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Physiology > Anatomy and physio of lactation > Flashcards

Anatomy and physio of lactation Flashcards

1
Q

name 4 computes of the breasts

A

Glandular tissue
Connective tissue
Lymph
Adipose (fatty) tissue

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2
Q

what is the function of glandular tissue in the breast

A

makes and transports the milk

Blood supply which nourishes the breast tissue and provides the nutrients necessary for milk synthesis

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3
Q

function of CT in the breast

A

supports the breast

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4
Q

function of lymph in the breasts

A

removes waste products

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5
Q

role of the nerves in the breast while Breast feeding

A

Nerves which makes nipple sensitive and allows baby’s suckling to stimulate the release of hormones necessary for milk ejection reflex and the production of milk

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6
Q

what protect the breasts from injury

A

Adipose (Fatty) tissue

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7
Q

how do breast change in p

A

enlarge in size and the development of the mammary function occurs only in pregnancy

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8
Q

where do the breast lie on the chest

A

Lie generally each side of the midline of the anterior chest wall between 2nd and 6th rib
Lie over the pectoralis muscle, and attached by connective tissue

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9
Q

when dose Breast development start

A

Development of the breast occurs in the fetus as early as four weeks gestation

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10
Q

where is the mammary ductal system

A

Inside the bud

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11
Q

how many stages are there to B development

A

4 stages

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12
Q

what occurs at puberty in the D of B

A

At puberty the effects of oestrogen and progesterone facilitate further development of the ducts and the glandular system to form the adult breast

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13
Q

when is B development completed

A

In P due to the Complete development of the mammary function

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14
Q

In puberty what hormones stimulate B development

A

During puberty , oestrogen and growth hormone stimulate the growth of the mammary ducts

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15
Q

what occurs in the luteal phase (2 phase of M cycle) what happens to the B

A

In the second half of each menstrual cycle, progesterone stimulates development of the lactiferous ducts and alveoli

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16
Q

what hormone stimulates the development of the lactiferous ducts and alveoli

A

Progesterone, but only in the luteal phase of menstruation

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17
Q

what pre-determines B size

A

Genetics

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18
Q

what is the last stage of B development

A

Breast feeding

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19
Q

what are the The areola

A

circular middle of the breast, darker pigment so the baby has something to target to feed due to their poor eyesight

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20
Q

location of Montgomery tubercles

A

on the areola- small little spot like bumps, enlarge in P

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21
Q

function of Montgomery tubercles

A

small sebaceous glands, secreting oil lie over the areola

They provide lubrication and alter the pH of the skin discouraging the growth of bacteria on the nipple.

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22
Q

how many lobes are there in each B

A

are 7-10 lobes, divided by bands of fibrous tissue

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23
Q

how many lobules are in each lobe

A

within each lobe are 20-40 lobules

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24
Q

how many alveoli are in each lobules

A

Within each lobule are 10-100 alveoli- grape like clusters of glandular tissue

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25
Q

what is the function of the alveoli

A

Alveoli are composed of milk secreting cells, called acini cells that extract the nutrients necessary for milk production from the network of capillaries which surround each alveolus

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26
Q

what are acini cells

A

milk secreting cells

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27
Q

location of myoepithelial cells

A

enclose the alveoli

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28
Q

function of myoepithelial cells

A

cause the alveoli to contract under the influence of oxytocin

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29
Q

dose the size of the B determine the amount of milk produced

A

No

30
Q

function of lactiferous duct

A

milk drain - milk duct leads to the nipple for feeding

31
Q

location and function of lactiferous sinus

A

just under the nipple and areola the lactiferous duct widened to form the lactiferous sinus
F-act as reservoirs for milk during lactation

32
Q

what causes the expulsion of milk

A

contraction of the Myoepthilail cells due to oxytocin

33
Q

in what week do the B undergo changes (enlargement +D)

A

from week 6

34
Q

what hormone is responsible for the growth of the lactiferous ducts, and myoepithelial cells, and increased blood flow to the breast

A

oestrogen

35
Q

when do the Lactiferous ducts and myoepithelial cells undergo hypertrophy

A

1st trimester

36
Q

when is the secretion of colostrum

A

2 trimester

37
Q

when do the alveoli mature

A

3 trimester

38
Q

in what w is colostrum formed

A

by W 16

39
Q

what causes the creation of colostrum

A

formed under the influence of human placental lactogen (HPL) and prolactin

40
Q

what hormone allow for the proliferation and enlargement of the alveoli during third trimester

A

Progesterone, prolactin and human placental lactogen (HPL)

41
Q

what hormones prevent milk production

A

High levels of oestrogen and progesterone prevents milk production

42
Q

what hormone causes the growth of the nipple and areola

A

HPL and prolactin

43
Q

which hormone Inhibition of lactation and milk secretion

A

progestrone

44
Q

which hormone causes milk synthesis

A

increased levels of prolactin

45
Q

what is Lactogenesis

A

the initiation of milk production involving a complex interaction of hormones and other factors.
occurs-Following delivery of the placenta, oestrogen progesterone and human placental lactogen levels fall abruptly allowing a rise in prolactin and oxytocin levels.
High levels of prolactin secreted by the anterior pituitary gland stimulates the acini cells to produce milk

46
Q

how many stages are there to Lactogenesis

A

3

47
Q

what occurs in Lactogenesis 1

A

I occurs at 15–20 weeks gestation. This stage is hormonally driven
Colostrum production begins midway through the pregnancy.

48
Q

what occurs in Lactogenesis 2

A

occurs 30–40 hours after birth.
It is initiated by the birth of infant plus removal of the placenta.
This stage is also under endocrine control and will occur in all women immediately after birth.
Most women will feel increased breast fullness after Lactogenesis II, generally anywhere between 50 and 73 hours

49
Q

what occurs in lactogenesis 3

A

occurs and continues only with ongoing milk production (galactopoesis).
Unlike the first two stages, lactogenesis III is under autocrine control, and is driven by milk removal

50
Q

name some similarities between the first two stages of lactogenesis

A

are hormonally driven and under autocrine control

51
Q

name some differences of the 3 stage of lactogenesis

A

lactogenesis III is under autocrine control, and is driven by milk removal- differs from 1 and 2 which are homrome driven and autocrine controlled

52
Q

which hormones decrease and increase after birth

A

oestrogen and progesterone decline → rise in prolactin and oxytocin

53
Q

which hormone stimulates acini cells

A

Prolactin (released from anterior pituitary gland) stimulates acini cells to produce milk

54
Q

which hormone causes contractions in the Myoepthilial cells

A

Oxytocin stimulates contraction of myoepithelial cells surrounding alveoli, causing ejection reflex → lactiferous ducts → lactiferous sinus

55
Q

what occurs when the baby is suckling

A

When baby suckling, prolactin-releasing hormone is released by the hypothalamus → prolactin released from anterior pituitary gland.
prolactin works on supply and demand process

56
Q

what occurs when the baby stop suckling

A

When stops suckling, prolactin-inhibiting factor (PIF) is released from hypothalamus → inhibits prolactin supply

57
Q

location and function of Oxytocin

A

released from the posterior pituitary via a neurosensory mechanism,
released in a pulsatile manner causing myoepithelial cells surrounding each alveolus to contract forcing milk into the ductal system towards the nipple. “let down reflex”

58
Q

what can enhance oxytocin

A

release can be enhanced by things such as hearing a baby crying, thinking about the baby or preparing to breastfeed

59
Q

what can inhibit oxytocin

A

can be inhibited by fear, pain, embarrassment, or anxiety by the mother

60
Q

name some benefits to both B and m of skin to skin contact

A

1-Calms and relaxes both mother and baby
2-Regulates the baby’s heart rate and breathing, helping them to better adapt to life outside the womb
3-Stimulates digestion and an interest in feeding
4-Regulates temperature
5-Stimulates the release of hormones to support breastfeeding and mothering

61
Q

name some benefits of skin to skin in NNU to babies

A

1- improves milk volume to M and contain up-to date antibiotics
2-Improves oxygen saturation
3-Reduces cortisol (stress) levels particularly following painful procedures
4-Encourages pre-feeding behaviour
5-Assists with growth
6-May reduce hospital stay

62
Q

name 3 compounds of colostrum

A

Colostrum contains high amounts of secretory IgA, lactoferrin, and oligosaccharides

63
Q

what is the foremilk

A

milk produced in first 3-4 days,
Thick and sticky – lower calorific value than breast milk.
High concentration of protective constituents coat the lining of the baby’s immature intestines, and helps to prevent pathogens from invading the baby’s system

64
Q

what helps prevent food allergies.

A

Secretory IgA within the colostrum

65
Q

what is hindmilk

A

mature milk- produced around day 3-5 due to increase lactose levels, contains more fat
and contains hormones like human growth factors, cortisol, insulin, thyroxine and prolactin

66
Q

what hormone can suppress continuing milk production

A

LH

67
Q

what is continuing milk production relay on

A

Reliant on maintenance of frequent suckling (to stimulate milk production) and effective removal by baby

68
Q

what are benefits of breast feeding for the infants

A

Immune response- protective against things like luekemia, Diabetes
improves IQ,
Psychological impact of bonding

69
Q

what conditions may breast feeding protect Babies from

A

Leukaemia
Rotavirus
Necrotising enterocolitis
Respiratory tract infections incl pneumonia
Urinary tract infections
Otis media
also things like-
Insulin Dependent Diabetes (Type 1 and 2)
Topical allergies (excema, asthma and food allergies)
Coronary Heart Disease in later life
Schizophrenia
Irritable bowel / Crohns Disease / Coeliac disease
Reduced risk of childhood obesity

70
Q

benefits of breast feeding for mothers

A

Protective against
a number of cancers but specifically breast and ovarian
Reduced risk of diabetes and hyperlipidaemia in later life
Reduced risk of anaemia
Reduced risk of hypertension in later life
Reduced risk of coronary heart disease

Effective for weight management
Protective long term against osteoporosis
Effective as short term method of contraception / family spacing

Physiology (10 decks)

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