NR509 Final Exam Study Guide 2023/2024 Advanced Physical Assessment

• Techniques of examination o Inspect the breasts in four views: arms at sides, arms over head, arms pressed against hips, and leaning forward (skin appearance, size, symmetry, contour, nipple characteristics). o Palpate the breasts (consistency, tenderness, nodules, nipple for color, consistency, and quantity of any discharge). o Inspect the axillae (rash, irritation, infection, unusual pigmentation). o Palpate the axillary nodes (size, shape, delimitation, mobility, consistency, and any tenderness). o In men: o Inspect the nipple and areola (nodules, swelling, ulceration). o Palpate the areola and breast tissue (nodules). • Anatomy- The female breast lies against the anterior thoracic wall, extending from the clavicle and second rib down to the sixth rib, and from the sternum across to the midaxillary line. The breast overlies the pectoralis major and, at its inferior and lateral margins, the serratus anterior. The glandular tissue of the breast is divided into 15 to 20 segments, or lobes, which converge in a radial fashion as lactiferous ducts and sinuses before opening on the surface of the nipple and areola. Each lactiferous duct drains a lobe that is made up of 20 to 40 smaller lobules, which consist of milk-secreting tubuloalveolar glands. Adipose tissue surrounds the breast, predominantly in the superficial and peripheral areas. The superficial fascia lies deep to the dermis, and the deep fascia lies anterior to the pectoralis major muscle. The breast is attached to the skin by suspensory Cooper ligaments, fibrous bands that travel through the