BREAST AND LYMPH

• Bachelor of Science in Nursing: Health Assessment


  Course module, Course unit, Week
• Course and unit objectives

  • Read course and unit objectives
  • Read and comprehend study guide prior to class attendance
  • Read and comprehend required learning resources
  • Engage in classroom discussions
  • Participate in weekly discussion board (Canvas)
  • Answer and submit course unit tasks
• The Breast


  A pair of mammary glands located on the anterior chest wall, the milk-producing gland of women

  
• Anatomic Breast Landmarks And Their Position In The Thorax

  • Extending vertically from the 2nd to the 6th rib and laterally from the sternal border to the axilla

  
• How the breasts change with age

  1. Occurs between ages 8-13

  2. Breast and nipple as a single mound

  3. Tender and full During the reproductive years

  4. During pregnancy – pigmentation and enlargement

  5. Darkening of nipples and areola during pregnancy

  6. Corpus luteum and placenta – can cause breast soreness during pregnancy

  7. Glandular tissue atrophy

  8. Gradual decline of tissues on the mammary glands during menopause
• Male Concerns

  • Composed of a well-developed areola and small nipple that has immature tissue underneath
  • Gynecomastia
• Nipples


  • Round, hairless pigmented protrusion of erectile tissue approximately 0.5 to 1.5 in diameter
  • Located at the center of the breast
  • Lactiferous ducts - there are 12 to 20 minute openings on the surface of the nipple
• Areola


  • A pigmented area surrounding the nipples approximately 2.5 to 10cm in diameter
  • Montgomery's tubercle - appears rough because it contains modified sebaceous (oil) glands, helps lubricate the nipple, lactation
• Axilla


  The small hollow portion beneath the arm where it joins the body at the shoulders, also called the armpit
• Functions Of The Breasts

  • Synthesis, secretion and ejection of milk for the nourishment and protection of neonates and infants
  • Breastfeeding
  • Provides sensual pleasure during sexual foreplay
  • Provides some protection on the anterior chest wall
• Central Nodes


  Most frequently palpable of the axillary lymph nodes, lie along the chest wall, usually high in the axilla and midway between the anterior and posterior axillary folds, into them drain channels from three other groups of lymph nodes, which are seldom palpable

  
• Other Groups of Lymph Nodes

  • Pectoral Nodes (anterior) - located along the lower border of the pectoralis major inside the anterior axillary fold
  • Subscapular Nodes (posterior) - located along the lower border of the pectoralis major inside the anterior axillary fold
  • Lateral Nodes (brachial) - located along the upper humerus

  
• General Approach to Breast Assessment

  1. Prior Assessment - preparation of the nurse, preparation of the patient, explain the procedure, adopt a non-judgmental and supportive approach, be aware of the impact of culture

  2. Positioning - presses the hands together, arms raised over client's head, arms lowered on client's sides, hands pressed against client's hips, lean forward
• Discharge


  • Normal - no discharge, yellow discharge known as COLOSTRUM, white discharge of breast milk
  • When assessing the breast think of the word DISC - Discharge, Inversion, Skin changes, Compare with the other side

  
• Inspection and Palpation of Male Breast