Chapter 21 PT 2 Flashcards

1
Q

the breast is a modified ______ gland located in the superficial fascia of the anterior chest wall.

A

sweat

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2
Q

sonographically the breast is divided into three layers located between the skin and the pectoralis major muscle on the anterior chest wall. these layers are the _______.

A

subcutaneous, mammary, and retromammary

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3
Q

fat is the least ______ tissue within the breast.

A

echogenic

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4
Q

the fatty tissue appears ______, whereas the ducts, glands, and supporting ligaments appear echogenic.

A

hypoechoic

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5
Q

the _______ quadrant of the breast contains the highest concentration of lobes.

A

upperouter

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6
Q

each lobule contains ______ (milk-producing glands) that are clustered on the terminal ends of the ducts like grapes on a vine.

A

acini

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7
Q

the ______ muscle lies posterior to the retromammary layer.

A

pectoralis major

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8
Q

the ______ tissue can situate itself in and among the areas of glandular tissue, and in some scanning planes it can mimic isoechoic or hypoechoic masses.

A

adipose or fatty

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9
Q

sonographically, cancers can be difficult to differentiate in the fatty breast because most cancer appear ______ and can be difficult to differentiate from the normal breast tissue.

A

hypoechoic

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10
Q

the main arterial supply to the breast comes from the internal ______ and the lateral _______ artery.

A

mammary, thoracic

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11
Q

lymphatic drainage from all parts of the breast generally flows to the ______ lymph nodes.

A

axillary

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12
Q

the primary function of the breast is ______ transport.

A

fluid

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13
Q

the ______ system is critical in the transport of fluids within the breast.

A

ductal

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14
Q

an important function during the reproductive years is for the breast to make ______ from nutrients and water taken from the bloodstream.

A

milk

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15
Q

milk is produced within the ______ and carried to the nipple by the ducts.

A

acini

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16
Q

breast development begins before ______ and continues until the patient is approximately 16 years old.

A

menarche

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17
Q

during this time of development, the ductal system proliferates under the influence of ______.

A

estrogen

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18
Q

during pregnancy, acinar development is accelerated to enable milk production by estrogen, ______, and prolactin.

A

progesterone

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19
Q

the hormone produced by the pituitary gland that stimulates the acini to produce and excrete milk is called ______.

A

prolactin

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20
Q

the expulsion of the placenta after the birth of a baby causes a drop in circulating progesterone, initiating ______ production within the breast.

A

milk

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21
Q

the physical stimulation of suckling by the baby initiates the release of ______ (produced by the hypothalamus and released by the pituitary gland), which further incites prolactin secretion, stimulating additional milk production.

A

oxytocin

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22
Q

full maturation of the acini occurs during lactation and is thought to be mildly protective against the development of breast _______.

A

cancer

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23
Q

ultrasound may be used for screening purpose in ______ breasts that are ______ and difficult to penetrate by mammography, to evaluate masses.

A

young, dense

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24
Q

ultrasound is also useful in ______ structures within uniformly dense breast tissue where mammography is limited.

A

differentiating

25
Q

a ______ aspiration can be performed to determine whether a lesion is a complex cyst or truly a solid mass.

A

cyst

26
Q

what basic clinical information must the sonographer have for any patient referred for breast ultrasound?

A

patients age, risk factor for cancer, symptoms, location and clinical impression of lumps

27
Q

pertinent clinical information that should be provided by the referring physician includes size and location of the lump, when it was noticed, and its relation to the ______.

A

menstrual cycle

28
Q

a dominant cyst is frequently ______ or ______, smooth, soft, and easily moveable.

A

round or oval

29
Q

fibroadenomas are usually similar in shape, but they are often quite firm and rubbery in consistency and ______ on ultrasound.

A

homogeneously solid

30
Q

breast cancer is usually lobular or ______ in shape, uneven in surface contour, and fixed or poorly moveable.

A

irregular

31
Q

most breast masses that arise during the adolescent years are ______.

A

fibroadenomas

32
Q

an ______ implant rupture occurs when there is a breach of the membrane surrounding an implant, but the silicone that leaks out is still confined within the fibrous scar tissue that forms around the implant.

A

intracapsular

33
Q

as the implant collapses and the membrane folds inward, a series of discontinuous echogenic lines parallel to the face of the transducer may be seen and are referred to as the “stepladder sign” or ______ sign.

A

linguine

34
Q

the use of the ______ positions is unique to the breast and can often pick up subtle abnormalities extending toward the nipple along the ductal system from the mass.

A

radial/ antiradial

35
Q

_______ tend to grow within the ducts and will often follow the ductal system in a radial plane, toward the convergence at the nipple.

A

malignancies

36
Q

to be considered a simple cyst, a lesion must meet which three criteria on ultrasound?

A

devoid of internal echoes, smooth inner margins within capsule, posterior acoustic enhancement

37
Q

discuss the disruption of breast architecture with both benign and malignant tumors of the breast.

A

benign usually are slow growing and do not invade surrounding tissue, tend to grow horizontally

38
Q

a rounded or oval shape is usually associated with ______ lesions, whereas sharp, angular margins are associated with ______ lesions.

A

benign, malignant

39
Q

the normal tissue planes of the breast are _______ oriented.

A

horizontally

40
Q

benign lesions tend to grow within the normal tissue planes, and their long axis lies _____ to the chest wall.

A

parallel

41
Q

malignant lesions are able to grow through the connective tissue and may have a ______ orientation when imaging the breast from anterior to posterior.

A

vertically

42
Q

if a mass measures longer in the anteroposterior dimension (______) then in either transverse or sagittal planes (______), the mass has a vertical orientation that is usually described as being “taller than wide” is suspicious for malignancy.

A

height, width

43
Q

malignant masses will often demonstrate increased ______ within the lesion and often have a feeder vessel, which can be identified with careful evaluation.

A

vascularity

44
Q

lesions more common to younger women are ______ disease and fibroadenomas.

A

fibrocystic

45
Q

older or postmenopausal women are more likely to have ______ papillomas, duct ectasia, and cancer.

A

intraductal

46
Q

skin dimpling or ulceration and nipple retraction nearly always result from ______.

A

cancer

47
Q

benign tumor are rubbery, ______, and well delineated, whereas malignant tumors are often stone hard and irregular with a gritty feel.

A

mobile

48
Q

clinical signs and symptoms of ______ include the lumps and pain that the patient feels that fluctuate with every monthly cycle.

A

fibrocystic conditions

49
Q

the growth of a fibroadenoma is stimulated ______.

A

estrogen

50
Q

sonographically, fat necrosis appears as an irregular, complex mass with low-level echoes, may mimic a ______ lesion, and may appear as fat, but is separated and difficult from the rest of the breast parenchyma.

A

malignant

51
Q

______ may result from infection, trauma, mechanical obstruction in the breast ducts, or from other conditions.

A

acute mastitis

52
Q

an intraductal papilloma is a small, ______ tumor that grows within the acini of the breast.

A

benign

53
Q

in ______ tissue, most cancer growth occurs along the borders.

A

fibrotic

54
Q

______ and ______ are frequently used as pathways for new tumor development.

A

lymphatics and blood vessels

55
Q

if the tumor is ______ is continues to grow in one area, compressing and distorting the surrounding architecture.

A

encapsulated

56
Q

most cancer originates in the ______ ductal lobular units, whereas a smaller percentage originates in the glandular tissue.

A

terminal

57
Q

______ refers to breast tumors that arise from the epithelium, in the ductal and glandular tissue, and usually have tentacles.

A

carcinoma

58
Q

breast carcinomas are generally categorized by two factors: where the cancer cells originate (______ or ______) and whether the cancer is prone to spreading (______ or ______).

A

ductal or lobular, noninvasive or invasive

59
Q

carcinomas that do not normally spread outside of the duct or lobule are called noninvasive, noninfiltrating, or ______ cancers, whereas cancers that spread into nearby tissue are said to be invasive or infiltrating.

A

in situ