乳腺解剖ppt課件

1、1乳腺是皮下結(jié)構(gòu)，包括乳腺，纖維組織，脂肪組織。在皮膚上覆蓋乳暈以及乳頭。 Adipose tissue (fat)脂肪Nipple乳頭Areola乳暈乳腺Milk glands結(jié)締組織Fibrous tissue2The 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稱為腋尾。Axillary tail(Tail of Spence

2、)3有一層結(jié)締組織稱為乳腺淺筋膜, 它覆蓋乳腺實體組織. 乳房位于胸腔前表面, 被下面的肋骨和肌肉支撐.在乳腺的下方是胸小肌. 胸小肌是較小, 位置較深的肌肉. 在乳房的旁側(cè)和后側(cè)的較寬的胸大肌.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

3、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. 胸大肌背闊肌鋸前肌指狀突起腹外斜肌4The pectoralis major and minor muscl

4、es 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 womans

5、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. 胸大肌和胸小肌被深筋膜包裹。胸大肌深筋膜的表面接觸到包裹乳腺的淺筋膜的深層。Pectoralis major fascia胸大肌筋

6、膜Pectoralis majorMuscle胸大肌Superficial fascia(deep layer)深層淺筋膜Superficial fascia(superficial layer)表層淺筋膜Retromammary space乳后間隙5The 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 br

7、anches of the internal thoracic, axillary and intercostal veins.乳腺血供來自腋窩、胸內(nèi)和鎖骨下動脈。靜脈引流自胸內(nèi)、腋窩和肋間靜脈。鎖骨下動靜脈腋靜脈腋動脈胸內(nèi)動靜脈分支6Lymph 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 cell

8、s. 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. Alo

9、ng 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. 淋巴是在組織間進行過濾的液體, 它流入自己的輸送渠道. 淋巴液載送感染性有機物, 毒素和癌細胞. 載送淋巴液的渠道稱為淋巴管。 這些淋巴管通常在組織周圍流動并且將組織維管聯(lián)結(jié)。 小的淋巴管流入大的淋巴管， 并且最終所有的淋巴液流入胸腔的

10、某個大血管。 在這些淋巴管道的路程中有一些軟組織稱為淋巴腺或淋巴結(jié)。 這些淋巴結(jié)象過濾器一樣過濾淋巴液中的有害物質(zhì)。Lymph nodesLymphatics7The majority of the lymphatic fluid from a breast drains to the ipsilateral axilla. The axilla is rich in both lymphatic channels and lymph nodes. A small portion of the lymphatic drainage from the inferomedial breast pa

11、renchyma will drain to the lymphatic system associated with the internal thoracic vessels. 乳腺的大部分淋巴液流入腋窩淋巴。 腋窩富含淋巴管和淋巴結(jié)。小部分乳腺內(nèi)下側(cè)淋巴液引流入胸內(nèi)脈管的淋巴系統(tǒng)。 Parasternal (internal thoracic) nodesSubclavian (apical axillary) nodesInterpectoral(Rotters) nodesCentral axillarynodesBrachial (lateral axillary)nodesSub

12、scapular (posterior axillary)nodesPectoral (anterior axillary)nodes8For convention the axillary lymph nodes are divided into three groups:1.Pectoral or level 1(inferior to pectoralis minor attachment)第一站淋巴結(jié)（胸小肌下）2. Central or level 2(posterior to pectoralis minor attachment)第二站淋巴結(jié)（胸小肌后）3. Apical or

13、level 3(superior to pectoralis minor attachment)第三站淋巴結(jié)（胸小肌上）9It 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. 普遍認為大部分的乳腺的腋窩淋巴引流都是從第一站到第二站到第三站。 10Th

14、e 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.乳房的腺體結(jié)合成小葉. 小葉腺體的分泌物流入小葉管LobuleLobular duct11Many lobules together form a lobe of the breast. The duct that carries the secretions from all the lob

15、ules in a lobe is referred to as a lobar duct. 許多個小葉匯聚成乳葉. 小葉分泌物匯聚流入乳管.Lobar ductLactiferous sinus(ampulla)Lobe12A 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

16、. 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.一個乳房有15-18個乳葉和15-18個乳管. 乳管也稱為乳汁輸送管. 每個乳汁輸送管在其乳頭處有一個開口. 在乳頭深處, 每個乳汁輸送管都有一個膨脹部位, 稱為壺腹.Lobular ductLobar duct(Lactiferous duct)LobuleAmpullaNipple13Over time, due

17、 to factors scientist poorly understand, the cells in the breast lobules and ducts may undergo changes. Some of these changes increase a womans risk of developing breast cancer while other changes are cancerous. To understand these changes lets look at a duct in cross section. This view is what it w

18、ould be seen if a piece of breast tissue were removed from the breast and then examined under a microscope.隨著時間推移, 由于某些無法解釋的原因, 乳腺小葉和乳管會發(fā)生變化. 有些變化會增加婦女罹患乳腺癌的風(fēng)險. 而有些變化本身就是癌變. 要了解這些變化, 讓我們來看一看乳腺的橫截面. 14 In a normal duct the cells lining the duct will be one or two layers thick. These cells will have s

19、imilar size and shape.正常的乳管有12層細胞。這些細胞有相似的大小和形狀15In some women, extra cells will grow in the duct. The latin term for excess is hyper and the term for growth is plasia , so a condition with excess growth is referred to as hyperplasia. In this case the specific term would be ductal hyperplasia This c

20、ondition confers no increase risk for developing breast cancer.有些婦女，乳管內(nèi)生長了額外的細胞。這稱為增生，乳管內(nèi)增生。乳管內(nèi)增生16Sometimes the excess growth within the duct includes some very abnormal or atypical cells. This condition is referred atypical ductal hyperplasia or ADH. The presence of this condition in a womans brea

21、st increases her risk of developing a breast cancer in her lifetime. Individually, these atypical cells may resemble cancer cells. The more abnormal and atypical an individual cell the more it resembles a cancer cell. 有時，額外的細胞包括不正?；虿坏湫偷募毎?。這些細胞增加了婦女得乳腺癌的風(fēng)險。單個來說，這些不典型細胞類似癌細胞。不典型增生17If there are many a

22、typical cells the entire duct may be filled with these abnormal, atypical cells. This condition is actually an early breast cancer. It is referred to as ductal carcinoma in situ or DCIS. Theoretically, the cancer cells are only located within the duct and have not spread out of the affected duct. So

23、me physicians refer to this condition as a “pre-cancer”. This is incorrect, this is indeed a localized breast cancer.如果乳管內(nèi)有許多不典型細胞，直至整個乳管都充滿了不正常不典型的細胞。這其實是早期的乳腺癌。稱為乳管內(nèi)原位癌。乳管內(nèi)原位癌 DCIS18If DCIS is not treated the cancer cells will eventually break out of the duct and invade the breast tissue. This is referred to as invasive ductal carcinoma. 如果原位癌沒有得到治療，癌細胞會最終突破乳管，侵犯乳腺組織。稱為浸潤性乳管癌。浸潤性乳管癌19If excess growth occurs in the lobules the condition is referred to as lobular hyperplasia. Atypical lobular hyperplasia may also