Q-1. Tubercles of Montgomery is seen in
a) Breast
b) Liver
c) Stomach
d) Lung
Answer: Breast
Explanation:
The skin surrounding the base of the nipple is pigmented and forms a circular area called the areola. This region is rich in modified sebaceous glands, particularly at its outer margin. These become enlarged during pregnancy and lactation to form raised tubercles of Montgomery. Oily secretions of these glands lubricate the nipple and areola and prevent them from cracking during lactation.
Q-2. Which of the following does NOT supply the breast with blood?
a) Lateral thoracic artery
b) Thoraco-acromial artery
c) Posterior intercostal arteries
d) Costo-clavicular artery
Answer: Costo-clavicular artery
Explanation:
The mammary gland is extremely vascular. It is supplied by branches of the following arteries:
Internal thoracic artery, a branch of the sub-clavian artery, through its perforating branches.
The lateral thoracic, superior thoracic and acromio-thoracic (Thoraco-acromial) are branches of the axillary artery.
Lateral branches of the posterior intercostal arteries.
Important point:
The arteries converge on the breast and are distributed from the anterior surface. The posterior surface is relatively avascular.
Q-3. Blood supply of breast is from all except
a) Internal mammary artery
b) Intercostal artery
c) Thoraco-dorsal branch of sub-scapular artery
d) Thoraco-acromial artery
Answer: Thoraco-dorsal branch of sub-scapular artery Explanation:
See above explanation.
Q-4. Lymph node which is first to be involved in carcinoma breast
a) Pectoral group
b) Internal mammary
c) Apical
d) Internal mammary
Answer: Pectoral group
Explanation:
The axillary lymph nodes (chiefly the anterior or pectoral) group: The posterior, lateral, central and apical groups of nodes also receive lymph from the breast either directly to indirectly.
About 75% of the lymph from the breast drains into the axillary nodes: 20% into the internal mammary nodes; and 5% into the posterior intercostal nodes.
Q-5. True about pectoralis major muscle-
a) Abductor & Internal rotator of shoulder
b) Blood supply by perforating branch of internal thoracic artery
c) Blood supply by intercostal artery
d) Nerve supply by lateral anterior thoracic nerve
e) Inserted into 2nd to 6th costal cartilage
Answer: Nerve supply by lateral anterior thoracic nerve
Explanation:
Pectoralis major muscle:
Origin:
Anterior surface of medial half of clavicle
Half of breadth of anterior surface of manubrium and sternum up-to 6th costal cartilages
Second to six costal cartilages
Aponeurosis of the external oblique muscle of abdomen
Insertion:
It is inserted by a bi-laminar tendon on the lateral lip of the bicipital groove. The two laminae are continuous with each other inferiorly.
Blood supply:
Pectoral branch of the thoraco-acromial trunk
Nerve supply:
The pectoralis major receives dual motor innervation by the medial pectoral nerve and the lateral pectoral nerve, also known as the lateral anterior thoracic nerve.
Actions:
Acting as whole: Adduction and medial rotation of shoulder/arm
Clavicular part: Flexion of the arm
Sterno-clavicular part: Extension of flexed arm against resistance and climbing
Q-6. Which of the following muscles are enclosed within the clavi-pectoral fascia?
a) Pectoralis major
b) Serratus anterior
c) Coraco-brachialis
d) Sub-clavius
Answer: Sub-clavius
Explanation:
Clavipectoral fascia:
Its upper part splits to enclose the sub-clavius muscle. Inferiorly it splits to enclose the pectoralis minor muscle.
Q-7. Structure piercing the clavi-pectoral fascia is
a) Basilic vein
b) Cephalic vein
c) Thoraco-acromial artery
d) Musculo-phrenic nerve
Answer- b and c
Explanation:
The clavi-pectoral fascia is pierced by the following structures:
Lateral pectoral nerve
Cephalic vein
Thoraco-acromial vessels
Lymphatic passing from the breast and pectoral region to the apical group of axillary lymph nodes
Q-8. All pierce the clavi-pectoral fascia except
a) Lateral pectoral vein
b) Lateral thoracic artery
c) Cephalic vein
d) Thoraco acromial artery
Answer: Lateral thoracic artery
Explanation:
See above explanation.
Q-9. Boxer’s muscle is -
a) Trapezius
b) Serratus anterior
c) Psoas major
d) Latissimus dorsi
Answer: Serratus anterior
Explanation:
Serratus Anterior:
Origin:
Serratus anterior muscle arises by eight digitations from the upper eight ribs, and from the fascia covering the intervening intercostal muscles
Nerve Supply:
The nerve to the serratus anterior is a branch of the brachial plexus. It arises from roots C5, C6 and C7 (Long thoracic nerve).
Action:
Along with the pectoralis minor, the muscle pulls the scapula forwards around the chest wall to protract the upper limb (in pushing and punching movements). When the muscle is paralyzed the medial margin of the scapula gets raised especially when ‘pushing movements’ are attempted. This is called ‘winging of the scapula’.
Paralysis of the serratus anterior produces ‘winging of scapula’ in which the inferior angle and the medial border of the scapula are unduly prominent. The patient is not able to do any pushing action nor can he raise his arm above the head. Any attempt to do these movements makes the inferior angle of the scapula still more prominent.
Q-10. Serratus anterior is supplied by
a) Thoraco-dorsal nerve
b) Nerve to sub-clavius
c) Long thoracic nerve
d) Axillary nerve
Answer: Long thoracic nerve
Explanation:
See above explanation.
Q-11. Winging of scapula is due to injury to
a) Long thoracic nerve
b) Short thoracic nerve
c) Axillary nerve
d) supra-scapular nerve
Answer: Long thoracic nerve
Explanation:
See above explanation.
Q-12. Regarding serratus anterior muscle, which is incorrect?
a) Multi-pinnate muscle
b) Lifts arm above the shoulder
c) Supplied by long thoracic nerve
d) Originates from lower 8 ribs
Answer: Originates from lower 8 ribs
Explanation:
See above explanation.
Q-13. All are sensory except
a) Saphenous nerve
b) Sural nerve
c) Inter-costo-brachial nerve
d) Long thoracic nerve
Answer: Long thoracic nerve
Explanation:
The nerve to the serratus anterior is a branch of the brachial plexus. It arises from roots C5, C6 and C7 (Long thoracic nerve).
Q-14. Winging of Scapula is due to paralysis of
a) Latissimus dorsi
b) Pectoralis major
c) Pectoralis minor
d) Serratus anterior
Answer: Serratus anterior
Explanation:
See above explanation.
Subject: Anatomy-Axilla
Root value of Musculo-cutaneous nerve is
a) C4, 5
b) C5, 6, 7
c) C5, 6, 7, 8
d) C8, T1
Fascia around nerve bundle of brachial plexus is derived from-
a) Pre-vertebral fascia
b) Pre-tracheal fascia
c) Investing layer
d) Superficial cervical fascia
The medial wall of the axilla is formed by the
a) Serratus anterior
b) Sub-scapularis muscle
c) Pectoralis major muscle
d) Teres major muscle
Marked structure in figure is
a) Teres Major
b) Teres Minor
c) Pectoralis Major
d) Pectoralis Minor
Marked structure in figure is (Axillary artery)
a) Teres Major
b) Teres Minor
c) Pectoralis Major
d) Pectoralis Minor
Condition depicted in figure is due to
a) Infiltration of suspensory ligament by cancer cells
b) Infiltration of lactiferous ducts by cancer cells
c) Infiltration and obstruction of superficial lymph vessels of breast by cancer cells
d) None
Subject: Anatomy: Pectoral Region
Breast usually lies in the
a) Fourth intercostal space just medial to mid-clavicular line
b) Fourth intercostal space just lateral to mid-clavicular line
c) Fifth intercostal space just medial to mid-clavicular line
d) Fifth intercostal space just lateral to mid-clavicular line
Tubercles of Montgomery is seen in
a) Breast
b) Liver
c) Stomach
d) Lung
Which of the following does NOT supply the breast with blood?
a) Lateral thoracic artery
b) Thoraco-acromial artery
c) Posterior intercostal arteries
d) Costo-clavicular artery
Lymph node which is first to be involved in carcinoma breast
a) Pectoral group
b) Internal mammary
c) Apical
d) Supra-clavicular
Which of the following muscles are enclosed within the clavi-pectoral fascia?
a) Pectoralis major
b) Serratus anterior
c) Coraco-brachialis
d) Sub-clavius
Structure piercing the clavi-pectoral fascia is
a) Basilic vein
b) Cephalic vein
c) Thoraco-acromial artery
d) Musculo-phrenic nerve
Regarding serratus anterior muscle, which is incorrect?
a) Multi-pinnate muscle
b) Lifts arm above the shoulder
c) Supplied by long thoracic nerve
d) Originates from lower 8 ribs
muscle is -
a) Trapezius
b) Serratus anterior
c) Psoas major
d) Latissimus dorsi
All are sensory except
a) Saphenous nerve
b) Sural nerve
c) Inter-costo-brachial nerve
d) Long thoracic nerve
Winging of scapula is due to injury to
a) Long thoracic nerve
b) Short thoracic nerve
c) Axillary nerve
d) supra-scapular nerve
Winging of Scapula is due to paralysis of
a) Latissimus dorsi
b) Pectoralis major
c) Pectoralis minor
d) Serratus anterior
Breast usually lies in the
a) Fourth intercostal space just medial to mid-clavicular line
b) Fourth intercostal space just lateral to mid-clavicular line
c) Fifth intercostal space just medial to mid-clavicular line
d) Fifth intercostal space just lateral to mid-clavicular line
Anterior axillary fold contains
a) Lower border of pectoralis major
b) Upper border of pectoralis major
c) Tendon of latissimus
d) Serratus anterior
Platysma may protect the following vein from external pressure:
a) External jugular vein
b) Occipital vein
c) Brachio-cephalic vein
d) Anterior jugular vein
Breast is modified
a) Sebaceous gland
b) Sweat gland
c) Both
d) None
The breast is separated from the pectoral fascia by loose areolar tissue, called
a) Retro-mammary space
b) Myoepitheliocytes
c) Suspensory ligament of Cooper
d) Sub-areolar plexus of Sappy
In resting phase, alveolar epithelium is
a) Cuboidal
b) Columnar
c) Stratified squamous keratinized epithelium
d) Myoepitheliocytes
Sub-areolar plexus of Sappy and most of lymph from the breast drain into the
a) Pectoral group
b) Internal mammary
c) Posterior intercostal
d) Supra-clavicular
Mammary ridge or line of Schultz appears during
a) 4 Weeks of intra-uterine life
b) 6 Weeks of intra-uterine life
c) 7 Weeks of intra-uterine life
d) 8 Weeks of intra-uterine life