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Chapter 17

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Structure and Function

Subjective DataHealth History

Questions

Objective Data

Physical Exam

Abnormal Findings

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Surface anatomy

Location of breasts

on chest wall

Axillary tail

of Spence

Nipple and areola

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Internal anatomy

Glandular tissue Lobes, lobules, and alveoli

Lactiferous ducts and sinuses Fibrous tissue Suspensory ligaments or

Coopers ligaments

Adipose tissue

Four quadrants of the breast

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Lymphatics

Axillary nodes

Central

Pectoral (anterior)

Subscapular (posterior)

Lateral

Drainage patterns

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Developmental care

Adolescent

Puberty

Pregnant female

Aging female

MenopauseMale breast

Cross-cultural care

Breast cancer

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Breast

Pain

Lump Discharge

Rash

Swelling

Trauma

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History of breast disease

Surgery

Self-care behaviors

Breast self-examination

Last mammogram

Axilla

Tenderness, lump, or swelling

Rash

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Additional history for preadolescent

Changes in breasts

Other changes

Additional history for pregnant female

Enlargement of breasts

Plans to breastfeedAdditional history for menopausal woman

Changes in breasts

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Preparation

Position

Draping

Equipment

Small pillow

Ruler marked in centimeters

Pamphlet or teaching aid for breast self-examination

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BreastsInspect

General appearance

Skin

Lymphatic drainage areas Nipple

Maneuvers to screen for retraction

AxillaeInspect and Palpate

Skin

Palpation technique

Lymph nodes

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If a lump is present, note

Location

Size

Shape Consistency

Mobility

Distinctness

Nipple retraction

Overlying skin

Tenderness

Lymphadenopathy

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Schedule for self-exam

Correct technique

Return demonstration

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Male breast

Gynecomastia

Developmental care Infants and children

Adolescent

Pregnant female

Lactating female Aging female

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Dimpling

Fixation

Edema (peau dorange)

Deviation in nipple pointing

Nipple retraction

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Benign breast disease (formerly fibrocystic

breast disease)

Cancer

Fibroadenoma

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Mammary duct ectasia

Carcinoma Intraductal papilloma

Pagets disease (intraductal carcinoma)

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Plugged duct

Breast abscess

Mastitis

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Gynecomastia

Carcinoma

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