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Breast Anatomy Flashcards

1
Q

What kind of gland is the breast?

A

apocrine

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2
Q

What are the parenchymal elements of the breast?

A

lobules, lobes, ducts, acini

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3
Q

What are the stromal elements of the breast?

A

skin, connective tissue, fat

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4
Q

Describe the make-up of a lobe (lobe to lactiferous sinus)

A

Lobe to numerous lobules
Lobules drained by small branching ducts
Ducts converge & form main lactiferous duct
MLD widens below nipple at lactiferous sinus

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5
Q

What is the lactiferous sinus?

A

reservoir for milk secretions

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6
Q

What happens at week 4 of gestation?

A

Paired mammary ridges develop from ectoderm

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7
Q

Milk lines disappear throughout the body except for where?

A

fourth intercostal space where mammary glands develop

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8
Q

What occurs at week 5 gestation?

A

mammary buds are visible

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9
Q

What happens between weeks 7-12 gestation?

A

Mammary buds branch several times to form mammary lobules

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10
Q

What happens at week 20 of gestation?

A

Small lumina develop within buds which elongate and become lactiferous ducts

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11
Q

When do primary breasts develop? What hormones influence this?

A

third trimester, placenta hormones

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12
Q

How many lobes with lactiferous ducts are developed at full term?

A

15-20

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13
Q

What develops from mesoderm?

A

fibrous connective tissue and nipple

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14
Q

What develops from ectoderm?

A

areola

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15
Q

What can occur in newborns due to maternal hormones?

A

mild breast tissue prominence and possible milk secretion

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16
Q

Where is the majority of glandular tissue in the breast?

A

upper outer quadrant

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17
Q

What is the functional unit of the breast?

A

Terminal duct lobular unit: extralobular terminal duct & lobule

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18
Q

Lobules contain intralobular terminal ducts that do what?

A

Drain 30-50 blind-ended ductules

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19
Q

What is the smallest functional element of breast tissue?

A

acini, tiny saccular milk-producing glands

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20
Q

What is fibroglandular tissue?

A

all non-fatty breast tissue

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21
Q

What components make up ducts?

A

Inner: epithelial cells
Myoepithelial
Basement membrane

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22
Q

What ductal structure aids in milk transport?

A

contractile fiber cells

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23
Q

What is loose intralobular stroma?

A

Connective tissue surrounding small ductal structures in lobules, provides lobular shape/definition

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24
Q

What is dense extralobular stroma?

A

Between lobes & lobules, supports larger ductal structures

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25
What are Cooper's ligaments?
dense connective tissue that separates fat, lobules, and lobes
26
Where do Cooper's ligaments run?
From deep part of superficial fascia to skin
27
What are the 6 layers of the breast & posterior?
- skin - subcutaneous fat (premammary) - mammary zone (fibrous & connective tissue) - retromammary zone (mainly fat) - muscle - thoracic cage
28
Breast skin is slightly thicker in who?
younger females
29
How thick is the skin typically?
2-3 mm
30
What are Montgomery's glands?
sebaceous glands that appear as small bumps on areola
31
The subcutaneous fat layer is located between what? It does not extend below what structure?
Skin & breast parenchyma, doesn't extend below nipple
32
What does the subcutaneous fat layer look like on US?
homogenous, mid-level gray lobules separated by echogenic ligaments
33
What 3 layers are Cooper's ligaments seen in and which one are they primarily seen in?
Primary: subcutaneous, mammary, retromammary
34
Where is the superficial fascia? Where is the deep fascia?
Superficial: within subcutaneous fat, anterior to mammary zone Deep: within retromammary space, posterior to mammary zone
35
Where is the mammary zone located?
within the superficial fascia and two fatty layers
36
Where is the mammary zone thicker?
UOQ
37
What is the Tail of Spence?
normal extension of tissue toward axilla
38
The mammary zone is made up of epithelial and stromal tissue. What elements are in each category?
Epithelial: acini, lactiferous ducts, epithelial cells, TDLUs, 15-20 lobes Stromal: connective tissues ex. Cooper's ligs, loose & dense connective tissue) & adipose tissue
39
What is the composition of the mammary zone before puberty compared to during adolescence?
Pre-puberty: mainly fatty, limited glandular tissue Adolescent: increasing glandular tissue, fat decreases
40
What happens to the mammary zone during adulthood and post menopause?
Adult: varying glandular tissue, proliferation & involution each period, mild ductal dilatation Post-menopause: decreasing glandular tissue & replacement with fat
41
How can HRT in post-menopausal women affect the composition of the mammary zone?
It can prohibit involutional changes (replacement with fat)
42
Where is the retromammary space located? What does it contain?
B/w posterior mammary zone & pectoral muscles, contains deep fascia & a smaller amount of fat lobules than subcutaneous layer
43
How does the retromammary space appear on US?
thin, mid-level gray parallel to pectoral muscle
44
What surrounds the chest muscles?
pectoral fascia
45
Where is the pectoralis major located?
- Beneath pectoral fascia - Arises from clavicle & sternal costal cartilage - Thickens beneath UOQ & attaches to humerus
46
Where is the pectoralis minor located?
- Deep to pec major - Arises medially from 3, 4, 5 ribs, attaches to scapula
47
The pectoralis minor serves as an important landmark for what?
the levels of axillary lymph nodes
48
Where is the serratus anterior located?
Posterior to UOQ
49
To make sure that you have captured all tissue layers, what landmark should be seen in the far field of your image?
top of rib
50
What minimum depth should you take images at for image quality?
2.5 cm
51
Where do lymphatic channels originate in the breast?
Within connective tissue and lactiferous ducts
52
The lymphatic channels in the breast flow toward?
the subareolar plexus
53
Flow through the subdermal lymphatic channels is towards?
centrifugal toward outer lymphatics
54
Where does 75% of lymphatic drainage occur?
along inf border of pectoralis major muscle from posterior intercostal nodes to axillary lymph nodes
55
Where does 20% of lymphatic drainage occur?
Along the inner aspect of the breast posterior to sternum by smaller nodes of internal mammary chain
56
Where does 5% of lymphatic drainage occur?
Along the inferomedial aspect of breast by subcutaneous nodules
57
Where are level I, II and III lymph nodes located?
I: lateral to pec minor II: deep to pec minor III: med to pec minor
58
What is axillary lymph node dissection?
removal of level I & II nodes, typically with total mastectomy
59
How are level III nodes removed?
Radical mastectomy which excises pec minor
60
What arteries supply the breast?
Lateral thoracic artery and internal mammary artery
61
Where is the lateral thoracic artery located?
Arises from axillary artery, runs inf along lat border of pec major & gives rise to lat mammary branches
62
Where is the internal mammary artery located?
arises from subclav artery, posterior to cartilage of upper ribs lat to sternum, gives rise to med mammary branches
63
What drains the breast?
Deep & superficial venous systems
64
What does the deep venous system in the breast drain into?
Drains into internal mammary, axillary, subclav, and intercostal veins
65
What is the superficial venous system?
beneath superficial fascia and communicates from rt to lt breast
66
What nerves supply the breast?
Lat & ant cutaneous branches of intercostal nerves 2-6 supply majority, supraclav nerve may innervate superior/superolat parts

Women's Health (10 decks)

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