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[OS 205] 3rd Lecture Exam > PE of the Breast > Flashcards

PE of the Breast Flashcards

1
Q

Location of Breasts

A

2nd to 6th rib and from sternal margin to mid-axillary line

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2
Q

Where are the Glands of Montgomery located?

A

Areola

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3
Q

[Glands of Montgomery]

Function

A

Produce lipoid fluid that protects nipple during suckling

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4
Q

Lobes per Breast

A

15-20

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5
Q

Lobules per Lobe

A

20-40

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6
Q

What contains acinar cells for milk production?

A

Lobules

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7
Q

Pathway of Milk

A

Lobe -> Lactiferous Duct -> Lactiferous Sinus -> Nipple Surface

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8
Q

[T/F]

Females have similar amounts of glandular tissue

A

T

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9
Q

[Cooper’s Ligament]

Function

A

Provides support for the breast

Fibrous tissue separating lobules

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10
Q

What do silicon implants do to the breasts?

A

Renders it impalpable

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11
Q

[PE of Breast]

Two main maneuvers

A

Inspection

Palpation

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12
Q

Proper Position for Breast Inspection

Why?

A

Sitting with arms at sides

Relaxes breasts and minimizes tension

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13
Q

[PE of Breast]

Inspect for? (4)

A

Size
Symmetry
Contour
Color and Texture

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14
Q

Dimpling in Breasts occur when?

A

Cooper’s Ligaments pull the skin and tissue inward due to malignant growth

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15
Q

Define: Peau d’orange

A

Enlarged pores due to edema caused by invasion of tumor in lymphatics of the breasts

Indicative of advanced malignancy

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16
Q

Define: Normal Venous Pattern

A

Bilaterally similar

Not usually visible

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17
Q

What could cause unilateral visible venous network?

A

Dilated superficial veins as a result of increased blood flow to malignant masses

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18
Q

[Nipple]

How should the color be?

A

Homogenous and matching that of the areola

Pregnancy may cause it to darken

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19
Q

[Nipple]

Normally everted or inverted?

A

Everted

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20
Q

What are the 5 D’s in Nipple Examination?

A 
Discharge
Depression
Discoloration
Dermatologic Changes
Deviation
21
Q

What could cause deviation of nipples?

A

Carcinoma pulling Cooper’s Ligaments

22
Q

What could cause retraction?

A

Could be normal

Inward pulling by an inflammatory/malignant mass

23
Q

What are supernumerary nipples?

A

Extra nipples that develop along the milk line

24
Q

When could supernumerary nipples have a risk for malignancy?

A

If they have glandular tissue

25
Q

Paget’s Disease

A

Crusting and Eczema of the Nipple

26
Q

Peau d’orange is first seen in?

A

The Areola

27
Q

[Different Positions of Breast PE]

Name 3

A

Arms over head
Hands hard against hips
Seated and leaning forward from waist

28
Q

Why Arms Over Head?

A

Adds tension to upper and lower suspensory ligaments
Accentuates dimpling if present
May reveal variation in color and symmetry

29
Q

Why Hands Pushed Together/Against Hips

A

Contracts pectoralis muscle, allows examiner to determine if breast mass is invading muscle

Mass that has invaded muscle cannot be moved in this portion

30
Q

Why Seated and Leaning Forward from Waist

A

Helpful for large breasts

May reveal variation in contour and symmetry

31
Q

In all positions, breasts should be?

7

A 
Bilaterally equal
Evenly contoured
Smooth
No dimpling
No nipple retraction
No deviation
No visible discharge
32
Q

[Techniques for Breast Palpitation]

Which parts of the hand to use?

A

2nd, 3rd and 4th finger pads

Never the palm

33
Q

Techniques for Breast Palpation (3)

A

Back and Forth
Concentric Circles
Wedge Technique

34
Q

Position of the Patient for Breast Palpation

A

Patient supine with one arm raised behind the head
Place a small pillow under the shoulder

Repeat with arms at the side

35
Q

How to palpate large breasts?

A

Immobilize the inferior surface with one hand while examining the superior surface with the other hand

36
Q

How to palpate the Tail of Spence

A

Patient should be seated with arms raised

Palpate between thumb and fingers

37
Q

Documenting Breast Masses (8)

A 
Location
Size
Shape
Consistency
Tenderness
Mobility
Borders
Retraction
38
Q

Characteristic of Cancer (5)

A 
Irregular Shape
Hard Consistency
Non-Tender
Movable/Fixed
Irregular Borders
39
Q

Where do most cancers occur?

A

Upper Outer Quadrant

40
Q

How to palpate the nipple?

A

Compress gently between thumb and index finger

41
Q

Is a spontaneous or non-spontaneous nipple discharge more dangerous?

A

Spontaneous

42
Q

What color of fluid would be pathologic? What is not pathologic?

A

Serious/Yellowish fluid: No pathologic

Bloody: Pathologic, could be caused by a tumor

43
Q

How do you determine the origin of a duct producing a discharge

A

Press the areola with one digit in a radial manner and observe, change position with every press

44
Q

Name of the Test for Nipple Discharge

A

Cytologic Smear

45
Q

[Patient Position]

Axilla Palpation

A

Seated with arms flexed at elbow

46
Q

[Patient Position]

Supraclavicular Area

A

Seated

47
Q

[Supraclavicular Area Palpation]

What do you palpate? What is it bounded by?

A

Supraclavicular Triangle

  1. Clavicle
  2. SCM
  3. Omohyoid
48
Q

[Lymph Node Enlargement]

Stage IV Cancers are Found?
Stage III Cancers are Found?

A
  1. In the Neck (Cervical Lymph Nodes)

2. Supraclavicular Area

49
Q

[T/F]

Axillary and supraclavicular lymph nodes are normally palpable

A

F

[OS 205] 3rd Lecture Exam (6 decks)

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