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block 11 anna > lecture 5 the breast > Flashcards

lecture 5 the breast Flashcards

1
Q

list the important hormones of breast feeding

A 
luteinising hormone
oestrogen
progesterone
prolactin
human placental lactogen
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2
Q

of the hormones what does the pituitary gland produce

A

leutinising hormone and prolactin

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3
Q

whats going on at gestational week 4

A

two milk lines

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4
Q

where do the milk lines go

A

from axilla to groin

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5
Q

what are the milk lines

A

thickening of epithelial cells - glandular cells

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6
Q

what happens in gestational weeks 7-8

A

milk hill stage - thickening and inward growth into the chest wall

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7
Q

weeks 12-16

A

differentiation of the smooth muscle cells of the nipple and aereola
branch into alveoli

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8
Q

weeks 28-32

A

canalisation of branched epithelial tissue

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9
Q

when are the primary milk ducts done

A

32 weeks

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10
Q

weeks 32-40

A

nipple and aereola become pigmented

colostrum

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11
Q

what creates the shape and size of breasts

A

fat deposits

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12
Q

effects of oestrogen on the developing breast

A

stimulate differentiation of the ductual system

stop all to ducts developing in one place

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13
Q

effect of progesterone on the growing breast

A

causes lobes lobules and alveoli to grow and leads to further development and duct enlargement

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14
Q

what does prolactin influence

A

growth of the nipple

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15
Q

what is responsible for aereolar grwoth

A

Serum placental lactogen

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16
Q

what promotes mammary growth

A

Adrenocorticotropic hormone and growth hormone combine synergistically with prolactin

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17
Q

what are the tubercles of montgomery

A

blind ended tubules for smell for the baby

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18
Q

what makes the size and shape of the breast

A

adipose tissue

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19
Q

what secretes milk into the lumen of the alveoli

A

lactocytes

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20
Q

what cells can eject milk into the suctures

A

myoepithelial cells

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21
Q

blood supply to the breast

A

mainly internal mammary artery

some lateral thoracic artery

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22
Q

venous drainage

A

internal & external mammary veins & axillary veins

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23
Q

main lymphatic nodes

A

axillary

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24
Q

nervous supply

A

2nd-6th intercostal nerves

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25
Q

why might womens breasts feel warm

A

lots of metabolic activity going on

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26
Q

what happens in week 6-8 for women

A

lumpy
fullness
tingling
incr blood supply

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27
Q

what is marbelling of the breasts

A

increased blood supply - more prominent veins

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28
Q

when is marbelling

A

weeks 6-8

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29
Q

when does the nipple get darker

A

week 12

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30
Q

what else happens at week 12 for women

A

areola enlarges, nipple becomes more pronounced and sebaceous glands secrete an oily substance

31
Q

when do the breasts start to secrete colostrum

A

week 12-16 of gestation

32
Q

LACTOGENESIS

A

lol

33
Q

when does lactogenesis 1 start

A

mid pregnancy to 48 hours after birth

34
Q

initially what is lactation driven by?

A

endocrine

35
Q

when does lactogenesis 2 start

A

day 3-8 after birth

36
Q

what is the time frame is the lactogenesis 3

A

day 8-9 days after birth to 40 days after stopping feeding

37
Q

what happens to acini in lactogenesis 1

A

they start to expand

38
Q

what is produced by the anterior pituitary gland in lactogenesis 1

A

prolactin

39
Q

in lactogenesis 1 what affect does prolactin have on colostrum

A

makes it accumulate

40
Q

how does the epithelium change in lactogenesis 2

A

Epithelium of the alveoli differentiates into secretory cells for milk production

41
Q

in lactogenesis 1 what happens in the lactocytes

A

fat droplets accumulate

42
Q

in lactogenesis 1 what decreases

A

lactose and lactalbumin

43
Q

during lactogenesis 1 what stops milk being released

A

high levels of progesterone and oestrogen inhibit prolactin

44
Q

what is the main trigger for lactogenesis 2

A

third stage of labour

45
Q

what specifically about the third stage of labour promotes lactogenesis 2

A

sudden drop of progesterone and oestrogen and human placental lactone

46
Q

in lactogenesis 2 what is there closure of

A

tight junctions between lactocytes

47
Q

in lactogenesis 2 what falls in the milk

A

proteins and sodium

48
Q

in lactogenesis 2 what rises in the milk

A

lactose and lipids

49
Q

in lactogenesis 2 milk production moves from an endocrine to an …

A

autocrine process

50
Q

benefits of colostrum

A

immunoglbins
unlikely to aspirate
laxative effect - clear meconium

51
Q

in later life how may breast feeding help

A

lower obesity

52
Q

lectogenesis 3 is under autocrine control, what does this mean

A

a local factor is causing the production of milk

53
Q

what parts of the body other than the breast are involved in breast milk

A

hypothalamus
anterioir pituitary
posterior pituitary

54
Q

what drives milk production

A

baby suckling

55
Q

when the baby sukles where does neural stimulation go to

A

hypothalamus

56
Q

what happens when there is neural stimulation to the hypothalamus

A

prolactin inhibitor is supressed

57
Q

what is prolactin inhibitor related to

A

dopamine

58
Q

what are the prolactin releasing factors

A

vasoactive intestinal polypeptide
oxytocin
thyrotropin releasing hormone

59
Q

how do the prolactin releasing system reach the pituitary gland

A

portal system

60
Q

which part of the pituitary gland do the prolactin releasing factors go to

A

anterior pituitary

61
Q

how does the prolactin get to the breast

A

blood stream

62
Q

where does prolactin act

A

it binds to the prolactin receptors on the lactocytes of the alveoli

63
Q

what does feedback inhibitor of lactataion do

A

it is in milk and removed when baby suckles so more milk is made

64
Q

what does neural stimuli make the hypothalamus do

A

release oxytocin

65
Q

where does oxytocin go to

A

posterior pituitary gland

66
Q

how does the oxytocin work at the breast

A

smooth muscle contractant

67
Q

what things can trigger the oxytocin mechanism

A

touch
baby crying
smell of baby

68
Q

what is the oxytocin reflex mechanism controlled by

A

limbic system

69
Q

what is the prolactin receptor theory

A

alveoli stretch with lots of milk
prolactin cant bind
decreases milk production
- if milk is emptied….

70
Q

what is FIL

A

feedback inhibitor of lactation - whey protein in breast milk, slows milk synthesis when the breasts are ful

71
Q

what supresses ovulation

A

prolactin

72
Q

things that inhibit prolactin production

A

not removing milk

retained products of conception

73
Q

things that inhibit milk ejection process

A

stress

pain

74
Q

what happens to the excess tissue after breast feeding

A

apoptosis

some was changed into adipose tissue

block 11 anna (14 decks)

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