Sys Tx - Breast , Cancer, Surgery

Which is false about the location of breast
A) Over lies pectoralis Major, serratus anterior muscle and fascia
B) extending from clavicle down to 5th rib

C) From sternum to the lateral border of scapula

D) All of the above are false

A) lies against anterior thoracic wall

Rational:

Extends to 6th rib, and to the lateral border of lats.

T/F
Breast tissue begins immediately deep to the skin

True

Which lymph nodes are compromised by tightness in pec minor / major?

A) Axillary nodes

B) Rotter’s nodes

C) Thoracica interna lymph nodes

D) Pectorales nodes

B) Rotter’s nodes

From PPT

Which Structure will cause pain and discomfort when breast tissue is over stretched?

A) Cooper’s Ligament

Explaination:

B : Lactiferous Duct

C : Lactiferous sinus

D : Gland Lobules

Which structure is a channel of lymph drainage of the breast

A) Lactiferous duct

B) Rotter’s nodes

C) Thoracica interna lymph nodes

D) Retromammary Space

Which of the following is Not an indication for breast massage?
A) Premenstrual Congestion

B) Reduction of Pectoralis Minor Tone

C) Client wants to be more comfortable with her breast and having them touched

D) Client wants assistance in breast monitoring

B) Reduction of Pectoralis Minor Tone

Explanation:

Reduce tone following submuscular implant placement is what is indicated for breast massage

Reference: Breast Massage – Debra Curties P.104

Which structure run from clavicle and clavipectorial facias and surround the breast providing structure support?

A) Retromammary space

B) Cooper’s Ligament

C) Pectorial Fascia

D) Fats

B) Cooper’s Ligament

It is a fibrous CT bands attach the breat to the dermis ans suspend the breast and on chest wall that provides structural support

Explain:

Retromammary space - channel of lymph channel

Fats - surrounds breast, predominantly in the superficial and peripheral areas. For breast development

Pectorial Fascia - structural support for pectoralis major

T/F
Male breast consist chiefly of a small nipple and areola

True

Which lymph nodes is palpable?

B) Central nodes

Explain:

A) Lateral nodes

C) Subscapular Nodes

D) Pectoral nodes

Warning signals of Cancer

• change in bowel and bladder habbits

• A sore that does not heal

• Unusual bleeding and discharge

• Thickening lump in breast

• Indigestion of difficulty swallowing

• Obvious change in wart / mole

• Nagging cough or hoarseness

How can massage benefit cancer patient?

• reduce muscle tension

• decrease pain

• lessening depression and anxiety

• promote relaxation

• improve sleep

• promote healthy immune response

• reduce edema & lymphedema

• decrease nausea

• reduce fatigue

• improve health of skin tissue

• reduce muscular soreness

• increase ROM

• increase blood flow

Treatment for Cancer

• Surgery

• Radiation

• Chemotherapy

• immunotherapy

• Hormonal therapy

• Bone marrow transplant

Side effects of Surgery from cancer

• bleeding

• blood clots

• disfigurement

• fatigue

• increase pain

• infection

• loss of function

• lymphedema

• scar tissue

Side effects of radiation therapy

• burns

• decreased platelets

• decreased WBC

• decreased RBC

• delayed wound healing

• Diarrhea

• Fatigue

• Fibrosis

• Fragility of blood vessel

• Headaches

• immunosuppression

• infection

• lymphedema

• radiation sickness

• skin irritation

• sterilization

• loss of appetite

• weight loss

Side effects of chemotherapy

• anemia

• constipation

• decreased platelets

• decreased WBC

• decreased bone density

• diarrhea

• orthostatic hypotension

• fatigue

• fever

• fragility of blood vessel

• hair loss

• hemorrhage

• immunosuppression

• intolerance to cold

• infection

• liver toxicity

• mouth sores

• muscle weakness

• nausea and vomiting

• neuropathy

• pain

• shortness of breath

• skin rashes

• vision impairments

• weight loss / gain

• decreased bone density

What Assessment is lease indicated for Cancer Pt

A) ROM test

B) DVT test

C) Facial assessment

D) All of the above are indicated

D) All of the above are indicated

Explain

A) ROM might be reduced

B) cancer stimulates blood clot, and likely to have DVT

C) Facia is restricted

Where does the Malignant breast tumour commonly develops ?

A)upper outside quadrant

B)lower outside quadrant

C)central portion

D) all portion of the breast have equal chance of developing tumour

A) upper outside quadrant

T/F

The first sign of breast cancer is usually a small, painless lump that is fixed

False

Lump are freely movable in early stage

What techniques are used to encourage lymphatic drainage?

stimulate lymph nodes before treating the breast

increase circulation with light petrissage

Which areas are indirect treatment for breast

pecs, abdominals, intercostals

Which type of surgery is:

very small incision and less pain and trauma. Surgeon see operated area by looking through fine tube, special instruments inserted through the tube to carry out operation

Laparoscopic / keyhole

Example: Removal of gall bladder

What is used in TRAM flap, what is the surgery for?

Breast reconstruction

TRAM flap ( Transverse rectus abdominus myocutaneous) , uses skin, fat and muscle of the Transverse rectus abdominis muscle for surgery

what are the common post operative complication?

• fever

• aatelectasis

• wound infection

• Embolism

• Deep Vein Thrombosis

• Haemorrhage

• Urinary Tract infection

• Bowel Obstruction

What is aatelectasis?

complete or partial collapse of the lung, due to aveolar collapse or fluid consolidation

When will the post - op complication occur?

1-3 days after operation

What affects healing rate?

• poor blood supply

• excess suture tension

• long term steroids

• immunosuppressive therapy

• radiotherapy

• severe rheumatoid disease

• malnutrition and vitamin deficiency

What are the stages of healing?

1. inflammatory phase

2. migratory phase

3. proliferative phase

4. maturation phase

What is an active scar?

A) painful scar

B) adhered to underlying structure

C) Resistant to stretch

D) thickened

E) All of the above

E) All of the above

What are the benign breast disorder

• Breast Cyst

• Fibroadenoma

• Abscess

• Fat Necrosis

• Non Cancerous tumors