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Year 2 RE > Anatomy of the breast > Flashcards

Anatomy of the breast Flashcards

1
Q

What is the difference between an exocrine and endocrine gland?

A
  • exocrine = use of ducts to secrete their contents onto an epithelial surface
  • endocrine = ductless, so secrete directly into the blood vessels
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2
Q

Exocrine glands are those that use ducts to secrete their contents onto an epithelial surface. There are 3 types of exocrine gland, that are categorised based on how they secrete their contents. Label the 3 types in the image using the labels below:

  • holocrine
  • merocrine
  • apocrine
A 
1 = merocrine
2 = apocrine
3 = holocrine
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3
Q

Exocrine glands are those that use ducts to secrete their contents onto an epithelial surface. There are 3 types of exocrine gland, categorised on how they secrete their contents, namely holocrine, merocrine and apocrine. Match the 3 types of exocrine glands holocrine, merocrine and apocrine with the way each one of these secrete their contents using the labels below:

  • whole cell bursts releasing its contents
  • form of exocytosis
  • part of the cell breaks away and cell repairs itself
A
  • holocrine = whole cell bursts releasing its contents
  • merocrine = form of exocytosis
  • apocrine = part of the cell breaks away and cell repairs itself
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4
Q

The breast, also known as the mammary gland is an exocrine gland. What type of exocrine gland are the mammary glands?

1 - modified sweat gland
2 - modified saliva gland
3 - modified lacrimal gland
4 - modified digestive gland

A

1 - modified sweat gland

- apocrine = part of the cell breaks away and cell repairs itself

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5
Q

What tissue accounts for the majority of the breast contour and bulk?

1 - muscle
2 - adipose tissue
3 - fibrous tissue
4 - collagen

A

2 - adipose tissue

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6
Q

Although all women are different, generally which ribs does the mammary gland cover?

1 - ribs 1-6
2 - ribs 2-6
3 - ribs 6-10
4 - ribs 1-10

A

2 - ribs 2-6

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7
Q

What layer of the skin does the mammary gland lie within?

A
  • lowermost layer of the skin caller the superficial fascia
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8
Q

What is the large muscle that the mammary gland covers 2/3rds of on the chest?

1 - teres minor
2 - subscapularis
3 - pectoralis major
4 - pectoralis minor

A

3 - pectoralis major

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9
Q

What is the muscle that the mammary gland covers 1/3rd of on the lateral aspect of the chest?

1 - teres minor
2 - subscapularis
3 - pectoralis major
4 - serratus major

A

4 - serratus major

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10
Q

The mammary gland overlies which abdominal muscle and layer?

A
  • recuts abdominas

- rectus sheath

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11
Q

The mammary gland sits infront of the pectoralis major, but between the pectoralis major and mammary gland lies a space. What is this space called?

1 - retromammary space
2 - quadrangular space
3 - pectoral space
4 - loose space

A

1 - retromammary space

  • allows movement of the breast
  • space that is filled with loose areolar tissue that can be used in reconstructive plastic surgery
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12
Q

The axilla is an anatomical region under the shoulder joint where the arm connects to the shoulder. It contains a variety of neurovascular structures, including the axillary artery, axillary vein, brachial plexus, and lymph nodes. What is the axillary tail of the breast?

1 - nerve supply to breast from axilla
2 - tail of axillary nerve supplying breast
3 - extension of axilla that includes the breast
4 - expansion of breast tissue ending in axilla

A

4 - expansion of breast tissue ending in axilla

- enters axilla through an opening in the deep fascia called foramen of Langer

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13
Q

The axilla is an anatomical region under the shoulder joint where the arm connects to the shoulder. It contains a variety of neurovascular structures, including the axillary artery, axillary vein, brachial plexus, and lymph nodes. The axillary tail of the breast, an extension of the tissue of the breast that extends into the axilla is able to enter the axilla through an opening in the deep fascia called foramen of Langer. What is the foramen of Langer?

1 - opening of the axilla
2 - opening in deep pectoralis fascia
3 - opening in superficial fascia
4 - opening at sternal notch

A

2 - opening in deep pectoralis fascia

- present at the level of the third intercostal space

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14
Q

The axilla is an anatomical region under the shoulder joint where the arm connects to the shoulder. The axillary tail of the breast, an extension of the tissue of the breast that extends into the axilla is able to enter the axilla through an opening in the deep fascia called foramen of Langer, an opening in the deep pectoralis fascia, present at the level of the third intercostal space. What is the importance of this site?

1 - breast attachment site
2 - site where breast reconstruction occurs
3 - 70% of lymph vessels drain breast into axilla
4 - nerves for breast pass through

A

3 - 70% of lymph vessels drain breast into axilla

- contains neurovascular structures, axillary artery, axillary vein, brachial plexus, and lymph nodes

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15
Q

What are the 4 quadrants of the breast?

A

1 - upper inner
2 - lower inner
3 - lower outer
4 - upper outer

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16
Q

The skin of the mammary gland has 2 main parts that can be visually seen and are important for breast feeding. What are these 2 areas called?

1 - nipple and areola
2 - nipple and labia majora
3 - labia minora and areola
4 - areloa and labia major

A

1 - nipple and areola

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17
Q

The areola is the pigmented area on the breast around the nipple. What is the function of the areola?

1 - holds nipple in place
2 - secretes oil around the nipple to reduce friction
3 - supplies innervation to the nipple
4 - supplied blood vessels to the nipple

A

2 - secretes oil around the nipple to reduce friction

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18
Q

What is the difference between stroma and parenchyma?

A
  • parenchyma = functional tissue of an organ

- stroma = structural/supportive tissue of an organ

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19
Q

The stroma of the breast is composed of 2 main components, what are they?

A

1 - adipose tissue

2 - fibrous connective tissue

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20
Q

The stroma of the breast is composed of 2 main components, adipose tissue and fibrous connective tissue. The fibrous connective tissue of the breast separates the fatty lobules and ensures firm attachment of the adipose tissue to the dermis and deep fascia. What are these fibrous connective tissue organisations called?

1 - ligaments of cooper
2 - ligaments bouchard
3 - ligamentous longus
4 - trigeminal ligaments

A

1 - ligaments of cooper

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21
Q

What are mammary glands composed of?

A
  • each breast contains aprox 12-20 lobes embedded in fat
  • each lobe contains smaller structures called lobules or globules
  • globules contain alveoli (hollow sacs)
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22
Q

The mammary glands are composed of aprox 12-20 lobes embedded in fat, where each lobe contains smaller structures called lobules or globules that contain alveoli (hollow sacs). What is the importance of these hollow sacs and what cells are they composed of?

1 - cuboidal cells secreting prolactin
2 - epithelial cells secreting oxytocin
3 - epithelial cells producing milk
4 - epithelial cells producing prolactin

A

3 - epithelial cells producing milk

- secrete milk that collects in the alveoli

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23
Q

The mammary glands are composed of aprox 12-20 lobes embedded in fat, where each lobe contains smaller structures called lobules or globules that contain alveoli (hollow sacs). The alveoli are lined by mammary secretary epithelial cells which secrete milk that collects in the alveoli. Select the correct path that the milk produced takes to the nipple:

1 - alveoli - lactiferous ducts - lactiferous sinus - nipple
2 - alveoli - lactiferous sinus - lactiferous ducts - nipple
3 - alveoli - lactiferous ducts - nipple
4 - alveoli - lactiferous sinus - nipple

A

1 - alveoli - lactiferous ducts - lactiferous sinus - nipple

24
Q

Label the image of the breast using the labels below:

  • lobe
  • lactiferous duct
  • lactiferous sinus
  • areola
  • lobules
A

Label the image of the breast using the labels below:

  • lobe
  • areola
  • lactiferous sinus
  • lactiferous duct
  • lobules
25
Q

The stroma of the breast is composed of 2 main components, adipose tissue and fibrous connective tissue. The fibrous connective tissue of the breast separates the fatty lobules and ensures firm attachment of the adipose tissue to the dermis and deep fascia. These fibrous connective tissue organisations are called ligaments of cooper. What is the importance of the ligaments of cooper clinically?

1 - breast become saggy if they are pathological
2 - breast become very tight if pathological
3 - shrivel up with dimples resembling an orange peel
4 - shrivel up and change their colour to orange

A

3 - shrivel up with dimples resembling an orange peel

  • if ligaments of cooper are affected by pathology such as cancer they can contract and shrivel up
  • can present as early marker of pathology with dimples on skin and retracted nipple
  • looks like an orange and is therefore called peau d’orange
26
Q

The flow of lymph moves from local tissue lymph nodes, to regional tissue lymph nodes, to central tissue lymph nodes and eventually back into the venous circulation. What is the basic flow of lymph?

A
  • lymph collected from interstitial fluid into lymphatic capillaries
  • capillaries merge into lymphatic vessels that meet up at lymph nodes
  • lymphatic leaves the lymphatic nodes and re-enters lymphatic vessels
  • lymphatic vessels merge to form lymphatic trunks
  • lymphatic trunks merge to form lymphatic ducts
  • lymphatic duct empties into the subclavian vein and internal jugular vein
27
Q

There are 2 types of lymphatic vessels located in the body based on where they are, what are they celled?

A

1 - superficial vessels

2 - deep vessels

28
Q

There is a plexus of lymphatics that surrounds the areola (pigmented tissue surrounding the nipple) and is superficial, what is the name it is given?

A
  • plexus of Sappey

- drains the areola and nipple region

29
Q

Do the deep lymphatics of the breast run through the stroma or parenchyma tissue of the breast?

A
  • stroma
30
Q

Using the labels below, label the lymphatic tissues in the image:

  • external mammary gland
  • internal mammary gland
  • subclavicular node
  • rotters interpectoral node
  • subclavicular node level III
  • central node level II
  • axillary node
  • subscapular node level 1
A

Using the labels below, label the lymphatic tissues in the image:

1 = subclavicular node
2 = subclavicular node level III
3 = central node level II
4 = subscapular node level 1
5 = axillary node
6 = external mammary gland
7 = internal mammary gland 
8 = rotters interpectoral node
31
Q

Which lymph does aprox 70% of the lymph from the breast tissue drain into?

A
  • via axilla tail of the breast into the axillary lymph node
32
Q

What is a Sentinel Lymph Node?

1 - first lymph node discovered near the breast tissue
2 - site unaffected by cancers
3 - location where axilla tail drains into from the breast
4 - 1st lymph node where cancer is likely to spread from primary tumour

A

4 - 1st lymph node where cancer is likely to spread from primary tumour

33
Q

Sentinel Lymph Node is the 1st lymph node where cancer is likely to spread from primary tumour. What is a Sentinel Lymph Node Biopsy?

A
  • a biopsy of the sentinel lymph nodes (first lymph node a cancer is likely to spread to)
  • sit between the breast tissue and the axillary lymph node
34
Q

A Sentinel Lymph Node Biopsy (SLNB) is a biopsy of the sentinel lymph nodes (first lymph node a cancer is likely to spread to) that sits from the cancer and the axillary lymph node. Why would the SLNB be performed?

A
  • identifies if the tumour has metastasised into the lymphatics tissue
35
Q

What are the lymph nodes called that run medially to the mammary gland and run alongside the sternum?

A
  • parasternal lymph nodes
36
Q

The axillary lymph node drains aprox 70% of lymph from the mammary gland and is extremely complex. Label the image below using these labels:

  • Pectoral (anterior) nodes
  • Subscapular (posterior) nodes
  • Humeral (lateral) nodes
  • Central nodes
  • Apical nodes
  • Interpectoral (Rotter’s) nodes
  • Parasternal nodes
A

The axillary lymph node drains aprox 70% of lymph from the mammary gland and is extremely complex. Label the image below using these labels:

1 = Humeral (lateral) nodes
2 = Central nodes
3 = Apical nodes
4 = Subscapular (posterior) nodes
5 = Pectoral (anterior) nodes
6 = Interpectoral (Rotter’s) nodes 
7 = Parasternal nodes
37
Q

What does apical, also referred to as apex refer to in anatomy?

A
  • opposite the base of a tissue or organ

- for the breast the base is the pectoralis muscle, so the apical site is at the top of the breast near the clavicle

38
Q

If a tumour metastasises in one breast and is able to travel to the other breast, which lymph nodes are they most likely to travel along?

1 - Central nodes
2 - Apical nodes
3 - Interpectoral (Rotter’s) nodes
4 - Parasternal nodes

A

4 - Parasternal nodes

39
Q

What is the main blood vessel that supplies the mammary gland and what is this blood vessel a branch of?

1 - subclavian artery from internal thoracic artery
2 - subclavian artery from external thoracic artery
3 - axillary artery from internal thoracic artery
4 - subclavian artery from pectoral artery

A

1 - subclavian artery from internal thoracic artery

40
Q

What does the subclavian artery turn into once it reaches the armpit area?

1 - brachial artery
2 - profundus brachial artery
3 - radial artery
4 - axillary artery

A

4 - axillary artery

41
Q

Where does the thoracoacromial artery arise from and supply?

1 - sub clavian artery supplying breast tissue
2 - 2nd part of the axillary artery supplying breast tissue
3 - 1st part of the axillary artery supplying breast tissue
4 - 3rd part of the axillary artery supplying breast tissue

A

2 - 2nd part of the axillary artery supplying breast tissue

42
Q

What are 3 branches of the axillary artery that supply the breast tissue?

1 - subclavian, superior thoracic and lateral thoracic artery
2 - thoracoacromial, superior thoracic and lateral thoracic artery
3 - brachial, superior thoracic and lateral thoracic artery
4 - thoracoacromial, brachial profundus and lateral thoracic artery

A

2 - thoracoacromial, superior thoracic and lateral thoracic artery

43
Q

What 2 major veins does the blood from the mammary glands drain into?

1 - subclavian and internal thoracic vein
2 - lateral and internal thoracic artery
3 - axillary and lateral thoracic artery
4 - axillary and internal thoracic artery

A

4 - axillary and internal thoracic artery

44
Q

The 2 major veins that drain the blood from the mammary glands are the axillary vein and internal thoracic vein. What is the the one other major vein that can also provide additional drainage of the breast?

1 - basilic vein
2 - cubital vein
3 - cephalic vein
4 - brachial vein

A

3 - cephalic vein

45
Q

What does cutaneous innervation mean?

A
  • an area of the skin which is supplied by a specific cutaneous nerve
  • cutaneous nerves provide neural innervation to the skin
46
Q

Which intercostal nerves innervate the breast tissue?

A
  • T1-T6

- lateral and anterior branches of the intercostals

47
Q

In addition to the lateral and anterior intercostal nerves innervating the breast tissue, using the labels below, label the 3 other major nerves that innervate the breast:

  • medial pectoral nerve
  • lateral pectoral nerve
  • long thoracic nerve
A 
1 = long thoracic nerve
2 = lateral pectoral nerve
3 = medial pectoral nerve

DO NOT SUPPLY BREAST TISSUE, BUT SURROUNDING STRUCTURES

48
Q

What is nipple retraction?

1 - nipples that have not formed
2 - nipples that point inward or are flat
3 - nipples that have discharge
4 - nipples that invert

A

2 - nipples that point inward or are flat

49
Q

What is amastia?

1 - a rare, congenital condition in which a child’s breast tissue doesn’t develop
2 - breast surgery following cancer
3 - breast reconstruction
4 - breast over develop due to congenital abnormality

A

1 - a rare, congenital condition in which a child’s breast tissue doesn’t develop

50
Q

What is polymastia?

1 - congenital condition causing only 1 breast to develop more than the other
2 - congenital condition causing a third breast to develop
3 - congenital condition causing an absence of nipples
4 - congenital condition causing inverted nipples

A

2 - congenital condition causing a third breast to develop

- may not present until puberty

51
Q

What is gynaecomastia?

A
  • development of breast tissue in males
52
Q

What is athelia?

1 - congenital condition causing only 1 breast to develop more than the other
2 - congenital condition causing a third breast to develop
3 - congenital condition causing an absence of nipples
4 - congenital condition causing inverted nipples

A

3 - congenital condition causing an absence of nipples

- can occur on one (unilateral) or both (bilateral) breasts.

53
Q

When a patient requires breast reconstruction, which muscle from the back can be used?

1 - teres major
2 - trapezius
3 - latissimus dorsi
4 - deltoid

A

3 - latissimus dorsi

54
Q

When a patient requires breast reconstruction, which muscle from the thigh can be used?

1 - vastus medialis
2 - gracilis muscle
3 - sartorius muscle
4 - soleus muscle

A

2 - gracilis muscle

- muscle of inner thigh

55
Q

What is often the site used in the breast for a breast implant?

A
  • retromammary space

- space filled with loose areolar tissue between breast and pectoralis muscle

Year 2 RE (53 decks)

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