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30 Cards in this Set
- Front
- Back
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where are the breasts located in reference to the ribs?
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b/w 2nd and 6th and b/w sternal edge and midaxillary
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where are breasts located in reference to muscles?
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2/3 superficial to pectoral muscle and 1/3 superficial to serratus anterior
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what are breasts made of?
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1. glandular tissue(lactiferous)
2. Fibrous tissue 3. adipose tissue 4. vessels 5. lymphatics |
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where does milk accumulate during lactation?
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at areola ducts
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what is the supportive structure for glandular tissue?
what ligament connects skin to breast fascia |
fibrous tissue supports glandular tissue
the coopers ligament is the suspensory ligament connecting skin to breast fascia |
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what surrounds glandular tissue?
where does this tissue predominate? |
adipose tissue surrounds the glandular tissue
it predominateds both superficially and deeply |
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what is the vascular supply to the medial quadrant?
what is the vascular supply to the lateral quadrants |
medial
~perforating branches (2,3,4) from internal thoracic artery ~branches of anterior intercostal artery lateral ~pectoral branches of thoracacromial branch of axillary artery ~external mammary branch of lateral thoracic artery |
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how do lymphatics of the breast drain?
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toward the axilla (most on ipsilateral side but some contralateral)
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which group of nodes drains most of the breast tissue?
where are the other group of nodes located? |
PECTORAL ANTERIOR NODES found on the lower border of pec major and inside the axillary fold DRAIN MOST OF BREAST tissue
*subscapular(lateral and deep axillary fold) *lateral(along upper humerus) *central nodes(high in axilla)*infra and supra clavicular |
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what are the most frequently palpable nodes?
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the central nodes high in the axilla
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where does the central nodes drain to?
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to the infra and supra clavicular nodes
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what is the nipple?
what is it made of? how does it usually point? what is normal variant? |
the nipple is the surface elevation
it is made of lactiferous ducts and smooth muscle *normaled is everted but inverted is a normal variant |
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what is the areola?
what are the small rounded elevations and what do they mark? what else is the areola made of? |
tge areika us the pigmented area around the nipple that sometimes forms a secondary mound above the level of the breast
*the small, rounded elevations are called montgomery tubercles and they mark sebaceous glands *also made of few hairs and smooth muscle |
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how is the breast divided?
where does the tail of the breast extend into? |
breast is divided into 4 quadrants
**THE TAIL OF SPENCE EXTENDS INTO AXILLA |
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what scale is used to asses stages of breast maturity?
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tanners stages of sexual maturity
stages 1-5 |
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what is stage 1 of tanners breast maturity?
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-preadolescent
-elevation of only nipple -no breast buds |
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what is stage 2 tanners breast maturity?
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-breast bud stage
-elevation of breast and nipple as a round mound -increase in areola diameter |
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what is stage 3 of tanners breast maturity?
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-further enlargement of breast elevation
-areola and breast are still confluent |
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what is stage 4 of tanners breast maturity?
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-areola and nipple project to form a secondary mound above breast
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what is stage 5 of tanner's breast maturity?
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-projection of nipple only
-in most cases areola have receded to the general contour of the breast |
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what are the changes in breasts due to pregnancy?
what is colostrum? |
Changes due to pregnancy:
-breast enlg due to glandular hyperplasia -nodularity increases -nipples enlg, darken and become more erect -color becomes darker -venous pattern is more visible **colostrum is thick yellow discharge from nipple near end of pregnancy |
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what are changes that occur in the breast due to aging?
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Changes due to aging:
-diminish in size -glandular tissue atrophies and is replaced by adipose tissue -amt of adipose tissue decreases but proportion increases -breast get flabby -ducts on nipple becom easily palpable as firm strands |
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what equpiment is needed for physical exam of the breast/
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none
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when will the breasts tend to be more sensitive?
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before menstruation so be alert to females's feelings
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what is a good techniqe for draping?
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full exposure for inspection then can cover one breast while the other is being examined
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what are the three chest movments to exaggerate dimpling or retractions while in SITTING position
what should you have large breasted women do? |
*sitting, arms over head and then press hard against hips
*lg breasted women should lean forward |
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why do we ask patient to raise arm up while palpating the breast in the supine position
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this spreads the breste venly over the chest and makes it easier to find nodules
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what does a red color of the breast and axilla indicate?
what does a thickening indicate? what do asymmetrical nipples indicate? |
red color=cancer or inflammatory condition
thickening=breast cancer asymmetric nipples=cancer |
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what are we looking at the contour for?
what can rashes or discharge of the nipple indicate? |
masses, dimpling and retraction
pagets disease |
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if you find an abnormality in the breast what are you describing about it?
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1. location
2. size 3. shape (round, disc like, regular, irregular) 4. consistency(soft, hard, firm) 5. tenderness 6. mobility(in relation to skin, chest wall, does it have accompanying dimpling?) |
