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MIDS 227 (module 1 + 2) > Ch 9 Physiology of the Breast > Flashcards

Ch 9 Physiology of the Breast Flashcards

1
Q

List the 2 hormones during puberty?

A

-Estrogen
-Progesterone

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2
Q

What does estrogen do?

A

-Stimulates stromal + ductal growth and development
-Alters body fat distribution

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3
Q

What does estrogen + progesterone do when combined?

A

-Skin pigmentation of nipple + areolar region
-Activity of montomgery’s glands

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4
Q

What 2 hormones effect pregnancy?

A

-Estrogen
-Progesterone

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5
Q

What does estrogen do in pregnancy?

A

-Increased vascularity
-Growth of ductal system

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6
Q

What does progesterone do in pregnancy?

A

-Increased activity of montomery’s glands
-Growth of alveoli

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7
Q

What 2 hormones effect lactation?

A

-Prolactin
-Oxytocin

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8
Q

What does prolactin do during lactation?

A

Stimulates alveoli to produce milk

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9
Q

What does oxytocin do during lactation?

A

Triggers milk ejection

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10
Q

What hormone effects menopause?

A

Estrogen

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11
Q

What does estrogen do during menopause?

A

It decreases ovarian function, therefore decreasing estrogen levels

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12
Q

What is the set-up for a breast u/s?

A

-Review prior scans (MRI, mammo, u/s, etc)
-Review clinical history
-Use highest frequency linear probe capable of obtaining good penetration

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13
Q

What is the pt positioning for a breast u/s?

A

-Variable, depending on where mass is
-Position them to minimize the thickness of the portion of the breast being scanned (ex. oblique for lateral masses, supine for medial, etc.)
-Place arm overhead

(note: if a pt can only palpate a mass in a certain position, scan them in that exact position)

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14
Q

List history taking questions pertinent to a breast exam?

A

-Age
-Family history
-Hormonal status
-Palpable mass
-Previous u/s or mammo
-Injury or pain
-Nipple discharge
-Visual appearance

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15
Q

List the breast scanning procedure + techniques that can be used?

A

-Can scan whole breast or just a targeted area
-Can use palpation techniques (marking the skin, sonopalpation)
-Can use a stand off pad or extra gel for imaging superficial lesions
-Vary amount of pressure used
-Vary beam angles (heel-toe)
-Can turn off cross beam + spatial compounding if needed

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16
Q

What is the benefit of radial scanning?

A

-It follows lobar anatomy
-Best for assessing the major lactiferous ducts
-Best for documenting mass location according to nipple

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17
Q

How many quadrants of the breast are there?

A

4:
-UOQ
-UIQ
-LOQ
-LIQ

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18
Q

What are the scan planes for the breast?

A

-TRV/SAG
-Radial/Anti-Radial

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19
Q

Is radial + anti-radial scanning most similar to TRV or SAG?

A

Radial: think SAG (indicator points towards nipple)

Anti-radial: think TRV (indicator points towards pt’s right side)

20
Q

What are the 3 current recommendations how to document our breast images?

A

Include in our annotation:
-Clockface position
-Distance from nipple (in cm)
-Probe orientation

21
Q

What is the “123 - ABC” annotation documentation method?

A

SA: subareolar
1 = central ring
2 = middle ring
3 = outer ring

Ax: axillary segment

Depth of lesion:
A = superficial
B = middle 1/3rd
C = deep

22
Q

How to document a breast lesion?

A

-Compressibility
-Mobility
-Size (3 dimensions)
-Location
-Doppler findings

(sometimes compare to contralateral side)

23
Q

Is it necessary to scan into the axilla (armpit) during a breast u/s?

A

Yes!

24
Q

SF of coppers ligaments?

A

-Thin, hyperechoic bands
-Ascends to skin + encases fat lobules
-May cause shadowing

25
Q

SF of ducts?

A

-Anechoic tubes
-Echogenic walls

26
Q

SF of fat?

A

-Hypoechoic
-Will elongate in orthogonal planes

27
Q

SF of fibroglandular tissue?

A

This includes glandular, fibrous + fatty tissue

-Glandular tissue: isoechoic to fat
-Fibrous tissue: echogenic to fat

28
Q

Where is the premammary layer?

A

-Layer b/w the skin + mammary layer
-Does not extend behind the nipple

29
Q

Coopers ligaments (CL) are best seen in which breast layer?

A

Premammary layer

(note: CL can cause shadowing)

30
Q

What does the premammary layer contain?

A

Fat lobules

31
Q

What does the mammary layer contain?

A

Glandular tissue/breast parenchyma

32
Q

The sonographic appearance of which breast layer varies the most?

A

The mammary layer (due to composition variations)

33
Q

Major lactiferous ducts may be visible in which layer?

A

Mammary layer (usually <2mm)

34
Q

Most glandular tissue is found in which quadrant of the breast?

A

UOQ

35
Q

What does the retoromammary layer contain?

A

Retromammary fat + ligaments

36
Q

Which layer of the breast is the thinnest?

A

Retromammary

37
Q

Location of the retromammary layer?

A

Posterior to mammary fascia + anterior to the pectoralis major muscle

38
Q

List 5 sonographic appearances of the chest wall?

A

-Pectoralis major muscle (seen posterior to majority of breast)

-Pectoralis minor muscle (seen posterior + superolateral to pec major)

-Ribs

-Intercostal muscle

-Lung

39
Q

Sonographic variations of the breast occur depending on what factors?

A

-Age
-Parity
-Hormonal status
-Pregnancy status
-Lactating status
-Body habitus

40
Q

How does a pre + post puberty breast appear?

A

Pre: small + fatty

Post: glandular (isoechoic to mildly hyperechoic to fat)

41
Q

Fatty replacement of breast parenchyma occurs with ___ age?

A

Increasing

42
Q

During ___, proliferation of glandular tissue + duct dilatation may be seen?

A

Pregnancy + lactation

43
Q

A lesion sits at 10:00 in the right breast, which quadrant is this lesion in?

A

UOQ

44
Q

A lesion sits at 7:00 in the left breast, which quadrant is this lesion in?

A

LIQ

45
Q

Which hormone is responsible for stimulating the alveoli to secrete milk?

A

Prolactin

MIDS 227 (module 1 + 2) (14 decks)

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