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Women's Health > Breast Anatomy > Flashcards

Breast Anatomy Flashcards

1
Q

What kind of gland is the breast?

A

apocrine

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2
Q

What are the parenchymal elements of the breast?

A

lobules, lobes, ducts, acini

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3
Q

What are the stromal elements of the breast?

A

skin, connective tissue, fat

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4
Q

Describe the make-up of a lobe (lobe to lactiferous sinus)

A

Lobe to numerous lobules
Lobules drained by small branching ducts
Ducts converge & form main lactiferous duct
MLD widens below nipple at lactiferous sinus

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5
Q

What is the lactiferous sinus?

A

reservoir for milk secretions

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6
Q

What happens at week 4 of gestation?

A

Paired mammary ridges develop from ectoderm

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7
Q

Milk lines disappear throughout the body except for where?

A

fourth intercostal space where mammary glands develop

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8
Q

What occurs at week 5 gestation?

A

mammary buds are visible

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9
Q

What happens between weeks 7-12 gestation?

A

Mammary buds branch several times to form mammary lobules

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10
Q

What happens at week 20 of gestation?

A

Small lumina develop within buds which elongate and become lactiferous ducts

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11
Q

When do primary breasts develop? What hormones influence this?

A

third trimester, placenta hormones

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12
Q

How many lobes with lactiferous ducts are developed at full term?

A

15-20

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13
Q

What develops from mesoderm?

A

fibrous connective tissue and nipple

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14
Q

What develops from ectoderm?

A

areola

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15
Q

What can occur in newborns due to maternal hormones?

A

mild breast tissue prominence and possible milk secretion

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16
Q

Where is the majority of glandular tissue in the breast?

A

upper outer quadrant

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17
Q

What is the functional unit of the breast?

A

Terminal duct lobular unit: extralobular terminal duct & lobule

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18
Q

Lobules contain intralobular terminal ducts that do what?

A

Drain 30-50 blind-ended ductules

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19
Q

What is the smallest functional element of breast tissue?

A

acini, tiny saccular milk-producing glands

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20
Q

What is fibroglandular tissue?

A

all non-fatty breast tissue

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21
Q

What components make up ducts?

A

Inner: epithelial cells
Myoepithelial
Basement membrane

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22
Q

What ductal structure aids in milk transport?

A

contractile fiber cells

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23
Q

What is loose intralobular stroma?

A

Connective tissue surrounding small ductal structures in lobules, provides lobular shape/definition

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24
Q

What is dense extralobular stroma?

A

Between lobes & lobules, supports larger ductal structures

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25
Q

What are Cooper’s ligaments?

A

dense connective tissue that separates fat, lobules, and lobes

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26
Q

Where do Cooper’s ligaments run?

A

From deep part of superficial fascia to skin

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27
Q

What are the 6 layers of the breast & posterior?

A
  • skin
  • subcutaneous fat (premammary)
  • mammary zone (fibrous & connective tissue)
  • retromammary zone (mainly fat)
  • muscle
  • thoracic cage
28
Q

Breast skin is slightly thicker in who?

A

younger females

29
Q

How thick is the skin typically?

A

2-3 mm

30
Q

What are Montgomery’s glands?

A

sebaceous glands that appear as small bumps on areola

31
Q

The subcutaneous fat layer is located between what? It does not extend below what structure?

A

Skin & breast parenchyma, doesn’t extend below nipple

32
Q

What does the subcutaneous fat layer look like on US?

A

homogenous, mid-level gray lobules separated by echogenic ligaments

33
Q

What 3 layers are Cooper’s ligaments seen in and which one are they primarily seen in?

A

Primary: subcutaneous, mammary, retromammary

34
Q

Where is the superficial fascia? Where is the deep fascia?

A

Superficial: within subcutaneous fat, anterior to mammary zone
Deep: within retromammary space, posterior to mammary zone

35
Q

Where is the mammary zone located?

A

within the superficial fascia and two fatty layers

36
Q

Where is the mammary zone thicker?

A

UOQ

37
Q

What is the Tail of Spence?

A

normal extension of tissue toward axilla

38
Q

The mammary zone is made up of epithelial and stromal tissue. What elements are in each category?

A

Epithelial: acini, lactiferous ducts, epithelial cells, TDLUs, 15-20 lobes
Stromal: connective tissues ex. Cooper’s ligs, loose & dense connective tissue) & adipose tissue

39
Q

What is the composition of the mammary zone before puberty compared to during adolescence?

A

Pre-puberty: mainly fatty, limited glandular tissue
Adolescent: increasing glandular tissue, fat decreases

40
Q

What happens to the mammary zone during adulthood and post menopause?

A

Adult: varying glandular tissue, proliferation & involution each period, mild ductal dilatation
Post-menopause: decreasing glandular tissue & replacement with fat

41
Q

How can HRT in post-menopausal women affect the composition of the mammary zone?

A

It can prohibit involutional changes (replacement with fat)

42
Q

Where is the retromammary space located? What does it contain?

A

B/w posterior mammary zone & pectoral muscles, contains deep fascia & a smaller amount of fat lobules than subcutaneous layer

43
Q

How does the retromammary space appear on US?

A

thin, mid-level gray parallel to pectoral muscle

44
Q

What surrounds the chest muscles?

A

pectoral fascia

45
Q

Where is the pectoralis major located?

A
  • Beneath pectoral fascia
  • Arises from clavicle & sternal costal cartilage
  • Thickens beneath UOQ & attaches to humerus
46
Q

Where is the pectoralis minor located?

A
  • Deep to pec major
  • Arises medially from 3, 4, 5 ribs, attaches to scapula
47
Q

The pectoralis minor serves as an important landmark for what?

A

the levels of axillary lymph nodes

48
Q

Where is the serratus anterior located?

A

Posterior to UOQ

49
Q

To make sure that you have captured all tissue layers, what landmark should be seen in the far field of your image?

A

top of rib

50
Q

What minimum depth should you take images at for image quality?

A

2.5 cm

51
Q

Where do lymphatic channels originate in the breast?

A

Within connective tissue and lactiferous ducts

52
Q

The lymphatic channels in the breast flow toward?

A

the subareolar plexus

53
Q

Flow through the subdermal lymphatic channels is towards?

A

centrifugal toward outer lymphatics

54
Q

Where does 75% of lymphatic drainage occur?

A

along inf border of pectoralis major muscle from posterior intercostal nodes to axillary lymph nodes

55
Q

Where does 20% of lymphatic drainage occur?

A

Along the inner aspect of the breast posterior to sternum by smaller nodes of internal mammary chain

56
Q

Where does 5% of lymphatic drainage occur?

A

Along the inferomedial aspect of breast by subcutaneous nodules

57
Q

Where are level I, II and III lymph nodes located?

A

I: lateral to pec minor
II: deep to pec minor
III: med to pec minor

58
Q

What is axillary lymph node dissection?

A

removal of level I & II nodes, typically with total mastectomy

59
Q

How are level III nodes removed?

A

Radical mastectomy which excises pec minor

60
Q

What arteries supply the breast?

A

Lateral thoracic artery and internal mammary artery

61
Q

Where is the lateral thoracic artery located?

A

Arises from axillary artery, runs inf along lat border of pec major & gives rise to lat mammary branches

62
Q

Where is the internal mammary artery located?

A

arises from subclav artery, posterior to cartilage of upper ribs lat to sternum, gives rise to med mammary branches

63
Q

What drains the breast?

A

Deep & superficial venous systems

64
Q

What does the deep venous system in the breast drain into?

A

Drains into internal mammary, axillary, subclav, and intercostal veins

65
Q

What is the superficial venous system?

A

beneath superficial fascia and communicates from rt to lt breast

66
Q

What nerves supply the breast?

A

Lat & ant cutaneous branches of intercostal nerves 2-6 supply majority, supraclav nerve may innervate superior/superolat parts

Women's Health (10 decks)

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