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Health Assessment > Week 10 - Breasts and Genitalia > Flashcards

Week 10 - Breasts and Genitalia Flashcards

1
Q

Axillary Tail of Spence

A

Axillary Process

Breast tissue projecting laterally and up into the axilla

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2
Q

Areola

A

Surrounds nipple for 1-2cm radius

Contain Montgomery’s glands (aka areolar glands)
Contain muscle fibres causing nipple erection when stimulated

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3
Q

Montgomery’s glands

A

Areolar Glands

Small, sebaceous glands
Secrete protective lipid material during lactation

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4
Q

Location of the breasts

A

Between the 2nd and 6th ribs

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5
Q

Composition of the breast (4)

A
  • glandular tissue
  • fibrous tissue
  • suspensory ligaments
  • adipose tissue

The proportion of these tissues varies depending on age, cycle, pregnancy, lactation, and nutritional state

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6
Q

Breast Alveoli

A

Milk glands in the breast lobules

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7
Q

Lactiferous ducts

A

Milk collecting system from the lobes that converges (15-20 ducts) at the nipple

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8
Q

Cooper’s ligaments

A

Suspensory ligaments that attach the breast to the chest wall

Become contracted during breast cancer

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9
Q

Adipose tissue

A

Provide most of the bulk of the breast

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10
Q

Four (five) quadrants of the breast

A

Upper inner quadrant
Lower inner quadrant
Upper outer quadrant
Lower outer quadrant

Axillary process

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11
Q

4 Axillary Lymph Nodes

A

Central Axillary
Pectoral
Subscapular (posterior)
Lateral

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12
Q

Supernumerary nipple

A

Extra nipple

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13
Q

Tanner Staging of puberty

A

Five stages of breast development

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14
Q

Thelarche

A

Signals the beginning of puberty at 8-10 years of age

Beginning of breast development

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15
Q

Menarche

A

Beginning of menstruation

About 2 years after breasts

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16
Q

Colostrum

A

Thick, yellow fluid appears after 4th month of pregnancy

Precedes milk production

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17
Q

Gynecomastia

A

Temporary enlargement of male breast tissue in male adolescence

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18
Q

Andrenarche/Pubarche

A

Second development of puberty

Axillary and Pubic Hair Development

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19
Q

GnRH

A

(Gonadotropin Releasing Hormone)

Stimulates lutenizing hormone and folicular stimulating hormone in the pituirary gland

Produce testosterone in testicles and estrogen in the ovaries

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20
Q

Considerations fo Pregnancy (5)

A
  1. Change in breast and nipple size and shape
  2. Blue vascular pattern becomes visible
  3. Stretch marks
  4. Darker, more erect nipples
  5. Expression of colostrum (4th month)
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21
Q

Age-related breast changes (5)

A

Decrease in ovarian secretion of estrogen and progesterone

  1. Glandular tissue atrophies, replaced with fibrous connective tissues
  2. Fat atrophies
  3. Reduced breast size and elasticity
  4. Masses/lumps may become palpable
  5. Lactiferous ducts more palpable (firm and stringy from fibrosis)
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22
Q

Age-related breast changes (5)

A

Decrease in ovarian secretion of estrogen and progesterone

  1. Glandular tissue atrophies, replaced with fibrous connective tissues
  2. Fat atrophies
  3. Reduced breast size, density and elasticity
  4. Masses/lumps may become palpable
  5. Lactiferous ducts more palpable (firm and stringy from fibrosis)
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23
Q

Male breasts

A

Rudimentary
Small nipples, large areola
Milk ducts and mammary tissues
Oxytocin and prolactin

24
Q

Approach for breast inspection

A

LACE

Look
Arm positions
Check lymph nodes
Examine breast tissue

25
Q

“Look”

In the LACE breast exam

A
  1. Symmetry/contour/size/shape
  2. Skin changes: mass fixation, dimpling, depressions, skin colour, swelling, venous patterns, edema
  3. Nipple changes: size/shape, inversion (new or hx)
  4. Discharge: scaling, ulceration, bleeding, discharge
26
Q

“Arm positions”

In the LACE breast exam

A
  1. Raised
  2. Akimbo
  3. Lean forward

*helps contract underlying pectoralis muscle

27
Q

“Check the lymph nodes”

In the LACE breast exam

A

Check for:
Inflammation/swelling of lymph nodes
Check in supraclavicular and axillary regions

*Palpation

28
Q

“Examine breast tissue”

In the LACE breast exam

A

*Palpation for:

  • Consistency
  • Elasticity
  • Tenderness
  • Thickening
  • Masses/lumps
  • Erythema

Describe location, size, shape, consistency, movability of mass. Also describe the nipple.

29
Q

Breast Cancer (signs)

A 
Ages 30-80
Irregular star-shaped mass that is hard, dense, and fixed
Usually painless
Often nipple retraction
Skin tethering
Peau d'orange
Constant growth

Right upper quadrant is most common

30
Q

Paget’s disease

A

Cancer of the areola

31
Q

Non-modifiable risk factors for Breast Cancer (10)

A
  • F
  • Age (50-69)
  • PHx or FHx
  • Dense breasts
  • BRCA
  • Ashkenazi Jews
  • previous breast biopsies with atypical hyperplasia
  • breast irradiation
  • menarche pre 11 or menopause after age 55 (high estrogen exposure)
  • tall adult height
32
Q

Modifiable risk factors for Breast Cancer (7)

A
  • nulliparity or first parity post age 30
  • hormonal contraceptive use
  • postmenopausal hormone therapies
  • not breastfeeding
  • more than one alcoholic drink daily
  • obesity
  • high socioeconomic status
33
Q

POSSIBLE risk factors for Breast Cancer (5)

A
  • physical inactivity
  • adult weight gain
  • smoking and 2nd hand
  • high birth weight
  • night shift work
34
Q

BREAST Mnemonic

A

For breast examination

B- Breast mass
R- Retraction
E- Edema (peau d'orange)
A- Axillary mass
S- Skin changes / scaly nipple
T- Tender breasts
35
Q

External male genitalia

A
  • penis
  • glans
  • urethra
  • foreskin
  • scrotum
  • cremaster muscle
36
Q

Internal male genitalia

A
  • testis
  • spermatic cord
  • epididymus
  • vas deferens
  • prostate gland
  • seminal vesicles
  • vulval-urethra gland
37
Q

Male lymphatic genitalia

A
  • Scrotum drain into inguinal lymph nodes

- Testes drain into abdominal lymph nodes

38
Q

Subjective assessment of male genitourinary system (11)

A

Hx:

  • urinary patterns, colour, frequency, control
  • kidney disease/stones
  • flank pain
  • UTIs
  • prostate concerns
  • penis pain, lesions, discharge
  • scrotum pain or swelling, change in size
  • sexual history and STIs
  • testicular self-exam
  • hernias
  • abuse
39
Q

Describing testicular masses

A
  • size, contour, nodularity
  • tenderness
  • location
  • transilluminance
  • do things change when supine
40
Q

Palpation for hernia

A
  • pt is standing
  • palpate external inguinal ring
  • palpate in femoral canal area
41
Q

Male Genitourinary age considerations for infants

A

Testes descend along inguinal canal to scrotum before birth

Uncircumcised vs. circumcised

42
Q

Male Genitourinary age considerations for Older Adults

A
  • decrease in pubic hair
  • penis size decreases
  • testes decrease in size, less firm
  • diminished sexual response
43
Q

Risk factors for testicular cancer

A

age 15-49
undescended testicles
family history

Lu

44
Q

Signs of testicular cancer

A

lumps or swelling

“heaviness” in abdomen or scrotum

45
Q

Risk factors for prostate cancer

A

over 65
family history
African ancestry
high fat diet

46
Q

Signs of prostate cancer

A

urinary symptoms

painful ejaculation

47
Q

Objective assessment of male genitalia (5)

A
  1. Inspect and palpate the penis
  2. Inspect and palpate the scrotum
  3. If a mass exists, transilluminate
  4. Palpate for inguinal hernia
  5. Palpate inguinal lymph nodes
48
Q

Subjective assessment of female genitourinary system (10)

A 
Obstetrical history
Menstruation history
Menopause
Urinary symptoms
Vaginal discharge
GU history
Sexual activity
Contraceptive use
STI contact
STI risk reduction
49
Q

Objective assessment of female genitalia

A

Inspect:
skin colour, hair distribution
pubic area for discoloration or irritation
external anatomy for colour, lesions, masses, discharge
perineum for colour, lesions, masses, scars

50
Q

Skene’s gland

A

periurethral glands

51
Q

Bartholin’s gland

A

greater vestibular gland

52
Q

Female Genitourinary age considerations for infants

A

Engorgment of external genitalia

53
Q

Female Genitourinary age considerations for pregnancy

A
  • cervical softening (Goodell)
  • discoloration of cervix and vagina (Chadwick)
  • uterine softening (Hegar)
  • uterus increases in size and capacity
54
Q

Female Genitourinary age considerations for older adults

A
  • reduction in menses
  • uterus and cervix shrink
  • ovaries atrophy
  • ovulation becomes sporadic
  • pelvic musculature weakens
  • vagina shortens, narrows, skin thins
55
Q

Risk Factors for Cervical Cancer

A
  • sex at an early age
  • multiple sexual partners
  • history of STIs
  • aging
  • immunocompromised
  • HPV
  • smoking
  • low socioeconomic status
56
Q

Risk Factors for Ovarian Cancer

A
  • age >50
  • PHx of cancer
  • genetics (BRCA)
  • nulliparous

Health Assessment (8 decks)

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