Ch 7 Phys Exam of Breasts Flashcards
Breast extends from the ____ rib to the ____ rib
2nd to 3rd
6th to 7th
Breasts extends from what margin?
Sternal margin to mid-axillary line
The female breast is composed of:
Granular and fibrous tissue
Fat
The glandular tissue of the breast is arranged into ____ lobes per breast
15-20
Each lobe is composed of ____ lobules
20-40 lobules
Consist of milk-producing acini cells that empty into lactiferous ducts during lactation
Lobules
Which duct drains milk from each lobe onto the surface of the nipple?
Lactiferous duct
Which ligaments extend from the connective tissue layer through the breast and attach to the underlying muscle fascia, providing support?
Suspensory ligaments
The muscles forming the floor of the breast:
Pectoralis major
Pectoralis minor
Serratus anterior
Latissimus dorsi
Subscapularis
External oblique
Rectus abdominis
Five segments of the breast
4 Quadrants
1 Tail of spence
Vascular supply to the breast is primarily through branches of the:
Internal mammary
Lateral thoracic artery
Subcutaneous and retromammary fat that surrounds the glandular tissue lies in the _____ quadrant
Upper outer quadrant
The greatest amount of glandular tissue lies in the _____ quadrant
Upper Outer
Breast tissue from the upper outer quadrant extends from the quadrant into the axillae
Tail of Spence
What stimuli produces erection of the nipple and causes the lactiferous ducts to empty?
Tactile, sensory, or autonomic
In the axillae the mammary tissue is in direct contact with:
Axillary lymph nodes
Nipple erection is supported by:
Venous stasis in the erectile vascular tissue
Nipple range in color:
Pink to black
Lymphatic network that radiates the breast radially and deeply
Pectoral
Subscapular
Central
Brachial
Equipment for a breast exam
Small pillow or folded towel
Ruler
Flashlight with transilluminator
Palpate breasts in what position?
Seated
Supine
Five D’s related to nipples
Discharge
Depression
Discoloration
Dermatologic changes
Deviation
Seated
Reinspect in what various positions?
Arms extended over head
Hands pressed against hips and shoulder
Leaning forward from waist
Patient is seated with arms hanging freely
Palm of right hand is placed at the patient’s right clavicle at the sternum
Sweep downward from clavicle to the nipple feeling for superficial lumps
Chest wall sweep
Place hand, palmar surface facing up, under the patient’s right breast
Position that hand so it is flat surface where you can compress
With the finger of the other hand, walk across the breast tissue
Bimanual digital palpation
Palpate for lymph nodes on both females and males
Patient is seated, arms flexed at elbow
Using Palmer surface of your fingers, reach deeply into the axillary hollow, pushing firmly
Palpate medially, posterior wall along the scapular, supraclavicular, and infraclavicular
Lymph node palpation
What do you palpate while the patient is laying supine?
All areas of the breast including the tail of Spence
Rotate fingers clockwise or counterclockwise; palpate light, medium, deep
During palpation avoid lifting your fingers off the breast tissue because:
Makes it easy to miss tissue
If a beast mass is felt, note its characteristic and palpate its:
Dimensions
Consistency
Mobility
Nipple compression should be performed only if the patient reports:
Spontaneous discharge
Normal findings
Breast tissue is:
Dense, firm, elastic
Visible vein networks in patients who are:
Pregnant
Obese
Decrease in glandular alveolar and lobular tissue
Premenopausal
Glandular tissue atrophies and is replaced by fat
Menopause
Breasts are flatter, longer, and more relaxed from the chest wall
Postmenopausal
Breasts of older women are more:
Fine and granular
Benign cyst formation caused by ductal enlargement is associated with a long follicular or luteal phase of the menstrual cycle
Lesions are filled with fluid and usually bilateral and multiple
Fibrocystic changes
Benign tumors composed of stromal and epithelial elements that represent a hyperplastic or proliferative process
Account for the majority of breast tumors in young women
Fibroadenoma
Malignant breast tumors have peak incidence between ages ___ and ___ normally occurring in women older than ____
40 to 75
50
Mass or thickening
Marked asymmetry
Prominent unilateral veins
Discoloration
Ulcerations
Dimpling
Puckering
Retraction of skin
Inversion/deviation of the nipple
Findings associated with breast cancer
Response to local injury
A firm, irregular mass, often appearing as an area of discoloration
Fat necrosis
Benign 2-3 cm tumors of the sub-areolar ducts that occur singly or in multiples.
Common cause of serous or bloody nipple discharge
Intraductal papilloma and Papillomatosis
Surface manifestation of underlying ductal carcinoma.
Red, scaling, crusty patch forms on the nipple, areola, and surrounding skin
Lesions appear eczematous and usually unilateral
Paget disease
Smooth, firm, mobile, tender disk of breast tissue located behind the areola in males.
Caused by hormone imbalance; by testicular, pituitary or hormone secreting tumors; liver failure or antihypertensive meds.
Gynecomastia
Inflammation of the sebaceous glands in the areola
Retention cysts
Lactation not associated with childbearing and most commonly caused by pituitary tumors, Cushing’s syndrome and hypoglycemia
Galactorrhea
What drugs caused galactorrhea?
Phenothiazines
Tricyclics
Antidepressants
Estrogen
Inflammation and infection of the breast tissue characterized by sudden onset of swelling, tenderness, erythema, and heat
Usually the result of a staph infection and most common in lactating women
Mastitis
Most commonly occur in menopausal women
The sub-areolar ducts become blocked with desquamating secretory epithelium, necrotic debris, and chronic inflammatory cells
Mammary duct ectasia
