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31 Cards in this Set
- Front
- Back
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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
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2nd; 6th; midaxillary
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What shape is the surface area of the breast?
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rectangular
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The breast overlies this muscle: ______.
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pectoralis major |
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And, this muscle is at its inferior margin: _____.
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serratus anterior
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The breast is divided into 4 quadrants, what is the upper lateral "5th" portion called?
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tail of spence
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What provides structural support to the breast?
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Fibrous CT bands: fibrous bands, suprasensory ligaments
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What surrounds the breast?
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adipose tissue
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When does glandular tissue of the breast start to atrophy?
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after menopause
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What causes variation in different breasts?
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age, pregnancy, hormone use, nutrition
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The areola has elevations with these 3 types of glands
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sweat, sebaceous, areolar
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What does the smooth muscle in the nipple and areola do?
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contracts to allow milk secretion; rich innervation allows for milk let down during infant suckling
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What does a nodular or granular surface mean for a breast?
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normal - physiologic nodularity
bilateral; can often worsen/become painful during menses |
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Where do extra nipples develop?
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supernumeray nipples develop on the milk line; they are non pathologic; can be mistaken for moles
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Why don't males develop breasts?
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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)
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What do you ask pts. during a breast exam?
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Have you noticed any lumps?
Do they perform breast exams on themselves? (if no, teach them how and when to do it) |
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What kind of search pattern do you use for breast exam? What kind of pressure?
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Systemic search pattern (circular motion with finger pads); Varying palpation pressure, BE GENTLE
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What different arm positions do you want patients to have during the breast exam?
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Arms at side; Arms above head; Arms pressed against hips; Leaning forward
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What should you note (appearance-wise)?
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Color (redness); Thickening of skin (lymph ob.); prominent pores (lymph ob.); size and symmetry; flattening my suggest breast cancer; nipples (size, shape, ulcerations, discharge)
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What does consistency tell you during palpation?
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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 |
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What two other things do you look at during palpation?
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tenderness; nodules
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What is a nodule
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lump or mass that is qualitatively different or larger than the rest of the breast known as "dominant mass"
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What do you have to do when you find a nodule?
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Note the location, size, shape, consistency, delimitation, and mobility (look for dimpling)
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What do you look for when palpating the nipple?
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elasticity; palpate more firmly if history of discharge
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How to inspect a male breast: the areola and nipple
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look for nodules, swelling, ulcerations
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How to inspect a male breast: areala and breast tissue
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palpate for nodules
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How to inspect a male breast: why squeeze the nipply nips?
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look for discharge; describe it and note exact location!
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What would a fibroadenoma feel like?
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fine, round, mobile NONTENDER; (15-25 yo)
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What would a cyst feel like?
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soft to firm, round, mobile often TENDER (25-50 yo)
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What would a fibrocystic change feel like?
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nodular, ropelike (25-50 yo)
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What would cancer feel like?
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irregular, stellate, and firm not clearly delineated from surrounding tissue (25-50+ yo)
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How to palpate axilla?
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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. |
