If not having periods, select a familiar date to examine her breasts each month – same time each month Self-examination will familiarize the woman with her own breasts and their normal variation Emphasize the absence of lumps (not the presence of them) Encourage her to report any unusual findings promptly While teaching, focus on the positive aspects of BSE – avoid citing frightening mortality statistics of breast cancer Keep teaching simple – more likely for compliance Teach woman to do this in front of a mirror while she is disrobed to the waist At home, she can start palpation in the shower, where soap and water assist palpation Then palpation should be performed while lying supine Know quadrants of breast and tail of Spence inner quadrant Upper outer quadrant – site of most breast tumors Lower inner quadrant Lower outer quadrant Tail of Spence – located in the upper outer quadrant; cone shaped breast tissue that projects up into the axilla, close to the pectoral group of axillary lymph nodes Know axillary lymph nodes and where to palpate Central axillary nodes – high up in the middle of the axilla, over the ribs and serratus anterior muscle; these receive lymph from the other three groups of nodes Pectoral (anterior) – along the lateral edge of the pectoralis major muscle, just inside the anterior axillary fold Subscapular (posterior) – the lateral edge of the scapula, deep in the posterior axillary fold Lateral – along the humerus, inside the upper arm What is mammography Mammography: the process of using low-energy X-rays (usually around 30 kVp) to examine the human breast, which is used as a diagnostic and screening tool. The goal of mammography is the early detection of breast cancer, typically through detection of characteristic masses and/or microcalcifications of breast cancer The genetic contribution to breast cancer involves specific gene mutations at the BRCA1 and BRCA2 locations – women with these mutations are at increased risk for breast cancer and ovarian cancer White women have a higher incidence of breast cancer than African-American women starting at age 45
Abnormalities of tongue (see above) Antibiotic therapy and tongue appearances Black hairy tongue – occurs after use of antibiotics (see above) Turbinates—names—color—acute/rhinitis/sinusitis—differentiate Turbinate: the bony ridges curving down from the lateral walls Superior turbinate will not be in view, but the middle and inferior turbinates appear in the same light red color as the nasal mucosa Turbinates are vascular and tender if touched Allergic Rhinitis: rhinorrhea, itching of nose and eyes, lacrimation, nasal congestion, and sneezing are present Serous edema and swelling of turbinates fill the air space Turbinates are usually pale, and their surface looks smooth and glistening May be seasonal or perennial, depending on allergen Acute Rhinitis: first sign is a clear, watery discharge, rhinorrhea, which later becomes purulent Accompanied by sneezing and swollen mucosa, which causes nasal obstruction Turbinates are dark red and swollen Sinusitis: facial pain, upper respiratory infection Signs include red, swollen nasal mucosa, swollen turbinates, and purulent discharge Person also has fever, chills, malaise With maxillary sinusitis, dull, throbbing pain occurs in cheeks and teeth on the same side, and pain with palpation is present With frontal sinusitis, pain is above the supraorbital ridge