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Surgery- Breast > Physiology Of The Breast > Flashcards

Physiology Of The Breast Flashcards

1
Q

What is the mammary gland comprised of?

A
  • Lactiferous ducts

- Lactiferous sinuses

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2
Q

What is the destiny of mammary buds in females?

A

Form ductal system

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3
Q

What is the destiny of mammary buds in males?

A

Remain underdeveloped because of androgens

- Maternal hormones can cause increase in breast size and milk prod.

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4
Q

What is the abnormal milk, produced in the male breast exposed to maternal hormones, called?

A

Witches milk

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5
Q

What physiological change does, the hormone estrogen, cause on breast development?

A

Ovarian estrogen stimulates proliferation of mammary ducts

- Estrogen Increases cell size

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6
Q

What physiological change does, the hormone estrogen, cause on breast development?

A

Development of lobules and alveoli

- Progesterone indexes the secretory function of the cells

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7
Q

What physiological change does, the hormone prolactin, cause on breast development?

A

Stimulates the production and secretion of breast milk.

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8
Q

What physiological change does, the hormone oxytocin, cause on breast development?

A

Myoepithelial cell contraction

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9
Q

What is the function of sebaceous glands of the nipple?

A

Prevent the nipple from drying out.

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10
Q

What hormone stimulates breast growth during puberty?

A

Ovarian estrogen

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11
Q

Name 3 signs of risking estrogen levels:

A
  1. Darkened areola
  2. Hardened mass beneath the breast
  3. Increase in breast size
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12
Q

Which receptors are important to note in the effect of estrogen in ductal proliferation, and breast development.

A

Prolactin dependent Estrogen receptors

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13
Q

What day of the cycle does ovulation take place?

A

Day 14.

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14
Q

What is day 14 of the menstrual cycle and

- Which hormone experiences an increase after day 14?

A

Ovulation: Egg is released.

- Progesterone is most abundant at this point.

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15
Q

Describe hormone levels on day 28:

- How does ones breasts present at said time?

A

On day 28, estrogen and progesterone are at an all time low

  • Menstruation takes place
  • Breasts are tender
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16
Q

Which days in the menstrual cycle, are most ideal for a breast exam?

A

Day 4-7

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17
Q

Which month of pregnancy does the breast reach it’s full mature functionality?

A

3rd month

18
Q

Name the 8 hormones that true alveoli (True glandular acini) develop under:
- First 4 are most important.

A
  1. Estradiol
  2. Progesterone
  3. Thyroid hormone
  4. Prolactin
  5. Growth hormone
  6. Insulin
  7. Human placental lactose
19
Q

What hormone is hypothalamically regulatedbincreased by estradiol in pegnancy?

A

Prolactin

20
Q

What hormone antagonises prolactin ACTION in pregnancy at a prolactin-receptor level ?

A

Progesterone

21
Q

Name the hormone that antagonises prolactin action:

- Name 3 mechanisms used to antagonize prolactin action

A

Progesterone

  1. Inhibiting up regulation of prolactin receptor
  2. Reduce estrogen binding
    • ( Note E is hypothalamically responsible for prolactin prod.)
  3. Competes for binding at glucocorticoid receptor.
22
Q

When does lactation start?

A

After birth

- Nipple stimulation and suckling.

23
Q

After birth, there is prolonged prolactin release without progesterone inhibition.
- Give 2 reasons for this.

A
  1. More rapid clearance of progesterone (3-4 days)

2. Slower clearance o prolactin ( +/- 7 days)

24
Q

Name 2 prolactin inhibiting drugs that can be administered to stop lactation.

A
  1. Bromocripine

2. Dopamine

25
Q

Name an alternative way one can stop lactation.

A

Breast binding

  • Use ice
  • Avoid Nipple stimulation
26
Q

In the case of breast feeding after birth, what hormone is secreted when the anterior pituitary is stimulated?
Mention what the effect of this hormone is, on the breast:

A

Stimulation of the anterior pituitary leads to Prolactin secretion.
- Prolactin is responsible for milk production and secretion.

27
Q

In the case of breast feeding after birth, what hormone is secreted when the posterior pituitary is stimulated?
Mention what the effect of this hormone is, on the breast:

A

Stimulation of the posterior pituitary leads to Oxytocin secretion.

  • Oxytocin leads to the contraction of myoepithelium in the breast.
  • Ejecting milk
28
Q

Name 3 conditions that lead to male gynecomstia:

A

Klienfelters syndrome
Anorchia
Hypogonadia

29
Q

Name 2 male groups that are usually afflicted with male gynecomastia:

A
  1. 70% of boys at puberty

2. Men over 50: Andropause

30
Q

Name 6 clinical conditions that can lead to male gynecomastia:

A

Increased estrogen levels:

  1. Testicular/ adenocortical tumors
  2. Obesity
  3. Hypothyroidism
  4. Liver failure
  5. Androgen insensitivity
  6. XXY
31
Q

Name 2 Estrogen receptor antagonists

A

Digoxin

Phytoestrogens

32
Q

Name 6 lesions typically found in the terminal duct lobular unit:

A 
Sclerosing adenoma 
Cyst 
Small duct papilloma 
Hyperplasia 
Carcinoma 
Atypical hyperplasia
33
Q

Name 2 lesions that typically form in the lobular stroma:

A

Fibroadenoma

Phyllodes tumor

34
Q

Name 3 lesions that typically form in the nipple:

A
  1. Recurrent Subareola abscess
  2. Ductal ecstasies
  3. Pagets disease
35
Q

Name 4 lesions that typically form in the interlobular stroma:

A
  1. Fat necrosis
  2. Lipoma
  3. Fibrous tumor
  4. Sarcoma
36
Q

Name 3 development disorders of the breast:

A
  1. Milk line remnants
  2. Accessory fat in the axilla
  3. Congenital nipple inversion
37
Q

What is milk line remnants?

A

Extra breast or nipple from epidermal thickening along the milk line

38
Q

What is accessory axillary breast tissue?

A

Duct formation continues into the axilla or subcutaneous tissue of the chest wall

39
Q

What is congenital nipple inversion?

A

Failure of nipple to every in development

40
Q

Name 4 symptoms of breast disease:

A
  1. Lumps
  2. Pain
  3. Palpable mass
  4. Nipple discharge
41
Q

What are 4 main causes of breast lumps:

A

Fibrocystic changes
Benign cysts
Firboadenomas
Invasive carcinomas

42
Q

What epithelial change is seen in non- proliferation changes of the breast?

A

Apocrine metaplasia of the epithelial lining

Surgery- Breast (3 decks)

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