IBCLC Exam #1|338 Q’s and A’s
What week gestation does the breast begin to develop in utero? - -*4th*
week of gestation
-Where does the primitive milk streak develop - -Bilaterally from the axilla
to the groin
-By the 5th week gestation the milk streak becomes what? - -Mammary Milk
Ridge (or milk line)
-Thickening and inward growth into the chest wall continues during what
weeks gestation? - -*7-8* weeks gestation
-Between weeks 12 and 16 gestation specialized cells differentiate into
what? - -Smooth muscles of the nipple and areola
-What forms the mammary pit? - -Lactiferous ducts and their branches open
into a shallow epithelial depression
-What failure creates an inverted nipple? - -When the Mammary pit fails to
elevate
-What is witches milk? - -After birth, a neonate's mammary tissue (under
the influence of maternal hormones) might recreate colostral like fluid
-At what age do the primary and secondary ducts grow and divide and form
the terminal end buds that become the alveoli? - -10-12 years old (puberty)
-When does *complete* development of mammary function occur? - -During
pregnancy
-What is superficial fiscia? - -Fibrous tissue beneath the skin
-Where is the breast located? - -In the superficial fascia between the *2nd
rib and 6th ICS*
-What are the two major divisions of the breast? - -Parenchyma and Stroma
-What makes up the Parenchyma? - -Ducts, lobes, and aveoli
-What are alveoli? - -Small sacs where milk is secreted
-What makes up the Stroma? - -Connective and fat tissue, blood vessels,
nerves, and lymphatics.
, -What is Cooper's Ligament? - -Suspensory ligament that are the fibrous
connections between the inner side of the breast skin and pectoral muscles.
Help to shape the breasts
-What does the nipple contain? - -15-25 milk ducts, smooth muscle fibers,
sebaceous and apocrine sweat glands, and dense innervations of sensory
nerve endings
-How many milk ducts does the nipple contain? - -15-25
-What are Montgomery Tubercles? - -Sebaceous glands in the areola
surrounding the nipple
-What do the Montgomery Tubercles secrete? - -*Oily secretions* (lipoid
fluid) to keep the areola and the nipple lubricated and protected
-What 2 arteries supply blood to the breast (60% / 30%)? - -Internal
mammary artery (60%) and lateral thoracic artery (30%)
-Where does the lymphatic system of the breast drain excess fluids from
tissue space, bacteria and cast off cells? - -Auxiliary lymph node
-Where do the nerves of the breast branch from? - -4th, 5th, and 6th
intercostal nerve
-What nerve supplies the greatest amount of *sensation* to the areola? - -
*4th* intercostal nerve
-What part of the breast is most sensitive? - -The areola followed by the
general skin of the breast, and then the nipple which is least sensitive.
-What percent of breast milk is *carbohydrates*? - -Approximately 7%
-What are the six infant behavioral "states" - -*Crying*
*Active alert*=fussy
*Quiet alert*=ready to play
*Drowsy*= irreg. breathing, heavy eyes
*Active sleep*= eye movement under lids, twitching
*Quiet sleep*= reg resp. relaxed, diff. to wake
-Milk components that protect the infant/lactating breast actively bind
______, preventing their passage through the permeable infant _____ _____ - -
pathogens
gut mucosa
, -How does the infant get the antibodies produced by mom? - -antibodies
are produced in moms blood, targeted *SIgA* which is transported across the
mammary secretory cells and released in the milk.
-What is sIgA? - -Immunoglobulin A is an antibody that coats mucosal
surfaces to prevent adherence and penetration by pathogens
-What are the most common food allergies? - -1. Cow's milk protein
2. Eggs
3. Peanuts
4. Tree nuts
5. Fish
6. Shellfish
7. Soy
8. Wheat
-What are the common symptoms of food allergies? - -1. Eczema
2. Hives
3. Digestive or respiratory problems (e.g. mucus or blood in the stool)
-The infant uses their _____ to draw in the nipple and ____ it in the mouth - -
Lips
Stabilize
-Weak lip tone is also called? - -*Hypotonic lips* result in the inability to seal
lips around the breast impacting the amount of suction created
-What is a sucking blister? What are 2 things it can be caused by? - -friction
abrasions resulting from *retracted lips or a labial frenulum* that restricts
the lips from flanging
-What does weak lip tone look like? - -Milk spilling, smacking sound
(breaking suction), infant tires faster due to increased work of the feedings
even though they aren't efficient feedings
-Things to look for when assessing the lips: - -Seal
Tone
Stretchy labial frenulum
No breaks in suction
No milk spilling
-What do fat deposits in the cheeks help provide? - -*structural support* to
stabilize nipple in the mouth
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