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Flashcards in Breast Dev + Phys Deck (39)
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1

How long does the AAP recommend breastfeeding newborns for?

6 months
- nutritional and health advantage

2

How is having your first child protective against having breast cancer (timeline)?

First 10 years following first birth
- increased risk for breast cancer

Then having a baby is protective in later years
- earlier you have a kid, sooner it kicks in?

3

How is breast feeding beneficial to the baby?

1. reduced incidence of infectious diseases
2. Reduced post natal infant mortality rates
3. Decreased incidence of SIDS
4. Improved cognitive fxn

4

Breast feeding benefits for mom

1. Decreased postpartum bleeding and more rapid uterine involution
(oxytocin)
2. Decreased menstrual blood loss and increased child spacing
(lactational amenorrhea)
3. Earlier return to pre-pregnancy weight

5

Lobes of the breast
- what are they
- what are they composed of?
- Importance?

glandular units of the breast
- composed of multiple lobules containing alveoli (milk producing units)
- Milk ducts form multiple lobes feed into the nipple
- Glandular structures during lactation are the most prominent component of breast (62%) (when non lactating, intraglandular fat is largest at 49%) - 3 fold increase

6

Describe breast anatomy from stroma --> nipple

Stroma --> Lobules --> Terminal duct -->
Major duct --> Lactiferous sinus --> Nipple

7

Non lactating breast is mainly composed of what?

Intraglandular fat (49%)

*vs lactating breast have more glandular structures (62%)

8

Lactation cycle and how architectural changes occur (list the 5 distinct secretory pathways)

Get pregnant:
1. Glandular morphogenesis -->
2. Secretory differentiation -->
3. Lactation -->
4. Involution - apoptosis, glandular regression and return to quiescence

9

Embryonic development of breast

1. Ectodermal origin -->
2. Invaginates into underlying mesenchyme -->
3. Starts off as primary bud -->
4. Becomes secondary bud -->
5. Invaginates into fat pad

10

What induces differentiation of dermal mesenchyme to mammary mesenchyme?
What happens if it isnt present?

PTHrP secreted by epithelial cells.
- without it, no dermal mesenchymal condensation occurs and no differentiation into to mammary mesenchyme
- Mammary mesenchyme doesnt develope and secrete signals to stimulate nipple formation --> primary bud epithelial cells regresses

11

Blomstrands chondroplasia (amastia)

absence of PTHrP --> primary bud epithelial cells regresses --> no nipple or mammary morphogenesis

12

Mom's Elevated prolactin and decreased progesterone at parturition can induce what in the infant?

Hormonal changes act on baby (a little bit)
- temporary milk secretion in both male and female neonates (witches milk)

13

How long do progesterone receptors present in glandular elements in the neonate last for?

3 months after birth
- Temporary GnRH driven spike in progesterone during infancy stimulates branching and lobule fxn

14

What elaborates in puberty?

Ductal morphogenesis --
- driven by E (principal regulator) and P
- macroscopic breast development ends at age 15, but fxnal development continues on

15

Formation of ductal network and lobules are regulated ______

independently
- by two different ovarian hormones

16

Which phases of the menstrual cycle/hormones do the alveoli and ducts primarily mature in?

Ducts: Around ovulation
- E in combo with GH induce elongation and branching of the ductal network by increasing IGF-1 production by stromal cells
- E is just the activator, IGF-1 is the money maker

Alveoli: secretory phase (Progesterone)
- P during the luteal phase brings about side branching and lubulo-alveolar development

17

During pregnancy, which morphogenesis occurs?

Glandular morphogenesis
- associated with secretory differentiation
1. Lactogenesis-1
- initiation of milk protein expression and development of secretory capacity
2. Lactogenesis-2
- copious milk production

18

What is essential for producing a robust side branching of lobuloalveolar formation

Prolactin + progesterone

*progesterone alone not enough for formation of mature alveoli ***

- Milk product synthesis is initiated during pregnancy by the actions of prolactin or placental lactogen but milk secretion is held in check by high progesterone levels

19

- Milk product synthesis is initiated during pregnancy by the actions of ______ or ______ but milk secretion is held in check by high ______levels

Prolactin
placental lactogen

progesterone

20

Milk secretion is initiated by the fall in ____ at parturition.

Progesterone
(due to removal of placenta!)
(remember progesterone holds milk secretion in check)
- even if a small amt of placenta is left behind, woman will not be able to lactate

21

Elevated prolactin levels is required to:

maintain milk synthesis and secretion
Pituitary kicks in and makes more prolactin

22

How does suckling allow for lactation?

1. Suckling stimulated afferent activation of the hypothalamus
2. Hypothalamic regulated production and release of prolactin and oxytocin
- inhibits hypothalamic DA release --> no more inhibition of prolactin
3. Prolactin/Oxytocin mediated secretion and ejection

*prolactin is normally inhibited by DA

23

Which hormone is involved in:
1. Milk removal
2. Milk ejection

1. Milk removal: prolactin (milk synthesis and secretion)
2. Milk ejection: oxytocin

*milk removal is required to maintain glandular integrity and milk production

24

INfant suckling leads to downregulation of what?

DA and GnRH
- women who are lactating are less likely to get pregnant

25

Suckling is required to maintain _____ levels. Failure to initiate breastfeeding shortly after parturition diminishes what?

prolactin
- failure to initiate breastfeeding shortly after parturition diminishes PROLACTIN signaling and impairs milk synthesis and secretion

-Particular problem for women that deliver preterm infants --> milk production capacity of the mother and suckling ability of the infant are both immature

26

Particular lactation problem for women that deliver preterm infants

milk production capacity of the mother and suckling ability of the infant are both immature

27

Milk ejection requires _____ to be squeezed, and _____ to be released.

alveoli (by myoepithelial cells)
- oxytocin is also required for milk ejection: stimulates contraction of myoepithelial cells that form a basket-like network around alveoli

Suckling stimulates synthesis and release of oxytocin from hypothalamic neurons

28

Factors negatively affecting lactation

1. Anxiety/stress
2. Delayed lactation initiation
3. Pituitary disorders or damage
4. Excessive weight

29

How does excessive weight affect lactation

Decreased ability to initiate lactation and maintain lactation
- Produce less prolactin
- cannot efficiently mobilize energy for lactation
(fat is selfish)

30

Energetic demand during lactation

Energy maintenance requirement are increased by 20%