Autoexaminarea

sânilor
Curs: Obstetrică, ginecologie și nursing specific
Elev: Irimia Gina-Cătălina
AMG III B
 Cuprins

1.Anatomia și fiziologia sânului

2. Aspectul normal al țesutului mamar
3. Autoexaminarea sânilor
 Anatomia sânului
Sânii sunt organe glandulare de origine cutanată poziționate
simetric de-o parte și de alta a liniei mediosternale în regiunea
toracică anterioară.
Sunt prezente la ambele sexe, însă dezvoltarea si
comporatamentul lor sunt complet diferite. Astfel, la barbat nu
sunt altceva decat organe rudimentare, fara structura complexa
sau activitate secretorie, pe cand la femeie, acestea evolueaza cu
o importanta deosebita, mai ales in cadrul sarcinii si in perioada
de dupa sarcina, laptele matern constituind alimentul esential al
nou-nascutului si al sugarului. Dependenta hormonala este pusa
in evidenta la pubertate, cand la sexul feminin mamelele incep sa
se dezvolte progresiv, in copilarie neexistand diferente sexuale.
Dezvoltarea completa a acestora se inregistreaza la femeia in
decursul activitatii sexuale, iar de la menopauza se declanseaza
un proces lent de atrofiere senila.
 Breast Cancer Infographics

Adipose tissue
Skin
Earth is the third planet Mercury is the closest
from the Sun object to the Sun

Ducts Nipple
Neptune is the farthest Despite being red,
planet from the Sun Mars is a cold place

Lobules Pectoral muscle

Saturn is composed of Jupiter is a gas giant
hydrogen and helium and the biggest planet
Dezvoltarea si intrarea in functiune a glandei mamare sunt declansate de o varietate de stimuli
hormonali, reprezentati in principal de estrogeni, progesteron si prolactina. Dintre acestia, cei
care initiaza dezvoltarea canaliculara a sanului sunt estrogenii, iar hormonul responsabil de
diferentierea celulelor epiteliale si dezvoltarea lobulara este progesteronul. De asemenea,
progesteronul poate actiona asupra estrogenilor, inhibandu-le legarea acestora in epiteliul mamar
ce conduce la limitarea proliferarii sistemului tubular. Prolactina reprezinta stimulul principal pentru
lactogeneza, creste numarul de receptori estrogenici, stimuland astfel celulele epiteliale sa
actioneze sinergic cu dezvoltarea canaliculara si lobuloalveolara. Hormonul eliberator de
gonadotropine (GnRH) din hipotalamus actioneaza asupra adenohipofizei, care secreta hormonul
luteinizant (LH) si hormonul foliculostimulant (FSH), ambii cu efect reglator asupra secretiei
ovariene de estrogeni si progesteron. Printr-un mecanism de feedback, pozitiv sau negativ,
nivelurile circulante de estrogeni si progesteron regleaza secretia hormonilor LH, FSH si GnRH.

Dupa nastere, la nou-nascutul de sex feminin, se inregistreaza niveluri plasmatice scazute de

estrogeni si progesteron, ce raman reduse pana mai tarziu in timpul copilariei, datorita reglarii
sensibilitatii axului hipotalamo-hipofizar prin efecte de feedback negativ ale hormonilor sexuali. La
inceputul pubertatii se remarca scaderea sensibilitatii la feedback-ul negativ realizat de estrogeni si
In timpul ciclului menstrual apar variatii semnificative in ceea ce priveste volumul sanului. In faza
luteala, progesteronul poate stimula cresterea glandulara, in aceasta perioada inregistrandu-se
modificari in rata mitotica a componentelor glandulare mai mari decat in faza foliculara. Se
constata astfel cresterea in volum a sanului in a doua jumatate a ciclului menstrual, pusa pe
seama dezvoltarii temporare in dimensiuni a lobulilor, fara vreo evidenta proliferare epiteliala.

In sarcina are loc o crestere marcata a secretiei si eliberarii de estrogeni si progesteron circulanti,

de origine ovariana si placentara, ce determina modificari majore in ceea ce priveste forma si
structura sanului. Glandele areolare devin proeminente pe un tegument areolar ce se inchide la
culoare, in timp ce ductele si lobulii prolifereaza, iar glanda creste in volum. Odata cu expulzia
placentei, la nivel plasmatic au loc scaderi cantitative ale estrogenilor si progesteronului, fenomen
ce permite exprimarea maximala a activitatii lactogenice a prolactinei. Producerea si evacuarea
laptelui sunt fenomene intermediate de arcuri reflexe neurale, a caror origine se afla la nivelul
terminatiilor nervoase libere ale complexului areolo-mamelonar. Ocitocina are efect contractil
asupra componentelor musculare netede din celulele mioepiteliale din jurul alveolelor, ceea ce
conduce la compresia acestora si expulzia laptelui sub presiune in sinusurile galactofore. In
Scaderea secretiei ovariene de estrogeni si progesteron de la menopauza determina o
involutie progresiva a componentelor canaliculare si glandulare, epiteliul acestora devenind
atrofic sau hipoplazic. Este favorizata condensarea tesutului fibros inconjurator, iar parenchimul
este substituit cu tesut adipos si stromal, in detrimentul structurii glandulare suportive. Stroma
si continutul adipos se pierde odata cu inaintarea in varsta si astfel are loc o reducere a
structurii lobulare, a densitatii, formei si conturului.

Ginecomastia presupune dezvoltarea exagerata a glandei mamare la sexul masculin. Este

frecvent pusa pe seama unor conditii patologice, insa trebuie tinut cont ca ginecomastia poate
aparea fiziologic, in special in trei etape ale vietii, in perioada neonatala, ca rezultat al actiunii
estrogenilor placentari asupra parenchimului mamar neonatal, in adolescenta, cand poate
exista un exces de estradiol in raport cu testosteronul, si in senescenta, cand datorita unui
hiperestrinism relativ are loc deprimarea nivelului de testosteron.
 Breast Cancer Infographics

Good rest
Earth is the third planet
from the Sun

Good nutrition
Jupiter is a gas giant
and the biggest planet

Sport
Saturn is composed of
hydrogen and helium
Aspectul normal al ţesutului mamar
Consistenţa şi aspectul ţesutului mamar variază în funcţie de mai mulţi factori: genetica,
vârsta, numărul naşterilor, perioada ciclului menstrual. Partea glandulară (exterior-sus) a sânilor
este mai tare, mai fermă, în timp ce partea adipoasă (interior-jos) se simte ca fiind mai moale.
Aceste diferenţe se pot constata la examinarea mamară, care poate fi prin auto-examinare sau
realizată de către medic.

Semnele de normalitate sunt: forma şi mărimea similară a sânilor, situarea sfârcurilor la acelaşi

nivel, culoarea şi aşezarea areolei, pielea netedă, fără ulceraţii şi umflături sau retrageri atât în
zona sânilor, cât şi în zona subrațului  şi în cea de deasupra claviculei.
 
Următoarele modificări necesită examinare medicală de urgenţă:

distorsiunea sau retracţia sfârcului (la femei care nu au inversia acestuia)

modificarea consistenţei şi a dimensiunii unui sân (asimetrie)
retracţia tegumentului
ulceraţii, eczeme, înroşirea pielii, aspect de coajă de portocală
 Contents of This Template

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 Table of Contents

01 02 03
About the Project Discussion Diagnosis
Here you could describe the Here you could describe the Here you could describe the
topic of the section topic of the section topic of the section

04 05
Treatment Patient Monitoring
Here you could describe the Here you could describe the
topic of the section topic of the section
 Introduction
Mercury is the closest planet to the Sun
and the smallest one in the Solar
System—it’s only a bit larger than our
Moon. The planet’s name has nothing to
do with the liquid metal, since it was
named after the Roman messenger god
01
About the Project

You could enter a subtitle

here if you need it
 Identifying Information

Mars Jupiter Saturn

Despite being red, Mars is Jupiter is a gas giant and also Saturn is the ringed one. It’s
actually a cold place. It’s full of the fourth-brightest object in a gas giant, composed mostly
iron oxide dust the sky of hydrogen and helium
 Patient Medical History

Age 2010
35 years Despite being red, Mars is
actually a cold place. It’s full of
iron oxide dust
Gender
Female
2015
Mercury is the closest planet
Allergies to the Sun and the smallest in
None our Solar System

Location 2019
Málaga, Spain Saturn is the ringed one. It’s
composed of hydrogen
 Family History

1st Generation 2nd Generation Patient

Saturn is the ringed

one. Is a gas giant

Despite being red, Jupiter is a gas giant

Mars is a cold place and the biggest planet

Mercury is the closest

planet to the Sun
 Review of Systems

Saturn Mercury Mars Jupiter

Saturn is a gas giant, Mercury is the closest Despite being red, Mars Jupiter is a gas giant and
composed mostly of planet to the Sun and is a cold place. The the biggest planet in our
hydrogen and helium the smallest one planet is full of iron dust Solar System
Physical Examination

Mars
Despite being red, Mars is
actually a cold place. It’s full of
iron oxide dust

Saturn
This is the ringed one. It’s a
gas giant, composed mostly of
hydrogen and helium

Jupiter
Jupiter is a gas giant and the
biggest planet in our Solar
System
More Findings
Expansion

3.3M
Mercury is the closest planet to the Sun and
the smallest one in our Solar System

22.5K
Saturn is a gas giant, composed mostly of
hydrogen and helium
 Discussion

Dr. Jenna Doe

“Despite being red, Mars is actually a cold place. It’s full of
iron oxide dust, which gives the planet its reddish cast”

Dr. John James

“Jupiter is a gas giant and the biggest planet in our Solar
System. It’s the fourth-brightest object in the sky”

Dr. Daniel Patterson

“Saturn is the ringed one. It’s a gas giant, composed mostly of
hydrogen and helium”
Discussion Summary

Mercury is the closest planet to the Sun and

the smallest one in the Solar System—it’s only
a bit larger than our Moon. The planet’s name
has nothing to do with the liquid metal, since
it was named after the Roman messenger god
 Comparison

Test 1 Test 2 Test 3

Factor 1 0.001 2.1 0.5

Factor 2 2.1 3.3 2.34

Factor 3 1.23 0.002 0.345

Factor 4 4.6 7.8 4.98

Factor 5 2.567 3.009 0.0078

 Diagnosis

Mercury Venus Mars

Mercury is the closest planet Venus has a beautiful name Despite being red, Mars is a
to the Sun and the smallest and is the second planet from cold place. The planet is full of
one in the Solar System the Sun iron oxide dust

Jupiter Saturn Neptune

Jupiter is a gas giant and the Yes, this is the ringed one. It’s Neptune is the farthest planet
biggest planet in our Solar a gas giant, composed mostly from the Sun and the fourth-
System of hydrogen and helium largest by diameter
 Treatment
Venus
Venus has a beautiful name and is the
second planet from the Sun. It’s hotter
than Mercury and its atmosphere is
extremely poisonous
Mercury
Mercury is the closest planet to the
Sun and the smallest one in the Solar
System—it’s only a bit larger than our
Moon
Patient Monitoring

Week 1 Week 2 Week 3

Neptune is the Venus has a Despite being
farthest planet beautiful name, red, Mars is a
from the Sun but it’s too hot cold place

Mercury Mercury Mercury

Mars Mars Mars

Saturn Saturn Saturn

 Contraindications & Indications
● Here you can describe the
reason to stop the treatment
● Here you can describe the
reason to stop the treatment
● Here you can describe the
reason to stop the treatment
● Here you can describe the
reason to stop the treatment
● Here you can describe the
reason to stop the treatment
● Here you can describe the
reason to start the treatment
● Here you can describe the
reason to start the treatment
● Here you can describe the
reason to start the treatment
● Here you can describe the
reason to start the treatment
● Here you can describe the
reason to start the treatment
 Post-prevention

Mercury Mars
Despite being red, Mars is Despite being red, Mars is
actually a cold place. It’s full of actually a cold place. It’s full of
iron oxide dust iron oxide dust

Venus Saturn
Venus has a beautiful name This is the ringed one. It’s a
and is the second planet from gas giant, composed mostly of
the Sun hydrogen and helium

Neptune Jupiter
Neptune is the fourth-largest Jupiter is a gas giant and the
planet in our Solar System and biggest planet in our Solar
the farthest from the Sun System
 Case Timeline

Week 1 Week 2 Week 3 Week 4

Despite being red, Mars Saturn is composed of Neptune is the farthest Mercury is the closest
is actually a cold place hydrogen and helium planet from the Sun planet to the Sun
Conclusions
Mercury is the closest planet to the Sun
and the smallest one in the Solar
System—it’s only a bit larger than our
Moon. The planet’s name has nothing
to do with the liquid metal, since it was
named after the Roman messenger god
References

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 Our Team

Dr. John James

Here you could talk a bit about this

person
Dr. Daniel
Patterson
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 Thanks!

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