Ch 7 Phys Exam of Breasts

Question 1

Breast extends from the ____ rib to the ____ rib

Answer 1

2nd to 3rd

6th to 7th

Question 2

Breasts extends from what margin?

Answer 2

Sternal margin to mid-axillary line

Question 3

The female breast is composed of:

Answer 3

Granular and fibrous tissue

Fat

Question 4

The glandular tissue of the breast is arranged into ____ lobes per breast

Answer 4

15-20

Question 5

Each lobe is composed of ____ lobules

Answer 5

20-40 lobules

Question 6

Consist of milk-producing acini cells that empty into lactiferous ducts during lactation

Answer 6

Lobules

Question 7

Which duct drains milk from each lobe onto the surface of the nipple?

Answer 7

Lactiferous duct

Question 8

Which ligaments extend from the connective tissue layer through the breast and attach to the underlying muscle fascia, providing support?

Answer 8

Suspensory ligaments

Question 9

The muscles forming the floor of the breast:

Answer 9

Pectoralis major

Pectoralis minor

Serratus anterior

Latissimus dorsi

Subscapularis

External oblique

Rectus abdominis

Question 10

Five segments of the breast

Answer 10

4 Quadrants

1 Tail of spence

Question 11

Vascular supply to the breast is primarily through branches of the:

Answer 11

Internal mammary

Lateral thoracic artery

Question 12

Subcutaneous and retromammary fat that surrounds the glandular tissue lies in the _____ quadrant

Answer 12

Upper outer quadrant

Question 13

The greatest amount of glandular tissue lies in the _____ quadrant

Answer 13

Upper Outer

Question 14

Breast tissue from the upper outer quadrant extends from the quadrant into the axillae

Answer 14

Tail of Spence

Question 15

What stimuli produces erection of the nipple and causes the lactiferous ducts to empty?

Answer 15

Tactile, sensory, or autonomic

Question 16

In the axillae the mammary tissue is in direct contact with:

Answer 16

Axillary lymph nodes

Question 17

Nipple erection is supported by:

Answer 17

Venous stasis in the erectile vascular tissue

Question 18

Nipple range in color:

Answer 18

Pink to black

Question 19

Lymphatic network that radiates the breast radially and deeply

Answer 19

Pectoral

Subscapular

Central

Brachial

Question 20

Equipment for a breast exam

Answer 20

Small pillow or folded towel

Ruler

Flashlight with transilluminator

Question 21

Palpate breasts in what position?

Answer 21

Seated

Supine

Question 22

Five D’s related to nipples

Answer 22

Discharge

Depression

Discoloration

Dermatologic changes

Deviation

Question 23

Seated

Reinspect in what various positions?

Answer 23

Arms extended over head

Hands pressed against hips and shoulder

Leaning forward from waist

Question 24

Patient is seated with arms hanging freely

Palm of right hand is placed at the patient’s right clavicle at the sternum

Sweep downward from clavicle to the nipple feeling for superficial lumps

Answer 24

Chest wall sweep

Question 25

Place hand, palmar surface facing up, under the patient's right breast Position that hand so it is flat surface where you can compress With the finger of the other hand, walk across the breast tissue

Answer 25

Bimanual digital palpation

Question 26

Palpate for lymph nodes on both females and males Patient is seated, arms flexed at elbow Using Palmer surface of your fingers, reach deeply into the axillary hollow, pushing firmly Palpate medially, posterior wall along the scapular, supraclavicular, and infraclavicular

Answer 26

Lymph node palpation

Question 27

What do you palpate while the patient is laying supine?

Answer 27

All areas of the breast including the tail of Spence Rotate fingers clockwise or counterclockwise; palpate light, medium, deep

Question 28

During palpation avoid lifting your fingers off the breast tissue because:

Answer 28

Makes it easy to miss tissue

Question 29

If a beast mass is felt, note its characteristic and palpate its:

Answer 29

Dimensions Consistency Mobility

Question 30

Nipple compression should be performed only if the patient reports:

Answer 30

Spontaneous discharge

Question 31

Normal findings Breast tissue is:

Answer 31

Dense, firm, elastic

Question 32

Visible vein networks in patients who are:

Answer 32

Pregnant Obese

Question 33

Decrease in glandular alveolar and lobular tissue

Answer 33

Premenopausal

Question 34

Glandular tissue atrophies and is replaced by fat

Answer 34

Menopause

Question 35

Breasts are flatter, longer, and more relaxed from the chest wall

Answer 35

Postmenopausal

Question 36

Breasts of older women are more:

Answer 36

Fine and granular

Question 37

Benign cyst formation caused by ductal enlargement is associated with a long follicular or luteal phase of the menstrual cycle Lesions are filled with fluid and usually bilateral and multiple

Answer 37

Fibrocystic changes

Question 38

Benign tumors composed of stromal and epithelial elements that represent a hyperplastic or proliferative process Account for the majority of breast tumors in young women

Answer 38

Fibroadenoma

Question 39

Malignant breast tumors have peak incidence between ages ___ and ___ normally occurring in women older than ____

Answer 39

40 to 75 50

Question 40

Mass or thickening Marked asymmetry Prominent unilateral veins Discoloration Ulcerations Dimpling Puckering Retraction of skin Inversion/deviation of the nipple

Answer 40

Findings associated with breast cancer

Question 41

Response to local injury A firm, irregular mass, often appearing as an area of discoloration

Answer 41

Fat necrosis

Question 42

Benign 2-3 cm tumors of the sub-areolar ducts that occur singly or in multiples. Common cause of serous or bloody nipple discharge

Answer 42

Intraductal papilloma and Papillomatosis

Question 43

Surface manifestation of underlying ductal carcinoma. Red, scaling, crusty patch forms on the nipple, areola, and surrounding skin Lesions appear eczematous and usually unilateral

Answer 43

Paget disease

Question 44

Smooth, firm, mobile, tender disk of breast tissue located behind the areola in males. Caused by hormone imbalance; by testicular, pituitary or hormone secreting tumors; liver failure or antihypertensive meds.

Answer 44

Gynecomastia

Question 45

Inflammation of the sebaceous glands in the areola

Answer 45

Retention cysts

Question 46

Lactation not associated with childbearing and most commonly caused by pituitary tumors, Cushing's syndrome and hypoglycemia

Answer 46

Galactorrhea

Question 47

What drugs caused galactorrhea?

Answer 47

Phenothiazines Tricyclics Antidepressants Estrogen

Question 48

Inflammation and infection of the breast tissue characterized by sudden onset of swelling, tenderness, erythema, and heat Usually the result of a staph infection and most common in lactating women

Answer 48

Mastitis

Question 49

Most commonly occur in menopausal women The sub-areolar ducts become blocked with desquamating secretory epithelium, necrotic debris, and chronic inflammatory cells

Answer 49

Mammary duct ectasia