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Health Assessment > ch. 20 Breast Assessment > Flashcards

ch. 20 Breast Assessment Flashcards

1
Q

subjective data collection

A

history of present concern COLDSPA, past health history, family history, lifestyle/health practices

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2
Q

breast function

A

paired mammary glands, produce/store milk (females), aid sexual stimulation

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3
Q

breast anatomy

A

pectoralis major, axillary tail of spence, areola, serrates anterior, nipple, montogomery’s glands

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4
Q

Internal anatomy of the breast is composed of

A

glandular tissue, fibrous tissue, adipose tissue. divided into four quadrants centered at nipple

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5
Q

Which quadrant has the most tumors?

A

upper outer quadrant

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6
Q

Glandular tissue

A

radiates from nipple, where milk is produced - functional part of breast

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7
Q

Fibrous tissue

A

suspensory ligaments or connective tissue that attach to chest wall muscles and support the tissue

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8
Q

Adipose tissue

A

subcutaneous fat that provides most of bulk of breast, determines size/shape

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9
Q

Lymph nodes that drain the breasts

A

supraclavicular, infraclavicular, lateral, central, posterior, anterior

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10
Q

Breast has extensive lymph drainage

A

more than 75% of body’s lymph drains into axillary nodes. don’t take bp on side of mastectomy

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11
Q

breast development (adolescent)

A

enlarge due to extensive fat deposition, early development linked to high BMI. tenderness common during growth, pubic hair develops, axillary hair two years after, menarche after beginning breast development

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12
Q

What stimulates breast changes?

A

estrogen

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13
Q

pregnancy

A

stimulates expansion of ductal system/supporting fatty tissue, breasts enlarge and feel more nodular, nipples grow larger/darker and more erectile, areolae never return to original color, venous pattern prominent

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14
Q

Preparing the client

A

sitting upright, assistant (witness), explain importance of exposure (drape when can), explain process. inspect, palpate

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14
Q

aging female

A

menopause = decrease in estrogen/progesterone, glandular tissue atrophy replaced w/ fibrous connective tissue, decreases breast size/elasticity, breasts decrease in firmness

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15
Q

Equipment

A

centimeter ruler, small pillow, gloves, specimen slide, client handout on breast self exam

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16
Q

Assessment technique

A

inspection, palpation

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17
Q

inspection

A

size/shape, color/texture, superficial venous patterns, retraction/dimpling, bilaterally color, size, shape, texture of areolae. bilaterally note size/directions of nipples

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18
Q

palpation

A

texture/elasticity, tenderness/temperature, masses, milky discharge normal only during pregnancy/lactation, mastectomy/lumpectomy site

19
Q

What do you palpate for with masses?

A

size in cm, shape, mobility, consistency, tenderness

20
Q

male breasts

A

inspect/palpate breasts, areolae, nipples, axillae. shouldn’t have swelling, nodules, ulceration. gynecomastia

21
Q

Gynecomastia

A

development of breast tissue in males

22
Q

When is tenderness common?

A

w/ ovulation/period. usually ovulate on day 13-17 of cycle.

23
Q

Assessment

A

Note tenderness, lumps, bumps in breast or axilla. nipples may be flat or inverted - retraction = problem. can palpate up and down, concentric circles or spokes on a wheel. nulliparous women have firm smooth elastic breast tissue, after pregnancy = softer/looser. implants?

24
Q

Vertical strip pattern

A

up and down, start high in axilla, palpate down

25
Q

Axillae

A

inspect/palpate - no rash/infection, no palpable nodes or 1-2 small discrete nontender movable nodes in central area

26
Q

Abnormalities noted on inspection

A

peau d’orange, Paget disease, retracted nipple, dimpling, retracted breast tissue, mastitis, mastectomy

27
Q

Peau d’orange

A

orange peel appearance

28
Q

Paget disease

A

intraductal carcinoma in the breast

29
Q

Abnormalities on palpation

A

cancerous tumors, fibroadenomas, benign breast disease

29
Q

Mastitis

A

inflammation of breast

30
Q

Fibroadenoma

A

benign breast mass

31
Q

Self breast exam (SBE)

A

teaches woman to know normal breast/detect changes

32
Q

Cancer

A

usually solitary, unilateral, non-tender mass. as cancer progresses may be solid, hard, dense, fixed to underlying tissues. PAINLESS, usually in UOQ. firm and hard irregular axillary nodes, skin dimpling, nipple retraction, discharge

33
Q

Doing a self breast exam

A

lying down - spread out breast tissue. right arm behind head, use three middle finger pads of opposite hand to feel for lumps, overlapping/dime-sized circular motions. move in up and down pattern starting on imaginary line from underarm to middle of sternum. feel down to ribs/up to clavicle. repeat on other side. look in mirror w/ hands on hips - changes in size/shape/contour/dimpling/redness/scaliness of nipple or skin. examine underarm while sitting w/ arm slightly raised

34
Q

Which pattern is most effective?

A

up and down

35
Q

What causes gynecomastia?

A

testosterone deficiency or too much estrogen

36
Q

Obesity contributes to ____________ in girls

A

early puberty

37
Q

Men have thin underdeveloped tissue under the _______

A

nipple

38
Q

Do blacks or whites have earlier onset of breast development?

A

blacks

39
Q

Who has higher incidence of breast cancer after 45?

A

whites

40
Q

When does mammography screening begin?

A

age 40 unless family history

41
Q

Who has higher incidence and death from breast cancer before 45?

A

blacks

42
Q

What are some lifestyle factors contributing to higher breast cancer risk?

A

alcohol, birth control

43
Q

What may reduce breast cancer risk?

A

physical activity

Health Assessment (32 decks)

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