Anatomy of the Female Breast PDF

Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care Toni Turner Biosciences for Midwifery Practice 4KNIW001 Senior Teaching Fellow 17th October 2023 Midwifery Anatomy of the breast Learning outcomes Have a...

Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care Toni Turner Biosciences for Midwifery Practice 4KNIW001 Senior Teaching Fellow 17th October 2023 Midwifery Anatomy of the breast Learning outcomes Have an understanding of the macro and micro anatomy of the female breast. Have an understanding of how the anatomy of the breast relates to lactation (milk production). DD/Month/YYYY Professor/Dr: Topic title: 2 DD/Month/YYYY Professor/Dr: Topic title: 3 DD/Month/YYYY Professor/Dr: Topic title: 4 Mammals: Produce milk Have hair or fur Have a unique jaw structure Are warm blooded DD/Month/YYYY Professor/Dr: Topic title: 5 DD/Month/YYYY Professor/Dr: Topic title: 6 Site of female breast and macro anatomy DD/Month/YYYY Professor/Dr: Topic title: 7 Macro-anatomy of the breast Breastfeeding Training Pack © UNICEF UK Baby Friendly Initiative DD/Month/YYYY Professor/Dr: Topic title: © Ramsay DT, Hartmann RL, Hartmann PE 10/16/2023 Micro-anatomy of breast: Alveoli Each lobe of the human breast consists of 20-40 lobules, and each lobule contains 10-100 alveoli, the glandular, milk-producing units within the breast Progesterone, oestrogen and human placental lactogen (HPL) lead to proliferation and enlargement of alveoli during pregnancy DD/Month/YYYY Professor/Dr: Topic title: 9 DD/Month/YYYY Professor/Dr: Topic title: 10 Microanatomy of breast - alveoli Alevoli consist of a single layer of milk producing lactocytes (secretory epithelium, also known as ‘acini cells’) During pregnancy the hormone prolactin enables the biosynthetic development of the acini cells and their ability to synthesise the components of milk DD/Month/YYYY Professor/Dr: Topic title: 11 Changes to the breast during pregnancy Areola may become wider and darker Little bumps appear around areola – Montgomery glands Some breast may leak colostrum, some may not Breasts may become larger Breasts may become fuller Skin around the breast may becomeProfessor/Dr: DD/Month/YYYY more thin and veiny Topic title: 12  Increased vascularity enhances blood supply to lactating breast Hypertrophy of lobules Darker, larger nipples easier for baby to see Thickening of nipple skin and secretions from Montgomery glands (tubercles) help protect nipples during infant feeding. DD/Month/YYYY Professor/Dr: Topic title: 13 Anatomy and physiology of the nipple The nipple is surrounded by the areola, a pigmented area of varying size, which darkens during pregnancy (and remains so) and has rich vascular supply and sensory nerve inputs (sensitivity increases markedly after delivery) Surrounding the nipple are Montgomery tubercles – sebaceous glands that hypertrophy and become prominent during pregnancy, providing lubrication and protection Suckling results in an influx of afferent nerve impulses to the hypothalamus, controlling lactation and human behaviour DD/Month/YYYY Professor/Dr: Topic title: 14 Recent change to understanding of anatomy of lactating human breast Study: Anatomy of the lactating human breast redefined with ultrasound imaging Subjects: 21 fully-lactating women aged 22-28, between 1-6 months postpartum, exclusively breastfeeding Methods: Ultrasound imaging to measure number of ducts, ductal characteristics, distribution of fatty and glandular tissue Ramsay et al, Journal of Anatomy, 2005 (206:525-534) DD/Month/YYYY Professor/Dr: Topic title: 15  Ramsay et al, Journal of Anatomy, 2005 (206:525-534) Ducts branch closer to the nipple Old New No branching of Branching of ducts until deep ducts close to in the breast the nipple DD/Month/YYYY Professor/Dr: Topic title:  N Ramsay et al, Journal of Anatomy, 2005 (206:525-534) ew View: what has changed? Conventionally described lactiferous sinuses do not exist Old New Lactiferous No Lactiferous Sinuses Sinuses DD/Month/YYYY Professor/Dr: Topic title:  Ramsay et al, Journal of Anatomy, 2005 (206:525-534) Glandular tissue is found closer to the nipple Old New Even distribution 65% of glandular of glandular tissue within tissue 30 mm of nipple DD/Month/YYYY Professor/Dr: Topic title:  NewRamsay et al, Journal of Anatomy, 2005 (206:525-534) iew: what has changed? The ductal network is not always radial or symmetrical Old New Ductal network Ductal network depicted as radial not always radial and symmetrical or symmetrical DD/Month/YYYY Professor/Dr: Topic title:  Ramsay et al, Journal of Anatomy, 2005 (206:525-534) Fewer ducts exiting the nipple than previously thought Old New 15 – 20 ducts 4 -18 ducts exiting exiting at the the nipple nipple (average of 9) DD/Month/YYYY Professor/Dr: Topic title:  Anatomy of the Lactating Breast Cooper‘s Ligaments Retromammary Fat Glandular Tissue Intraglandular Fat Subcutaneous Fat Main Milk Duct Milk Duct DD/Month/YYYY Professor/Dr: Topic title:  Question - The clusters of alveoli in the breast consist of: a) Adipose tissue? b) Glandular tissue? c) Muscular tissue? DD/Month/YYYY Professor/Dr: Topic title: 22 References and bibliography Baby Friendly Initiative: http://www.unicef.org.uk/BabyFriendly/Health- Professionals/ Geddes DT, 2007, Inside the lactating breast: the latest anatomy research. American College of Nurse Midwives Journal, 52, 6, p556-562 Marshall J E, Raynor M D, Myles’ Textbook for Midwives, 2014. Elsevier Marshall P, Anatomy and Physiology in Healthcare, 2017, Scion Pub. Pollard M, 2012, Evidence based care for breastfeeding mothers: a resource for midwives and healthcare professionals. Routledge. http://www.unicef.org.uk/BabyFriendly/Health-Professionals/ Ramsay et al, https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1469- 7580.2005.00417.x Walker, M., 2013. Breastfeeding management for the clinician: Using the evidence. Jones & Bartlett Publishers. DD/Month/YYYY Professor/Dr: Topic title: 23