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14. the BREAST (HARC) Flashcards

1
Q

What are the BREASTS known as

A

MAMMARY GLANDS

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2
Q

where are BREASTS

A

TRANSVERSLY extends from the LATERAL MARGIN of the STERNUM to MID AXILLARY LINE LATERALLY (by armpit)

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3
Q

do MALES also have Breast Tissue

A

YES
rudimentary

(gynaecomastia when enlarged)

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4
Q

on which wall do the BREASTS lie

A

ANTERIOR THORACIC WALL

spreading Laterally

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5
Q

Breasts overlie which MUSCLE mainly

A

PECTORALIS MAJOR

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6
Q

breasts found in which FASCIA

A

SUPERFICIAL FASCIA

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7
Q

breasts over which RIBS

A

2/3 - 6

and COSTAL CARTILAGES

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8
Q

what is the INFRAMAMMARY CREASE

A

an area of adherence between SUPERFICIAL FASCIA to the UNDERLYING CHEST WALL at the INFERIOR CRESCENT of the breast

(below breast)

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9
Q

where is the TAIL OF SPENCE

A

SUPERIOR, LATERAL
(near armpit)

Superolateral quadrant extends to axilla along Inferolateral edge of Pec Major

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10
Q

what does BREAST TISSUE consist of

A

a SYSTEM of DUCTS
- Embedded in connective tissue
- does NOT extend beyond the margin of the AREOLA

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11
Q

System of DUCTS in the breast tissue does NOT extend beyond the margin of the..

A

AREOLA
(coloured area around nipple)

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12
Q

the DEEP SURFACE of the breast LIES on the… COVERING the…

A

lies on the DEEP FASCIA

Covering the MUSCLES of the ANTERIOR and LATERAL aspect of THORAX

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13
Q

NIPPLES are SURROUNDED by a COLOURED AREA of SKIN called the…

A

AREOLA
- circular PIGMENTED skin
(vary in position depending on breast size)

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14
Q

what does the AREOLA CONTAIN

A

modified SEBACEOUS GLANDS and SWEAT GLANDS
(GLANDS OF MONTOGMERY)
that LUBRICATE the NIPPLE and keep it SUPPLE

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15
Q

SEBACOUS and SWEAT GLANDS in the AREOLA are known as the..

A

GLANDS OF MONTGOMERY

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16
Q

what is the role of the GLANDS OF MONTGOMERY

A

LUBRICATE the NIPPLE and keep it SUPPLE

  • OILY SECRETIONS
  • facilitate LATCHING of neonate during lactation
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17
Q

where is MALE NIPPLE usually situated

A

at 4th INTERCOSTAL SPACE in the MIDVLAVICULAR LINE

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18
Q

SURFACE of NIPPLE and AREOLA is

A

CONVOLUTED

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19
Q

what are NIPPLES and AREOLA RICH IN

A

MELANOCYTES
- darker colour

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20
Q

what is POLYMASTASIA

A

MORE THAN 2 BREASTS (supernumerary)

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21
Q

what is POLYTHELIA

A

MORE THAN 2 NIPPLES (supernumerary)

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22
Q

where can you get POLYMASTASIA or POLYTHELIA (extra breasts/nipples)

A

ALONG MAMARRY RIDGES - MILK LINES

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23
Q

what is it called when a person has NO BREAST TISSUE

A

AMASTASIA

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24
Q

what is called when there is NO breast development and ONLY NIPPLE DEVELOPMENT

A

AMAZIA

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25
Q

in breast tissue HOW MANY LOBES

A

15-20 LOBES

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26
Q

LOBES in breast tissue consist of…

A

15-20 LOBULES

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27
Q

Mammary/breast tissue is COMPOSED of ….
ORGANISED into..

A

TUBULOACINAR GLANDS (tubular glands with rounded end)

organised into 15-20 LOBES

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28
Q

LOBES are SUPPORTED and SEPARATED from each other by..

A

ADIPOSE TISSUE

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29
Q

LOBES are CONDENSED in Some areas as FIBROUS CONNECTIVE TISSUE known as

A

SUSPENSORY LIGAMENTS
/ LIGAMENTS OF COOPER

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30
Q

each LOBE is DIVIDED into LOBULES of..

A

SECRETORY ACINI (type of gland) and their DUCTS

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31
Q

MAMMARY DUCTS CONVERGE to form…

A

15-20 LACTIFEROUS DUCTS
which open independently onto the nipple

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32
Q

what do LOBULES CONSIST of

A

Clusters of ALVEOLI

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33
Q

What do ALVEOLI CONTAIN

A

LACTOCYTES
- produce MILK

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34
Q

where does the MILK come out from (from nipple)

A

LACTIFEROUS DUCTS

  • from lactocytes in alveoli in lobules (in lobes)
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35
Q

Internal breast, CONNECTIVE TISSUE STROMA has a FIBROUS and FATTY COMPONENT.
from which Stroma do SUSPENSORY LIGAMENTS (OF COOPER) come from

A

FIBROUS STROMA
- condenses to form suspensory ligaments

36
Q

what are the 2 main FUNCTIONS of the SUSPENSORY LIGAMENTS OF COOPER

A
  • ATTACH and SECURE BREAST to the UNDERLYING FASCIA
  • SEPARATE the LOBULES (found between lobules, separating them)
37
Q

what does a NEONATAL BREAST contain (newborn)

A

LACTIFEROUS DUCTS

NO ALVEOLI

38
Q

What happens to breast during PUBERTY and POSTPUBERTY

A
  • upon PUBERTY, LITTLE BRANCHING of ducts
    slight mammary englargement reflects GROWTH of FIBROUS STROMA and FAT
  • in POSTPUBERTAL, DUCTS become BRANCHED stimulated by OESTROGENS from ovaries
  • ends of the branches form Solid, Spheroidal masses of GRANULAR POLYHEDRAL CELLS : POTENTIAL ALVEOLI
  • OESTROGENS also promote ADIPOCYTE DIFFERENTIATION from Mesenchymal cells in the Interlobar Stroma
39
Q

BREAST ENLARGEMENT at PUBERTY is mainly a consequence of..

A

LIPID ACCUMULATION by ADIPOCYTES

(differentiated from mesenchymal cells in interlobar stroma due to oestrogens)

40
Q

what do OESTROGENS STIMULATE in breast development during PUBERTY

A
  • BRANCHING of DUCTS (ends will give potential alveoli)
  • promote ADIPOCYTE DIFFERENTIATION
    from MESENCHYMAL cells in Interlobar Stroma
41
Q

what are the AGES for the 5 PHASES in breast development

A

1: 11 YEARS
2: 12 YEARS
3: 13 YEARS
4: 14 YEARS
5: 16 YEARS

42
Q

what happens in the 5 PHASES of breast development

A

1 (11). ENLARGEMENT of the BREAST BUD

2(12). GLANDULAR and SUBAREOLAR TISSUE is present in both NIPPLE and BREAST from the chest at a SINGLE MASS

3(13). AREOLAR INCREASES in DIAMETER, becomes PIGMENTED,
PROLIFERATION of breast tissue

4(14). AREOLAR FURTHER PIGMENTATION and ENLARGEMENT causing SECONDARY MASS anterior to breast

5(16). SMOOTH CONTOUR to breast develops

43
Q

when does a SINGLE MASS of breast develop

A

STAGE 2 - 12 YEARS

44
Q

when does a SECONDARY MASS of breast develop

A

STAGE 4 - 14 YEARS

45
Q

during PREGNANCY, INCREASED OESTROGEN, PROGESTERONE and PROLACTIN results in INCREASED..

A

increased WATER, ELECTROLYTE and ADIPOSE content

46
Q

during PREGNANCY what happens in the breast

A
  • Increased WATER, ELECTROLYE, ADIPOSE
  • INCREASED BLOOD FLOW : Increased VASCULAR BRANCHING and DILATED VEINS
  • Increase SIZE and PIGMENTATION of NIPPLES in response to INCREASED OESTROGEN
  • SEBACOUS GLANDS ENLARGE - PRODUCE LUBRICANT
  • DUCTAR, ALVEOLAR and MYOEPITHELIAL elements undergo Marked HYPERPLASIA (CELLULAR REPRODUCTION)
47
Q

how does BLOOD FLOW to breasts INCREASE in PREGNANCY

A
  • INCREASED VASCULAR BRANCHING
  • DILATED VEINS
    (present on surface of breast)
48
Q

what Increase as a response to INCREASED OESTROGEN in PREGNANCY

A

SIZE and PIGMENTATION of NIPPLES

49
Q

what do DUCTAL, ALVEOLAR and MYOEPITHELIAL elements undergo during PREGNANCY

A

marked HYPERPLASIA - CELLULAR REPRODUCTION

50
Q

during PREGNANY what ENLARGE and PRODUCE LUBRICANT

A

SEBACEOUS GLANDS

51
Q

how is the DUCT SYSTEM in NON-PREGNANT women

52
Q

in PREGNANCY what PROLIFERATE at the ENDS of DUCTS

53
Q

what do we get in LACTATING WOMEN in the ALVEOLAR LUMEN

A

MILK SECRETION and ACCUMULATION

(Larger breast)

54
Q

what happens in response to PROGESTERONE

A

clusters of ALVEOLI BUD from the DUCTS and EXPAND OUTWARD TOWARDS the CHEST WELL

55
Q

ALVEOLI are LINED WITH

A

LACTOCYTES - milk-secreting cuboidal cells

56
Q

LACTOCYTES are SURROUNDED by a NET of..

A

CONTRACTILE MYOEPITHELIAL CELLS
- help expel milk

57
Q

what is LACTATION

A

the process by which MILK is SYNTHESISED and SECRETED from the MAMMARY GLANDS of the POST-PARTUM female breast

58
Q

pathway of MILK SECRETION

A
  • SECRETED from LACTOCYTES
  • FILL ALVEOLI
  • SQUEEZED INTO DUCTS
  • into SINUSES and NIPPLE PORES (lubricated by Montgomery glands)
59
Q

which (anterior) PITUITARY HORMONE is essential in Establishing and Maintaining BREAST MILK SUPPLY - PRODUCE MILK

60
Q

which (posterior) PITUITARY HORMONE STIMULATES RELEASE of MILK

61
Q

which hormones INHIBIT PROLACTIN-mediated MILK SYNTHESIS during PREGNANCY

A

OESTROGEN
PROGESTERONE
other Placental Hormones

inhibition is lifted when PLACENTA is EXPELLED and MILK PRODUCTION COMMENCES

62
Q

when is MILK PRODUCED

A

after pregnancy when PLACENTA IS EXPELLED

63
Q

POSITIVE FEEDBACK loop of BREAST FEEDING

A
  • SUCKLING triggers SENSORY NERVE IMPULE in the AREOLA
  • PROLACTIN stimulated LACTOCYTES in Alveoli to PRODUCE MILK
  • OXYTOCIN SYNTHESISED in HYPOTHALAMUS and RELEASED from POSTERIOR PITUITARY (brain receives sensory impulses)
  • OXYTOCIN triggers MYOEPITHIAL CELLS CONTRACTION which SQUEEZES MILK from Alveoli into LACTIFEROUS DUCTS
  • Milk pooled in LACTIFEROUS SINUS before discharged through nipple pores
  • INCREASED MILK PRODUCTION triggers INCREASED SUCKLING by infant
64
Q

what does OXYTOCIN RELEASE from POSTERIOR PITUITARY trigger for MILK RELEASE

A

CONTRACTION of MYOEPITHELIAL CELLS
- squeeze milk from Alveoli into Lactiferous Ducts

65
Q

how is CONNECTIVE TISSUE in PREGNANT woman breast

A

LESS CONNECTIVE TISSUE
(More GLANDULAR)

66
Q

in a HISTOLGOY IMAGE of breast what does PINK show and what does WHITE show in the ALVEOLI

A

PINK - MILK
WHITE - milk FAT

67
Q

what are the 3 main ARTERIES in BLOOD SUPPLY to the BREAST

A
  • AXILLARY ARTERY
  • INTERNAL THORACIC ARTERIES
  • POSTERIOR INTERCOSTAL ARTERIES
68
Q

BRANCHES from the AXILLARY ARTERY

A
  • LATERAL THORACIC ARTERY
  • LATERAL MAMMARY BRANCHES
69
Q

3 main VEINS in VENOUS SUPPLY to breast

A
  • AXILLARY VEIN
  • INTERNAL THORACIC VEIN
  • POSTERIOR INTERCOSTAL VEINS
70
Q

where is the CIRCULAR VENOUS PLEXUS

A

AROUND AREOLA drains into axillary vein, internal thoracic vein and posterior intercostal veins

71
Q

ANTERIOR and LATERAL Cutaneous Branches from which SPINAL NERVES innervate the breast

A

T2-T6
(INTERCOSTAL NERVES)

72
Q

which NERVES INNERVATE the breast

A

INTERCOSTAL NERVES (T2-T6)

carry SENSORY and SYMPATHETIC EFFERENT FIBRES

73
Q

which NERVE INNERVATES the NIPPLE

A

4TH INTERCOSTAL NERVE
(extensive plexus within nipple)

74
Q

SENSORY FIBRES of 4th INTERCOSTAL NERVE TERMINATE close to the Epithelium as FREE ENDINGS known as:

A

MEISSNER CORPUSCLES and MERKEL DISC ENDINGS

  • ESSENTIAL in SIGNALLING SUCKLING to the CNS (for prolactin and oxytocin release)
75
Q

which INTERCOSTAL NERVE INNERVATES the NIPPLE and is essential for signally SUCKLING to the CNS

A

4TH Intercostal Nerve

with MEISSNER CORPUSCLES and MERKEL DIC ENDINGS (free endings)

76
Q

how are SENSORY ENDINGS in the AREOLA

A

FEWER SENSORY ENDINGS

  • MORE in NIPPLE (more SENSITIVE)
77
Q

SECRETORY ACTIVITES of Mammary Gland are largely CONTROLLED by …. rather than efferent motor fibres

A

OVARIAN and HYPOPHYSIAL HORMONES

78
Q

How many LYMPH NODES in breast

79
Q

LYMPH Drainage originates from breast LOBULES and flows into a SUBAREOLAR PLEXUS called

A

SAPPEY’S PLEXUS

80
Q

2 MAIN LYMPH NODES in Breast

A

AXILLARY
PARASTERNAL

81
Q

75% of LYMPH from the breast is RECEIVED BY

A

AXILLARY LYMPH NODES

82
Q

name the AXILLARY LYMPH NODES

A
  • APICAL
  • HUMERAL (lateral)
  • CENTRAL
  • PECTORAL (anterior)
  • SUBSCAPULAR (posterior)
83
Q

SURGICALLY the LYMPH NODES are described in RELATION to the..

A

PECTORALIS MINOR

84
Q

How many AXILLARY LYMPH NODES

A

5

(Apical, Humeral, Central, Pectoral, Subscapular)

85
Q

which HORMONE causes MYOEPITHIAL CELLS to CONTRACT

86
Q

which NUCLEI are responsible for the PRODUCTION of OXYTOCIN

A

HYPOTHALAMIC

(-> posterior pituitary)

87
Q

where does the MAJORITY of the LYMPH DRAIN from Breast tissue

A

AXILLARY NODES

UROGENITAL (19 decks)

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