乳腺解剖

Axillary tail (Tail of Spence)
有一层结缔组织称为乳腺浅筋 膜, 它覆盖乳腺实体组织. 乳 房位于胸腔前表面, 被下面的 肋骨和肌肉支撑.在乳腺的下 方是胸小肌. 胸小肌是较小, 位置较深的肌肉. 在乳房的旁 侧和后侧的较宽的胸大肌.
胸大肌
背阔肌
锯前肌指状突起
腹外来自百度文库肌
A layer of connective tissue called the superficial fascia of the breast surrounds the parenchyma of the breast. The breast lies on the anterior surface of the thoracic cage supported by the underlying ribs and muscles. Immediately deep to the breast are the pectoralis muscles. The pectoralis minor is a smaller more deeply situated muscle. The pectoralis major muscle is a broad muscle that lies adjacent and immediately posterior to the breast.
Lactiferous sinus (ampulla) Lobar duct
A breast contains 15-18 lobes and therefore 15-18 lobar ducts. The lobar ducts are also referred to as lactiferous ducts. Each lactiferous duct has an opening on the surface of the nipple. There is a dilated region in each lactiferous duct just deep to the surface of the nipple. This dilated area is referred to as the ampulla.
一个乳房有15-18个乳叶和15-18个乳管. 乳管也称为乳汁输送管. 每个乳汁输送管在其乳头处有一个开口. 在乳头深处, 每个乳汁输 送管都有一个膨胀部位, 称为壶腹.
Lobular duct Lobar duct (Lactiferous duct) Lobule Ampulla
Nipple
Over time, due to factors scientist poorly understand, the cells in the breast lobules and ducts may undergo changes. Some of these changes increase a woman‟s risk of developing breast cancer while other changes are cancerous. To understand these changes let‟s look at a duct in cross section. This view is what it would be seen if a piece of breast tissue were removed from the breast and then examined under a microscope. 随着时间推移, 由于某些无法解释的原因, 乳腺小叶和乳管会发生变化. 有 些变化会增加妇女罹患乳腺癌的风险. 而有些变化本身就是癌变. 要了解 这些变化, 让我们来看一看乳腺的横截面.
Lymph nodes
Lymphatics
Parasternal (internal thoracic) nodes
The majority of the lymphatic fluid Subclavian (apical axillary) nodes from a breast drains to the ipsilateral Interpectoral axilla. The axilla is rich in both (Rotter‟s) nodes lymphatic channels and lymph nodes. A small portion of the lymphatic Central axillary nodes drainage from the inferomedial breast parenchyma will drain to the lymphatic Brachial (lateral axillary) system associated with the internal nodes thoracic vessels. Subscapular 乳腺的大部分淋巴液流入腋窝淋巴 (posterior axillary) nodes 。 腋窝富含淋巴管和淋巴结。小部 分乳腺内下侧淋巴液引流入胸内脉 管的淋巴系统。
2. Central or level 2 (posterior to pectoralis minor attachment) 第二站淋巴结（胸小肌后）
3. Apical or level 3 (superior to pectoralis minor attachment) 第三站淋巴结（胸小肌上）
Lobule
Lobular duct
Lobe
Many lobules together form a lobe of the breast. The duct that carries the secretions from all the lobules in a lobe is referred to as a lobar duct. 许多个小叶汇聚成乳叶. 小叶分泌物汇聚流 入乳管.
胸内动静脉分支
Lymph is a fluid that filters between the cells of tissue and then drains into its own set of transport channels. Lymph fluid may carry infectious organisms, toxins or cancerous cells. The channels that carry the lymph fluid are referred to as lymphatics. These lymphatics usually travel near or with the vascular supply of a tissue. Small lymphatics drain into larger lymphatics and eventually all the lymphatic fluid empties into one of the large veins in the thoracic cavity. Along the course of these lymphatic channels are soft tissue structures called lymph glands or nodes. The lymph glands act as filters to remove harmful substances from the lymph fluid. 淋巴是在组织间进行过滤的液体, 它流入自 己的输送渠道. 淋巴液载送感染性有机物, 毒素和癌细胞. 载送淋巴液的渠道称为淋巴 管。 这些淋巴管通常在组织周围流动并且将 组织维管联结。 小的淋巴管流入大的淋巴管 ， 并且最终所有的淋巴液流入胸腔的某个大 血管。 在这些淋巴管道的路程中有一些软组 织称为淋巴腺或淋巴结。 这些淋巴结象过 滤器一样过滤淋巴液中的有害物质。
The glands of the breast are arranged into collections called lobules. The secretions of the glands of each lobule drain into a tube called a lobular duct. 乳房的腺体结合成小叶. 小叶腺体的分泌物流入小叶管
Retromammary space 乳后间隙
Pectoralis major fascia 胸大肌筋膜
Pectoralis major Muscle 胸大肌
Superficial fascia (deep layer) 深层浅筋膜
胸大肌和胸小肌被深筋膜包裹。 胸大肌深筋膜的表面接触到包裹 乳腺的浅筋膜的深层。
Superficial fascia (superficial layer) 表层浅筋膜
锁骨下动静脉 腋静脉 腋动脉
The arterial blood supply to the breast originates from branches of the axillary, internal thoracic and subclavian arteries. The venous drainage of the breast empties into branches of the internal thoracic, axillary and intercostal veins. 乳腺血供来自腋窝、胸内和锁骨 下动脉。静脉引流自胸内、腋窝 和肋间静脉。
Pectoral (anterior axillary) nodes
For convention the axillary lymph nodes are divided into three groups: 1.Pectoral or level 1 (inferior to pectoralis minor attachment) 第一站淋巴结（胸小肌下）
乳腺是皮下结构，包括乳腺，纤维组织，脂肪组织。在皮肤上覆盖乳晕以及 乳头。
乳腺Milk glands
结缔组织 Fibrous tissue
Adipose tissue (fat) 脂肪 Nipple 乳头 Areola 乳晕
The portion of the breast that extends toward or into the underarm or axilla is referred to as the axillary tail of the breast or the tail of Spence. 乳房延伸至腋下部分称为腋尾。
The pectoralis major and minor muscles are both surrounded by a layer of fascia referred to as deep fascia. The superficial layer of the deep fascia of the pectoralis major muscle is in contact with the deep layer of the superficial fascia that surrounds the breast. These two surfaces normally glide over one another allowing a woman„s breast to move. If anything were to occur that prevented this type of normal motion the breast becomes immobile and is referred to as “fixed”. Specifically, this situation may occur if a cancer grows from the breast into these layers.
It is believed that the majority of the lymph drainage from the breast toward the axilla travels to the level 1 axillary nodes then to the level 2 axillary nodes and then to the level 3 axillary nodes. 普遍认为大部分的乳腺的腋窝淋巴引流 都是从第一站到第二站到第三站。