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RD1033 > breast anatomy-physiology > Flashcards

breast anatomy-physiology Flashcards

1
Q

where does 2/3 of the breast rest?

A

on pectoralis major muscle

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2
Q

where does 1/3 of the breast muscle rest?

A

on serratus anterior muscle

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3
Q

which ribs does the breast overlie

A

2nd and 6th ribs

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4
Q

what does the breast extend into?

A

axilla

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5
Q

superior boundaries of the breast

A

each clavicle

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6
Q

inferior boundaries of the breast

A

abdominal wall

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7
Q

lateral boundary of the breast

A

latissimus dorsi muscle

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8
Q

medial boundary of the breast

A

sternum

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9
Q

breast quadrants

A
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10
Q

how many lobes of glandular tissue is embedded in fat

A

15-20 lobes

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11
Q

what are lobes in breast separated by

A

suspensory ligaments of cooper

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12
Q

what are groups of secretory alveoli drained by

A

intralobular ducts

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13
Q

intralobular ducts unite to form what?

A

a single lactiferous duct from each lobe

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14
Q

what is the arterial supply of the breasts

A
  • thoracic branches of axillary artery
    -internal thoracic (mammary) artery
  • inter-costal arteries
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15
Q

what is the venous drainage of the breasts

A
  • anastomotic (connection between blood vessels) circle around base of nipple
  • branches to circumference of breast
  • axillary vein and internal thoracic (mammary) vein
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16
Q

how can cancer spread in the breasts?

A

via direct invasion through the pectorals muscle and via bloodstream

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17
Q

how much lymph does axillary lymph nodes receive

A

recieve 75-90% of breasts lymph

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18
Q

how much do internal mammary lymph nodes receive

A

10-25%

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19
Q

what are the 5 axillary lymph node groups

A
  • apical (subclavier)
  • central
  • anterior (pectoral)
  • posterior (subscapular)
  • lateral (brachial)
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20
Q

what happens in stage 1 preadolescent stage of breast development

A
  • slight elevation of papilla (typically age 10 and younger)
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21
Q

stage 2 breast budding

A

elevation of the breast and papilla
- breast bud forms and increase in size of areola (age 10-11.5)

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22
Q

stage 3 continued enlargement

A

breast begins to become more elevated
- extends beyond borders of areola ( age 11.5/13)

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23
Q

stage 4 areola/ papilla

A
  • increased breast sizing and elevation
  • areola and papilla form secondary mound projecting from contour of surrounding breast (age 13-15)
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24
Q

stage 5 mature breast

A
  • breast reaches final adult size
  • areola returns to contour of surrounding breast with projecting central papilla (age 15+)
25
Q

how does LH and FSH work in puberty

A

increase stimulation of ovaries to secrete oestrogen

26
Q

lactation functions of the breast

A
  • ejection
  • secretion
  • milk synthesis
27
Q

how is milk synthesis stimulated in lactation

A
  • stimulated by prolactin hormone released by anterior pituitary gland
28
Q

what is prolactin released in response to

A

prolactin releasing hormone (PRL) which is secreted by hypothalamus

29
Q

what two other hormones help stimulate milk production

A

progesterone + oestrogen also help stimulate milk production

30
Q

how does prolactin make breast milk

A

causes alveoli to take nutrients (proteins and sugars) from blood supply and turn them into breast milk

31
Q

secretion and ejection of lactate

A
  • oxytocin released from posterior pituitary gland in response to suckling
  • cells around alveoli contract + pass milk to milk ducts
  • milk ejection reflex
32
Q

name 5 breast disorders

A
  • amastia
  • amazia
  • gynecomastia
  • accessory breast tissue
  • lymphedema
33
Q

amastia

A
  • failure of breast + nipple to develop
  • usually due to failure of milk line to develop
  • associated absence of pectoral muscles and associated syndactyly
34
Q

amazia

A
  • absent of mammary gland beneath normal nipple - areola complex
  • usually associated with syndrome and can be diagnosed during infancy/ beginning of puberty
  • rare breast anomaly
35
Q

gynecomastia

A
  • benign proliferation of tissue in male breast
  • presents clinically as a palpable mass - an area of pinpoint tenderness nipple discharge
36
Q

polymastia/ accessory breast

A
  • residual breast tissue that persists form normal embryologic development
37
Q

congenital anomalies - nipple inversion

A
  • usually bilateral if congenital
  • unilateral might be related to pathological change
38
Q

congenital anomalies - athelia

A

absence of nipple

39
Q

congenital anomalies - polythelia

A
  • accessory nipples develop anywhere along milk line
  • often appear inferior to normal nipple
  • common congenital anomaly in both male and female breasts
40
Q

signs and symptoms requiring a referral

A
  • new discrete lump
  • new + persistent asymmetrical nodularity
  • abscess/ inflammation
  • recurrent cyst
  • severe breast pain
  • nipple discharge
  • change in skin contour
41
Q

benign pathologies

A
  • fibroadenoma
  • cysts
  • fibrocystic change
  • mastalgia (breast pain)
42
Q

breast cancer metastatic spread

A

via axillary lymph nodes
- lung
- liver
- brain

43
Q

how are axillary lymph nodes tested

A

by needle biopsy

44
Q

breast cancer grade 1 - low grade

A

cells well differentiated
- some degree of variation in size and shape
- slow growing and good prognosis

45
Q

breast cancer grade 2 - moderate grade

A
  • cells little unorganised with moderate differences in size + shape of nuclei
  • reasonable prognosis
46
Q

breast cancer grade 3 - high grade

A
  • cells growing quickly and badly organised
  • lost most their normal appearance + function
  • very poor prognosis
47
Q

what is fibroadenoma?

A
  • a solid breast lump (not cancer)
  • develop from whole lobule not single cell
  • affected by hormonal changes
  • 30-35yrs
48
Q

breast cysts

A
  • involution of breast lobules
  • develop naturally with age
  • common to have 1+
  • drains if symptomatic
49
Q

how much cysts in both breasts

A

1/3

50
Q

benign pathologies - fibrocystic changes

A
  • inflammatory reaction around terminal duct —-> fibrosis
  • combination of cyst formation + fibrosis
51
Q

mastalgia

A
  • cyclical pain
  • non cyclical pain
52
Q

when does mastalgia affect woman

A

before and after menopause

53
Q

lymphoedema

A
  • damaged/ removed lymph nodes can affect how much lymph fluid drains + fluid build-up = swelling
54
Q

what does treatment of lymphoedema aim to prevent?

A

progression of this condition through early detection
- swelling reduction
- maintenance

55
Q

where does breast cancer start

A
  • starts at epithelial lining of terminal duct lobular unit
56
Q

stage 1 tumours

A
  • under 2cm
  • no lymph node involvement
  • no spread
  • 98% 5 year survival rate
57
Q

stage 2 tumours

A
  • 2cm + 5cm
  • no spread
  • 88% 5 year survival rate
58
Q

stage 3 tumours

A
  • locally advanced cancer
  • larger than 5cm
  • no sign cancer spread
  • 49-56% 5 yr survival rate
59
Q

stage 4 metastatic cancer

A
  • any size
  • lymph nodes affected + cancer spread
  • secondary breast cancer
  • 16% 5yr survival rate

RD1033 (12 decks)

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