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What week gestation does the breast begin to develop in utero? Correct Answer: *4th* week of gestation Where does the primitive milk streak develop Correct Answer: Bilaterally from the axilla to the groin By the 5th week gestation the milk streak becomes what? Correct Answer: Mammary Milk Ridge (or milk line) Thickening and inward growth into the chest wall continues during what weeks gestation? Correct Answer: *7-8* weeks gestation Between weeks 12 and 16 gestation specialized cells differentiate into what? Correct Answer: Smooth muscles of the nipple and areola 2 What forms the mammary pit? Correct Answer: Lactiferous ducts and their branches open into a shallow epithelial depression What failure creates an inverted nipple? Correct Answer: When the Mammary pit fails to elevate What is witches milk? Correct Answer: After birth, a neonate's mammary tissue (under the influence of maternal hormones) might recreate colostral like fluid
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What week gestation does the breast begin to develop in utero? Correct Answer: 4th week of gestation Where does the primitive milk streak develop Correct Answer: Bilaterally from the axilla to the groin By the 5th week gestation the milk streak becomes what? Correct Answer: Mammary Milk Ridge (or milk line) Thickening and inward growth into the chest wall continues during what weeks gestation? Correct Answer: 7-8 weeks gestation Between weeks 12 and 16 gestation specialized cells differentiate into what? Correct Answer: Smooth muscles of the nipple and areola
What forms the mammary pit? Correct Answer: Lactiferous ducts and their branches open into a shallow epithelial depression What failure creates an inverted nipple? Correct Answer: When the Mammary pit fails to elevate What is witches milk? Correct Answer: 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? Correct Answer: 10 - 12 years old (puberty) When does complete development of mammary function occur? Correct Answer: During pregnancy What is superficial fiscia? Correct Answer: Fibrous tissue beneath the skin Where is the breast located? Correct Answer: In the superficial fascia between the 2nd rib and 6th ICS
What are Montgomery Tubercles? Correct Answer: Sebaceous glands in the areola surrounding the nipple What do the Montgomery Tubercles secrete? Correct Answer: Oily secretions (lipoid fluid) to keep the areola and the nipple lubricated and protected What 2 arteries supply blood to the breast (60% / 30%)? Correct Answer: 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? Correct Answer: Auxiliary lymph node Where do the nerves of the breast branch from? Correct Answer: 4th, 5th, and 6th intercostal nerve What nerve supplies the greatest amount of sensation to the areola? Correct Answer: 4th intercostal nerve What part of the breast is most sensitive?
Correct Answer: 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? Correct Answer: Approximately 7% What are the six infant behavioral "states" Correct Answer: 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 _____ _____ Correct Answer: pathogens gut mucosa How does the infant get the antibodies produced by mom? Correct Answer: antibodies are produced in moms blood, targeted SIgA which is transported across the mammary secretory cells and released in the milk.
Weak lip tone is also called? Correct Answer: 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? Correct Answer: friction abrasions resulting from retracted lips or a labial frenulum that restricts the lips from flanging What does weak lip tone look like? Correct Answer: 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: Correct Answer: Seal Tone Stretchy labial frenulum No breaks in suction No milk spilling What do fat deposits in the cheeks help provide? Correct Answer: structural support to stabilize nipple in the mouth
Does low/weak tone cause the infant to have higher or lower levels of suction? Correct Answer: lower levels of suction What does Hypotonia mean? Correct Answer: Low tone What does it mean if an infant has thin cheeks due to reduced fat pads? Correct Answer: That the infants intraoral space is larger than normal, forcing them to create a larger vacuum to generate and sustain suction. So the work for a feeding increases What does the dancer's hand help with? Correct Answer: Cheek stability What does the jaw provide stability for? Correct Answer: Tongue, lips, and cheeks Almost all babies have ___ jaws Correct Answer: receding Preterm infants usually have jaw instability because of what 2 things? Correct Answer: Low muscle tone Immature muscles
Correct Answer: The tongue should be able to lift freely and lift the mothers nipple against the hard palate so with each drop of the tongue, the oral cavity gets larger and creates negative pressure When assessing the tongue you should look for all of the following: Correct Answer: 1. shape
Correct Answer: It opposes the tongue helping to compress the nipple and maintain its position in the mouth What are Epstein's pearls? Correct Answer: They are small, round, white cysts that are found on the ridge of the hard palate or gums and they usually go away within 2 months (do not affect BF) Epstein's Pearls can sometime be mistaken for what? Correct Answer: teeth or thrush What is a partial or incomplete cleft lip? Correct Answer: Small gap or indentation of the lip What is the difference between a unilateral and bilateral complete cleft lip? Correct Answer: Unilateral refers to 1 side, bilateral refers to both sides and complete means that it continues into the nose. What is an incomplete cleft palate? Correct Answer: A "hole" in the roof of the mouth, usually as a cleft soft palate D What is a complete cleft palate? Correct Answer: Soft and hard palate, possibly including a gap in the jaw
Correct Answer: Milk producing cell What are the cranial nerves and what is the acronym? Correct Answer: I. Olfactory-smell II. Optic-sight III. Oculomotor-movement of the eye IV. Trochlear- movement of the eye up and down V. Trigeminal- muscle of mastication* VI. Abducens- moves the eye away from the center of the body VII. facial-moves the muscles of the face* VIII. auditory (vestibulocochlear) hearing and equilibrium IX. Glossopharyngeal- taste, sensation in the pharynx* X. Vagus-larynx and pharynx* XI. Spinal accessory-muscles of the neck and shoulder* XII. Hypoglossal-muscles of the tongue* "On Old Olympus' Towering Top A Fin and German Vend Some Hops" What does the sternohyoid muscle do? Correct Answer: Depresses the hyoid and larynx what does the Omohyoid muscle do? Correct Answer: Depresses the Hyoid
What does the Thyrohyoid muscle do? Correct Answer: Raises and changes the form of the larynx What is the buccinator and masseter muscles and what do they do? Correct Answer: Sucking pads that consist of fatty tissue in the cheek that provide stability of the nipple during sucking What is the lingual frenulum? And if it is short, more posterior or anterior what does it cause? Correct Answer: Strip from floor of the mouth to the midline under the surface of the tongue. Can cause tongue tie What is the labial frenulum and if it is short or extends what does it cause? Correct Answer: Membrane that attaches the lips to the gum ridge. if it is short or attaches to the papilla it can cause a lip tie What is the oropharnyx? Correct Answer: Area between the elevated soft palate and epiglottis Where do the estuation tubes originate? Correct Answer: Nasopharynx
What doe MER stand for? Correct Answer: Milk Ejection Reflex What controls the volume of milk? Correct Answer: MER Does positive or negative pressure within the oral cavity help support milk removal? Correct Answer: Negative What is Oxytocin? Correct Answer: Hormone produced in the pituitary gland that signals the body to let down stimulated by the infant suckling. It also is released during loving behaviors What is Prolactin? Correct Answer: It is a hormone released when a baby is sucking at the breast and it's primary function is to signal to the body to make more milk What three tasks does the infant need to be able to coordinate? Correct Answer: Sucking, swallowing, and breathing What is an immature suck pattern (how many sucks per burst)? Correct Answer: 3 - 5 sucks per burst
what is a transitional suck pattern (how many sucks per burst)? Correct Answer: 6 - 10 sucks per burst What is a mature suck pattern (how many sucks per burst)? Correct Answer: 10 - 30 sucks per burst What is a dysfunctional suck pattern? Correct Answer: Lack of suckling and abnormal movements of the tongue and jaw What is the standard holder pasteurization temp and time? Correct Answer: 144.5 degree's F for 30 minutes What is mammary hypoplasia associated with? Correct Answer: IGT (Insufficient glandular tissue) What medication is most likely to suppress lactation? Correct Answer: Bromocriptine ( bro, you don't need to lactate) Beriberi is a deficiency if what vitamin? Correct Answer: B What component of milk provides visual acuity?
Extremly low birth weight (ELBW) is described as less than.... Correct Answer: Less than 1,250 g (2. 75 lbs) What are the 6 infant behavioral states? Correct Answer: 1. Crying infant
At what age do night wakings usually decrease (weeks)? Correct Answer: 12 - 16 weeks How many grams in an ounce? Correct Answer: 28.3 grams in an oz How many ounces in a pound? Correct Answer: 16 How many ML in an ounce? Correct Answer: 29.5mL in an oz True or false: a CC is a ML Correct Answer: True Day 1, how much does baby eat? Correct Answer: about 30 ml (1 ounce) Step 1 of baby friendly Correct Answer: Have a written breastfeeding policy that is routinely communicated to all health care staff