NR 509 Final Exam Study Guide Review 2024 PDF

Summary

This document is a study guide review for a medical exam, specifically focusing on Chapter 18: Breasts and Axillae. It covers examination techniques, breast anatomy, female breast assessment, lymph nodes, male breast, and breast cancer, including screening and risk factors. The guide is updated for 2024.

Full Transcript

NR 509 Final Exam Sudy Guide Review 2024 New Updaes Perec Revision Chapter 18 Breasts and Axillae Techniques o examinaon o Arms over head ▪ Can bring ou dimpling or reracon ha may b...

NR 509 Final Exam Sudy Guide Review 2024 New Updaes Perec Revision Chapter 18 Breasts and Axillae Techniques o examinaon o Arms over head ▪ Can bring ou dimpling or reracon ha may be invisible Palpae he breass ▪ Bes wih p. supine ▪ A horough examinaon akes a leas hree minues ▪ Use he vercal srip paern o deec breas mass ▪ Palpae in small, concenric circles applying ligh, medium, and deep pressure a each examining poin ▪ When pressing deeply on he breas a normal rib can be misaken or a hard breas mass ▪ To palpae laeral breas, ask paen o roll ono he opposie hip, placing her hand on her orehead bu keeping he shoulder pressed agains he bed or examining able as his aens he laeral breas ssue. ▪ To palpae he medial poron o he breas, have p. lie a wih shoulders agains he examining able ▪ Inspec he axillae ▪ Palpae he axillary nodes ▪ By moving in a sraigh line down he bra line, hen move ngers medially and palpae in a vercal rip up he ches o he clavicle. Anaomy o Female breas/axillae assessmen o Breas lump or mass ▪ Can be physiologic or pahologic ranging rom cyss and broadenomas o breas cancer o Breas cys ▪ Usually rm, round, mobile, and oen ender, mosly common beween ages o 25-50 years old o Breas discomor or pain ▪ SSRI, Haldol, Aldacone, and dig can cause breas pain Nipple discharge o Lymph nodes o The lymphac drainage o he breas is o grea imporance in he spread o carcinoma, and abou hree-quarers o i is o he axillary nodes. ▪ Cenral nodes (axillary) o The male breas o Gynecomasa: males who develop benign breas enlargemen. Causes include increased esrogen, decreased esoserone, and medicaon side eecs o Inspec he nipple and areola (nodules, swelling, ulceraon) o Palpae he areola and breas ssue (nodules) Breas cancer (including screening and risk acors) o Redness suggess local inecon or inammaory carcinoma Thickening and prominen pores suggess breas cancer o Flang o he normally convex breass sugges cancer Asymmery in nipple direcon suggess cancer o Eczemaous changes wih rash scaling or ulceraon on he nipple exending o areola suggess Page disease o Invered nipple sugges cancer o Breas dimpling or reracon sugges cancer o Milky discharge unrelaed o pregnancy is nonpuerperal galacorrhea ▪ Caused by hypohyroidism, piuiary prolacnoma, and dopamine anagoniss o Risk acors ▪ Increasing age 65+ unl age 80 ▪ Biopsy: conrmed aypical hyperplasia ▪ Firs-degree amily members diagnosed wih breas cancer a an early age ▪ Inheried genec muaons- BRCA 1 and BRCA2 ▪ Personal hisory o breas cancer or ducal or lobular carcinoma ▪ Relavely denser breass on mammography ▪ High-dose radiaon o he ches a a young age ▪ High levels o endogenous hormones ▪ Age a rs ull erm pregnancy ▪ Lae menopause o Modiable risk acors ▪ Breasteeding or less han 1 year, posmenopausal obesiy, use o HRT, smoking, alcohol consumpon, physical inacviy, and ype o conracepon. Clinical breas examinaon (CBE) and sel-breas examinaon (SBE) echniques o The bes me is in a paen who is sll mensruang 5-7 days aer he onse o mensruaon because breass end o swell and become more nodular beore menses o Inspec breass in our views: arms a sides, arms over head, arms pressed agains hips, and leaning orward. o Breas sel-examinaon ▪ A high proporon o breas masses are deeced by women examining heir own breass. For screening, he BSE has no been shown o reduce breas cancer moraliy bu may promoe healh awareness and earlier reporng o breas changes or masses, which may reduce unnecessary esng and biopsies compared o monhly sel-examinaon. The BSE is bes med 5 o 7 days aer menses, when hormonal smulaon o breas ssue is low. Physiologic changes associaed wih he normal aging process o Fibroadenoma ▪ very mobile, round dislike, ypically small (1-2cm), rm, usually single bu very well delineaed. 15-25 years, pubery. o Cys ▪ mobile, round, well delineaed, so o rm, single, 30-50 years. o Cancer ▪ may be xed o he skin or underlying ssues, usually single, irregular or sellae in shape, rm or hard, mos common over age o 50 Lacaon o

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