question

alveoli

answer

smallest structures in a mammary gland

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areola

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darkened area surrounding nipple

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colostrum

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thin, yellow fluid, precursor of milk, secreted for a few days after birth

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cooper ligaments

answer

suspensory ligaments; fibrous bands extending from the inner breast surface to the chest wall muscles

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fibroadenoma

answer

benign breast mass

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galactorrhea

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persistent white discharge of milk between nursing sessions or after weaning

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gynecomastia

answer

excessive breast development in the male

question

intraductal papilloma

answer

serosanguineous nipple discharge

question

inverted

answer

nipples that are depressed or invaginated

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lactiferous

answer

conveying milk

question

mastalgia

answer

pain in breast

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mastitis

answer

inflammation of the breast

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Montgomery glands

answer

sebaceous glands in the areola that secrete protective lipid during lactation; also called tubercles of Montgomery

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Paget disease

answer

intraductal carcinoma in the breast

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Peau d' orange

answer

orange peel appearance of breast due to edema

question

retraction

answer

dimple or pucker on the skin

question

striae

answer

atrophic pink, purple, or white linear streaks on the breasts, associated with pregnancy, excessive weight gain, or rapid growth during adolescence

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supernumerary nipple

answer

minute extra nipple along the embryonic milk line

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tail of spence

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extension of breast tissue into the axilla

question

thelarche

answer

beginning of prepubertal breast development

question

Appropriate history questions to ask regarding the breast examination.

answer

-pain -lump -discharge -rash -swelling -trauma -history of breast disease - surgery or radiation -medications -patient-centered care -perform breast self-examination -last mammogram -tenderness, lump, or swelling -rash

question

Anatomy of the breast

answer

Lactiferous duct; lactiferous sinus; lobule ; lobe; adipose tissue; cooper ligament; pectoralis major muscle

question

normal developmental stages of breast

answer

1.preadolescent: there is only a small elevated nipple 2. breast bud stage: small mound of breast and nipple develops; the areola widens 3. the breast and areola enlarge; the nipple is flush with the breast surface 4. the areola and nipple form a secondary mound over the breast 5. mature breast: only the nipple protrudes; the areola is flush with the breast contour the areola may continue as a secondary mound in some normal woman

question

components of the breast examination

answer

lie down. press the 3 middle fingers in a circular motion and use 3 levels of pressure. follow an up and down pattern. sit up. examine underarm with arm slightly raised. note surface changes with hands pushed on hips, shoulders hunched

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points for self breast examination

answer

-technique -timing -know what is normal for yourself

question

significance of a supernumerary nipple or breast

answer

normal and common variation. an extra nipple along the embryonic "milk line" on the thorax or abdomen is a congenital finding. no associated glandular tissue. Tiny areola and nipple; distinguish from a mole.

question

difference between male and female examination procedures and findings

answer

male exams are shorter; painless, firm retroareolar lump; less frequent signs of nipple discharge, ulceration, retraction, axially lymphadenopathy.

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benign breast disease -fibrocystic -multiple tender masses -fibroadenoma- solitary nontender mass, solid, firm, rubbery

answer

fibrocystic; multiple tender masses that occur with numerous symptoms and physical findings: -swelling and tenderness -mastalgia -nodularity (lumpiness) - dominant lumps - nipple discharge -infections and inflammations nodules are mobile, well demarcated, and feel rubbery like small water balloons

question

abscess

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rare complication of generalized infection if untreated; a pocket of pus that feels hard, looks red, and is quite tender.

question

acute mastitis

answer

uncommon; inflammatory mass before abscess formation. single quadrant. area is red, swollen, tender, very hot, and hard. may be from a plugged duct

question

breast cancer

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solitary, unilateral, nontender mass. single focus in one area. solid, hard, dense, and fixed to underlying tissues or skin as cancer becomes invasive. borders are irregular, and poorly delineated. grows constantly. often painless

question

describe the characteristics to consider when a mass is noted in the breast

answer

-location -size -shape - consistency -moveable - distinctness -nipple - note the skin over the lump -tenderness -lymphadenopathy

question

define gynecomastia

answer

benign growth of this breast tissue; making it distinguishable from the other tissues in the chest wall. feels like a smooth, firm, movable disk. temporary. can also occur with use of anabolic steroids, some medications, cirrhosis, and other diseases.

question

describe screening mammography and clinical breast examination for the diagnosis of breast lesions

answer

vertical strip palpitation - 3 different pressures

question

list the high risk and moderate risk factors that increase the usual risk for breast cancer

answer

tumor suppressor genes termed BRCA 1 and BRCA2; inherit a mutation. long term use of hormone replacement therapy increase risk alcohol breastfeeding is a risk reducer

question

What are the reservoirs for storing milk in the breast?

answer

lactiferous sinuses

question

What is the most common site of breast tumors. what quadrant

answer

upper outer quadrant

question

during a visit for a school physical, the 13 year old girl being examined questions the asymmetry of her breasts. what is the nurses best response?

answer

one breast normally may grow faster than the other during development

question

when teaching the breast self-examination you would inform the woman that the best time to conduct breast self examination is:

answer

Right after the menstrual period day 4 to 7 of the cycle; when the breasts are the smallest and least congested

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you are providing health promotion teaching for a 40 year old woman. what is the current recommendation for women 40 years of age and older for breast cancer screening with mammography?

answer

every year

question

you are going to inspect a female patients breasts for retraction .the best position for this part of the exam is?

answer

sitting with hand pushing onto hips

question

A bimanual technique may be the preferred approach for a woman who is:

answer

with pendulous breasts

question

During the examination of a 70 year old man you note gynecomastia you would:

answer

review the medications for drugs that have gynecomastia as a side effect

question

during a breast exam you detect a mass. which of the following is most consistent with cancer rather than benign breast disease?

answer

irregular, poorly defined, fixed

question

during the exam of the breasts of a pregnant woman, you would expect to find

answer

blue vascular pattern over both breasts

question

which woman should not be referred to a physician for further evaluation?

answer

a 25 year old with asymmetric breasts and inversion of nipples since adolescence

question

any lump found in the breast should be referred for further evaluation. a benign lesion will usually have 3 of the following characteristics. which one is characteristic of a malignant lesion?

answer

irregular shape

question

gynecomastia is:

answer

enlargement of the male breast

question

which is the first physical change associated with puberty in girls?

answer

breast bud development

question

during the exam of a 30 year odl woman, she asks about the 2 large moles that are below her breast. after examining the area, how would you respond?

answer

this is a normal finding of supernumerary nipples that are developed

question

colostrum

answer

rich with antibodies that protect the newborn against infection. first few days after delivery

question

neonatal breast enlarge and visible from maternal estrogen crossing placenta and producing white discharge called :

answer

Witch's milk

question

breast dimpling

answer

shallow dimple also called skin tether shown as a skin retraction. cancer causes firbrosis; which contracts the suspensory ligaments.

question

peau d' orange

answer

edema of the breast; lymphatic obstruction

question

fixation

answer

asymmetry, distortion, or decreased mobility with the elevated arm maneuver. cancer can fix the breast to the underlying pectoral muscles.

question

deviation in nipple pointing

answer

underlying cancer causese fibrosis in the mammary ducts, which pulls the nipple angle toward it.

question

paget disease

answer

intraductal carcinoma - early lesion has unilateral, clear, yellow discharge, and dry scaling crusts, spreasds outward to areola with erythematous halo on areola and crusted, eczematous, retracted nipple

breasts and regional lymphatic CH 17 – Flashcards

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