lateral breast via mammary branches.

• Thoracoacromial trunk supplies lateral breast via pectoral branches.

• Anterior and posterior intercostal arteries supply medial and lateral breast.

Venous Circulation:

• Mostly parallel arteries to axillary and subclavian veins.

• Blood also returns to vertebral venous plexus via azygous system. Thus, spinal cord may be implicated in spread of infection or tumor.

Lymphatic Circulation:

• Very important clinically.

• Lateral quadrants drain mostly to axillary nodes.

• Medial quadrants also drain to axillary nodes.

• Supplemental drainage to parasternal nodes and intercostal nodes.

• Some drainage to opposite side nodes also possible.

Innervation:

• Provided by the lateral and anterior cutaneous branches of 2nd-6th intercostal nerves.

Congenital Clinical Manifestations:

Polymastia:

• Extra breasts (with or without nipples), usually in axilla or groin.

Polythelia:

• Persistence of multiple nipples.

Amastia:

• Mammary line (milk ridge) never develops.

Gynecomastia:

• Development of female breast in males.

If you find yourself with time on your hands or with a particularly fast computer, you may find that internet searches of these clinical terms can be quite informative. Try using the Google search engine for images, then type in the bold terms above. This applies to all of the clinical lessons to come as well.

More Topics on Chest Wall:

1. Osteology of Pectoral Region
2. Glandular Structure of the Mammary Gland
3. Development of the Breast
4. Fluid Circulation in the Breast
5. Muscles of the Pectoral Region
6. Intercostal Connective Tissue
7. Notes on Neurovascular Bundle

Additional Reading:

Histology and Cytology

1. Cell Components
2. Nervous Tissue
3. Muscle Tissue
4. Lymphoid Tissue
5. Integument
6. Respiratory System
7. Gastrointestinal System
8. Renal/Urinary System
9. Male Reproductive System
10. Female Reproductive System

Gross Anatomy

1. Back and Nervous System
2. Thorax
3. Abdomen, Pelvis, and Perineum
4. Upper Limb
5. Lower Limb
6. Head and Neck
7. Chest Wall
8. Shoulder

Anatomy Videos

1. Video of Musculoskeletal Examination in a Clinical Setting
1. Video of HEENT Examination in a Clinical Setting

Related Topics

1. Jugular Venous Distention Workup

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Useful Medical Images & Diagrams (link opens in a new window)

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