NUR 505 Module 10 Study Guide 2026 | Female GU Assessment, Breast Examination,
Women's Health & Exam Prep PDF | University of Alabama
The University of Alabama
Capstone College of Nursing
NUR 505 Advanced Health Assessment
Module 10 Female GU Study Guide
Chapter 17
1. Be able to identify the tanner stages for females.
The Tanner Stages, also known as the Sexual Maturity Rating (SMR), categorize female development based
on two criteria: breast development (M stages) and pubic hair growth (P stages). Breast development is
typically the first sign of puberty in girls.
Female Breast Development (M Stages)
Stage Key Description
Characteristic
M1 Preadolescent Only the nipple is raised above the level of the breast.
M2 Budding Bud-shaped elevation of the areola; areola diameter increases.
M3 Enlargement Breast and areola are further enlarged, with no contour separation.
M4 Secondary The areola and nipple form a secondary elevation above the breast contour.
Mound
M5 Adult The areola is usually part of the general breast contour, and the nipple projects.
Female Pubic Hair Development (P Stages)
Stage Key Description
Characteristic
P1 Preadolescent No growth of pubic hair.
P2 Initial Growth Initial, scarcely pigmented, straight hair along the medial border of the labia.
P3 Sparse/Curly Sparse, dark, visibly pigmented, curly hair on the labia.
P4 Abundant Hair is coarse and curly, abundant but does not yet extend past the inguinal fold.
P5 Adult Lateral spreading of adult hair type to the medial surface of the thighs.
Distribution
The onset of female puberty is marked by reaching stage M2 or P2. Menarche (the first menstrual period)
generally occurs when the patient is in SMR 4 or breast stage 3 to 4.
2. Review the risk factors for breast cancer.
, The risk factors for breast cancer are categorized as nonmodifiable (cannot be changed) and
modifiable (lifestyle-related).
Breast Cancer Risk Factors
Category Risk Factor Detail
Nonmodifiable Age & Gender Risk increases with aging. Incidence is higher in female
breasts. Transgender men with intact breasts remain at
risk. Most malignant tumors occur after age 50 years.
Genetics Having an inherited BRCA1 or BRCA2 mutation gives a
45% to 80% lifetime risk.
Family History Risk approximately doubles with one first-degree
relative (parent, sibling, child) who had breast cancer.
Prior History Personal history of breast cancer in one breast
increases the risk in the other. Certain benign breast
conditions (e.g., atypical hyperplasia or lobular cancer
in situ) substantially increase risk.
Other Factors Radiation therapy to the chest as a young adult
significantly increases risk. Menarche before age 12 or
menopause after age 55 slightly increases risk.
Modifiable/Lifestyle Childbirth Nulliparity (no children) or giving birth to the first child
after age 30 increases risk.
Hormone Therapy Use of combined estrogen and progesterone hormone
replacement therapy (HRT) for more than 4 years after
menopause increases risk.
Obesity/Diet Obesity is associated with increased risk, especially
after menopause, as fat tissue can increase estrogen
levels.
Lifestyle Lack of physical activity. Risk increases with the
amount of alcohol consumed.
3. Know how to perform a breast exam. What are some different techniques used? Know
what a hook technique is and how to perform it. What are normal findings? What are
abnormal findings? What are signs of cancer? What about for a patient who has had a
mastectomy?
The breast exam uses inspection and palpation to assess the breasts, axillae, and related lymph
node chains.
, Breast Examination Technique
The general exam involves Inspection (patient seated in various positions) and Palpation
(patient seated and supine).
1. Inspection (Patient Seated): Compare size, symmetry, and contour as the patient changes
positions:
• Arms hanging loosely at sides.
• Arms extended overhead.
• Hands pressed on hips (to contract pectoral muscles).
• Leaning forward from the waist (especially helpful for large breasts),.
2. Palpation Techniques (Systematic Assessment): While the patient is supine, palpate
systematically using light, medium, and deep pressure,. Common patterns include the:
• Vertical Strip Technique: Moving up and down across the breast tissue. (This method is
found to be more thorough.)
• Concentric Circle Technique.
• Wedge Method.
Hook Technique: This term in the context of the breast exam often refers to palpation of the
supraclavicular lymph nodes. The examiner hooks their fingers over the clavicle lateral to the
sternocleidomastoid muscle to feel deep into the fossa.
Normal Findings
Area Normal Finding
Size & Contour Breasts are compared for symmetry (though some minor asymmetry is
common in adolescents),. Contour should be uninterrupted.
Skin & Vessels Skin is smooth and texture is fine. Venous patterns should be
symmetric.
Nipple/Areola Nipples are typically everted. Areolae are round or oval, with expected
Montgomery tubercles (tiny sebaceous glands).
Palpation Tissue feels dense, firm, and elastic. Expect the lobular feel of glandular
tissue or fine, granular tissue in older adults,. Lymph nodes
(axillary/supraclavicular) are not usually palpable,.
Abnormal Findings and Signs of Cancer
Abnormal findings during inspection or palpation may suggest malignancy or other conditions,.
Finding Indication / Concern
Women's Health & Exam Prep PDF | University of Alabama
The University of Alabama
Capstone College of Nursing
NUR 505 Advanced Health Assessment
Module 10 Female GU Study Guide
Chapter 17
1. Be able to identify the tanner stages for females.
The Tanner Stages, also known as the Sexual Maturity Rating (SMR), categorize female development based
on two criteria: breast development (M stages) and pubic hair growth (P stages). Breast development is
typically the first sign of puberty in girls.
Female Breast Development (M Stages)
Stage Key Description
Characteristic
M1 Preadolescent Only the nipple is raised above the level of the breast.
M2 Budding Bud-shaped elevation of the areola; areola diameter increases.
M3 Enlargement Breast and areola are further enlarged, with no contour separation.
M4 Secondary The areola and nipple form a secondary elevation above the breast contour.
Mound
M5 Adult The areola is usually part of the general breast contour, and the nipple projects.
Female Pubic Hair Development (P Stages)
Stage Key Description
Characteristic
P1 Preadolescent No growth of pubic hair.
P2 Initial Growth Initial, scarcely pigmented, straight hair along the medial border of the labia.
P3 Sparse/Curly Sparse, dark, visibly pigmented, curly hair on the labia.
P4 Abundant Hair is coarse and curly, abundant but does not yet extend past the inguinal fold.
P5 Adult Lateral spreading of adult hair type to the medial surface of the thighs.
Distribution
The onset of female puberty is marked by reaching stage M2 or P2. Menarche (the first menstrual period)
generally occurs when the patient is in SMR 4 or breast stage 3 to 4.
2. Review the risk factors for breast cancer.
, The risk factors for breast cancer are categorized as nonmodifiable (cannot be changed) and
modifiable (lifestyle-related).
Breast Cancer Risk Factors
Category Risk Factor Detail
Nonmodifiable Age & Gender Risk increases with aging. Incidence is higher in female
breasts. Transgender men with intact breasts remain at
risk. Most malignant tumors occur after age 50 years.
Genetics Having an inherited BRCA1 or BRCA2 mutation gives a
45% to 80% lifetime risk.
Family History Risk approximately doubles with one first-degree
relative (parent, sibling, child) who had breast cancer.
Prior History Personal history of breast cancer in one breast
increases the risk in the other. Certain benign breast
conditions (e.g., atypical hyperplasia or lobular cancer
in situ) substantially increase risk.
Other Factors Radiation therapy to the chest as a young adult
significantly increases risk. Menarche before age 12 or
menopause after age 55 slightly increases risk.
Modifiable/Lifestyle Childbirth Nulliparity (no children) or giving birth to the first child
after age 30 increases risk.
Hormone Therapy Use of combined estrogen and progesterone hormone
replacement therapy (HRT) for more than 4 years after
menopause increases risk.
Obesity/Diet Obesity is associated with increased risk, especially
after menopause, as fat tissue can increase estrogen
levels.
Lifestyle Lack of physical activity. Risk increases with the
amount of alcohol consumed.
3. Know how to perform a breast exam. What are some different techniques used? Know
what a hook technique is and how to perform it. What are normal findings? What are
abnormal findings? What are signs of cancer? What about for a patient who has had a
mastectomy?
The breast exam uses inspection and palpation to assess the breasts, axillae, and related lymph
node chains.
, Breast Examination Technique
The general exam involves Inspection (patient seated in various positions) and Palpation
(patient seated and supine).
1. Inspection (Patient Seated): Compare size, symmetry, and contour as the patient changes
positions:
• Arms hanging loosely at sides.
• Arms extended overhead.
• Hands pressed on hips (to contract pectoral muscles).
• Leaning forward from the waist (especially helpful for large breasts),.
2. Palpation Techniques (Systematic Assessment): While the patient is supine, palpate
systematically using light, medium, and deep pressure,. Common patterns include the:
• Vertical Strip Technique: Moving up and down across the breast tissue. (This method is
found to be more thorough.)
• Concentric Circle Technique.
• Wedge Method.
Hook Technique: This term in the context of the breast exam often refers to palpation of the
supraclavicular lymph nodes. The examiner hooks their fingers over the clavicle lateral to the
sternocleidomastoid muscle to feel deep into the fossa.
Normal Findings
Area Normal Finding
Size & Contour Breasts are compared for symmetry (though some minor asymmetry is
common in adolescents),. Contour should be uninterrupted.
Skin & Vessels Skin is smooth and texture is fine. Venous patterns should be
symmetric.
Nipple/Areola Nipples are typically everted. Areolae are round or oval, with expected
Montgomery tubercles (tiny sebaceous glands).
Palpation Tissue feels dense, firm, and elastic. Expect the lobular feel of glandular
tissue or fine, granular tissue in older adults,. Lymph nodes
(axillary/supraclavicular) are not usually palpable,.
Abnormal Findings and Signs of Cancer
Abnormal findings during inspection or palpation may suggest malignancy or other conditions,.
Finding Indication / Concern
