UPPER LIMB

Introduction Organization Function

By: Dr. Mujahid Khan

Introduction
The

upper limb is a multijointed lever that is freely movable on the trunk at the shoulder joint
the distal end of the upper limb is the prehensile organ, the hand.

At

Introduction
Much

of the importance of the hand depends on the pincerlike action of the thumb, which enables one to grasp objects between the thumb and index finger
upper limb is divided into the shoulder (junction of the trunk with the arm), arm, elbow, forearm, wrist, and hand.

The

BREAST
Introduction:
Breasts

are specialized accessory glands Secrete milk Present in both sexes Similar in males and immature females

Anatomy of Breast
Has

nipples
by a colored area of skin

Surrounded

Areola
Consist

of a system of ducts embedded in connective tissue

At Puberty
Gradually
Assume

enlarge

their hemispherical shape under the influence of ovarian hormones ducts elongate in size

The

Extension
Base From

extends from 2nd to the 6th ribs

lateral margin of sternum to midaxillary line part of a gland lies in superficial

Greater

fascia

Axillary Tail
Extends
Pierces

upward and laterally

the deep fascia at the lower border of pectoralis major muscle

Then

enters the axilla

Formation

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 Base of nipple is surrounded by AREOLA Tiny tubercles on the areola produced by the underlying areolar glands

Fibrous Septa
Lobes

of the glands are separated by fibrous septa well developed in the upper part of the gland

Are

Extend
Serve

from skin to the deep fascia

as a suspensory ligament

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

Young & Old

Breasts

tend to protrude forward from a circular base in young women

tend to be pendulous in older women

They

They

reach their maximum size during lactation

Early Pregnancy
In

the early months of pregnancy, there is a rapid increase in length and branching in the duct system
secretory alveoli develop at the ends of the smaller ducts and the connective tissue becomes filled with expanding and budding secretory alveoli

The

Early Pregnancy

The vascularity of the connective tissue also increases to provide adequate nourishment for the developing gland

The nipple enlarges, and the areola becomes darker and more extensive as a result of increased deposits of melanin pigment in the epidermis
The areolar glands enlarge and become more active

Late Pregnancy
During

the second half of pregnancy, the growth process slows

breasts continue to enlarge, mostly because of the distention of the secretory alveoli with the fluid secretion called colostrum

The

Postweaning
Once

the baby has been weaned, the breasts return to their inactive state
remaining milk is absorbed, the secretory alveoli shrink, and most of them disappear interlobular connective tissue thickens

The

The

Postweaning
The

breasts and the nipples shrink and return nearly to their original size pigmentation of the areola fades, but the area never lightens to its original color

The

Postmenopause
After
Most

the menopause, the breast atrophies

of the secretory alveoli disappear, leaving behind the ducts

The

amount of adipose tissue may increase or decrease

Postmenopause
The

breasts tend to shrink in size and become more pendulous atrophy after menopause is caused by an absence of ovarian estrogen and progesterone

The

Blood Supply
Perforating

branches of the internal thoracic artery and the intercostal arteries artery via lateral thoracic and thoracoacromial branches

Axillary

Lymph Drainage
Important

clinically because of frequent development of a cancer dissemination of the malignant cells along the lymph vessels to the lymph nodes

Subsequent

Division
Breast is divided into 4 quadrants for lymph drainage

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

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