Exam 2- Module 5

Question 1

Breasts location

Answer 1

Between 2nd and 6th ribs

Nipple below center of breast

Question 2

Montgomerys glands

Answer 2

Secrete protective lipid material during lactation

elevated sebaceous glands on areola

Question 3

Breast composed of

Answer 3

Glandular tissue (15-20 lobes)

Fibrous tissue , suspensory ligaments

Adipose tissues

Question 4

Suspensory/coopers ligaments

Answer 4

Fibrous bands extending vertically from surface to attach on chest wall muscles

Support breast tissue

Contracted when cancer

Question 5

Breasts: 4 quadrants

Answer 5

Horizontal and vertical line through nipple

Map for clinical findings

Upper outer: usually site of breast tumors

Question 6

Breasts: axillary nodes

Answer 6

Central

Pectoral (anterior)

Sub-scapular (posterior)

Lateral

Question 7

Breast development

Answer 7

Embryonic: “milk lines” present and curve down from axilla groin bilaterally

Birth: only breast structure present are lactiferous ducts within nipple

Puberty: estrogen stimulates, normal to have temporary asymmetry

Question 8

Tanner staging

Answer 8

5 stages breast development

Question 9

Breast changes: pregnant

Answer 9

2nd month of pregnancy

4th month: colostrum expressed- thick yellow fluid, 1st few days after delivery

Question 10

Lactation

Answer 10

1-3 days postpartum

White color is emulsified fat and calcium caseinate

Question 11

Breast: Aging woman

Answer 11

Ovarian secretion of estrogen and progesterone decrease, causing glandular tissue atrophy

Decreased breast size

Breast lump now suddenly palpable

Fibrosis and calcification make breast feel firm and stringy

Axillary hair decrease

Question 12

Make breast: gynecomastia

Answer 12

During adolescence breast tissue temporarily enlarges

Reassurance important to body image

May reappear in aging male due to deficiency in testosterone

Question 13

**Breast cancer nonmodifiable risk factors

Answer 13

BRCA1 and BRACA2 mutations increase risk for breast or ovarian cancer

Age and ethnicity

Screening mammography recommended at age 40

Question 14

Factors related to breast health care

Answer 14

Low income

Lack of health insurance

Geographic

Cultural and language barriers

Racial bias

Question 15

Supernumerary nipple

Answer 15

Normal variation

Extra nipple on thorax or abdomen

Congenital finding

Question 16

Breasts: nulliparous women

Answer 16

Firm, smooth, elastic

Question 17

Breasts: after pregnancy

Answer 17

Tissue is softer and looser

Question 18

Breasts: premenstrual

Answer 18

Slight enlargement, tenderness

Increase progesterone

Question 19

Breast lump characteristics

Answer 19

Location

Size (width, length, thickness)

Shape (oval, round, lobulated, indistinct)

Consistency (soft, firm, hard)

Movability (freely moveable or fixed)

Distinctness (solitary or multiple)

Nipple (displaced or retracted)

Tenderness

Lymphadenopathy (any regional lymph nodes palpable)

Question 20

Breast development: adolescent girl

Answer 20

8-10yrs

Palpate as would with adult

Teach BSE now so technique will become natural

Question 21

*Tactile fremitus

Answer 21

Palpable vibration

Use palmar (ball) of fingers or ulnar edge of hand

Touch persons chest while repeating words

Question 22

Rhonchi lung sounds

Answer 22

Low pitched

Resemble “snoring”

Heard when patients have chronic obstructive pulmonary disease (COPD), bronchiectasis, pneumonia, cystic bronchitis, chaotic fibrosis

Question 23

Wheezing

Answer 23

Narrowed airways or inflammation

High pitches whistling sound

Heard more during exhalation

Question 24

Stridor lung sound

Answer 24

High pitched

Wheezing

Airflow disrupted by larnyx (voice box) blockage or trachea (windpipe) blockage

Question 25

Crackles

Answer 25

Excessive fluid in airways

Caused by pneumonia or congestive heart failure

Question 26

Pleural friction rub

Answer 26

Freaking/grating sounds

Inflamed surfaces sliding over one another

Pleurisy

Similar sounds to walking on snow or leather on leather sound

Question 27

Egophony

Answer 27

Voice sounds heard when ausculating lungs

Lung consolidation and fibrosis

High frequency sound across fluid

Saying the vowel “e”

Question 28

Brochophony

Answer 28

Abnormal transmission of sounds from lungs

say 99 in normal voice

Question 29

Pneumonia

Answer 29

Infection inflames air saves in lungs

Air sacs filled with fluid or pus

Cough, fever, chills, difficulty breathing

Question 30

Emphysema

Answer 30

Shortness of breath

Air sac (alveoli) damage

Question 31

Asthma

Answer 31

Chronic long term lung disease

Inflames and narrows airways

Wheezing, chest tightness, shortness of breath, coughing

Question 32

Acute bronchitis

Answer 32

Chest cold

Inflammation of bronchi

Cough

Some wheezing, shortness of breath, fever & chest discomfort

Few-10 days

Question 33

Barrel chest

Answer 33

Lungs inflated with air

Rib cages stays partially expanded

Chronic obstructive pulmonary disease -emphysema

Question 34

Pectus excavatum

Answer 34

Sternum and rib cage grow abnormally

*Caved-in, sunken appearance of chest

Present at birth or develops at puberty

Question 35

Pectus carinatum

Answer 35

“Pigeon chest”

Protrusion of sternum and ribs

Question 36

Kyphosis

Answer 36

Outward curvature in thoracic vertebra

Spine is bent forward

“Hunchback”

Osteoporosis

Question 37

Hypertension

Answer 37

Increased blood pressure

Blacks 41% experience earlier in life

Question 38

Characteristics of lump or mass in breast

Answer 38

Location
Size
Shape
Consistency (soft, firm, hard) 
Movability
Distinctness (solitary or multiple) 
Nipple (displaced or retracted?)
Skin over lump (erythematous, dimpled, retracted) 
Tenderness
Lymphadenopathy (regional lymph nodes palpable)

Question 39

**breast cancer modifiable risk factors

Answer 39

Alcohol

Physical exercise

Postmenopausal weight gain