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Korenkov Topographic Anatomy (1)

Breast innervation
 
(Fig. A.4)
 
1) rr. mammarii laterales from n. cutanei laterales the 2nd –
7th intersotal nerves; 
2) rr. mammarii mediales from r. cutanei anteriores the 
3rd – 5th intercostal nerves; 
3) nn. supraclaviculares from plexus cervicales. 
The main function of mammae is a synthesis and secretion 
of milk. The structure and functions of mammae are 
significantly changing depending on different phases of 
menstrual cycle, pregnancy and lactation. The changes are 
determined by functionality of endocrine glands. 
Among the defects we should mention increase of number 
of nipples (polythelia), and number of mammae (polymastia). 
When tissue of mammae loses its elasticity – mastoptosis 
appears (ptosis of mammae). In case of mastoptosis the plastic 
surgery is recommended for young women. 
The men breast augmentation (gynecomastia) is not 
dangerous for men health, and the mastectomy is indicated 
for cosmetic reasons only. 
The breast inflammation (mastitis) is frequently observed 
among lactating mothers. This disease is associated with 
infection invading the mammae through scratches and fissures 
from apostasis on skin surface, and through lactiferous ducts, 
and hematogenic and lymphatic sinuses as well. 
According to localization we can distinguish: superficial 
abscesses, antemammary, abscesses located in the first layer 
of cellular tissue, abscesses or phlegmons located in the 
mamma (intramammary), and located behind the mamma 


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(retromammary). 
The operation is performed under general anaesthesia. The 
inramammarial abscesses are lancing according to Angerer 
method. Fibroadenoma is the most frequent type of benign 
tumour. Fibroadenomae are slowly growing round nodes of firm 
or a bit elastic texture, with smooth or a bit lumpy surface, and 
are well-separated from surrounding tissues. Fibroadenomae are 
considered as precancer conditions, and are subject to operative 
treatment. The definitive treatment of mammary cancer is 
radical mastectomy. 
Under the breast fascia there are muscles mm. pectorales 
major et minor, which cover chest cage in front, and m. 
serratus anterior and m. latissimus dorsi, which cover it 
sideways and from behind. The m. obliquus abdominis 
externus spring from lateral surface of thoracic cage and 
covers external surfaces of ribs and intercostal spaces. 
In its turn intercostal spaces are filled with intercostal 
muscles, blood vessels and nerves. External intercostal 
muscles (mm. intercostales externi) fill intercostal spaces 
between the head of the ribs to the cartilage. Membrana 
intercostalis externa is their prolongation which looks libe 
bright aponeurotic plates. The direction of muscle is from top 
to bottom and back to front.
Internal intercostal muscles (mm. intercostales interni) fill 
intercostal spaces from the lateral part of the chest to the 
costovertebral angle. The direction of muscles is from bottom 
to top and from the front to back. Membrana intercostali 
interna is the prolongation of muscles. 
There is an intercostal slot between external and internal 
intercostal muscles bounded with costal sulcus. The slot is 
filled with adipose tissue where the intercostal neurovascular 
bundle is located. The elements of neurovascular bundle are 


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located in the following way: there are a vein on the top, a 
nerve on the bottom, and the artery is located between the 
vein and nerve (Fig. A.6; Fig. A.7).
The chest is supplied with blood by aa. intercostales 
posteriores from the thoracic part of aorta and by anterior 
intercostal arteries (aa. intercostales anteriores) from a. 
thoracica interna. The first and the second intercostal spaces 
are supplied with blood by the a. intercostalis suprema from 
truncus costocervicalis and a. thoracica superior from the first 

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