Breast_BTED Part 5 Flashcards Preview

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Flashcards in Breast_BTED Part 5 Deck (84):
1

When does puberty happen?

8 - 15 years of age

2

What happens during pubertal development?

Glandular development and increased fat deposition

3

What factors are pubertal developments affected by?

Genetic/racial/dietary factors

4

How many stages are there to the tanner stages?

5 stages

5

What happens during stage 1 of the Tanner Stages?

Preadolescent juvenile breast with elevated papilla and small flat areola

6

What happens during stage 2 of the Tanner Stages?

The breast bud forms under the influence of hormonal stimulation.
The papilla and areola elevate a a small mound, and the areolar diameter increases.

7

What happens during stage 3 of the Tanner Stages?

Continued enlargement of the breast bud further elevates the papilla.
The areola continues to enlarge, no separation of breast contours is noted.

8

What happens during stage 4 of the Tanner Stages?

The areola and papilla separate from the contour of the breast to form a secondary mound.

9

What happens during stage 5 of the Tanner Stages?

Mature areolar mound recedes into the general contour of the breast, papilla continues to project.

10

When does the thickened epidermis at the mammary ridge develop?

Week 6

11

What is the position of the breast?

At the anterior chest wall
Ribs 2 - 6

12

What does the breast look like?

Circular base with an axillary process or tail (of Spence)

13

What muscles are located around the breast?

Pectoralis Major
Serratus anterior

14

What are the boundaries of the breast?

Superior
Lateral
Medial
Inferior

15

Where is the superior border of the breast located?

It is the inferior border of the clavicle

16

Where is the lateral border of the breast located?

It is the anterior border of the Latissimus dorsi muscle

17

Where is the medial border of the breast located?

It is the lateral Sternal border

18

Where is the inferior border of the breast located?

It is at the inframammary fold

19

Why is the nipple not a useful landmark?

Varies

20

What is the retromammary space consisted of?

Loose areolar tissue
Contains lymphatics and small vessels

21

What does the retromammary space do?

Allows movement of the breast on the chest wall

22

Where does the retromammary space lie?

Lies between the superficial and deep (pectoral) fascia

23

What is the fascia related to the breast?

Superior fascia

24

What is the superior fascia?

Fatty layer surrounds the breast

25

Which fascia is the superior fascia continuous with?

Camper's and Scarpa's fascia of the abdominal wall

26

Where is the Superior fascia continuous with the Camper's and Scarpa's fascia?

At the inframammary fold

27

What does the Camper's fascia look like?

Thick and fatty

28

What does the Scarpa's fascia look like?

Thin and membranous

29

In the thoracic wall, there are two fascia, what are they?

- Pectoral (deep) fascia
- Clavipectoral fascia

30

What does the pectoral (deep) fascia look like

Membranous layer

31

What does the pectoral fascia cover?

Cover the Pectoralis major

32

What is the pectoral fascia attached to?

Sternum and Clavicle
Deep to retromammary space

33

What is the pectoral fascia continuous with?

Deep fascia of the abdomen

34

Where is the clavipectoral fascia?

Deep to the pectoralis major

35

What does the clavipectoral fascia envelopes?

Subclavius muscle

36

Where is the clavicpectoral fascia suspended from?

Clavicle

37

What does the clavipectoral fascia do?

Thickened laterally
Envelops axillary vessel

38

What is the four breast quadrants?

Superial medial
Inferior medial
Inferior lateral
Superior lateral

39

What are the basic tissues of the breast?

1) Glandular tissue
2) Ductal tissue
3) Connective tissue
4) Adipose tissue

40

What does the glandular tissue consist of?

Mammary gland
Lobules

41

What does the ductal tissue consist of?

Lactiferous Ducts

42

What does the connective tissue of the breast consist of?

Suspensory ligaments

43

What does the adipose tissue of the breast consist of?

Fatty tissue

44

What does the nipple look like?

Circularly arranged smooth muscle

45

What are the properties of the nipple?

1) Opening of 15 - 20 lactiferous ducts, each arising from a lobule
2) Central raised bud - Mammary papilla (nipple)

46

What does the areola contain?

Contains montgomery's tubercles

47

What does the areola look like?

Circula pigmented area but pigmentation varies

48

What is the montgomery's tubercle?

Areolar glands which are sebaceous glands

49

How many montgomery's tubercle are there?

4 - 28 per nipple

50

What does the montgomery's tubercles do?

1) Produce protective lipid based fluid, this is for protection and lubrication
2) Olfactory appetite stimulus for the newborn

51

What happens when the olfactory appetite is stimulated?

The montgomery's tubercle becomes firm

52

What is the innervation of the breast?

Anterior and lateral cutaneous branches of the 4th to 6th intercostal nerves.

53

Where does the anterior and lateral cutaneous branches pass through?

Through the deep pectoral fascia to the skin

54

Where does the anterior and lateral cutaneous branches get to?

Sensory fibres to the skin
Sympathetic fibres to blood vessels of breasts and the overlying skin and nipple

55

What is the arterial supply for the breast?

1) Lateral Thoracic artery
2) Lateral Mammary branches
3) Lateral mammary branches of lateral cutaneous branches of posterior intercostal artery
4) Internal Thoracic (mammary) artery
5) Medial (internal) mammary branches

56

What category is the internal thoracic artery?

Subclavian artery

57

What is under the Axillary artery category?

Lateral Thoracic artery
Thoracoacromial artery

58

What category is the intercostal artery?

Thoracic aorta

59

Where is the thoracoacromial artery located?

Branch of part 1

60

Where is the thoracoacromial artery and the lateral thoracic artery lead to?

To the lateral breast

61

Where is the lateral thoracic artery located?

Branch of part 2

62

What is with the thoracoacromial artery and the lateral thoracic artery?

Corresponding veins

63

What are two veins that corresponds with the arteries in the breast?

Axillary vein
Internal Thoracic Vein

64

What are the veins responsible for?

Venous Drainage

65

What do the axillary lymph nodes of the breast consist of?

- Apical Lymph Nodes
- Humeral (Lateral) Lymph Nodes
- Central Lymph Nodes
- Pectoral (Anterior) Lymph Nodes
- Subscapular (Posterior) Lymph Nodes

66

Which part of the lymphatic drainage system leads to the left breast from the right breast?

Subareolar lymphatic plexus

67

What do lymphatic drainage systems do?

Play a role in metastases

68

What is the pathway of lymphatic drainage at the breast?

Gland -> Nipple -> Areola -> Subareolar lymphatic plexus

69

75% (mainly supero-lateral quadrant) drain to which category of axillary lymph nodes?

Pectoral - anterior
Humeral
Subscapular
Central
Apical

70

Where does the remainder drain to (which category of the) axillary lymph nodes?

Interpectoral
Deltopectoral
Supraclavicular
Inferior Deep Cervical Nodes

71

Where is the medial part of the lymphatic drainage?

Parasternal or opposite beast

72

Where is the inferior part of the lymphatic drainage?

Inferior phrenic (abdominal)

73

What is used as the landmark of the lymph nodes location of the breast?

Pectoralis minor

74

What happens during Sentinel Node Biospy

- Flow of lymph is directional.
1) Inject a radioactive substance or dye to locate near the tutor to locate the position of the sentinel lymph node
2) Use a probe to detect radioactivity to find the sentinel node
3) Once the sentinel node is located, surgeon removes it
4) Sentinel node is then checked to see if it is cancerous
5) if there is, the surgeon may then remove additional lymph nodes

75

What is a cause for concern for women in regards to their breast?

- Lump (may not be seen, but might be felt)
- Skin texture (e.g. dimpling or puckering)
- Appearance or direction of nipple
- Nipple discharge
- Rash or crusting

76

What does nipple discharge mean?

Most commonly benign

77

What is a red flag for nipple discharge?

If purulent, yellow/straw coloured, pink or bloody

78

What may be the cause of skin changes that can happen to the breast?

- Inflammatory cancer of the breast
- Pagets disease of the nipple (which is cancerous)
- Cutaneous Lymphoedema

79

What causes secondary lymphoedema?

Impaired lymph flow from upper limb to axilla

80

What are the signs of lymphoedema?

Engorged tissues

81

What is the treatment for lymphoedema?

Sleeve
Bandage
Exercise
Massage
Laser Therapy
Conservative surgery

82

What is the Sentinel Node biopsy for?

If the cancer has spread to the sentinel lymph node (very first draining lymph node), then it may have spread to other parts of the body. If it hasn't, then it's probably localised.

83

How many percentage of each breast quadrant contains carcinomas?

Superior lateral: 60%
Superior medial: 15%
Inferior lateral: 10%
Inferior medial: 5%

84

What do breast glands contain?

1) modified sweat glands
2) Subcutaneous fat (90%)
3) No capsule/sheath