Breasts can form the basis of race, genetic, age, and factors such as breastfeeding greater difference. My adult female breasts were generally hemisphere - or cone, and both basic symmetry, breastfeeding after a certain degree of prolapse or slightly flat. Older women often shrink breasts droop less soft. The breast center is part of nipple. Nipple was normal Tube-shaped or conical form symmetrical on both sides of the surface, pink or brown. Nipple diameter of about 0.8 to 1.5 cm, there are many pits to lose duct openings. Nipple skin pigmentation around the ring deeper zones are areola. Areola diameter of about 3 to 4 cm, the colors vary, red roses were adolescence, pregnancy and lactation pigmented deepening, dark brown. The Department of breast glands in the skin thicker around the nipple and areola Department thinner. This can sometimes see through the skin subcutaneous superficial vein.
Both sides of the chest at breast chest in front of their location with age, size and degree of development of the breasts. Adult female breasts in front of the general section 2 ~ 6 ribs between the inner margin of nearly parasternal, axillary to the outer edge of the front line, breast mast up when axillary centerline. Extramammary the very narrow part of the breast to form axillary tail extended armpit. Young women generally located nipple intercostal four or five intercostal level, collarbone midline 1cm; Middle-aged female nipple located six intercostal, a clavicle midline ~ 2cm.
Because breast shape and position with significant individual variability, the female breast development by age and also various physiological factors such as the time and therefore should be avoided within the normal range of patterns and the location of the breast is seen as pathological, thereby creating unnecessary burden on the idea.
The internal structure of the breast
Breast mainly by the glands, ducts, fatty tissue and fibrous tissue components. Its internal structure is like an upright growth of trees.
Breast by 15 ~ 20 Lobectpomy components, each lobe divided into several gland lobule, each gland lobule again from 10 ~ 100 acinar components. These acinar closely with the small duct around the openings and acinar small duct connected. Many small duct between pooled into lobular breast, a number of inter-lobular breast further consolidated into a whole lobe of the mammary duct, also known as losers duct. Duct lost a total of 15 ~ 20, a nipple radially arranged for the center gathered at the areola, the openings in the nipple, as losers foramen. Losers duct in the nipple Department relatively narrow, followed swelling of the ampulla, known as losers duct sinus, the role of milk storage. For mammary duct openings Cladding squamous epithelial cells, narrow Department to shift shape epithelium, ampulla subnational catheter to double columnar epithelial monolayer or columnar epithelium, terminals catheter Department for nearly cubic acinar epithelium, the lining cubic acinar epithelium.
Nipple surface coverage Cladding horny squamous epithelium, on the thin cortex. Nipple by dense connective tissue and smooth muscle composition. Smooth muscle was around or radiation-arranged, when mechanical stimulation, the smooth muscle contraction, can nipple erection, and squeeze milk duct and losers from their sinus contents. Areola hair and skin glands. A sweat gland, the sebaceous gland and breast. Its also known as the areola sebaceous glands, and more superficial, with the protection of the skin secretions, lubrication nipple and baby lips role.
The breast was fatty tissue in the breast cystic packets around a hemispherical form the whole, this layer of fat tissue cystic called fatty capsule. Fat thickness of the capsule may be because of age, fertility and other reasons, varied greatly among individuals. Adipose tissue of the number of breast size is determined one of the important factors.
Subcutaneous breast at the superficial fascia between shallow and deep. Extended breast superficial fascia tissue formation of the cable-like lobular partitions, one end connected to the chest muscle, even on the other side of the skin, mammary glands fixed to the chest among the subcutaneous tissue. These supportive role and position of breasts fixed connective tissue fibers known as breast or suspensory ligament Cooper ? s ligament. Deep superficial fascia at the deep breast, the chest and between the superficial fascia organizations linked to osteoporosis, breast Space said. It will enable the breast is relatively fixed, while the chest wall for a certain period of mobility. Sometimes, some may pass through breast glands and osteoporosis organizations shallow depth of the chest, therefore, for radical mastectomy for breast cancer, should be pectoralis major muscle and fascia together resection.
Most of breast pectoralis major surface, deep in the lateral surface serratus anterior, medial and inferior oblique abdominal wall at the bottom and the surface rectus fascia.
In addition to these structures, the distribution of breast also rich in blood vessels, lymphatic vessels and nerves, the role of nutrition in breast play and the maintenance of metabolic role, and has an important foreign scientific significance. Breast arterial supply mainly from : a branch of the axillary artery, the internal thoracic artery branches of the intercostal descending aorta and the intercostal vascular perforator. Breast-deep venous return, and in the shallow two groups : Superficial distribution in the breast skin, and more gathered vein and internal mammary anterior vein; Deep venous injection of thoracic vein, intercostal vein and the vein axillary branches, and then into the innominate veins, vein, semi-azygos vein, axillary vein. When hematogenous metastasis of breast cancer, blood into the cancer cells or tumor thrombus through these channels into the superior vena cava, lung or other parts of the transfer; Also by the intercostal vein into the spine venous plexus, occurred bone or central nervous system of transfer. Breast lymphatic drainage mainly in the following ways : Axillary lymph nodes, internal mammary lymph nodes, subclavian / lymph node, abdominal lymphatic milk and two subcutaneous lymphatic network traffic. Among them, the most important thing is axillary lymph nodes and internal mammary lymph nodes, lymph node metastasis of breast cancer is the first stop. The nerves from the breast section 2 ~ 6 intercostal nerve plexus and neck skin collateral 3 ~ 4 disclaimer. In addition to sensory nerve, there are sympathetic nerve fibers running with vascular distribution in the nipple, areola and breast tissue. Nipple and Areola the nerve endings rich and astute, there chapped nipple, intense pain. In addition, qualified radical mastectomy for breast cancer, also need to address the brachial plexus, thoracodorsal nerve and the long thoracic nerve anatomy.
Breast growth experienced in different periods
Mastitis is a common mammalian characteristics, the general expectation for growth, and both symmetric. Human breast of only one pair of breasts, and from the tumor. Since birth, breast development experience in early childhood, adolescence, sexual maturity, pregnancy, lactation and menopause such different periods. At various times of change, the body endocrine hormone levels vary widely, affected by, breast development and physiological function is special.
Child period, in the neonatal period, as the mother of estrogen through the placenta into small baby, cause breast tissue, so about 60% of newborns after birth two to four days, there was a nipple under 2 cm size of the nodules, and a small amount of milk-like objects quality secretion, as the mother of the progressive metabolic hormones, a phenomenon that was born after an in ~ 3 weeks to disappear. It should be noted here is not to squeeze a hand nipple, so as to avoid infection. Some of our popular areas of customs, that all newborns after birth extrusion nipple, otherwise that will cause Crater Nipple, this understanding is unscientific and practice is not desirable, and the result is Crater Nipple embryonic period of breast abnormalities, and not because there is no extrusion nipple. The infant, breast basically “static” state glands showed degeneration, more men than women completely. Since the beginning of adolescence, by various endocrine hormones in female breast into a lifetime physical and functional activity of the most active period until menopause. In the adolescent experience, the organizational structure of the breast are almost complete, entered sexual maturity breast. In each month by the cycle, with the ovarian hormones cyclical changes, breast tissue is also taking place in the cycle of proliferation and restoration of the original changes. During pregnancy and breastfeeding women of childbearing age is the special physiological periods, when the breast in order to meet the special physiological needs, and a series of changes. Since the beginning of menopause, ovarian hormones gradually reduced breast physiological activities and the increasingly weakened.
Breast physiological function mainly in the following areas :
(1) breastfeeding : lactating breast is the most basic physiological functions. Breast is unique to mammals feeding future generations of organs, the breast development, maturity, is to prepare for nursing activities. Postpartum hormones in the role of large and small babies suck stimulation, breasts have started to law and from the milk for infant growth and development needs.
(2) secondary levy : breast female pubic hair is an important symbol. Generally speaking, breasts in menarche before 2 to 3 years been in the process of development, that is to say the 10-year-old had already started to grow, is the first of pubic hair, adolescent girls is a sign of the beginning. Have one pair of fullness, symmetrical shape and beautiful woman’s breasts is a beautiful symbol. Many women because their breasts are not satisfied with the variety and seek to do plastic surgery or wear a prosthesis, especially those due to breast cancer surgery and had the affected breast removed swap persons. This is because every woman wants to have complete and beautiful breasts and women to demonstrate their charm. Therefore, it can be said that the female breast is physical beauty of a vital component.
(3) Participation in activities : in sexual activities, in addition to breast female genital outside the most sensitive organs. In touch, and caressing and kissing sexually stimulated, the breast-response performance : erectile nipples, breasts superficial venous congestion, the breast is full, etc.. With the increased stimulation, which would also be strengthened, Passionate climax comes, the culmination of these changes, dissipated period gradually returning to normal. It can be said that the entire breast in sexual activities occupy important positions. For newlyweds, and those who instigated sex life is particularly important to understand breast sexual life in the importance, will help you obtain a perfect and harmonious sexual life. Regardless of the stage to arouse sexual desire or sexual excitement has come when gently fondled and kissed the breast can stimulate the libido, sexual excitement growing stronger, until the climax.
Breast affect physiological function of the endocrine hormone
Breast multiple endocrine hormone is the target organ, therefore, the growth of the breast and its physiological functions of play is dependent upon various endocrine hormones related to the common role. If one of the one or more of a hormone disorder, or between the various hormone imbalance, will directly or indirectly affect the situation of the breast and its physiological function.
(1) of the breast direct role of the hormone
Estrogen hormone (estrogen, E) : Major from the ovarian follicle secretion of adrenal and testicular also produced small quantities of estrogen, in the middle and late pregnancy estrogen mainly stems from the placenta chorionic epithelium. Estrogen physical activity is the strongest estradiol (E2). In puberty, the ovarian follicles mature and start producing a lot of estrogen, estrogen may promote breast ductal epithelial hyperplasia, and lobular breast connective tissue surrounding development, and extend the duct branches. The effect of estrogen on breast lobular breast and the formation of mature, we can not separate role to play, there must be a complete pituitary function of the control system. Estrogen can stimulate the synthesis and release of the anterior pituitary prolactin, thereby promoting the development of the breast; While large doses of estrogen can compete prolactin receptor, thereby inhibiting lactation role of prolactin. During pregnancy, estrogen in hormone such as lutein synergies, but also promote the development of acinar and milk production. The exogenous estrogen can OVX animals breast tissue, cell proliferation index was significantly higher than normal breast tissue. Estrogen may make breast vascular dilation, increased permeability.
Progesterone (progesterone, P) : also known as lutein, mainly by the luteal secretion by the placenta during pregnancy secretion. Progesterone most physiological activity of progesterone, whose main role is to facilitate the breast lobules and the acinar development, the estrogen to stimulate the development of mammary duct, on the basis of breast to be fully developed. Large doses of progesterone inhibited prolactin role of lactation. Progesterone right breast and development of, we not only need estrogen synergies, but also must have a complete system of pituitary function. Experiments show that the removal of the pituitary ovariectomized rats, breast total lack of progesterone response. Progesterone is by stimulating pituitary prolactin secretion, or it may be through increased mammary epithelial cells on the prolactin response and completion of its joint development of the role of the breast.
Prolactin (prolactinoma PRL) : from the anterior pituitary cells secreted a protein hormone. Its main role is to facilitate the growth of breast development, launch and maintain lactation. Prolactin and breast epithelial cells PRL receptors, produce a series of responses, including stimulation of ? - lactalbumin Synthesis, uracil nucleotide change ? breast cell Na + ions and the conversion of synthesis of fatty acids stimulate mammary acinar development and the promotion of milk production and secretion. In puberty, prolactin in estrogen, progesterone and other hormones in working together, can promote breast development; Breast during pregnancy can be fully developed so that the breast ductal lobular terminal as small acinar to prepare for breastfeeding. Pregnancy lot of estrogen and progesterone suppression of prolactin in lactating; After childbirth, estrogen and progesterone levels drop rapidly, lifting the inhibition of PRL, prolactin secretion of an increase in the number of breast milk began. Since then, as the laws and the establishment of breastfeeding, infant constantly sucking reflex nipple created to stimulate the secretion of pituitary prolactin, thereby lactation may last for several months to several years. PRL secretion by the hypothalamus prolactin inhibitory factor and the release of prolactin and other hormones factor adjustment. Bromocriptine levodopa and other drugs can inhibit the secretion of prolactin; Thyrotropin-releasing hormone, 5-hydroxytryptamine and certain drugs (such as reserpine, chlorpromazine) promotes the secretion of prolactin; Small doses of estrogen and progesterone can promote secretion of pituitary prolactin, and large doses of estrogen , progesterone inhibit the secretion of prolactin.
(2) of the breast have indirect effects of hormones
Follicle stimulating hormone (follicle-stimulating hormone, FSH) : secreted by the anterior pituitary. A major role to stimulate ovarian secretion of estrogen, so as to the development of breast and physiological function of an indirect effect.
Luteinizing hormone (Beijing hormone, LH) : secreted by the anterior pituitary. The main role of lutein stimuli so as to the development of breast and physiological function of an indirect effect.
Oxytocin (SON) : from posterior pituitary secretion. In promoting breastfeeding milk from the role.
Androgen (androgen) : female secreted by the adrenal cortex come. Small can promote the development of the breast; While substantial disincentive permitted.
Other hormones : If growth hormone (growth hormone, GN), adrenocorticotropic hormone (pathological - hormo ne), thyroxine (-3,5) and insulin (insulin), these hormones on the development of breast and various functional activities have indirect effects.
The selection of milk
Breast milk from the acinar cells secreted. However, the secretion of milk secretion need anterior pituitary prolactin cells of the role of the milk from which depends on posterior pituitary neurosecretory cells in the role of oxytocin. Of course, milk secretion in the regulation process, estrogen and progesterone, growth hormone, thyroxine, adrenal cortical hormones, insulin and other hormones participants. In addition, the wet nurse of the nutrient intake of lactating mothers and the emotional state of this will have a definite impact.
After the baby is delivered, estrogen, progesterone secretion suddenly reduced secretion of pituitary prolactin increase substantially, prolactin direct role in breast acinar specific membrane receptor, adenylate cyclase and cAMP - Pk system, and milk production by the enzyme phosphorylation and activation, promoting Progressive milk protein synthesis, including alpha-lactalbumin and lactose synthesis and triglyceride synthesis, to ensure that the milk of synthesis and secretion. But after giving birth, posterior pituitary neurosecretory cells to secrete a lot of oxytocin, it role in the breast ductal epithelial cells and muscle around the breast muscle cells, myoepithelial stimulated contraction induced by, the original depositors in the acinar transported to the breast milk duct exit, and the emergence of “milk-ejection” . Oxytocin has been the lack of will in the synthesis of milk within acinar retention, thus oppression breast acinar epithelium of milk inhibit the synthesis and secretion.
Milk production and discharge of process is this : Most of acinar epithelium showed the top of the secretion, or glandular epithelial cells to the cavity prominent part, milk containing various ingredients, when secreted from the cell together, free to glandular cavity, namely milk, lipid more this way. Some openings for milk secretion, or secretions from glands from within the cytoplasm to glandular cavity, with exfoliated cells, protein and more this way. More water and salts through the diffusion and penetration. After childbirth 2 ~ 3 days secretion of milk, or colostrum. Colostrum than thin, water-like transparent, slightly viscous. Colostrum, which contains large amounts of protein and fat, which is full of lipid droplets macrophages, known as colostrum body, disappeared after starting breastfeeding. After becoming as milk, it is milky white, opaque liquid, we can see the ball fine fat, can be seen in mammary epithelial cells and leukocyte.
As the baby’s sucking stimulate the nipple of sensory nerve endings, thus evoked action potentials, and upstream along the spinal cord to the hypothalamus, pituitary secretion of prolactin and oxytocin. The baby’s repeated stimulation hormone secretion above will continue to take place. Therefore, the law of breastfeeding may last for several months to several years. Once the baby’s sucking stop lactation reduce or stop immediately. In lactating animals, such as adrenalectomy of acceptance, quickly reduce lactation; Another corticosteroid injections, lactation can resume. Similarly, thyroxine, growth hormone, ACTH, etc. on the occurrence and lactation have to maintain a very important role. In addition, the transverse thoracic spinal cord waist, the breast or the spinal cord was cut off after, it will also stop lactation. A large number of exogenous estrogen intake may also terminate lactation, such as clinical use of high doses of estrogen to breast milk as may terminate breastfeeding. Breastfeeding mothers of anxiety, anguish, fear, anxiety and other emotional changes, but will also affect neural reflex and secretion of milk from. Nannie poor nutritional status, it will also reduce the secretion of milk, as some mothers fear of obesity and body shape refused food nutrient-rich food, refused to eat boiled, or even go on a diet, it is bound to make milk secretion reduce or even stop milk secretion.
Meridian right breast, anatomy, physiology, pathology awareness at the earliest Chinese classics, “Classic” has been documented that later generations of family medicine has many expositions, such as “nipple man is the liver, breast is a kidney; Woman nipple is the liver, stomach breast is, “said Meridian breasts attribution; “Women are 12 abundant milk,” said the breast anatomy; “Raiding the sea of qi and blood, milk was uplink, downlink from scriptures,” said the source milk production; “Chong as a woman-centered, in the circles of Jimmy, red-and - not, or are blown off, which will obstruct lingers , the agglomeration of milk, or hardware or swelling, pain nuclear, “said the not-chong and breast disease is an important factor in the pathogenesis. These expositions breast disease to the Chinese medicine system theory forming the basis of modern Chinese medicine theory breast disease research and clinical treatment of the academic sources.
In general, breast physiology, pathology most affected were : liver, kidney, spleen and stomach function of normal and two by GanWeiShu Flushing whether the two veins - emphasize. Qi-blood in the viscera, a congenital kidney Essence, the spleen and stomach after Tianshui Valley Gas, possession of the liver and reduced blood-gas machines on the physiological and pathological breast greatest impact. Breast development in the process, whether congenital Shenqi exuberant play a decisive role. Kidney-shing, to metformin, the two punch Naomaitong Sheng, can be in the role of intracellular Palace have menstruation, his reproductive function; Can role in the breast, breast development, to generate after preparing for lactation. Breast milk is a woman’s basic function, milk secretion and regulation and kidney, spleen and stomach and liver very close relationship. Sheng is Shenqi to metformin, gynecomastia in full, then filling milk; Qi stomachs acquired for the country, the formation of qi and blood from the spleen and stomach Water Valley gas, milk production from water stomachs Valley niceties as metaplasia, it is fitting stomachs more milk and thick, Qi stomachs were less milk and desalination; Liver possession of blood, hepatic blood deficiency is less milk. The milk secretion in the regulation process, and liverQI Shuxie comprising the stomachs of the most important. Liver-QI, air-Stagnant or stomachs transportation, missing Secretary, dampness and heat, milk Tongxinluo closed resistance, where Qi and blood stasis from sluggish milk, or a sudden decrease or even condensed milk into septic for Mastitis. Meridian links breast : breast and stomach by Sibai, Jueyin adequate liver and salt by the two veins are closely related. Sibai stomach classics were straight from the ST under milk and milk penetration; Jueyin foot on the liver consistent diaphragm, cloth around the nipple and the Chest; Chong-2 veins are at a cell, through abdominal Ren, on the customs yuan, to the hearts, red - umbilical vein embrace uplink to the hearts and casual. These passages of immigration custody reconcile irrigation, a common breast maintain physiological function. If Meridian closed sluggish resistance toward the disorders can lead to various kinds of breast diseases.
