Anatomy & Physiology of Lactation Flashcards

A client had breast reduction surgery with nipple transposition. Which lactation complication is she most at risk for?

Answer: Disrupted glandular tissue and nerve pathways leading to low milk supply

Nipple transposition during breast reduction surgery may sever major milk ducts and the lateral fourth intercostal nerve, significantly impairing both milk transfer and the let-down reflex.

Insufficient glandular tissue (IGT) is associated with which breast appearance?

Answer: Tubular or asymmetric breasts with wide areolar spacing

IGT is often recognized by tubular (conical) breast shape, wide spacing between breasts (>1.5 inches), ptosis, and areolar herniation due to underdevelopment of glandular lobes.

Which variation in nipple anatomy can impede effective latch but does NOT necessarily prevent breastfeeding?

Answer: Flat or inverted nipples

Flat or inverted nipples can make initial latch difficult but can often be managed with positioning techniques, nipple shields, and breast shaping; many mothers successfully breastfeed.

During breast engorgement, the backup of milk primarily causes decreased supply through which mechanism?

Answer: FIL accumulation and pressure-induced apoptosis of alveolar cells

Severe engorgement allows FIL to accumulate and sustained intraluminal pressure can trigger apoptosis (programmed death) of secretory cells, permanently reducing capacity if unresolved.

Which anatomical feature of the nipple-areolar complex secretes an oily bacteriostatic substance that lubricates and protects the nipple during breastfeeding?

Answer: Montgomery glands (tubercles)

Montgomery glands (also called areolar glands or Montgomery tubercles) are modified sebaceous glands that secrete a lubricating fluid with a scent that may also help the infant locate the nipple.

Retained placental fragments postpartum are associated with delayed Lactogenesis II because they:

Answer: Continue secreting progesterone, suppressing full milk production

Retained placental tissue continues secreting progesterone, mimicking the pregnancy hormonal milieu and blocking the prolactin-driven onset of copious milk secretion.

The breast lobes are drained by a system that leads to the nipple. Approximately how many main lactiferous ducts open at the nipple tip in most women?

Answer: 15–25

Current ultrasound research indicates approximately 15–25 lactiferous ducts drain breast lobes and open as separate pores at the nipple tip, though earlier anatomical texts cited 15–20.