PHYSICAL EXAMINATION OF THE BREASTS AND AXILLA Flashcards
What are paired mammary glands located on the anterior chest wall, superficial to the pectoralis major and serratus anterior muscles?
Breasts
True or False
In women, the breast extends from the second or third rib to the sixth or seventh rib and from the sternal margin to the mid-axillary line
True
What is composed of the following?
- glandular and fibrous tissue (provides support for the breast)
- fat (subcutaneous and retromammary)
Female breast
The glandular tissue of the breast is arranged into how many lobes per breast that radiate about the nipple?
15-20 lobes
Each lobe in the glandular tissue of the breast is composed of how many lobules; each lobule consisting of milk-producing acini cells that empty into lactiferous ducts during lactation?
20-40 lobules
Lactiferous ducts drains milk from each lobe to where?
surface of the nipple
What extends from the connective tissue layer through the breast and attach to the underlying muscle fascia, providing support?
suspensory ligaments
What do these muscles form?
- pectoralis major
- pectoralis minor
- serratus anterior
- latissimus dorsi
- subscapularis
- external oblique
- rectus abdominus
muscles forming the floor of the breast
Vascular supply to the breast is primarily through branches of the ______ and the ______
internal mammary and the lateral thoracic artery
The greatest amount of glandular tissue lies in the upper outer quadrant of the breast; breast tissue extends from this quadrant into the axilla, forming the what ?
Tail of spence
In the axillae the mammary tissue is in direct contact with what?
axillary lymph nodes
True or False
Contraction of the smooth muscle, induced by tactile, sensory, or autonomic stimuli, produces erection of the nipple and causes the lactiferous ducts to empty
True
What are the 5 D’s as related to the inspection if the nipples?
- Discharge
- Depression or inversion
- Discoloration
- Dermatologic changes
- Deviation
What are the various positions you would inspect the breasts in?
- Seated, arms over head
- Seated, hands pressed against hips and shoulders rolled forward
- Seated, and leaning forward at the waist
What are the areas of palpation of the breast?
- breast
- axillae
- supraclavicular
- infraclavicular
True or False
Nipple compression should be performed only if the patient reports spontaneous discharge
True
Supernumerary nipples appear as one or more extra nipples located along the embryonic mammary ridge and are more common in what women?
black women
How should normal breast tissue feel?
dense, firm, and elastic
True or False
Venous networks may be visible, but are usually only pronounced in the breasts of pregnant or obese women
true
After menopause, glandular tissue in the breast atrophies and is replaced by what?
fat
What are benign cyst formations caused by ductal enlargement and is associated with a long follicular or luteal phase of the menstrual cycle?
Fibrocystic changes
What are benign tumors composed of stromal and epithelial elements that represent a hyperplastic or proliferative process; they account for the majority of breast tumors in young women?
Fibroadenoma
Malignant breast tumors have peak incidence between what ages?
40-75 years old
normally occur in women older than 50 y/o
These are all findings associated with what?
- mass or thickening in the breast
- marked asymmetry
- prominent unilateral veins
- discoloration
- peau d’orange
- ulcerations
- dimpling
- puckering
- retraction of the skin
- fixed inversion or deviation of the nipple
Malignant breast tumors
What is a response to a local injury of the breast; a firm, irregular mass, often appearing as an area of discoloration?
Fat necrosis
What are 2-3 cm benign tumors of the sub areolar ducts that occur singly or in multiples, a common cause of serous or bloody nipple discharge?
Intraductal papillomas or papillomatosis
What is know as the surface manifestation of underlying ductal carcinoma; a red scaling, crusty patch forms on the nipple, areola, and surrounding skin; lesions appear eczematous and are usually unilateral?
Paget disease
What is known as a smooth, firm, mobile tender disk of breast tissue located behind the areola in males; caused by hormone imbalances; by testicular, pituitary, or hormone secreting tumors; liver failure or antihypertensive meds?
Gynecomastia
What is lactation not associated with childbearing and most commonly
caused by pituitary tumors, Cushing’s syndrome and hypoglycemia, drugs such as phenothiazines, tricyclics, antidepressants and estrogen?
Galactorrhea
What is inflammation and infection of the breast tissue characterized by sudden onset of swelling, tenderness, erythema, and heat; usually the result of a staph infection and most common in lactating women?
Mastitis
What is when the sub areolar ducts become blocked with desquamating secretory epithelium, necrotic debris, and chronic inflammatory cells?
Mammary duct ectasia
most common in menopausal women
