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Breast Sonography > Anatomy & Physiology > Flashcards

Anatomy & Physiology Flashcards

1
Q

🎗List the anatomic layers from anterior to posterior (6 items).

A
  1. Skin
  2. Subcutaneous (premammary) layer
  3. Mammary layer
  4. Retromammary space
  5. Muscle layer
  6. Chest wall
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2
Q

🎗List the anatomic layers from posterior to anterior (6 items).

A
  1. Chest wall
  2. Muscle layer
  3. Retromammary space
  4. Mammary layer
  5. Subcutaneous (premammary) layer
  6. Skin
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3
Q

The skin is composed of the ___ and ___ layers.

A

Epidermis and dermis

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4
Q

🎗The thickness of mammary skin is…

A

0.5 to 2 mm

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5
Q

T/F? The mammary skin is thinner in young females and thickens with age.

A

False, the opposite

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6
Q

The nipple consists of ___ tissue and ___ muscle.

A

dense connective tissue and erectile muscle

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7
Q

How many lactiferous duct openings may be seen on the nipple surface?

A

15-20

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8
Q

The circular area of dark pigmentation around the nipple is the…

A

areola

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9
Q

The areola consists of ___ muscle.

A

smooth

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10
Q

T/F? Areola skin is slightly thicker than surrounding skin.

A

True

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11
Q

🎗The small bumps on the areola are the…

A

Montgomery glands (a type of sebaceous gland)

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12
Q

This layer lies just beneath the skin extending to the mammary layer.

A

subcutaneous (premammary) layer

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13
Q

🎗The subcutaneous layer consists mostly of…

A

fat.

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14
Q

Which layer is NOT seen posterior to the nipple?

A

subcutaneous

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15
Q

T/F? The amount of fat in the subcutaneous layer increases with age, pregnancy, and obesity.

A

True

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16
Q

What appears as prominent structures within the subcutaneous layer?

A

Cooper’s ligaments

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17
Q

At the breast, this divides into superficial and deep layers.

A

superficial fascia

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18
Q

🎗Breast tissue is completely contained between…

A

2 layers of superficial fascia.

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19
Q

The superficial fascia is contained within the ___ layer anterior to the mammary layer.

A

subcutaneous

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20
Q

The mammary layer is also known as the…

A

Parenchymal or Glandular layer

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21
Q

🎗What is the Axillary Tail of Spence?

A

the portion of glandular tissue that extends into the axilla

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22
Q

The mammary layer is composed of ___ and ___ tissue.

A

Stromal and Epithelial tissue

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23
Q

Which is the supportive tissue of the breast?

A

stromal

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24
Q

Which type of tissue consists of interlobular fat, Cooper’s ligaments, and loose and dense connective tissue?

A

stromal

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25
Q

Which is the functional tissue of the breast?

A

epithelial

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26
Q

Which type of tissue consists of acini, lobules, TDLU’s, lobes, and lactiferous ducts?

A

epithelial

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27
Q

🎗These are ‘suspensory’ - part of the stroma and supportive tissue of the mammary layer.

A

Cooper’s ligaments

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28
Q

🎗These provide the architectural ‘framework’ of the breast.

A

Cooper’s ligaments

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29
Q

Where can Cooper’s ligaments be found?

A

running between the superficial and deep layers of the superficial fascia

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30
Q

🎗This is also called Acinus or Acinar cell.

A

Acini

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31
Q

What is the smallest functional unit of the breast?

A

Acini

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32
Q

🎗What is the milk-producing gland?

A

Acini

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33
Q

T/F? There are tens of acini in each breast.

A

False, hundreds

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34
Q

🎗Each acini gives rise to a ___ or ___.

A

ductule or terminal duct

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35
Q

This is composed of approximately 30 acini, intralobular terminal ducts, and loose (stromal) connective tissue.

A

Lobule

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36
Q

What is a lobule composed of?

A

approximately 30 acini, intralobular terminal ducts, and loose (stromal) connective tissue

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37
Q

What does TDLU stand for?

A

Terminal Duct Locular Unit

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38
Q

🎗TDLU is made up of…

A

lobule, intralobular terminal ducts, and an extralobular terminal duct

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39
Q

How big is a TDLU?

A

2 mm or less

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40
Q

🎗Where does nearly all breast pathology originate?

A

TDLU

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41
Q

Several lobules make up a…

A

breast lobe

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42
Q

🎗How many lobes in each breast?

A

15-20

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43
Q

How many lactiferous ducts emerge from each lobe and travel toward the nipple?

A

One

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44
Q

What transports milk from the acini to the nipple?

A

lactiferous ducts

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45
Q

Where is an intralobular terminal duct?

A

within the lobule

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46
Q

Where is an extralobular terminal duct?

A

outside the lobule

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47
Q

Where is an interlobular duct?

A

between the lobules

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48
Q

🎗What does a lactiferous duct do beneath the areola?

A

enlarge to form the lactiferous sinus

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49
Q

What kind of duct empties milk from the nipple?

A

collecting duct

50
Q

Lactiferous ducts are lined with ___ and ___ cells

A

epithelium and myoepithelium

51
Q

T/F? the myoepithelium is the inner lining of the lactiferous ducts.

A

False, the epithelium is the inner lining

52
Q

The epithelium cells of the lactiferous ducts are supported by the…

A

basement membrane (adventitia)

53
Q

Which is the outer fibrous portion of the lactiferous duct?

A

basement membrane (adventitia)

54
Q

🎗What is the function of the myoepithelium in the lactiferous ducts?

A

to propel the milk toward the nipple (myo = muscle)

55
Q

Where is the deep fascia located?

A

within the retromammary space posterior to the mammary layer

56
Q

Why is maintaining the integrity of the deep fascia important?

A

to deter the spread of cancer to the chest wall

57
Q

The retromammary space is between the ___ and the ___.

A

posterior margin of the mammary layer and the pectoral muscles

58
Q

The retromammary space contains a thin layer of…

A

fat.

59
Q

T/F? the amount of fat in the retromammary space increases with age, pregnancy, and obesity.

A

True

60
Q

The retromammary space contains the [superficial/deep] layer of superficial fascia.

A

deep

61
Q

What allows for movement of the breast over the chest wall?

A

the retromammary space

62
Q

Which muscle arises from the clavicle and costal cartilage of the sternum?

A

pectoralis major

63
Q

Which muscle attaches to the proximal humerus?

A

pectoralis major

64
Q

Which muscle arises from the 3rd, 4th, and 5th ribs?

A

pectoralis minor

65
Q

Which muscle attaches to the scapula?

A

pectoralis minor

66
Q

This encloses the chest muscles and may appear deep to the retromammary layer.

A

the pectoral (muscular) fascia

67
Q

Which is more anterior - pectoralis major or minor?

A

major

68
Q

Ribs are located [anterior/posterior] to the pectoral muscles.

A

posterior

69
Q

🎗In small-breasted females, don’t confuse a rib with a ___.

A

intramammary tumor

70
Q

Intercostal muscles are located…

A

between the ribs.

71
Q

The lung is ___ to the chest wall layer.

A

deep

72
Q

Glandular tissue is usually thicker in which quadrant of the breast?

A

Upper Outer

73
Q

🎗In which quadrant of the breast is the largest percentage of cancers found?

A

Upper Outer

74
Q

What is important to correlate when using Clock Method anatomic reference.

A

Rt vs Lt

75
Q

Breast enlargement in newborns may be seen due to…

A

placental and maternal hormone stimulation.

76
Q

The early mammary gland begins development during the ___ week of embryonic life.

A

4th

77
Q

At ___ weeks gestation testosterone in the male fetus prohibits further development.

A

15

78
Q

The ‘milk line’ extends from the ___ to the ___.

A

axilla to the inguinal region

79
Q

amastia

A

absence of one or both breasts

80
Q

polymastia

A

accessory breast or more than two breasts

81
Q

🎗athelia

A

absence of the nipple

82
Q

🎗polythelia

A

accessory nipple (most common anomaly)

83
Q

🎗amazia

A

absense of the breast tissue with development of the nipple

84
Q

unilateral early ripening

A

asymmetric growth of the breasts

85
Q

T/F? Polythelia is more common in women than men.

A

False, men than women

86
Q

Which two main arteries supply blood to the breast tissues?

A

lateral thoracic artery and internal mammary artery

87
Q

T/F? The lateral thoracic artery arises from the axillary artery.

A

True

88
Q

T/F? The internal mammary artery arises from the axillary artery.

A

False, the subclavian

89
Q

Which artery is often used in coronary artery bypass grafts?

A

The internal mammary artery

90
Q

Two secondary sources of blood supply to the breast tissues are…

A

the thoracoacromial artery (superior region) and the intercostal artery (inferior margin)

91
Q

🎗 The superficial veins of the breast are located just ___ to the superficial fascia.

A

deep

92
Q

What is the communication route that allows cancer to metastasize to the opposite breast?

A

the superficial veins

93
Q

What are the deep veins of the breast? (5)

A
  1. internal mammary vein
  2. lateral thoracic vein
  3. axillary vein
  4. subclavian vein
  5. intercostal vein
94
Q

What is the communication route that allows cancer to metastasize to the bone?

A

the intercoastal veins with the vertebral veins

95
Q

Which system closely follows the superficial and venous system of the breast?

A

the lymphatic vessels of the breast

96
Q

🎗Breast cancer most frequently spreads by ___.

A

hematogeneous route

97
Q

Where does lymph flow begin?

A

From the stroma and lactiferous ducts (deep system)

98
Q

🎗 Lymph flow direction is [away from/towards] the areola and periareolar plexus on the way to the superficial system.

A

Towards

99
Q

Name the 6 groups of nodes in the Axillary Lymph Node Chain.

A
  1. External Mammary
  2. Scapular
  3. Axillary
  4. Central
  5. Subclavicular
  6. Interpectoral (Rotter’s nodes)
100
Q

Where are the External Mammary lymph nodes?

A

along the lateral thoracic vessels

101
Q

Where are the Scapular lymph nodes?

A

with the subscapular vessels

102
Q

Where are the Axillary lymph nodes?

A

with the axillary vessels

103
Q

Where are the Central lymph nodes?

A

with the axillary vessels

104
Q

Where are the Subclavicular lymph nodes?

A

with the subclavicular vessels

105
Q

Where are the Interpectoral (Rotter’s) lymph nodes?

A

between pectoralis major and minor muscles

106
Q

🎗Approx how much of the lymphatic drainage is to the axilla?

A

75%

107
Q

Besides the Axillary Lymph Node Chain, where does the remaining drainage go? [5]

A
  1. Internal Mammary (w/ the internal mammary vessels)
  2. Intercostal
  3. Flow to the opposite breast
  4. Supraclavicular
  5. Diaphrgmatic - allows draining to the abd (thus liver mets)
108
Q

🎗 Lymph nodes have what sort of shape?

A

reniform (kidney-like)

109
Q

Define afferent

A

moving toward

110
Q

Define efferent

A

moving away

111
Q

What vessels carry lymph into the lymph node through the cortex where it is filtered?

A

Outer Afferent Lymphatic Vessels

112
Q

What vessel carries lymph back into the system from the lymph node hilum?

A

Efferent Lymphatic Vessel

113
Q

Name 7 mammary nerves

A
  1. long thoracic nerve
  2. thoraco-dorsal nerve
  3. thoracic intercostal nerves
  4. 3rd and 4th branch of the cervical plexus
  5. 🎗 circumflex nerve
  6. subscapular nerves
  7. anterior thoracic nerves
114
Q

What is thelarche?

A

At puberty, breast development occurring due to the hormonal stimulation by the ovaries.

115
Q

🎗Estrogen stimulates changes of the ___ tissues.

A

stromal - elongation of the mammary ducts, connective tissue growth, increase in adipose, increased vascularity

116
Q

🎗 Progesterone stimulates changes of the ___ tissues.

A

glandular - TDLUs

117
Q

🎗 Late in pregnancy, the ___ increase in size in preparation for lactation.

A

lactiferous ducts

118
Q

🎗 What do the hormones do shortly after birth?

A

estrogen and progesterone drop and prolactin dominates

119
Q

How long after ceasing lactation does it take for ducts and lobules to return to normal size?

A

approx 3 months

120
Q

What are the most common causes of glandular tissue increase with age? (3)

A
  1. pregnancy/lactation
  2. hormone replacement therapy (HRT)
  3. significant weight loss
121
Q

🎗 The ratio of glandular to fatty tissue is determined by…

A

…the patient’s BMI.

Total Body Fat: Total Body Weight

Breast Sonography (7 decks)

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