Breast Pelvic Exam Flashcards
Primary lymph drainage of the breasts
Axillae
Secondary lymph drainage of breasts
internal mammary nodes
Where else can breast lymph drain
supraclavicular and infraclavicular
Where most cancers are found
upper outer quadrant; Tail of spence
Quadrants of the breast
Upper outer upper inner lower outer lower inner tail of spence
Concerning sx
breast lump/mass
discomfort/pain
nipple d/c
How to inspect breasts?
- arms overhead with palms together
- hands on hips and press down
- shrug shoulder
- lean forward
Skin dimpling
sign of cancer pulling on the breast tissue
Nipple inspection
inspect for eversion or inversion; recent onset of unilateral nipple inversion is suggestive of underlying malignancy
Concentric search pattern
begin w/ tail of spence and move in concentric circular fashion progressing from outer breast, ending up near the nipple; palpate areola, then region beneath nipple; assess for loss of nipple elasticity
Nipple d/c
Light milky discharge may be normal
Serous or bloody discharge typically abnormal
Examination of axillary nodes
1st: anterior axillary region, under pectoralis
2nd- mid axillary high into apex
3- posterior axillary beneath tere minor
4. down medial aspect of upper arm
Skene’s gland
paraurethral gland near urethral opening
Bartholian’s glands
to the left and right of vaginal opening; secrete mucous to lubricate vagina
Patient hx for pelvic exam
Date of menarch LMP Menses Last PAP/any abnormals? Sexually active? # partners Have you been pregnant (G, P) Hx of STI;s menopause sexual assault, abuse Do you feel safe? Contraceptive use?
