Breast Development and Physiology Flashcards

1
Q

Breast feeding has been shown to lead to what benefits for the mother?

A
  • Decreased postpartum bleeding
  • More rapid uterine involution
  • Earlier return to pre-pregnancy weight
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2
Q

The AAP recommends exclusive breast feeding for ______________.

A

all children for the first six months

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3
Q

Breast feeding has been shown to decrease what negative outcomes in neonates?

A
  • Meningitis
  • Diarrhea
  • Bacteremia
  • URIs
  • UTIs
  • Sepsis
  • SIDS
  • OM
  • Diabetes
  • Leukemia/lymphoma
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4
Q

Describe the structure or the breast.

A

Breasts are divided into lobes that contain milk-producing alveoli. These are surrounded by myoepithelium that pushes milk into the conducting ductules that ultimately lead to one duct.

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5
Q

The bumps on the areolae are called ______________.

A

glands of Montgomery

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6
Q

What changes in composition occur during lactation?

A

A much greater percentage of the breast becomes glandular and a much less percent of the breast is intraglandular fat

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7
Q

Prior to puberty, the ductules lead to __________.

A

terminal limb buds in the breast (that have not differentiated into glands)

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8
Q

What embryologic structures give rise to the breast?

A

The ectoderm dives into the underlying mesoderm

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9
Q

What protein induces differentiation of the mammary mesenchyme?

A

Parathyroid hormone-related protein (PTHrp)

Note: even the nipple is dependent on the development of the mesenchyme, so mutations in PTHrp can lead to agenesis of the nipple.

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10
Q

What is witch’s milk?

A

Elevated prolactin and progesterone levels in pregnancy can pass into neonates and cause transient neonatal lactation.

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11
Q

Which hormones stimulate the development of ducts and alveoli?

A
  • Ducts: LH (terminal end buds)

* Alveoli: progesterone (side branching and TDLU development)

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12
Q

Increased _______________ during puberty induces the elongation and branching of the ductal network by increasing IGF-1 production by stromal cells.

A

estrogen and GH

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13
Q

_______________ regress at the end of the luteal phase unless pregnancy occurs.

A

TDLU

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14
Q

Milk secretion is initiated by _______________.

A

the fall in progesterone that occurs when the placenta is removed

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15
Q

Why does suckling induce milk secretion?

A

suckling inhibits hypothalamic dopamine release, this allows prolactin to be released from the anterior pituitary to cause milk secretion .

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16
Q

______________ stimulates the contraction of mammary myoepithelium.

A

Oxytocin

17
Q

What can inhibit the release of oxytocin?

A

Stress

18
Q

Obesity – and gaining too much weight during pregnancy –reduces ability to _____________.

A

initiate lactation

Also, lactation is an energy-intensive process and obesity seems to impact women’s ability to mobilize energy for lactation.

19
Q

_____________ affects the terminal ducts and _____________ induces side-pouching.

A

Estrogen; progesterone

20
Q

Milk secretion during pregnancy is held in check by _______________.

A

progesterone

21
Q

The junctions start out os ____________.

A

open and then close

22
Q

How much breast milk can a woman make in a day?

A

Up to one liter

23
Q

what is Blomstrands chondroplasia?

A

also called amastia (no nipple or mammary glands), from a lack of PTHrP or its signaling

24
Q

what two hormones work together to cause side branching?

A

prolactin and progesterone

25
Q

what stimulates milk ejection?

A

oxytocin , suckling

26
Q

what stimulates milk secretion?

A

prolactin, milk removal

27
Q

what was once used to inhibit lactation?

A

bromocriptine - a dopamine agonist

28
Q

what is colostrum and what does it contain

A

it is the milk secreted in the first 2 days postpartum, it contains a large amount of IgA and lactoferrin (bigger use = immunity)

29
Q

5 pathways of milk secretion

A

1) apocrine
2) classical - exocytosis
3) transcytosis
4) membrane transport
5) paracellular