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BF Course > Section 1: anatomy > Flashcards

Section 1: anatomy Flashcards

1
Q

acinus

A
  • A group of secretory cells
  • In the breast, an acinus secretes milk.
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2
Q

alveolus

A
  • a small sac at the end of a lobule to which milk is secreted and stored
  • Located in the mammary gland
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3
Q

areola

A

Pigmented skin that surrounds the nipple.

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4
Q

colostrum

A
  • The fluid in the breast at the end of pregnancy and in the early postpartum period
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5
Q

estrogen

A
  • hormone
  • causes growth of mammary tissue during part of each menstrual cycle
  • assists in the secretion of prolactin during pregnancy.
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6
Q

lactiferous duct

A
  • Milk ducts
  • 15 to 24 tubes that collect milk from the smaller ductules and carry it to the nipple.
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7
Q

Lactobacillus bifidus

A
  • principal Gram-positive bacillus found in the intestinal flora of breastfed infants.
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8
Q

lactoferrin

A
  • A protein
  • important immunological component of human milk
  • binds with iron in the intestinal tract, making it unavailable to bacteria that require iron to survive.
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9
Q

lactogenesis

A

The initiation of milk secretion.

  • Lactogenesis I is the initial synthesis of milk components that begins late in pregnancy
  • Lactogenesis II is the onset of copious milk production 2 or 3 days postpartum.
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10
Q

lactose

A
  • The major carbohydrate in human milk
  • forms about 4% of colostrum and 7% of mature milk
  • disaccharide
  • metabolizes readily to glucose
  • enhances calcium absorption.
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11
Q

myoepithelial cells

A
  • Contractile cells
  • surround the milk-secreting alveoli
  • oxytocin causes these cells to contract, forcing milk into the ducts.
  • A “letdown response” occurs when many cells contract at the same time.
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12
Q

nipple

A
  • The pigmented projection at the tip of each breast
  • lactiferous ducts open into about 15 to 20 pores through which milk flows.
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13
Q

oxytocin

A
  • A lactogenic hormone produced in the posterior pituitary gland
  • released during suckling, causing milk to be ejected and the uterus to contract.
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14
Q

progesterone

A
  • hormone
  • produced by the corpus luteum and placenta
  • maintains pregnancy
  • assists with mammary alveoli development.
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15
Q

prolactin

A
  • hormone
  • produced in the anterior pituitary
  • stimulates development of the breast
  • controls milk synthesis.
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16
Q

What is important for efficient milk removal?

A

A rapid first milk ejection

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17
Q

Research shows that a rapid first milk ejection will then lead to

A

more subsequent milk ejections.

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18
Q

When milk is not removed from the breast,

A

a protein called feedback inhibitor of lactation (FIL) is produced.

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19
Q

When the amount of Feedback Inhibitor of Lactation (FIL) increases

A
  • a signal is sent to the hypothalamus to reduce prolactin
  • milk production is reduced.
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20
Q

The majority of the glandular tissue is found

A

within 30 mm of the nipple

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21
Q

When does breast development begin

A

In the 4th week of embryonic life

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22
Q

What causes rapid development of breasts in puberty?

A

increasing levels of progesterone

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23
Q

Rapid growth in adolescence is characterized by

A
  • Branching and lengthening of the ductal system
  • increased development of connective tissue surrounding the ducts and alveoli
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24
Q

When does the major growth change occur?

A

12 to 24 months after the onset of the first menstrual period.

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25
Q

What hormone influences proliferation of the ductal system?

A

estrogen

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26
Q

Proliferation of the ductal system begins with

A
  • each menstrual cycle
  • continues until the breast reaches its maximum development state
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27
Q

Complete development of mammary function occurs when?

A

in pregnancy when the breasts increase in size and the nipple pigment darkens.

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28
Q

New breast structures continue to bud until what age?

A

about age 35

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29
Q

The basic units of the mature glandular tissue of the breast

A

The alveoli

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30
Q

Each breast contains how many lobes?

A

15-20 subdivided lobes

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31
Q

Each lobe contains how many alveoli?

A

10-100 alveoli

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32
Q

contractile units responsible for ejecting milk into the ductules,

A

myoepithelial cells

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33
Q

Myoepithelial cells surround the

A

secretory cells of the alveolus

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34
Q

The ductules merge to form

A

a larger duct, which leads to a duct opening called nipple “pores.

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35
Q

Milk is continually secreted where?

A

into the alveolar lumina

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36
Q

where is milk stored?

A

The alveolar lumina

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37
Q

Milk is stored in the alveolar lumina until

A

the letdown reflex triggers the myoepithelial cells to contract and eject the milk

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38
Q

The breast is highly

A

vascularized

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39
Q

What arteries supply the breast?

A
  • internal mammary artery
  • lateral thoracic artery
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40
Q

Function of the lymphatic system

A

removes waste products from the breast

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41
Q

Lymphatic system is made up of

A

nodes

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42
Q

lymph system originates in the

A

lymph capillaries

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43
Q

lymph system drains extracellular fluid towards

A
  • axillary lymph nodes
  • parasternal lymph nodes
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44
Q

Where are the axillary and parasternal nodes found?

A

along the intercostal thoracic artery (inside the thoracic cavity)

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45
Q

Why could the lymph nodes cause difficulty latching?

A

if the mother becomes extremely engorged due to the lymph fluid behind the areola.

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46
Q

What nerves supply the breast?

A

Branches of the second to sixth intercostal nerves

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47
Q

The fourth intercostal nerve branches and penetrates

A
  • the posterior aspect of the breast
  • 4 o’clock on the left breast
  • 8 o’clock on the right breast
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48
Q

Which nerver supplies the greatest amount of sensation to the nipple and areola?

A

The fourth intervostal nerve

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49
Q

Trauma to the 4th intercostal nerve will cause

A

some loss of sensation in the breast

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50
Q

Is there nervous innervation of the epithelial cells that line the alveoli?

A

None has been found

51
Q

secretory functions of the acinar epithelium could depend on

A

hormonal stimulation of prolactin, rather than sensory stimulation.

52
Q

Where are Mongomery’s tubercules?

A

within the areola

53
Q

Montgomery’s tuberciles consist of

A
  • mammary milk glands
  • sebaceous glands
  • together called areolar glands.
54
Q

The fluid from the areolar glands

A

lubricates the nipple and areola

55
Q

Lubrication of the nipple and areaola may assist the infant in

A

finding the nipple, latching on, sucking, and increasing weight

56
Q

In pregnancy, increased levels of estrugen stimulate

A

proliferation of the glandular tissue of the breast

57
Q

Proliferation of the glandular tissue of the breast involves

A

the branching out and lengthening of the ductal system.

58
Q

During pregnancy, higher progesterone levels promote the growth of what part of the breast?

A

lobes, lobules, and alveoli

59
Q

During pregnancy, superficial veins in the breast become more prominent due to

A

increased vascularity of the breast tissue

60
Q

Near the end of the first trimester, what happens to the Montgomery’s glands and pigmentaiton of areola?

A
  • Montgomery’s glands enlarge
  • pigmentation of areola darkens
61
Q

SECOND TRIMESTER

What hormone stimulates the alveolar cells to differentiate in the second trimester?

A

Placental prolactin

62
Q

Prolactin is prevented from exerting its effects by

A

an inhibitory factor from the hypothalamus

63
Q

Why are high levels of prolactin during pregnancy not associated with milk production?

A
  • Partly due to progesterone antagonism of prolactin
64
Q

What happens to progesterone and estrogen levels at delivery?

A

They fall

65
Q

What happens to prolactin levels at delivery?

A

Remain high

66
Q

When does colostrum start being produced?

A

By the end of the second trimester

67
Q

Do women who deliver infants prematurely have trouble lactating?

A

no

68
Q

At the end of pregnancy, the breasts are ready to

A

secrete milk for the human infant

69
Q

What are the stages of lactation?

A
  • Lactogenesis I
  • Lactogenesis II
  • galactopoiesis
  • Involution
70
Q

What is lactogenesis?

A

The transition from pregnancy to lactation

71
Q

When does Lactogenesis Stage I occur?

A

Mid to late pregnancy, during which the mammary gland has the capacity to secrete milk

72
Q

When does Lactogenesis Stage II occur?

A
  • day 2-3 to day 8 postpartum
  • During which there is copius milk secretion from the breasts
73
Q

What is Galactopoiesis?

A

The maintenance of established milk production

74
Q

Following the delivery of the placenta, what hormones decline?

A
  • Placental lactogen
  • Estrogen
  • Progesterone
75
Q

Following delivery of the placenta, what hormones increase?

A

Serum prolactin

76
Q

When serum prolactin increases after placental delivery

A

alveolar cells are stimulated to create milk

77
Q

The suckling of the baby at the breast stimulates what?

A
  • the nerve pathway from the nipple to the brain
  • sends a message to the hypothalamus to inhibit secretion of prolactin inhibitory factor (PIF)
78
Q

After delivery, oxytocin is released by what?

A

The posterior pituitary

79
Q

Oxytocin does what?

A
  • Acts on the myoepithelial cells surrounding the alveoli and ducts
  • causes them to contract, initiating the milk ejection reflex
80
Q

What maintains a milk supply?

A

Frequent suckling and efficient removal of milk

81
Q

What is involution?

A

The process that removes milk-producing epithelial cells and replaces them with fat cells when they are no longer necessary

82
Q

Prolactin appears to have what effect on breastfeeding women?

A

A calming effect

83
Q

What are factors known to increase prolactin levels?

A
  • sleep,
  • infant suckling at the breast,
  • neuroleptic drugs (drugs that decrease catecholamines, which in turn inhibit PIF secretion),
  • efficient removal of milk from the breast.
84
Q

What are medications hat decrease prolactin levels?

A
  • dopamine,
  • L-dopa,
  • ergot
85
Q

What is Human Placental Lactogen?

A
  • hormone produced by the placenta
  • high levels during pregnancy
  • abrupt decline within hours following delivery.
86
Q

What are other hormones that play a role in milk production?

A
  • Human Placental Lactogen
  • Glucocorticoids
  • TSH
87
Q

What role do glucocorticoids have in lactation?

A
  • secreted by the adrenal gland
  • regulate water transport across cell membranes.
88
Q

What role does TSH have in lactation?

A
  • promotes mammary growth
  • regulates the maternal metabolism
  • A thyroxin deficiency can decrease milk supply.
89
Q

What is oxytocin?

A

a lactogenic hormone

90
Q

Where is oxytocin produced?

A

Posterior pituitary

91
Q

What are the effects of oxytocin?

A
  • contraction of smooth muscle of the uterus and myoepithelial cells surrounding the alveoli and ducts
  • –>initiating the milk-ejection reflex
92
Q

Breastfeeding following delivery can reduce the risk of what?

A

Postpartum bleeding (by contraction of the uterus caused by oxytocin)

93
Q

Oxytocin inhibiting factors

A
  • stress,
  • pain,
  • anxiety,
  • alcohol
  • adrenaline.
94
Q

Where is prolactin produced

A

anterior pituitary

95
Q

What colour is colostrum?

A
  • Thick and straw coloured
96
Q

What is the nutrient content of colostrum compared to mature milk?

A
  • higher in proteins than mature milk.
  • also higher in fat-soluble vitamins and some minerals.
97
Q

Most of the proteins in colostrum are what?

A

immunoglobulins

98
Q

What prevents prolactin from exerting its effect on milk secretion during pregnancy?

A

Elevated levels of progesterone

99
Q

How does progesterone prevent milk secretion during pregnancy?

A

Elevated levels of progesterone have inhibitory effect on prolactin

100
Q

What non-medication factors decrese prolactin levels?

A
  • pacifiers, ineffective suckling, supplements,
  • severe blood loss
  • nipple shields (possibly).
101
Q

Where is Human Placental Lactogen produced?

A

The PLacenta

102
Q

During pregnancy, human placental lactogen levels are

A

HIGH

103
Q

In the hours following delivery, human placental lactogen levels

A

Decline abrubptly

104
Q

What type of bacteria is lacobacillus bifidus?

A

Gram positive

105
Q

Where is lacobacillus bifidus mainly found?

A

In the intestine of breastfed infants

106
Q

The presence of the bacillus leads to

A
  • low intestinal pH of fully breastfed infants
  • discourages the colonization of bacteria.
107
Q

Where are myoepithelial cells located?

A

surround the milk-secreting alveoli

108
Q

What causes myoepithelial cells to contract?

A

oxytocin causes these cells to contract, forcing milk into the ducts.

109
Q

What occurs when many myoepithelial cells contract at the same time?

A

A “letdown response”

110
Q

What can a thyroxine deficiency do to milk supply?

A

decrease it

111
Q

Where is progesterone produced?

A

Corpus luteum and placenta

112
Q

What is the major carbohydrate in human milk?

A

Lactose

113
Q

Lactose makes up what percentage of colostrum?

A

about 4%

114
Q

Lactose makes up what percentage of mature milk?

A

about 7%

115
Q

What type of carbohydrate is lactose?

A

A disaccharide

116
Q

LActose metabolizes readily to

A

glucose

117
Q

Lactose enhances absorption of what mineral?

A

Calcium

118
Q

What drugs are known to increase prolactin levels?

A
  • neuroleptic drugs
  • (drugs that decrease catecholamines, which in turn inhibit PIF secretion),
119
Q

What hormone

  • stimulates development of the breast
  • controls milk synthesis.
A

Prolactin

120
Q

Estrogen’s MAIN JOB

A

Makes GLANDULAR breast tissue GROW during menstration and pregnancy

Stimulates prolactin release

121
Q

Progesterone’s MAIN JOB in puberty

A

Rapid breast development

122
Q

Progesterone’s main job in pregnancy

A

Makes lobes, lobules and alveoli GROW

Inihibits PROLACTIN

Maintains pregnancy

123
Q

Prolactin’s MAIN JOB

A

MILK SYNTHESIS

124
Q

OXYTOCIN’S MAIN JOB

A

LETDOWN

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