the topic of this video is lymphatic drainage of memory gland this is a very very important topic in anatomy so why lymphatic drainage of memory gland is so important it is because the cancer carcinoma of breast that spreads mainly along the lymphatics so let's study the lymphatic drainage of memory gland we will do this under three headings first is we'll get to know the lymph nodes that drain the lymph from the memory gland then we look at the organization of lymph vessels in the memory gland and they are present at two levels superficial and deep and last we will also look at the clinical anatomy of the lymphatic drainage of memory gland now lymphatics from memory gland that drains into the following lymph nodes and these are the most important group is the axillary lymph nodes which you can see here few of them can be seen and next i show you all the five groups of the axillary lymph nodes these are obviously located in the excellent second is the internal memory or the parasternal lymph nodes which are located just literal to the sternum along the internal thoracic vessels then third is the posterior intercostal nodes as the name suggest they are present in the intercostal space on its posterior aspect that is very close to the head of the ribs and then we also have some other nodes into which the limb from the breast drains and these are the supraclavicular nodes can be seen here and the lymphatics from the breast also communicate with the sub peritoneal and sub diaphragmatic plexus which are present in the abdomen now let us look at the x-ray lymph nodes as i said earlier there are five groups of axillary lymph nodes and these are the first is the pectoral or the anterior group here we can see this is located along the inferior border of pectoralis minor muscle and the vessels or the vein associated with this is the lateral thoracic vein next we have the posterior group or the subscapular group he is present in the posterior wall of the axilla along the vessels that is the subscapular vessels third is the brachial or lateral group this is in the lateral wall of the axilla and this is associated with the axillary wave then we have the central group this is located in the center of the axilla base of the axilla in the axillary fat and last is the apical group this is present at the apex of the excellent let us now see how the lymphatic vessels are arranged in the memory gland they are arranged in two groups superficial and deep the superficial lymphatic vessels they will drain the limb from the skin which overlies the memory gland except for the nipple and the areola the deep lymphatic vessels they will drain the parenchyma of the memory gland that means the glandular tissue and the ducts and in addition to that it will also drain the lymphatics from the areola and the nipple superficial lymphatic vessels which will be draining the skin overlying the memory gland except for areola and the nipple they will drain into two groups of lymph nodes and these are from the medials aspect of the breast they will be draining into the parasternal lymph nodes not only of the same side but also to the opposite side so this is very important because carcinoma from one side of the breast can spread to the other side also rest of the skin covering the memory gland that will be drained into the anterior or the pectoral group of axillary lymph nodes coming to deep lymphatic vessels which will be draining the parenchyma of the memory gland plus the areola and the nipple before we study that let us divide the memory gland into four quadrants upper medial lower medial upper lateral and lower lateral so let us first consider the lateral quadrants limb from the lateral quadrants both that is upper lateral and lower lateral that will mainly reach the anterior or pectoral group of axillary lymph nodes some of the lymph will also reach the posterior group of x-ray lymph nodes from here from anterior and posterior it will go to the central group and from the central group it will go to the epical group now from the lower lateral quadrant some of the lymph will also reach the posterior intercostal group of lymph nodes coming to the medial quadrants from the medial quadrants the lymph will go to parasternal lymph nodes and not only to the same side but also to the opposite side from the lower medial quadrant some lymph will also reach or will the lymphatic vessels because here communicate with the sub diaphragmatic and subperiosteal lymph flexes so it will reach the abdomen and finally here we can see moon shaped area that is from the upper two quadrants upper medial and upper little quadrants the upper part some lymph will directly reach the supraclavicular lymph nodes now if we look at the overall drainage of lymph then axillary lymph nodes receive the maximum lymph from the memory gland so 75 percent of the lymph drains from memory gland into axillary lymph nodes 20 percent of the lymph drains into internal memory or parasternal lymph nodes five percent of the lymph will drain into posterior intercostal lymph nodes coming to clinical anatomy there are some clinical conditions which occur because of the occurrence of cancer or carcinoma of the breast and these are first is the beauty orange appearance as the name suggests that means here the skin covering the breast that will look like the peel of the orange now why does it happen this happens because of obstruction of the superficial lymph vessels right that could be because of the malignant cells there and this leads to stagnation of limb and results in edema because the extracellular fluid now cannot be drained so there will be some raised area and adjusting to that we will have some depressed areas also so the skin will look like the peel of the orange the second is that there will be retraction or puckering of the skin we can see here the skin is retracted it is pulled back why this happens this is an egg this one so why this happens because cancer cells they may infiltrate the suspensory ligaments which support the breast breast they result in retraction of the skin or we also call it puckering of the skin because there is these uh ligaments which are there they will shorten right and they will pull the skin ah towards the deeper aspect because one end of the suspensory ligament that is attached to the pectoral fascia then we have another tumor which may occur as a result of malignancy of the breast and that tumor secondary may occur in the ovary and this is known as crickenburg's tumor so why this happens i have already told you that from the lower medial quadrant the lymph vessels they communicate with the sub periosteal lymph vessels in the abdomen and from here these cancer cells these malignant cells they can reach the ovary and form the secondary seer so they can start multiplying here and make or produce a tumor and that tumor is known as crickenbark's tumor so thank you so much for watching if you have not 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