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Q1. What fascia covers pectoralis major?
→ Pectoral fascia.
Q2. What fascia forms the suspensory ligament of axilla?
→ Clavipectoral fascia.
Q3. Which structures pierce clavipectoral fascia?
→ Cephalic vein, thoracoacromial vessels, lymphatics, lateral pectoral nerve.
Q4. What is the anterior axillary fold formed by?
→ Lower border of pectoralis major.
Q5. What forms the posterior axillary fold?
→ Latissimus dorsi and teres major.
Q6. Origin and insertion of pectoralis major?
→ Origin: clavicle, sternum, upper 6 costal cartilages; Insertion: lateral lip of bicipital groove of humerus.
Q7. Nerve supply of pectoralis major?
→ Medial and lateral pectoral nerves.
Q8. Action of pectoralis major?
→ Adduction and medial rotation of arm; clavicular head flexes, sternocostal head extends.
Q9. How do you test pectoralis major in clinical exam?
→ Ask patient to adduct arm against resistance → palpate contraction of muscle.
Q10. What happens if pectoralis major is absent congenitally?
→ Poland’s syndrome (absent sternocostal head).
Q11. Origin and insertion of pectoralis minor?
→ Origin: ribs 3–5; Insertion: coracoid process of scapula.
Q12. Nerve supply of pectoralis minor?
→ Medial pectoral nerve.
Q13. Action of pectoralis minor?
→ Protraction and depression of scapula; accessory muscle of respiration.
Q14. What is the surgical importance of pectoralis minor?
→ Divides axillary artery into 3 parts.
Q15. How do you clinically test pectoralis minor?
→ Ask patient to push shoulders forward against resistance → muscle contraction felt deep to pectoralis major.
Q16. Origin and insertion of subclavius?
→ Origin: 1st rib; Insertion: subclavian groove of clavicle.
Q17. Nerve supply of subclavius?
→ Nerve to subclavius (C5–C6).
Q18. Function of subclavius?
→ Steadies clavicle, protects subclavian vessels.
Q19. How to test subclavius clinically?
→ Ask patient to draw shoulder downward and forward → contraction palpable beneath clavicle.
Q20. Clinical importance of subclavius?
→ Protects subclavian vessels in clavicle fracture.
Q21. Origin and insertion of serratus anterior?
→ Origin: upper 8–9 ribs; Insertion: medial border of scapula (anterior surface).
Q22. Nerve supply of serratus anterior?
→ Long thoracic nerve (C5–C7).
Q23. Action of serratus anterior?
→ Protraction of scapula, upward rotation for abduction >90°.
Q24. How do you test serratus anterior?
→ Ask patient to push against wall → medial border of scapula lifts (if weak = winging scapula).
Q25. Clinical sign of serratus anterior paralysis?
→ Winging of scapula.
Q26. What is the apex of axilla called?
→ Cervicoaxillary canal.
Q27. Boundaries of apex of axilla?
→ Clavicle (anterior), scapula (posterior), 1st rib (medial).
Q28. What forms the floor of axilla?
→ Skin, superficial fascia, axillary fascia.
Q29. What forms the anterior wall of axilla?
→ Pectoralis major, pectoralis minor, clavipectoral fascia.
Q30. What forms the posterior wall of axilla?
→ Subscapularis, latissimus dorsi, teres major.
Q31. Vertical extent of breast?
→ 2nd to 6th rib.
Q32. Horizontal extent of breast?
→ Sternum to mid-axillary line.
Q33. What is the axillary tail of breast called?
→ Tail of Spence.
Q34. What structures support breast shape?
→ Suspensory ligaments of Cooper.
Q35. Which nerve supplies nipple sensation?
→ 4th intercostal nerve.
Q36. Main arterial supply of breast?
→ Internal thoracic, lateral thoracic, thoracoacromial, intercostal arteries.
Q37. Main venous drainage of breast?
→ Axillary vein and internal thoracic vein.
Q38. Which lymph nodes receive most lymph from breast?
→ Axillary nodes (especially anterior group).
Q39. Which lymph nodes drain medial quadrant of breast?
→ Parasternal nodes.
Q40. Which lymphatic plexus drains nipple and areola?
→ Subareolar plexus of Sappey.
Q41. Most common site of carcinoma breast?
→ Upper outer quadrant.
Q42. What causes peau d’orange appearance?
→ Lymphatic obstruction.
Q43. What causes nipple retraction in carcinoma?
→ Fibrosis of lactiferous ducts.
Q44. What causes skin dimpling in carcinoma?
→ Involvement of Cooper’s ligaments.
Q45. Why does carcinoma breast spread to vertebrae?
→ Via posterior intercostal veins → vertebral venous plexus.
Q46. How do you test pectoralis major separately from deltoid?
→ Ask patient to adduct and medially rotate arm against resistance (deltoid abducts).
Q47. How do you test pectoralis minor function clinically?
→ Patient pushes shoulder downward and forward; palpate coracoid process for contraction.
Q48. How do you differentiate winging of scapula due to serratus anterior vs trapezius paralysis?
→ In serratus anterior → winging on pushing against wall;
In trapezius → winging on arm abduction above shoulder level.
Q49. What clinical sign indicates axillary lymph node involvement in carcinoma breast?
→ Hard, immobile nodes in axilla.
Q50. What is Poland’s syndrome?
→ Congenital absence of sternocostal head of pectoralis major with ipsilateral hand anomalies.
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