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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
how does LH and FSH work in puberty
increase stimulation of ovaries to secrete oestrogen
26
lactation functions of the breast
- ejection - secretion - milk synthesis
27
how is milk synthesis stimulated in lactation
- stimulated by prolactin hormone released by anterior pituitary gland
28
what is prolactin released in response to
prolactin releasing hormone (PRL) which is secreted by hypothalamus
29
what two other hormones help stimulate milk production
progesterone + oestrogen also help stimulate milk production
30
how does prolactin make breast milk
causes alveoli to take nutrients (proteins and sugars) from blood supply and turn them into breast milk
31
secretion and ejection of lactate
- oxytocin released from posterior pituitary gland in response to suckling - cells around alveoli contract + pass milk to milk ducts - milk ejection reflex
32
name 5 breast disorders
- amastia - amazia - gynecomastia - accessory breast tissue - lymphedema
33
amastia
- failure of breast + nipple to develop - usually due to failure of milk line to develop - associated absence of pectoral muscles and associated syndactyly
34
amazia
- 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
gynecomastia
- benign proliferation of tissue in male breast - presents clinically as a palpable mass - an area of pinpoint tenderness nipple discharge
36
polymastia/ accessory breast
- residual breast tissue that persists form normal embryologic development
37
congenital anomalies - nipple inversion
- usually bilateral if congenital - unilateral might be related to pathological change
38
congenital anomalies - athelia
absence of nipple
39
congenital anomalies - polythelia
- accessory nipples develop anywhere along milk line - often appear inferior to normal nipple - common congenital anomaly in both male and female breasts
40
signs and symptoms requiring a referral
- new discrete lump - new + persistent asymmetrical nodularity - abscess/ inflammation - recurrent cyst - severe breast pain - nipple discharge - change in skin contour
41
benign pathologies
- fibroadenoma - cysts - fibrocystic change - mastalgia (breast pain)
42
breast cancer metastatic spread
via axillary lymph nodes - lung - liver - brain
43
how are axillary lymph nodes tested
by needle biopsy
44
breast cancer grade 1 - low grade
cells well differentiated - some degree of variation in size and shape - slow growing and good prognosis
45
breast cancer grade 2 - moderate grade
- cells little unorganised with moderate differences in size + shape of nuclei - reasonable prognosis
46
breast cancer grade 3 - high grade
- cells growing quickly and badly organised - lost most their normal appearance + function - very poor prognosis
47
what is fibroadenoma?
- a solid breast lump (not cancer) - develop from whole lobule not single cell - affected by hormonal changes - 30-35yrs
48
breast cysts
- involution of breast lobules - develop naturally with age - common to have 1+ - drains if symptomatic
49
how much cysts in both breasts
1/3
50
benign pathologies - fibrocystic changes
- inflammatory reaction around terminal duct ----> fibrosis - combination of cyst formation + fibrosis
51
mastalgia
- cyclical pain - non cyclical pain
52
when does mastalgia affect woman
before and after menopause
53
lymphoedema
- damaged/ removed lymph nodes can affect how much lymph fluid drains + fluid build-up = swelling
54
what does treatment of lymphoedema aim to prevent?
progression of this condition through early detection - swelling reduction - maintenance
55
where does breast cancer start
- starts at epithelial lining of terminal duct lobular unit
56
stage 1 tumours
- under 2cm - no lymph node involvement - no spread - 98% 5 year survival rate
57
stage 2 tumours
- 2cm + 5cm - no spread - 88% 5 year survival rate
58
stage 3 tumours
- locally advanced cancer - larger than 5cm - no sign cancer spread - 49-56% 5 yr survival rate
59
stage 4 metastatic cancer
- any size - lymph nodes affected + cancer spread - secondary breast cancer - 16% 5yr survival rate

RD1033 (12 decks)

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