Trans - PE of the Breast

Question 1

boundaries of the breast (upper, lower, median, lateral)

Answer 1

2nd rib, 6th rib, sternal margin, mid axillary line

Question 2

areola

Answer 2

lateral extension of the nipple skin into the breast surface

Question 3

glands of montgomerey

Answer 3

sebaceous glands with surface elevations that produce lipoid material responsible for protecting the nipple during nursing of the baby

Question 4

what causes the differences in breast size?

Answer 4

difference in amounts of fat

Question 5

cooper’s ligaments

Answer 5

fibrous tissue separating the lobules

Question 6

attachment of cooper’s ligaments

Answer 6

attached to the pectoralis fascia from breast subcutaneous tissue

Question 7

changes in cooper’s ligaments with age

Answer 7

becomes lax with aging –> cause of sagging breasts

Question 8

clinical application of retromammary fat

Answer 8

silicon implants placed in retromammary fat

Question 9

2 main maneuvers during breast PE

Answer 9

[1] inspection

[2] palpation

Question 10

position optimal for comparing breast symmetry

Answer 10

sitting position with arms at sides

Question 11

things to examine in the breast [6]

Answer 11

[1] size
[2] symmetry
[3] contour
[4] skin color and texture
[5] venous pattern
[6] lesions

Question 12

which breast is usually larger?

Answer 12

left

Question 13

possible abnormalities in breast texture [2]

Answer 13

[1] dimpling

[2] peau d’orange

Question 14

dimpling

Answer 14

occurs when cooper’s ligaments pull the overlying skin and subcutaneous tissue inward due to malignant growth

Question 15

peau d’orange

Answer 15

thickening of the skin of the breast accompanied by enlarged pores –> result of edema caused by evasion of the tumor into the dermal lymphatics

Question 16

dimpling is a sign of:

Answer 16

malignant growth in cooper’s ligaments

Question 17

peau d’orange is a sign of

Answer 17

tumor invading dermal lymphatics of breast

Question 18

unilateral visible venous networks are a sign of

Answer 18

increased flow of blood due to malignant masses

Question 19

5Ds in nipple examination

Answer 19

[1] discharge
[2] depression/inversion
[3] discoloration
[4] dermatologic changes
[5] deviation

Question 20

Paget’s disease

Answer 20

crusting and eczema of the nipple

Question 21

supernumerary nipples

Answer 21

extra nipples along the milk line

Question 22

peau d’orange is first seen in what region of the breast?

Answer 22

areola

Question 23

position - sitting with arms down

Answer 23

useful to assess breast symmetry

Question 24

position - arms over head

Answer 24

[1] tension on upper and lower suspensory ligaments
[2] accentuates dimpling
[3] reveal variation in color and symmetry

Question 25

position - hands on hips / palms pushed together

Answer 25

[1] contracts pectoralis major

[2] determines if breast mass has invaded pectoral tissue

Question 26

indication that breast mass is associated with pectoralis

Answer 26

breast mass is fixed in hands on hips position

Question 27

position - seated and leaning forward from waist

Answer 27

[1] breasts hang freely and fall away from chest wall
[2] causes tension in upper suspensory ligaments
[3] helpful in large breasts

Question 28

positions causing tension in upper suspensory ligament

Answer 28

[1] arms over head

[2] seated and leaning forward

Question 29

positions causing tension in lower suspensory ligament

Answer 29

[1] seated and leaning forward

Question 30

normal breast

Answer 30

breasts should be: 
[1] bilaterally equal
[2] evenly contoured
[3] smooth with no dimpling
[4] nipple retraction
[5] no deviation

Question 31

breast palpation is used to:

Answer 31

examine/identify deep lymph nodes/tumors

Question 32

patient position for breast palpation

Answer 32

supine

Question 33

what part of the hand is used for breast palpation? why?

Answer 33

finger pads of 2nd, 3rd, 4th fingers, because these are the most sensitive parts of the hand

Question 34

documenting breast masses [8]

Answer 34

[1] location
[2] size
[3] shape
[4] consistency
[5] tenderness
[6] mobility
[7] border 
[8] retraction

Question 35

characteristics of cancerous masses

Answer 35

[1] irregular shape
[2] hard consistency
[3] nontender
[4] movable or fixed

Question 36

inframammary ridge

Answer 36

first transverse ridge of compressed mammary tissue

Question 37

characteristics of nipple discharge

Answer 37

[1] sponteneity
[2] color
[3] origin
[4] cytologic smear

Question 38

serous nipple discharge

Answer 38

yellowish, mostly nonpathogenic

Question 39

bloody nipple discharge

Answer 39

abnormal or pathologic; mostly caused by a tumor

Question 40

position - seated with arms flexed at elbow

Answer 40

[1] relax pectoralis major and clavipectoral skin

[2] examination of axilla

Question 41

position - seated neutral

Answer 41

[1] examination of supraclavicular area

Question 42

why is it important to examine the supraclavicular area?

Answer 42

to examine for lymph nodes and possible metastasis

Question 43

enlarged cervical lymph nodes may indicate:

Answer 43

Stage IV cancer

Question 44

enlarged supraclavicular lymph nodes may indicate:

Answer 44

Stage III cancer

Question 45

[T/F] axillary and supraclavicular lymph nodes are normally palpable

Answer 45

F