SBO - Breast and Thoracic Pain Flashcards Preview

HBSO - Scientific Basis for Osteopathy > SBO - Breast and Thoracic Pain > Flashcards

Flashcards in SBO - Breast and Thoracic Pain Deck (19):

Identify the Location, Structure and Function of the Breast.

Paired structures on the anterior thoracic wall.
Lie in the subcutaneous tissue.
Anterior to the pectoralis major mm (2/3), serratus anterior mm (1/3) and their fascia.
Contains mammary glands (modified sweat glands).
Supported by connective and adipose tissue.
Well developed in women (accessory reproductive function for nursing offspring).
Rudimentary in men (functionless).


Describe the nipple of the breast

Conical prominences
Circularly arranged smooth mm
Indented with openings of 15-20 lactiferous ducts
No fat, no hair, no sweat glands.


Describe the areola of the breast

Circular pigmented skin surrounding the nipple
Contains 18-20 sebaceous glands
Secretes an oily substance to protect and lubricate the nipple.


What are the boundaries of the breast

Lateral border of the sternum to mid-axillary line.
Vertically from 2nd to 6th ribs


Describe the tail / axillary process of the breast

Extends along pectoralis major toward the armpit.
Can become enlarged during menstruation


Describe the retromammary space

Between the breast and the deep pectoral fascia
Contain a small amount of fat
Allows some movement of the breast


What is the function of the suspensory ligaments of the breast and where do they attach?

Support the breast tissue
Attach between the mammary gland and the dermis


Describe the components of the lactiferous ducts

Carry milk to the nipple
Open independently on the nipple

Each duct has 15-20 lobules of glandular tissue draining into it.
Milk-secreting alveoli are arranged in grape-like clusters
Alveoli are drained by ducts that converge toward the nipple.
Become Lactiferous sinuses just before reaching the nipple.

Located within the breast tissue between the lobules and the nipple.


Identify the arterial supply of the breast

Anterior intercostal arteries
Lateral thoracic and thoracoacromial arteries
Posterior intercostal arteries (2nd, 3rd, and 4th)


What is the venous drainage of the breast

Axillary vein and internal thoracic vein


Describe the lymphatic drainage of the breast

Begins at the subareola lymphatic plexus
75% drains to the pectoral nodes (anterior axillary) some to other axillary nodes.
Remaining lymph (from medial aspect of breast) drains to the inferior phrenic and parasternal lymph nodes
Skin over the breast: drains to many different nodes around the sternum and clavicle.


What is the nerve supply to the breast

Anterior and lateral cutaneous branches of 4th-6th intercostal nerves


What are the two gonaditrophin hormones released by the pituitary gland. And what do they do

Follicle stimulating hormone (FSH)
Lutenising hormone (LH)
Stimulate the release of oestregen and progestorone


What does oestregen and progestorone do to the breast.

Stimulates growth and function


Where is Prolactin produced and what does it do?

Produced in the anterior portion pituitary gland.
Responsible for milk production.


Where is Oxitocin produced and what does it do?

Produced in the posterior portion of the pituitary gland
Responsible for milk ejection.


What is the definition and aetiology of acute mastitis

Acute inflammation of the breast
Often associated with staphlacoccus aureus and and streptococcal infections.
Usually occurs during lactation i.e. following cracked nipples.
Or from other nipple injuries.
Commensal or hospitial-sourced bacteria gain entry to the duct.
Proliferation occurs in stagnant milk


What are the clinical features of acute mastitis

Hard, painful and inflammed breasts
Axillary lymphadenpathy
+/- pyrexia, tachycardia

If not treated effectively
Breast abscess -> extensive scarring


What is the management process for acute mastitis

Culture the breast milk
Provide appropriate antibiotics
Treat the breast engorgement (analgesia, local heat)
Cessetation of breast feeding?
Abscess - inscision and drainage.