Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PD II > Breast Exam > Flashcards

Breast Exam Flashcards

1
Q

Female Breast Structures

A

fat, glandular and connective tissue, as well as lobes, lobules, ducts, lymph nodes, blood vessels and ligaments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Lobules and ducts

A

Lobules branch out from the nipple - each holds tiny, hollow sacs (alveoli).

The lobules are linked by a network of thin tubes (ducts).

If you’re breast-feeding, ducts carry milk from the alveoli toward the dark area of skin in the center of the breast (areola).

From the areola, the ducts join together into larger ducts ending at the nipple.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Superior breast anatomy

A

Breast tissue extends superiorly from the second and third ribs, inferiorly to the inframammary fold, and transversely from the sternum to the midaxillary lines.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Tail of Spence

A

peninsula of breast tissue may project into the axilla

It passes through an opening in the deep Pectoral fascia is known as (foramen of langer)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Two facial layers that enclose the breast tissue

A
  1. superficial layer beneath the dermis
  2. The deep layer overlying the pectoralis major muscle fascia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Breast tissue overlaying the dermis via bands of connective tissue

A

ligaments of Cooper

+ retro-mammary bursa, support the breast’s position while allowing free movement over the underlying thoracic walls

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Breast positioning

A

base of the breast - 2nd - 6th ribs

From the lateral margin of the sternum to the mid axillary line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Foramen of langer

A

a defect in the deep pectoralis fascia at the level of the third intercostal space, through which the upper lateral portion of the breast extends into the axilla forming the axillary tail of Spence.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Breast Muscle

A

The breast has no muscle tissue.

Muscles lie underneath the breasts, however, separating them from your ribs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Lymphatics of the breast

A
  1. Superficial lymphatics: Drains skin over the breasts except nipple and areola
  2. Deep lymphatics:
    Drains the parenchyma of breasts and drains the nipple and areola
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Deep surface of breast

A
  1. The retromammary space: - It is loose areolar tissue between the gland and deep fascia (pectoral fascia)- Allows the free mobility of the breast over the deep fascia.
  2. The deep fascia : covering the pectoralis major muscle
  3. The flat base of the breast lies on the pectoralis major (medial 2/3) and serratus anterior (lateral 1/3).
  4. The lower lateral part of the gland rests on the external oblique muscle of the abdomen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Breast Lymphatic Drainage

A
  1. Axillary Lymph node
    Drains 75% of chest wall and upper extremity
  2. Dermal Lymphatics
    Allows spread to the other breast
  3. Inferior Nodes
    Spread to stomach and liver
  4. Infrasternal nodes
    Spread to vertebral column up to the brain
  5. Rotter’s nodes
    Bypass the axillary nodes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Arterial supply to the breasts

A

1) Internal Thoracic Artery -50%
2) Intercostal Artery
3) Axillary Artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Nerve supply of the breast

A
  1. Intercostal nerves 2nd-6th
  2. Lateral Cutaneous nerves - 3-6
  3. Supraclavicular branches
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Venous Drainage

A

1) Axillary vein is main route
2) Internal mammary vein
3) Intercostal Vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Breast fascia positioning

A

Deep layer of this fasciasits immediately atop the pectoralis muscle

Superficial layer sits just under the skin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

projection from just below the center of the breast , Lies in the 4th intercostal space, contains circular smooth muscle

A

Nipple

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Carries the opening of lactiferous ducts (15-20 openings.

A

Longitudinal smooth muscle - flattens the nipple

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Pigmented area of skin that surrounds the base of the nipple and outer margin structure.

A

Areola -

It is rich in modified sebaceous gland particularly at the outer margin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q
A

1) Papilla mammaria

2) Areola mammae

3) Tubercula areolae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Tubercule of Montgomery

A

sebaceous (oil) glands that appear as small bumps around the dark area of the nipple.

primary function -lubricating and keeping germs away from the breasts.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Breast Development stages

A

Stage 1: Prepubertal.

Stage 2: Breast bud stage with elevation of breast and papilla; enlargement of areola.

Stage 3: Further enlargement of breast and areola; no separation of their contour.

Stage 4: Areola and papilla form a secondary mound above level of breast.

Stage 5: Mature stage with projection of papilla only, related to recession of areola.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Benign Diseases of the Breast.

A

Fibroadenoma
Fibrocystic Disease
Galactocele

Mastitis
Breast Abscess
Hematoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Fibroadenoma

A

common noncancerous (benign) breast lumps that rarely increase breast cancer risk.

(may get bigger or smaller over time)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Fibrocystic Disease

A

Painful, lumpy breasts.

Formerly called fibrocystic breast disease, this common condition is, in fact, not a disease.

Many women experience these normal breast changes, usually around their period.

26
Q

Galatocele

A

Caused byany kind of blockage in the ducts of the breast during or just after stopping lactation.

While breast carcinomas may sometimes cause a blockage which results in a galactocele, these lesions are due to more routine and benign causes in a majority of women.

Tx - Warm compress/pump with taper

27
Q

Mastitis

A

an inflammation of breast tissue that sometimes involves an infection.

28
Q

Mastitis notes

A

Usually 1st 6 weeks post partum
The inflammation results in breast pain, swelling, warmth and redness. You might also have fever and chills.

DX: PE, U.S, aspiration
Mammogram after tx to R/O abscess

29
Q

Breast Abscess

A

A localized collection of inflammatory exudate (ie, pus) in the breast tissue.

Most commonly when mastitis or cellulitis does not respond to antibiotic treatment, but an abscess can also be the first presentation of breast infection.

It is an uncommon problem in breastfeeding.

30
Q

Breast Hematoma

A

is a collection of blood that accumulates in your breast tissue.

Most hematomas resolve on their own without treatment.

31
Q

Breast Cancer

A

Except for skin cancer, breast cancer is the most common cancer in women in the United States.

breast cancer remains the second leading cause of cancer death among women overall, although death from breast cancer has declined overall.

32
Q

Breast Cancer insidence and details

A

1 out of 8 women will develop breast CA

Average age is 60
Affects women ages 30-90

Usually:
Hard, non-tender
Irregular
Fixed mass

33
Q

Un-changeable breast cancer risk factors

A
  1. Age - most are diagnosed after age 50.
  2. Genetic - BRCA1 & BRCA2
  3. Reproductive history - Starting menstrual periods before age 12 and starting menopause after age 55 expose women to hormones longer, raising their risk of getting breast cancer.
  4. Having dense breasts.

More connective tissue than fatty tissue - make it hard to see tumors on a mammogram.

34
Q

More Un-changeable breast cancer risk factors

A
  1. Personal history of breast cancer or certain non-cancerous breast diseases.
  2. Family history of breast or ovarian cancer. (first-degree relative) or multiple family members on either her mother’s or father’s side of the family who have had breast or ovarian cancer. Having a first-degree male relative with breast cancer also raises a woman’s risk.
  3. Previous treatment using radiation therapy.Women who hadradiation therapyto the chest or breasts (for instance, treatment of Hodgkin’s lymphoma) before age 30 have a higher risk of getting breast cancer later in life.

Exposure to the drugdiethylstilbestrol (DES).DES was given to some pregnant women in the United States between 1940 and 1971 to prevent miscarriage. Women who took DES, or whose mothers took DES while pregnant with them, have a higher risk of getting breast cancer.

35
Q

Changeable Breast cancer risk factors

A
  1. Not being physically active.
  2. Taking hormones - hormone replacement therapy (those that include both estrogen and progesterone) taken during menopause can raise risk for breast cancer when taken for more than five years.
  3. Reproductive history.Having the first pregnancy after age 30, not breastfeeding, and never having a full-term pregnancy can raise breast cancer risk.
  4. Drinking alcohol.Studies show that a woman’s risk for breast cancer increases with the morealcoholshe drinks.
36
Q

High risk critera for breast cancer

A

If you have a strongfamily history of breast
cancerorinherited changes in your BRCA1 and BRCA2 genes,you may have a high risk of getting breast cancer.

You may also have a high risk forovarian cancer.

37
Q

BRCA genes function

A

Tumor suppressor genes

these genes help keep breast, ovarian, and other types of cells from growing and dividing too rapidly or in an uncontrolled way

38
Q

American cancer society screening recs

A
  1. Women between 40 and 44have the option to start screening with a mammogram every year.
  2. Women 45 to 54should get mammograms every year. Women 55 and oldercan switch to a mammogram every other year, or they can choose to continue yearly mammograms.
  3. Screening should continue as long as a woman is in good health and is expected to live at least 10 more years.
39
Q

Breast cancer signs and symptoms

A

new lump or mass(although most breast lumps arenotcancer).

A painless, hard massthat has irregular edges is more likely to be cancer, but breast cancers can bealso soft, round, tender, or even painful.

40
Q

More breast cancer signs and symptoms

A

Swelling of all or part of a breast(even if no lump is felt)

Skin dimpling(sometimes looking like an orange peel)

Breast or nipple pain
Nipple retraction(turning inward)

Nipple or breast skin that is red, dry, flaking, or thickened

Nipple discharge(other than breast milk)

Swollen lymph nodesunder the arm or near the collar bone(Sometimes this can be a sign of breastcancer spread even before the original tumor in the breast is large enough to be felt.)

41
Q

Signs of advance breast cancer

A

breast lump that you can either see or feel.

skin changes, like dimpling or rash.

nipple discharge.

breast pain or discomfort.

fatigue.

unexplained weight loss.

loss of appetite.

42
Q

Discuss the following with your patient:

Assessing risk of breast cancer

A
  1. Screening measures: self breast exam, clinical breast exam, and mammography
  2. How to do self breast exam?
  3. Concerns about palpable masses of the breast.
43
Q

BREAST self exam

A

Women 20 yo and up may perform monthly self exams

Exams are perform 1 week after menstrual period

Done supine or standing

ALWAYS inspect first
Palpate /breast and axilla

44
Q

BREAST inspection

A
  1. Abnormalities in the overall shape of the breasts
  2. Changes in skin color
  3. Skin dimpling / retractions
  4. Spontaneous nipple discharge
45
Q

Skin dimpling

A

Breast skin dimpling is when an area of the breast looks similar to an orange peel.

Dimpling can be a sign of breast cancer.
Sometimes, it is inflammatory breast cancer.

This rare form of breast cancer blocks the skin’s lymph vessels,
causingswelling, redness, andinflammation.

46
Q

Early warning signs of breast cancer

A
  1. visible lump
  2. nipple change - inversion
  3. color or texture change
  4. dimpled or depressed skin
  5. bloody discharge
47
Q

Female breast exam

A

Clinical breast examination enhances detection of breast cancers that mammography may miss and provides opportunity for the patient demonstrate techniques for self-examination

48
Q

Clinician approach and technique to breast exam

A

Clinicians should adopt a standardized approach
Use a systematic and thorough search pattern

Use finger pads
Vary palpation pressures
Use a circular motion

49
Q

Patient interaction with breast exam

A

Women and girls may feel apprehensive about the exam

Reassure the patient
Use a courteous and gentle approach

Keep the patient properly draped

Ask the patient if she has noticed any lumps or other
problems and if she performs monthly breast self-exam

50
Q

components to female breast exam

A
  1. Inspect the breasts with the patient in sitting position and disrobed to the waist
  2. Look for skin changes (color, thickening, and unusually prominent pores), size and symmetry, contour, characteristics of the nipples (size, shape, direction in which they point, rashes, ulceration, and discharge)
  3. Ask the patient to raise her arms above her head or press them against the hips as this can bring out dimpling or retraction
    Assess four views: arms at sides, arms over head, arms pressed against hips, and leaning forward
51
Q

palpation technique with female breast exam

A

Place the patient in the supine position

Palpate a rectangular area from clavicle to inframammary fold and midsternal line to posterior axillary line and into axilla for the tail of the breast

Thorough examination takes 3 minutes per breast
Use finger pads of the 2nd, 3rd, and 4th fingers
Use the vertical strip pattern (best validated technique)

Palpate in small, concentric circles

Apply light, medium, and deep pressure

Examine the entire breast, including periphery, tail, and axilla

52
Q

Con’t palpation female breast exam

A

Lateral portion of breast
Ask the patient to roll onto the opposite hip, hand on forehead with shoulder pressed against exam table
This flattens lateral breast tissue

Medial portion of breast
Ask the patient to lie with shoulders flat against the exam table; place her hand at her neck and lift up her elbow until it is even with her shoulder

53
Q

Palpation feeling for

A

Consistency of tissues
Tenderness
Nodules
Location
Size

Shape
Consistency
Delimitation
Tenderness
Mobility

54
Q

Nipple exam

A

Palpate each nipple
Note elasticity

55
Q

Findings consistent with malignancy

A

Hard consistency
Irregular shape
Dimpling of overlying skin
Associated retraction of nipple
Non-tender

56
Q

Male breast exam

A

Inspect the nipple and areola for nodules, swelling, ulceration

Palpate the areola and breast tissue for nodules
If the breast is enlarged:

Distinguish between soft, fatty enlargement of obesity and the firm disc of glandular enlargement (gynecomastia)

57
Q

Con’t male exam 2

A

Have patient in a sitting position
Inspection
Rash
Infection
Unusual pigmentation

58
Q

cont male exam 3

A

Left axilla: ask patient to relax with left arm down

Cup together the fingers of your right hand
Reach as high as possible toward the apex of axilla

Fingers should lie directly behind pectoral muscles, toward midclavicle
Press fingers toward chest wall and slide them downward

Try to feel central nodes against chest wall
One or more soft, small (<1 cm), nontender nodes is normal

59
Q

axillae exam cont

A

If central nodes feel large, hard, or tender—or if there is suspicious lesion—feel for other groups of axillary nodes

Pectoral nodes
Lateral nodes
Subscapular nodes

60
Q

Assessment of spontaneous nipple discharge

A

Try to determine origin
Compress areola with index finger

Watch for discharge appearing through one of the duct openings on nipple’s surface

Note color, consistency, quantity, and exact location

61
Q

Chronic abscess

A

think DM, TB or duct tumor

PD II (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions