Breast Anatomy and Lactation Quiz

Anatomy of the Breast

• The breast, also known as the mammary gland, extends from the sternum to the axilla.
• It is positioned anteriorly on the chest, between the 2nd and 6th rib.
• It can be hemispherical, conical, or pendulous.
• The breast is reinforced by Cooper's ligaments.
• It is composed of varying proportions of fat, glandular, and connective tissue.
• Tissues are arranged in lobes, then subdivided into lobules, which are subdivided into alveoli and ducts.
• Alveoli contain milk-producing acini cells.
• Acini cells are surrounded by myoepithelial cells.
• Small lactiferous ducts unite to form larger ducts (lactiferous tubules), which emerge on the surface of the nipple.
• The nipple is covered with epithelium.
• The areola surrounds the nipple and contains pigmented skin.
• The areola contains Montgomery's glands, which produce sebum-like substances, acting as a lubricant during breastfeeding.

Blood Supply of the Breast

• The breast is supplied by internal and external mammary arteries and branches from intercostal arteries.
• Veins are arranged in a circular fashion around the nipple.
• Blood supply is crucial for proper breast function.

Lymph Drainage of the Breast

• Lymph drainage occurs into the axillae and mediastinum.
• This is an important part of the body's immune system.

Nerve Supply of the Breast

• Branches from the 4th, 5th, and 6th thoracic nerves supply the breast.
• This is essential for proper breast function.

Breast Changes After Conception

• Breast changes during pregnancy are due to milk duct growth.
• Breasts enlarge and develop under the influence of estrogen.
• Increased blood supply makes the veins more noticeable during pregnancy.
• The skin of the nipple and areola may darken.
• Skin color changes vary between individuals.
• Nipples may become more prominent and sensitive or sore.
• Supportive bras are recommended.

Breast Changes During Lactation

• Areolas come in different sizes and colors, due to hereditary factors.
• Some women experience darkening or enlargement of the areola during pregnancy and breastfeeding.
• These changes typically return to pre-pregnancy appearance after breastfeeding is complete.

Stages of Breastmilk

• The first stage of milk is colostrum, which is thick and yellow in color.
• It is rich in protein, antibodies, vitamins and minerals, and lasts for a few days after birth.
• Colostrum production prepares the baby for the next stages of feeding.
• Transitional milk follows colostrum and is thin and white, containing high quantities of fat, calories, protein, lactose, and vitamins.
• Mature milk, appearing bluish at first, is primarily composed of water and is rich in water, vitamins, and proteins, and gradually increases fat content.
• The hindmilk, at the end of a feeding, has a higher fat concentration, which is necessary for infant weight gain.

Physiology of the Breast

• The breast functions to produce milk after the birth of a baby.
• Alveoli contain milk-producing acini cells.
• Myoepithelial cells surrounding acini cells contract to propel milk.
• Elastic fibers in the nipple contract, causing it to become erect.
• A tight sphincter at the end of the teat prevents unwanted milk loss.
• Montgomery’s glands secrete substances acting as a lubricant.

Physiology of Breast Feeding

• Alveolar epithelial cells develop into lactocytes (during mid-pregnancy).
• Lactocytes produce milk components (casein and lactose).
• Colostrum is the first milk, containing high amounts of white blood cells, antibodies, and Immunoglobulin A (IgA).
• Lactogenesis 1 and 2 happen around mid-pregnancy. Production depends on fluctuating hormone levels and the presence of the placenta.
• Prolactin levels remain high and can initiate lactation even if breastfeeding is delayed.
• Delivery of the placenta causes sudden drops in progesterone, estrogen, and human placental lactogen levels.
• The abrupt decrease in progesterone and presence of high prolactin levels stimulate milk production.

Physiology of Breast Feeding Continued

• Continued production of prolactin is caused by touch as the baby feeds.
• Prolactin levels are highest during night feeds and suppress ovulation.
• Milk is synthesized continuously into the alveolar lumen.
• Milk is stored in the alveolar lumen.
• Oxytocin release causes contractions in myoepithelial cells.
• This process is the "let-down or milk-ejection reflex."
• Milk release is under neuro-endocrine control.
• Tactile stimulation of the breast stimulates oxytocin.

Differences Between Male and Female Breasts

• Male breasts are also called chests or boards.
• Male breasts are mostly adipose tissue (fat) and have less glandular tissue.
• Male breasts lack milk-producing lobules, which are present in females.
• Males have more hairs on their breasts.
• Male breasts have a lower incidence of breast cancer (about 1%).
• Female breasts have more glandular and adipose tissue than male breasts and contain milk-producing lobules.
• Females have less hair on their breasts, and have a higher incidence of breast cancer.
• Male nipples tend to point toward the armpits; female nipples point more directly forward.
• Males do not experience lactation, while females do.

Techniques of Breastfeeding

• Techniques involve positioning the mother, her breast, and the baby correctly.
• Mother’s positioning allows proper alignment of her back during breastfeeding.
• The baby’s nose is positioned opposite the mother’s nipple.
• Baby’s head is supported by the mother’s hand.
• If correctly attached, the baby will form a teat from the breast and nipple.

Advantages of Breastfeeding (Mother)

• May protect against breast cancer.
• Oxytocin aids in uterine involution.
• Reduces cost of feeding and preparation time.
• Encourages mother-child bonding.

Advantages of Breastfeeding (Infant)

• Breast milk contains secretory immunoglobulin A (IgA), binding foreign proteins and preventing absorption from the gastrointestinal tract (GIT).
• Lactoferrin is an iron-binding protein interfering with pathogenic bacteria growth.
• Leukocytes offer protection against common respiratory infections.
• Contains components (macrophages, bifidus factor, lactose, glucose, linoleic acid), ideal for electrolytes and promoting healthy infant growth.
• Preventing excessive weight gain.

Breast Conditions

• Conditions like abscesses, fibroadenomas, cysts, and fibroadenomatosis can affect the breast.

Test your knowledge on breast anatomy, lactation, and the hormonal changes that occur during pregnancy and breastfeeding. This quiz covers important topics such as colostrum, the milk-ejection reflex, and the role of various cells and structures in breast health. Perfect for students in nursing or related health fields.