THORACIC WALL

ACHMAD AMINUDDIN
SURFACE ANATOMY OF THE
THORAX
MOVEMENTS OF THORACIC
WALL
MUSCLES OF THORACIC WALL
BREASTS
 THE MAMMARY GLANDS
 In the subcutaneous tissue overlying the
pectoralis major and minor muscles.
 The amount of fat surrounding the glandular
tissue detrmines the size of non-lacting breast
 The nipple is surrounded by the areola
 The female breast rest on a bed that extends
transversely from the lateral border of the sternun
to the midaxillary line and vertically from the 2 nd
through 6th ribs
 MAMMARY GLANDS
 Two third of the bed of the breast are formed by
the pectoral fascia overlying the pectoralis major ;
the other third, by the fascia covering the serratus
anterior.
 Retromammary space ( bursa ), is a lose connective
tissue plane or potential space between the breast
and pectoral fascia. This space containing a small
amount of fat, allow the breast some degree of
movement on the pectoral fascia
 Tail, a small part along the inferolateral of p.m
 THE MAMMARY GLANDS
 TMG is firmly attached to the dermis of the
overlying skin, especially by the suspensory
ligaments ( of Cooper ).
 During puberty, the breast normally enlarge,
owing in part to glandular development but
primarily from increased fat deposition. The
areolae and nipples also enlarge.
 Breast size and shape are determined by genetic,
ethnic and dietary factors
 BREAST
 The lactiferous duct give rise to buds that form
15 – 20 lobules of glandular tissue, which
constitute the parenchyma of the mammary
gland
 Each lobule is drained by a lactiferous duct,
which usually opens independently on the
nipple.
 Deep to the areola, each duct has a dilated
portion, the lactiferous sinus
 BREAST
 The areola contain numeroud cebaceous glands,
which enlarge during prgnancy and secrete an
oily substance that provide a protective
lubricant for the areola and nipple
 The nipples are composed mostly of circularly
arranged smooth muscle fibers that compress
the lactiferous ducts during lactation and erect
the nipples in response t stimulation when a
baby begin to suckle
 THE PHYSIOLOGY OF THE
LACTATION
 PROLACTIN
- secreted from anterior pituitary gland.
- progesteron inhibit the effects of prolactin
 AFTER DELIVERY
- Estrogen and progesteron decrease.
- Sucking actions of the infant --- + --- stretch
receptors in the nipples ----- hypothalamus –
--- (-) – prolactin inhibiting h.
--- (+) -- ,, releasing h -------
 PHYSIOLOGY OF THE
LACTATION
-- prolactin is released by the anterior
pituitary
 Milk ejection reflex
- Suckling of the baby – (+)  sensory neuron
in nipple – (+)  hypothalamus and pituitary
- increased oxytocin in blood – (+)  con –
contraction of myoepithelial cells in mam
mary glands - milk ejection
 LACTATION OFTEN BLOCK
OVARIAN CYCLES
 During breast feeding , neural input from the
nipples reaches the hypothalamus and causes it
to produce neurotransmitter that suppres the
release of gonadotropin releasing hormon. As
a result , production of LH and FSH decreases
and ovulation is inhibited