chapter 17. structure and function subjective data—health history questions objective...
TRANSCRIPT
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Chapter 17
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Structure and Function Subjective Data—Health 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
Cooper’s 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
AdolescentPuberty
Pregnant female Aging female
Menopause Male breast
Cross-cultural care Breast cancer
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BreastPainLumpDischargeRashSwellingTrauma
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History of breast diseaseSurgerySelf-care behaviors
Breast self-examination Last mammogram
AxillaTenderness, lump, or swellingRash
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Additional history for preadolescent Changes in breasts Other changes
Additional history for pregnant female Enlargement of breasts Plans to breastfeed
Additional history for menopausal woman Changes in breasts
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PreparationPositionDraping
EquipmentSmall pillowRuler marked in centimetersPamphlet or teaching aid for breast self-
examination
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Breasts—Inspect General appearance Skin Lymphatic drainage areas Nipple Maneuvers to screen for retractionAxillae—Inspect 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 d’orange) Deviation in nipple pointing Nipple retraction
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Benign breast disease (formerly fibrocysticbreast disease)
Cancer Fibroadenoma
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Mammary duct ectasia Carcinoma Intraductal papilloma Paget’s disease (intraductal carcinoma)
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Plugged duct Breast abscess Mastitis
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Gynecomastia Carcinoma
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