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31 Cards in this Set

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The breast extends from the calvicle to the ___ rib down to the ____ rib and then across from the sternum to the _____ line
2nd; 6th; midaxillary
What shape is the surface area of the breast?
rectangular
The breast overlies this muscle: ______.

pectoralis major

And, this muscle is at its inferior margin: _____.
serratus anterior
The breast is divided into 4 quadrants, what is the upper lateral "5th" portion called?
tail of spence
What provides structural support to the breast?
Fibrous CT bands: fibrous bands, suprasensory ligaments
What surrounds the breast?
adipose tissue
When does glandular tissue of the breast start to atrophy?
after menopause
What causes variation in different breasts?
age, pregnancy, hormone use, nutrition
The areola has elevations with these 3 types of glands
sweat, sebaceous, areolar
What does the smooth muscle in the nipple and areola do?
contracts to allow milk secretion; rich innervation allows for milk let down during infant suckling
What does a nodular or granular surface mean for a breast?
normal - physiologic nodularity



bilateral; can often worsen/become painful during menses

Where do extra nipples develop?
supernumeray nipples develop on the milk line; they are non pathologic; can be mistaken for moles
Why don't males develop breasts?
no estrogen and progesterone stimulation; therefore the breast tissue (ductal branching and lobule development is minimal) doesn't really form; (sometimes there is a 2cm button of breast tissue)
What do you ask pts. during a breast exam?
Have you noticed any lumps?



Do they perform breast exams on themselves? (if no, teach them how and when to do it)

What kind of search pattern do you use for breast exam? What kind of pressure?
Systemic search pattern (circular motion with finger pads); Varying palpation pressure, BE GENTLE
What different arm positions do you want patients to have during the breast exam?
Arms at side; Arms above head; Arms pressed against hips; Leaning forward
What should you note (appearance-wise)?
Color (redness); Thickening of skin (lymph ob.); prominent pores (lymph ob.); size and symmetry; flattening my suggest breast cancer; nipples (size, shape, ulcerations, discharge)
What does consistency tell you during palpation?
when it's normal it will vary with person's relative proportion of fat to glandular tissue



the inframammary ridge is a firm ridge of compressed tissue on the inferior margin which is normal to find

What two other things do you look at during palpation?
tenderness; nodules
What is a nodule
lump or mass that is qualitatively different or larger than the rest of the breast known as "dominant mass"
What do you have to do when you find a nodule?
Note the location, size, shape, consistency, delimitation, and mobility (look for dimpling)
What do you look for when palpating the nipple?
elasticity; palpate more firmly if history of discharge
How to inspect a male breast: the areola and nipple
look for nodules, swelling, ulcerations
How to inspect a male breast: areala and breast tissue
palpate for nodules
How to inspect a male breast: why squeeze the nipply nips?
look for discharge; describe it and note exact location!
What would a fibroadenoma feel like?
fine, round, mobile NONTENDER; (15-25 yo)
What would a cyst feel like?
soft to firm, round, mobile often TENDER (25-50 yo)
What would a fibrocystic change feel like?
nodular, ropelike (25-50 yo)
What would cancer feel like?
irregular, stellate, and firm not clearly delineated from surrounding tissue (25-50+ yo)
How to palpate axilla?
Look for rash, infection (sweat gland infection is hidradenitis suppuativa), unusual pigmentation (acathosis nigricans)



Feel for lymph nodes (ask patient to relx with L arm down. )Enlarged axillary nodes may result from infection, immunizations, or lymphadenopathy.