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Health Ass Quiz 2 > Class notes breast/lymph > Flashcards

Class notes breast/lymph Flashcards

1
Q

What is the site of most breast tumors?

A

upper outer quadrant is site of most breast tumors.

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2
Q

Breast has an extensive lymphatic drainage; most (75%) drain into what side?

A

ipsilateral side.

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3
Q

What are the 4 groups of axillary lodes?

A

Central axillary
Pectoral (anterior)
Subscapular (posterior)
Lateral

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4
Q

in the adolescent mean age of onset breast development is: (caucasian & a. american)

A

mean age 8-9 (African American); 10 (Caucasian)

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5
Q

Now—onset of breast development is earlier or later?

A

earlier.

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6
Q

early breast development linked to:

A

greater BMI and reflects rise in obesity in U.S.

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7
Q

Beginning of breast development precedes menarche by how many years?

A

2 years.

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8
Q

Pregnant woman: after 4 months—what may be expressed in the breast?

A

colostrum

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9
Q

how long can colostrum be expressed in the pregnant woman after birth?

A

until 1st few days after delivery.

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10
Q

Colostrum rich with _____?

A

antibodies

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11
Q

Changes to nipples during pregnancy:

A

areolae larger, darker

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12
Q

Aging adult: after menopause—ovarian secretion of what hormones are decreased.

A

estrogen and progesterone

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13
Q

Breast glandular tissue atrophies, replaced by what type of tissue?

A

fibrous connective tissue.

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14
Q

Decreased ____, _____ in breast in aging adult

A

size and elasticity

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15
Q

Drooping in aging adult breast—accentuated by what in some older women.

A

kyphosis

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16
Q

Breast lumps may also be more or less palpable in aging adult?

A

more

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17
Q

Male breast: during adolescence—temporary enlargement is called what?

A

gynecomastia

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18
Q

Gynecomastia may also occur in aging males as a result of what deficiency?

A

testosterone deficiency

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19
Q

Tumor suppressor genes are called ____, ____ affecting breast cancer

A

BRCA1 , BRCA2

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20
Q

BRCA1 & BRAC2 mutation increases risk for developing what type of cancers?

A

breast and ovarian cancers.

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21
Q

3 reasons women would be least likely to have had a mammogram:

A

Less than a high school education
No health insurance
Recent immigrant

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22
Q

Pain: assess for:

A

PQRST

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23
Q

Common pain to assess for:

A

cyclical pain

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24
Q

Assess for lump:

A

how long have you had it?

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25
Q

Assess for relationship of lump to:

A

menstrual cycle

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26
Q

Assess for discharge in breast:

A

color, consistency, odor

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27
Q

Assess for rash in breast:

A

Where did it start?

28
Q

If rash involving nipple—think about what disease?

A

Paget’s disease

29
Q

Assess for swelling of breast:

A

local or generalized? May be related to menstrual cycle, pregnancy, breastfeeding.

30
Q

Assess for trauma in breast:

A

can sustain a hematoma from blunt trauma.

31
Q

Assess history of breast disease:

A

Increased risk of breast cancer with past history breast cancer.
Need to know relatives and their age at diagnosis of breast cancer.

32
Q

Some have what type of breasts? (which may make breast exam difficult)

A

Some have lumpy breasts (benign)

33
Q

Assess for surgery/radiation by asking:

A

Has the client had a breast biopsy, breast surgery (partial mastectomy; mastectomy)?

34
Q

what medications increases risk for breast cancer?

A

Oral contraceptive use; combined hormonal therapy after menopause

35
Q

What to assess in axilla?

A

assess for tenderness, swelling, lump.

36
Q

What 3 screening exams should you ask about:

A

Screening exams: ask about BSE, CSE, mammograms.

37
Q

Who would you teach about normal breast changes.

A

adolescents and pregnant women

38
Q

Is slight asymmetry normal in general appearance of breasts?

A

yes

39
Q

What do you inspect the breast for?

A

Redness, heat, vascular pattern (normal in pregnancy).

Edema—exaggerates hair follicles

40
Q

“orange peel” look is called:

A

“peau d’orange” occurs with edema in breast

41
Q

Assess axilla for:

A

edema, discoloration.

42
Q

Assess nipples for:

A

assess for discharge, nipples usually protrude

43
Q

Have client lift arms over her head and assess for:

A

assess for retraction;
note lag in movement in one breast;
note dimple or puckering.

44
Q

Axilla palpation:

A

rest arm on your arm—palpate in 4 directions

45
Q

Breasts—palpate with client in what position?

A

Supine position.
Tuck pad under side the to be palpated
Raise arm over head

46
Q

When tucking pad under side the to be palpated and raising arm over head does what to breasts:

A

(flattens tissue and displaces medially)

47
Q

Assess nipple discharge; if discharge, note what:

A

quadrant producing discharge.

48
Q

Location of lump—using a clock face note what:

A

note distance in cm from nipple or diagram breast and mark the location of the lump.

49
Q

Breast lump assess:

A 
Location
Size
Shape
Consistency (soft, firm, hard)
Movable
Distinctness—single or multiple
Nipple displaced or retracted
Skin over lump—erythema, dimpled, retracted
Tenderness
Lymphadenopathy
50
Q

More advanced cancer shows signs of:

A 
Breast mass
Retraction
Edema
Axillary mass
Scaly nipple
Tender breast
51
Q

Breast may normally be what right before menstruation?

A

tender and edematous

52
Q

Post-mastectomy—What is common sequela (complication of previous disease) of upper arms?

A

lymphedema-

due to interruption of lymphatic drainage and removal of nodes.

53
Q

When is it best to do Breast Self Exam (BSE)?

A

Right after menstrual period

54
Q

What is the steps of BSE? (supine)

A

Supine—palpate using vertical strip pattern.

55
Q

What is the step of BSE? (sitting)

A

Sitting up—palpate under arm, with arm raised.

56
Q

What is the step of BSE? (hand on hips)

A

Hand on hips with shoulder hunched—inspect in mirror, noting surface changes.

57
Q

Male breast cancer usually presents with:

A

retroareolar lump;

58
Q

In the male what is rare but strongly associated with breast cancer.

A

nipple discharge

59
Q

Adolescent gynecomastia is:

A

benign and temporary

60
Q

Adolescent gynecomastia is seen in:

A

seen in ½ adolescent boys (age 13, 14)

61
Q

Neonate—can have ____, _____ nipple discharge called:

A

clear, white discharge— called witch’s milk

62
Q

In the pre-pubertal child, nipples are located:

A

Just lateral to the mid-clavicular line between 4th and 5th ribs

63
Q

In adolescent—breast development begins between ___ - ____ years old:

A

8-10 years.

64
Q

Record child breast development using:

A

Tanner staging.

65
Q

Pregnant woman breast may appear:

A

visible blue vascular pattern; breast and nipples increase in size; striae may develop.

66
Q

Nipples appear in pregnant woman:

A

darker, more erectile; areolar widens, darkens; Montgomery glands elevated

67
Q

In pregnant woman- on palpation breasts are:

A

more nodular; colostrum may be expressed after first trimester.

Health Ass Quiz 2 (11 decks)

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