← Back to Session

Questions Answered: 238

Final Score 84%

200
38

Questions

  • Q1. ✓ Correct
  • Q2. ✓ Correct
  • Q3. X Incorrect
  • Q4. ✓ Correct
  • Q5. ✓ Correct
  • Q6. ✓ Correct
  • Q7. ✓ Correct
  • Q8. ✓ Correct
  • Q9. ✓ Correct
  • Q10. ✓ Correct
  • Q11. ✓ Correct
  • Q12. ✓ Correct
  • Q13. ✓ Correct
  • Q14. ✓ Correct
  • Q15. ✓ Correct
  • Q16. ✓ Correct
  • Q17. ✓ Correct
  • Q18. ✓ Correct
  • Q19. ✓ Correct
  • Q20. ✓ Correct
  • Q21. ✓ Correct
  • Q22. ✓ Correct
  • Q23. ✓ Correct
  • Q24. ✓ Correct
  • Q25. ✓ Correct
  • Q26. ✓ Correct
  • Q27. ✓ Correct
  • Q28. ✓ Correct
  • Q29. ✓ Correct
  • Q30. ✓ Correct
  • Q31. ✓ Correct
  • Q32. ✓ Correct
  • Q33. X Incorrect
  • Q34. ✓ Correct
  • Q35. ✓ Correct
  • Q36. ✓ Correct
  • Q37. X Incorrect
  • Q38. ✓ Correct
  • Q39. ✓ Correct
  • Q40. ✓ Correct
  • Q41. ✓ Correct
  • Q42. X Incorrect
  • Q43. ✓ Correct
  • Q44. ✓ Correct
  • Q45. ✓ Correct
  • Q46. ✓ Correct
  • Q47. ✓ Correct
  • Q48. ✓ Correct
  • Q49. ✓ Correct
  • Q50. ✓ Correct
  • Q51. ✓ Correct
  • Q52. ✓ Correct
  • Q53. ✓ Correct
  • Q54. X Incorrect
  • Q55. ✓ Correct
  • Q56. ✓ Correct
  • Q57. X Incorrect
  • Q58. ✓ Correct
  • Q59. ✓ Correct
  • Q60. X Incorrect
  • Q61. ✓ Correct
  • Q62. ✓ Correct
  • Q63. X Incorrect
  • Q64. ✓ Correct
  • Q65. X Incorrect
  • Q66. ✓ Correct
  • Q67. ✓ Correct
  • Q68. ✓ Correct
  • Q69. ✓ Correct
  • Q70. ✓ Correct
  • Q71. ✓ Correct
  • Q72. X Incorrect
  • Q73. ✓ Correct
  • Q74. ✓ Correct
  • Q75. ✓ Correct
  • Q76. ✓ Correct
  • Q77. ✓ Correct
  • Q78. ✓ Correct
  • Q79. ✓ Correct
  • Q80. ✓ Correct
  • Q81. ✓ Correct
  • Q82. ✓ Correct
  • Q83. X Incorrect
  • Q84. ✓ Correct
  • Q85. ✓ Correct
  • Q86. ✓ Correct
  • Q87. X Incorrect
  • Q88. ✓ Correct
  • Q89. X Incorrect
  • Q90. ✓ Correct
  • Q91. ✓ Correct
  • Q92. ✓ Correct
  • Q93. ✓ Correct
  • Q94. ✓ Correct
  • Q95. ✓ Correct
  • Q96. ✓ Correct
  • Q97. ✓ Correct
  • Q98. ✓ Correct
  • Q99. ✓ Correct
  • Q100. ✓ Correct
  • Q101. ✓ Correct
  • Q102. ✓ Correct
  • Q103. ✓ Correct
  • Q104. X Incorrect
  • Q105. ✓ Correct
  • Q106. ✓ Correct
  • Q107. ✓ Correct
  • Q108. ✓ Correct
  • Q109. ✓ Correct
  • Q110. ✓ Correct
  • Q111. ✓ Correct
  • Q112. ✓ Correct
  • Q113. ✓ Correct
  • Q114. X Incorrect
  • Q115. ✓ Correct
  • Q116. ✓ Correct
  • Q117. X Incorrect
  • Q118. ✓ Correct
  • Q119. ✓ Correct
  • Q120. ✓ Correct
  • Q121. ✓ Correct
  • Q122. ✓ Correct
  • Q123. ✓ Correct
  • Q124. ✓ Correct
  • Q125. ✓ Correct
  • Q126. ✓ Correct
  • Q127. ✓ Correct
  • Q128. ✓ Correct
  • Q129. ✓ Correct
  • Q130. ✓ Correct
  • Q131. ✓ Correct
  • Q132. ✓ Correct
  • Q133. ✓ Correct
  • Q134. ✓ Correct
  • Q135. ✓ Correct
  • Q136. ✓ Correct
  • Q137. ✓ Correct
  • Q138. ✓ Correct
  • Q139. ✓ Correct
  • Q140. ✓ Correct
  • Q141. ✓ Correct
  • Q142. X Incorrect
  • Q143. ✓ Correct
  • Q144. ✓ Correct
  • Q145. ✓ Correct
  • Q146. ✓ Correct
  • Q147. X Incorrect
  • Q148. ✓ Correct
  • Q149. ✓ Correct
  • Q150. X Incorrect
  • Q151. ✓ Correct
  • Q152. X Incorrect
  • Q153. ✓ Correct
  • Q154. ✓ Correct
  • Q155. ✓ Correct
  • Q156. ✓ Correct
  • Q157. ✓ Correct
  • Q158. X Incorrect
  • Q159. ✓ Correct
  • Q160. ✓ Correct
  • Q161. ✓ Correct
  • Q162. X Incorrect
  • Q163. ✓ Correct
  • Q164. X Incorrect
  • Q165. ✓ Correct
  • Q166. ✓ Correct
  • Q167. ✓ Correct
  • Q168. X Incorrect
  • Q169. ✓ Correct
  • Q170. ✓ Correct
  • Q171. ✓ Correct
  • Q172. ✓ Correct
  • Q173. ✓ Correct
  • Q174. ✓ Correct
  • Q175. X Incorrect
  • Q176. X Incorrect
  • Q177. X Incorrect
  • Q178. X Incorrect
  • Q179. ✓ Correct
  • Q180. ✓ Correct
  • Q181. ✓ Correct
  • Q182. X Incorrect
  • Q183. X Incorrect
  • Q184. ✓ Correct
  • Q185. ✓ Correct
  • Q186. X Incorrect
  • Q187. ✓ Correct
  • Q188. ✓ Correct
  • Q189. ✓ Correct
  • Q190. ✓ Correct
  • Q191. ✓ Correct
  • Q192. X Incorrect
  • Q193. ✓ Correct
  • Q194. ✓ Correct
  • Q195. ✓ Correct
  • Q196. ✓ Correct
  • Q197. ✓ Correct
  • Q198. ✓ Correct
  • Q199. ✓ Correct
  • Q200. ✓ Correct
  • Q201. ✓ Correct
  • Q202. ✓ Correct
  • Q203. ✓ Correct
  • Q204. ✓ Correct
  • Q205. ✓ Correct
  • Q206. ✓ Correct
  • Q207. ✓ Correct
  • Q208. X Incorrect
  • Q209. ✓ Correct
  • Q210. ✓ Correct
  • Q211. ✓ Correct
  • Q212. ✓ Correct
  • Q213. ✓ Correct
  • Q214. X Incorrect
  • Q215. ✓ Correct
  • Q216. X Incorrect
  • Q217. ✓ Correct
  • Q218. ✓ Correct
  • Q219. ✓ Correct
  • Q220. ✓ Correct
  • Q221. ✓ Correct
  • Q222. X Incorrect
  • Q223. X Incorrect
  • Q224. ✓ Correct
  • Q225. ✓ Correct
  • Q226. X Incorrect
  • Q227. ✓ Correct
  • Q228. ✓ Correct
  • Q229. ✓ Correct
  • Q230. ✓ Correct
  • Q231. ✓ Correct
  • Q232. ✓ Correct
  • Q233. ✓ Correct
  • Q234. ✓ Correct
  • Q235. ✓ Correct
  • Q236. ✓ Correct
  • Q237. ✓ Correct
  • Q238. ✓ Correct
  • Q239. Skipped

Anatomy

Upper Limb

Question 96 of 239

A 40 year old woman is found to have a suspicious breast lump just superior and lateral to the areolar region of her left breast. She undergoes a sentinel lymph node biopsy. Which of the following lymph nodes will most likely first encounter lymph from the tumour:

Answer:

Approximately 75% of lymph drainage from the breast is via lymphatic vessels that drain laterally and superiorly into axillary nodes. The lymph usually first drains to anterior axillary nodes, and from here, through central axillary, apical and supraclavicular nodes in sequence. Axillary nodes primarily drain to the subclavian lymph trunk.

Lymphatic Drainage of Breast

Anatomy / Upper Limb / Breast

Last Updated: 20th February 2019

The lymphatic drainage of the breast is of great clinical importance due to its role in the metastasis of breast cancer cells.

There are three main groups of lymph nodes that receive lymph from breast tissue:

  • Approximately 75% of lymphatic drainage is via lymphatic vessels that drain laterally and superiorly into axillary lymph nodes.
  • Most of the remainder (20%) is into medial parasternal lymph nodes, which lie deep to the anterior thoracic wall associated with the internal thoracic artery.
  • Some drainage (5%) may follow the lateral branches of posterior intercostal arteries and connect with posterior intercostal lymph nodes situated near the heads and necks of ribs.

From here:

  • Axillary nodes drain into the subclavian trunks
  • Parasternal nodes drain into the bronchomediastinal trunks
  • Intercostal nodes drain either into the thoracic duct or into the bronchomediastinal trunks

By Henry Vandyke Carter [Public domain], via Wikimedia Commons

Lymphatic Drainage of the Breast. (Image by Henry Vandyke Carter [Public domain], via Wikimedia Commons)

Report A Problem

Is there something wrong with this question? Let us know and we’ll fix it as soon as possible.

Loading Form...

Close
  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

Join our Newsletter

Stay updated with free revision resources and exclusive discounts

©2017 - 2024 MRCEM Success