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87 Cards in this Set
- Front
- Back
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What muscles do the breasts lay infront of?
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Pec. Major
Serratus Anterior |
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In women, the breasts extend between what margins, superiorly and inferiorly?
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Ribs 2/3 to 6/7
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In women, the breasts extend from what margins laterally and medially?
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Sternal margin to Midaxillary line
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How many lobes does each breast have?
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15 - 20 lobes
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How many Lobules does each Lobe have?
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20 - 40 lobules per lobe
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What drains milk from each lobe onto the surface of the nipple?
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A lactiferous duct
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What's another name for the suspensory ligaments, and where do they attach?
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Cooper Ligaments
Extend from CT layer thru breast, and attach to the underlying muscle fascia |
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Which muscles form the floor of the breast?
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1.) Pec. Major
2.) Pec. Minor 3.) Serratus Anterior 4.) Latissimus Dorsi 5.) Subscapularis 6.) External Oblique 7.) Rectus Abdominis |
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Which arteries supply the DEEP tissues of the Breast?
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Internal Mammary a.
Lateral Thoracic a. |
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Which arteries supply the SUPERFICIAL tissues of the Breast?
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Intercostal a.
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Which part of the breast contains the largest amt. of Glandular tissue
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Upper Outer Quadrant
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In the axilla, the mammary tissue is in direct contact with what?
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Axillary Lymph Nodes
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The nipple contains what kind of fibers?
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Circular and Longitudinal smooth muscle fibers
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What does contraction of the smooth muscle in the nipple cause?
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Erection of the nipple
& Lactiferous ducts to empty |
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What stimuli elicit contraction of the nipple smooth muscle
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Tactile
Sensory ANS |
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The Anterior Axillary nodes are also called what, and are located where?
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Pectoral nodes
along Lower border of Pec. Major Inside Axillary fold |
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The Midaxillary nodes are also called what, and are located where?
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Central nodes
High in the Axilla, close to the ribs |
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The Posterior Axillary nodes are also called what, and are located where?
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Subscapular nodes
along the Lateral border of the scapula and deep in the posterior axillary fold |
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The Lateral Axillary nodes are also called what, and located where?
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Brachial nodes
along the upper humerus |
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Lymph drainage for the Superficial breast: UPPER OUTER quadrant
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Scapular
Brachial Intermediate nodes toward axillary nodes |
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Lymph drainage for Superficial breast: MEDIAL portion
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Internal mammary chain towards OPPOSITE breast and abdomen
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Lymph drainage for the Deep breast: Posterior chest wall
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Posterior axillary nodes (subscapular) of the arm
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Lymph drainage for the Deep breast: Anterior chest wall
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Anterior axillary nodes (pectoral)
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Lymph drainage for the Deep breast: Upper Arm
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Lateral axillary nodes (brachial)
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Lymph drainage for the Deep breast: Retroareolar area
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Interpectoral (Rotter) nodes into the axillary chain
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Lymph drainage for Areola and Nipple
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Midaxillary
Subclavicular Supraclavicular nodes |
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Which race of women have a larger breast size, Asians or Whites?
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Asians
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What is the period of time of "breast development" called?
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Thelarche
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What is the classification that is most commonly used to describe the developmental process?
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the 5 Tanner Stages
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The onset of menses should occur before what Tanner Stage?
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before Stage 3
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About 25% of females begin mentruation at which stage?
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Stage 3
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about what percent of females are mentruating at Stage 4 and are beginning a reasonably regular mentrual cycle?
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75%
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What Percentage of females do not start mentruating until stage 5?
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10%
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Which stage is the breast bud?
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Stage 2
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What is the average interval between the appearance of the breast bud and menarche?
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2 years
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Which stage may not occur in as many as 25% of adolescents?
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Stage 4
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What changes occur in the breast during pregnancy in response to luteal and placental hormones?
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Lactiferous ducts proliferate
Alveoli increase |
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During pregnancy, the breasts enlarge how much?
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2-3 times
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Where does colostrum accumulate at the end of pregnancy?
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Acinus cells of the alveoli
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Hypertophy of sebaceous glands can lead to -
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Montgomery Tubercles
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How does colostrum differ from mature milk?
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Colostrum contains more protein and minerals than mature milk
Antibodies, and host resistance factors |
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When does milk production to replace colostrum begin?
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2-4 days after delivery
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What stimuli cause he production of milk after delivery?
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- Prolactin Surge
- Declining estrogen levels - Sucking |
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How long does Involution last?
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3 months
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During involution and reduction in breast size after lactation, what happens to lobular and alveolar components?
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They do not reduce in number
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What happens to breast tissue before menopause?
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Decrease in glandular tissue
Decoposition of alveolar and lobular tissue |
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What happens to suspensory ligaments and the nipple after menopause?
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they relax
the nipple becomes smaller flatter and less erectile tissue |
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What hereditary cancer syndromes can predispose a pt to beast cancer?
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BRCA1 or 2 mutation
Hereditary Non-Polyposis Colorectal Cancer Li-Fraumeni Syndrome Cowden syndrome |
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Overweight men tend to have what shape breast?
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Convex
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Retraction and Dimpling signify contraction of fibrotic tissue, and occur with what
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Carcinoma
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This appearance is due to edema of the breast from lymph drainage i nadvanced/inflammatory carcinoma. The skin appears thickened with large pores and accentuated skin markings.
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Peau d'orange
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Venous patterns are usu. pronounced in what individuals?
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Pregnant or Obese women
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What kind of venous pattern is normal
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Bilateral
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What does a unilateral venous pattern indicate?
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Dilated superficial veins from increaed blood flow to a malignancy
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A peppering of nontender, nonsuppurative Montgomery tubercles indicates what?
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Its a normal finding
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Where is peau d'orange usu. first seen?
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in the Areola
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When is nipple inverstion abnormal?
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When its a recent finding and it is unilateral it indicates a malignancy
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A flattening, withdrawal, or inversion of the nipple is called ____ and indicates what?
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Retraction and indicates Malignancy/infalmmatory tissue pulling inward.
Retraction can change the axis of the nipple |
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Are supernumerary nipples more common in whites or blacks?
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Blacks
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Supernumerary nipples can be associated with what?
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Congenital renal or cardiac anomalies, esp in Whites
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What 3 positions should you also inspect the pt in when examining the breast?
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1.) Seated w/ arms over head
2.) Seated w/ hands pressed against hips, shoulders rolled forward 3.) Seated and leaning forward form the waist |
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What position can you do alternatively to Seated w/ hands pressed against hips w/ shoulders rolled forward?
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Have pt push her palms together
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In whch positions do the pectoral muscles contract?
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Seated w/ hands pressed against hips
or Seated w/ pt pushing palms together |
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Which positions cause tension in the suspensory ligament?
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Seated w/ arms over the head
and Seated and leaning forward from the waist |
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When palpating the lymph nodes, which nodes are considered to be sentinel/Virchow's nodes?
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Supraclavicular and Infraclavicular nodes.
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If a breast mass is felt what should you note about it?
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Its Location
Size Shape Consistency Tenderness Mobility Delineation of borders & Retractions |
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When doing the wedge shaped method, where should you start?
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Near the nipple moving outward
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What kind of nipple discharge hsould be of concern?
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Spontaneous discharge that is Unilateral and from a SINGLE duct
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What drug is used as chemoprevention in women who are at high risk for developing Breast Cancer?
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Tamoxifen
It reduces the risk by 50% |
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What are some lifestyle changes that can reduce your risk for Breast Cancers
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- maintaining a healthy WEIGHT
- regular physical ACTIVITY - reduce ALCOHOL intake to less than 1 drink per day - avoid using postmenopausal combination hormone therapy |
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Normal breast tissue of adult women feels...
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Dense
Firm Elastic +Lobular feel of glandular tissue +fine, granular feel of older women |
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A cyclical pattern of breast enlargement , increased nodularity, and tenderness indicates what?
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A common response to hormaonal changes during the menstrual cycle
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When are changes LEAST noticeable in the menstrual cycle?
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in the WEEK AFTER menstrual flow
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In a pt with a mastectomy, do you palpate the area where the breast was removed?
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YES, even the area of the surgical scar. Malignancy may recur at the scar site.
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A newly born infant with breast tissue and milky white discharge may indicate what?
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The result of passively transferred maternal estrogen to the baby.
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How long does breast tissue in the infant last after birth?
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2 weeks
rarely it'll last till 3months |
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A young adolescent male is going through puberty and has noticed a subareolar mass that is firm and tender. What should you tell the patient's mother?
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That this is a breast bud, and will most likely disappear, usually within a year.
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How do the nipples change with pregnancy?
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Enlarge and are more erectile
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What are bluish venous structures that appear in the pregnant pt that do not blanch w/ pressure?
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Spiders due to elevated estrogen
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When do vascular spiders appear in the pregnant pt?
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2nd Trimester
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When is engorgment of the breasts considered normal?
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During the first 24 - 48 hours after the breasts fill with milk for lactation
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What does later development of breast engorgement signal?
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Mastitis
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What can cause clogged milk ducts, other than inadequate emptying of the breast?
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A Bra thats too tight
It may create tender spot that feels lumpy and hot. |
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How do you treat clogged milk ducts?
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Frequent nursing and local application of heat
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Redness and tenderness, and blisters or petechiae are signs of what?
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Overt Cracking
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What causes the breasts of postmenopausal women to sag and hang?
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Glandular tissue atrophy
& Relaxation of the suspensory ligaments they also have a finer, granular feel |
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A post-menopausal woman began to develop fluid-filled breast cysts after starting a new medication. What medication could cause this?
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Hormone Replacement Therapy, estrogen
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