Chapter 17

Structure

and Function Subjective DataHealth History Questions Objective DataPhysical Exam Abnormal Findings

Slide 172

Surface anatomy
Location Axillary

of breasts on chest wall tail of Spence

Nipple

and areola

Slide 17-3

Internal anatomy

Glandular tissue

Lobes, lobules, and alveoli Lactiferous ducts and sinuses Suspensory ligaments or Coopers ligaments

Fibrous tissue

Adipose tissue

Four quadrants of the breast

Slide 17-4

Lymphatics

Axillary nodes

Central Pectoral (anterior) Subscapular (posterior) Lateral

Drainage patterns

Slide 17-5

Developmental care
Adolescent

Cross-cultural care Breast cancer

Puberty

Pregnant

female Aging female

Menopause

Male

breast

Slide 176

 Breast

Pain Lump Discharge Rash Swelling Trauma

Slide 177

History of breast disease Surgery Self-care behaviors

Breast self-examination Last mammogram

Axilla

Tenderness, lump, or swelling Rash

Slide 178

Additional history for preadolescent

Changes in breasts Other changes Enlargement of breasts Plans to breastfeed Changes in breasts

Additional history for pregnant female

Additional history for menopausal woman

Slide 179

 Preparation

Position Draping

Equipment

Small pillow Ruler marked in centimeters Pamphlet or teaching aid for breast self-examination

Slide 1710

BreastsInspect General appearance Skin Lymphatic drainage areas Nipple Maneuvers to screen for retraction AxillaeInspect and Palpate Skin Palpation technique Lymph nodes

Slide 1711

 If

a lump is present, note

Location Size Shape Consistency Mobility Distinctness Nipple retraction Overlying skin Tenderness Lymphadenopathy
Slide 1712

 Schedule

for self-exam Correct technique Return demonstration

Slide 1713

Male breast

Gynecomastia

Developmental care

Infants and children Adolescent Pregnant female Lactating female Aging female

Slide 1714

 Dimpling
Fixation Edema

(peau dorange)

Deviation Nipple

in nipple pointing

retraction

Slide 1715

 Benign

breast disease (formerly fibrocystic breast disease)

Cancer Fibroadenoma

Slide 1716

 Mammary

duct ectasia Carcinoma Intraductal papilloma Pagets disease (intraductal carcinoma)

Slide 1717

 Plugged

duct Breast abscess Mastitis

Slide 1718

 Gynecomastia Carcinoma

Slide 1719