Reproductive System Flashcards
(131 cards)
Location of the breast
2nd-3rd rib to the 6th-7th rib; from the sternal margin to the midaxillary line
Male breast anatomy
consists of a small nipple and areola overlying a thin layer of breast tissue
Anatomy of the breast
Composed of glandular, firbrous tissue and subcu and retromammary fat.
Glandular tissue contains 15-20 lobes per breast that radiate to the nipple
Each lobe has 20-40 lobules
Acini Cells
Each lobule consists of milk-producing cells that empty into lactiferous ducts
Small and inonspicuous in nonpregnant/nonlactating women
Cooper ligament (suspensory ligament) and muscles supporting the breast
Extends through the breast, attaching to the underlying fascia, providing further support
Pectoralis major, minor, serratus anterior, latissimus dorsi, subscapularis, external oblique and rectus abdominis
Arteries of the breast tissue
Internal mammary artery, and lateral thoracic artery
Proportions of glandular tissue vary with
age, nutrition, pregnancy, lactation and genetics
Four quadrants of the breast
Upper inner Lower innner Lower outer Upper outer - largest amount of tissue Tail of Spence - tissue extending into axilla
Nipple is composed of smooth muscle innervated by
tactile, sensory and autonomic stimuli
causes erection of nipple and lactiferous ducts to empty
Montgomery Tubercles
Sebaceous glands found on the areolar surface
Hair follicles found here too
Supernumerary nipples or breast tissue
Sometimes present along the mammary ridges that extends from the axilla to the groin
Lymphatics network of breasts
Superficial lymphatics drain the skin
Deep drain the mammary lobules
Axillary lymph nodes
easier to palpate when enlarged
anterior axillary (pectoral) nodes are located along the lower border of pec major
Midaxillary (central) high in axila close to ribs
Posterior axillary (subscapular) - lateral scapula, deep axillary psosterior fold
Lateral axillary (brachial) felt along upper humerus
Thelarche
Breast development
First sign of puberty
Occurs earlier in blacks
Onset of menses
Stage 3 = 25%
Stage 4 = 75%
Stage 5 = 10%
Appearance of breast bud (stage 2) to menarche is 2 years
Changes in pregnanct women
Luteal and placental hormones cause lactiferous ducts to proliferate and the alveoli to increase in size in number
Breasts enlarge 2-3x
Softer and looser
Colostrum is produced and accumulates in alveoli towards end of pregnancy
Areolar changes and vascularization in pregnant
Deeply pigmented and diameter increases
Nipples are prominent, darker and more erectile
Montgomery tubercles develop as sebaceous glands hypertrophy
Veins engorge and are visible on surface of skin
Lactating women
Colostrum secretes from breasts after delivery
Contains more protein and minerals then mature milk, antibodies and resistance factors
Surging prolactin levels 2-4 days after pregnancy
Milk production replaces colostrum in response to prolactin, estrogen, and stimulation of sucking
Breasts become full and tense as alveoli and lactiferous ducts fill
Tissue edema, delay in ejection reflex, produce engorgement
Termination of lactation
involution occurs over a period of 3 months
Breast size decreases without loss of lobular and alveolar components
Breasts rarely return to prelactation size
Older Adults
Menopause causes atrophy of grandular tissue and is replaced by fat
Inframmamary ridge at lower edge of breast thickens
Relaxation of suspensory ligaments lowers breasts
Nipples become small and flat and lose erectile ability
Skin becomes dry and thin, loss of axillary hair
Nonmodifiable risk factors for breast cancer
Age, gender, genetic factors (BRCA1 and BRCA2)
Personal Hx of breast cancer
FH
Previous breast biopsies
Race - white
Previous breast radiation (Hodgkin lymph)
Menarche before 12 and menopause after 55
Breast Density - more dense or fatty
Diethylstilbestrol therapy
Modifiable risk factors for breast cancer
Childbirth - nulliparity/late age of first child birth Hormone therapy - HRT after menopause Alcohol Obesity/high-fat diet Lack of PA
Breast inspection
compare size, symmetry, contour, skin color, texture, venous pattern and lesions
Check skin under each breast
Convex, pendulous, or conical
One breast is smaller then other
Male breasts are even c chest wall, obese men have a convex shape