Nipple

The nipple is a raised region of tissue on the surface of the breast from which, in females, milk leaves the breast through the lactiferous ducts to feed an infant.[1][2] The milk can flow through the nipple passively or it can be ejected by smooth muscle contractions that occur along the ductal system. The nipple is surrounded by the areola, which is often a darker color than the surrounding skin.[3] It is often called a teat when referring to non-humans. Teat can also be used to describe the flexible mouthpiece of a baby bottle. In humans, nipples of both males and females can be stimulated as part of sexual arousal. In many cultures, human female nipples are sexualized,[4] or "...regarded as sex objects and evaluated in terms of their physical characteristics and sexiness."[5]

Nipple
African Breast SG
A nipple, areola and breast of a female human
Details
Part ofBreast
Identifiers
Latinpapilla mammaria
MeSHD009558
TAA16.0.02.004
FMA67771
Anatomical terminology

Anatomy

In mammals, a nipple (also called mammary papilla or teat) is a small projection of skin containing the outlets for 15–20 lactiferous ducts arranged cylindrically around the tip. Marsupials and eutherian mammals typically have an even number of nipples arranged bilaterally, from as few as two to as many as 19.[6]

The skin of the nipple is rich in a supply of special nerves that are sensitive to certain stimuli: these are slowly-adapting and rapidly-adapting cutaneous mechanoreceptors. Mechanoreceptors are identified respectively by Type I slowly-adapting with multiple Merkel corpuscle end-organs and Type II slowly-adapting with single Ruffini corpuscle end-organs, as well as Type I rapidly-adapting with multiple Meissner corpuscle end-organs and Type II rapidly-adapting with single Pacinian corpuscle end-organs. The dominant nerve supply to the nipple comes from the lateral cutaneous branches of fourth intercostal nerve.[7] The nipple is also used as an anatomical landmark. It marks the T4 (fourth thoracic vertebra) dermatome and rests over the approximate level of the diaphragm.[8]

The arterial supply to the nipple and breast originates from the anterior intercostal branches of the internal thoracic (mammary) arteries; lateral thoracic artery; and thoracodorsal arteries. The venous vessels parallel the arteries.[2] The lymphatic ducts that drain the nipple are the same for the breast.[2] The axillary nodes are the apical axillary nodes, the lateral group and the anterior group.[9] 75% of the lymph is drained through the axillary lymph nodes located near the armpit. The rest of the drainage leaves the nipple and breast through infroclavicular, pectoral, or parasternal nodes.

Since nipples change throughout the life span in men and women, the anatomy of the nipple can change and this change may be expected and considered normal.

In male mammals

Human nipple
A human male nipple

Almost all mammals have nipples. Why males have nipples has been the subject of scientific research. Differences among the sexes (called sexual dimorphism) within a given species are considered by evolutionary biologists to be mostly the result of sexual selection, directly or indirectly. For traits where there is no difference among the sexes, evolutionary biologists assume that there has been no advantage to one of the sexes losing the trait.[10][11][12]

Function

The physiological purpose of nipples is to deliver milk to the infant, produced in the female mammary glands during lactation. During breastfeeding, nipple stimulation by an infant will simulate the release of oxytocin from the hypothalamus. Oxytocin is a hormone that increases during pregnancy and acts on the breast to help produce the milk-ejection reflex. Oxytocin release from the nipple stimulation of the infant causes the uterus to contract even after childbirth.[13][14] The strong uterine contractions that are caused by the stimulation of the mother's nipples help the uterus contract to clamp down the uterine arteries. These contractions are necessary to prevent post-partum hemorrhage.[15]

When the baby suckles or stimulates the nipple, oxytocin levels rise and small muscles in the breast contract and move the milk through the milk ducts. The result of nipple stimulation by the newborn helps to move breast milk out through the ducts and to the nipple. This contraction of milk is called the “let-down reflex.”[16] Latching on refers to the baby fastening onto the nipple to breastfeeding. A good attachment is when the bottom of the areola (the area around the nipple) is in the baby's mouth and the nipple is drawn back inside his or her mouth. A poor latch results in insufficient nipple stimulation to create the let down reflex. The nipple is poorly stimulated when the baby latches on too close to the tip of the nipple. This poor attachment can cause sore and cracked nipples and a reluctance of the mother to continue to breastfeed.[17][18] After the birth of the infant, the milk supply increases based upon the continuous and increasing stimulation of the nipple by the infant. If the baby increases nursing time at the nipple, the mammary glands respond to this stimulation by increasing milk production.

Clinical significance

Pain

Nipple pain can be a disincentive for breastfeeding.[19] Sore nipples that progress to cracked nipples is of concern since many woman cease breastfeeding due to the pain. In some instances an ulcer will form on the nipple.[20] One reason for the development of cracked and sore nipples is the incorrect latching-on of the infant to the nipple. If a nipple appears to be wedge-shaped, white and flattened, this may indicates that the attachment of the infant is not good and there is a potential of developing cracked nipples.[21] Herpes infection of the nipple is painful.[22] Nipple pain can also be caused by excessive friction of clothing against the nipple that causes a fissure.

Discharge

Nipple discharge refers to any fluid that seeps out of the nipple of the breast. Discharge from the nipple does not occur in lactating women. And discharge in non-pregnant women or women who are not breastfeeding may not cause concern. Men that have discharge from their nipples are not typical. Discharge from the nipples of men or boys may indicate a problem. Discharge from the nipples can appear without squeezing or may only be noticeable if the nipples are squeezed. One nipple can have discharge while the other does not. The discharge can be clear, green, bloody, brown or straw-colored. The consistency can be thick, thin, sticky or watery.[23][24]

Some cases of nipple discharge will clear on their own without treatment. Nipple discharge is most often not cancer (benign), but rarely, it can be a sign of breast cancer. It is important to find out what is causing it and to get treatment. Here are some reasons for nipple discharge:[23]

  • Pregnancy
  • Recent breastfeeding
  • Rubbing on the area from a bra or T-shirt
  • Injury to the breast
  • Infection
  • Inflammation and clogging of the breast ducts
  • Noncancerous pituitary tumors
  • Small growth in the breast that is usually not cancer
  • Severe underactive thyroid gland (hypothyroidism)
  • Fibrocystic breast (normal lumpiness in the breast)
  • Use of certain medicines
  • Use of certain herbs, such as anise and fennel
  • Widening of the milk ducts[23]

Sometimes, babies can have nipple discharge. This is caused by hormones from the mother before birth. It usually goes away in 2 weeks. Cancers such as Paget disease (a rare type of cancer involving the skin of the nipple) can also cause nipple discharge.[23]

Nipple discharge that is not normal is bloody, comes from only one nipple, or comes out on its own without squeezing or touching the nipple. Nipple discharge is more likely to be normal if it comes out of both nipples or happens when the nipple is squeezed your nipples. Squeezing the nipple to check for discharge can make it worse. Leaving the nipple alone may make the discharge stop.[23]

Any nipple discharge in a male usually is of more concern. Most of the time a mammogram and an examination of the fluid is done. Oftentimes a biopsy is performed A fine needle aspiration (FNA) biopsy can be fast and least painful. A very thin, hollow needle and slight suction will be used to remove a small sample from under the nipple. Using a local anesthetic to numb the skin may not be necessary since a thin needle is used for the biopsy. Receiving an injection to prevent pain from the biopsy may be more painful than the biopsy itself.[25]

Some genetically-males develop a condition known as gynecomastia, in which the breast tissue under the nipple develops and grows. Discharge from the nipple can occur. The nipple may swell in some genetically-males possibly due to increased levels of estrogen.

Appearance

Changes in appearance may be normal or related to disease.

  • Inverted nipples - This is normal if the nipples have always been indented inward and can easily point out when touched. If the nipples are pointing in and this is new, this is an unexpected change.
  • Skin puckering of the nipple - This can be caused by scar tissue from surgery or an infection. Often, scar tissue forms for no reason. Most of the time this issue does not need treatment. This is an unexpected change. This change can be of concern since puckering or retraction of the nipple can indicate an underlying change in breast tissue that can be cancerous.[26]
  • Nipple is warm to the touch, red or painful - This can be an infection. It is rarely due to breast cancer.
  • Scaly, flaking, itchy nipple - This is most often due to eczema or a bacterial or fungal infection. This change is not expected. flaking, scaly, itchy nipples can be a sign of Paget disease. This is a rare form of breast cancer involving the nipple.
  • Thickened skin with large pores - This is called peau d'orange because the skin looks like an orange peel. An infection in the breast or inflammatory breast cancer can cause this problem. This not an expected change.
  • Retracted nipples - The nipple was raised above the surface but changes, begins to pull inward, and does not come out when stimulated. This is an expected change it did not exist before.[27]

The average projection and size of human female nipples is slightly more than 38 inch (9.5 mm).[28]

Breast cancer

Symptoms of breast cancer can often be seen first by changes of the nipple and areola, although not all women have the same symptoms, and some people do not have any signs or symptoms at all. A person may find out they have breast cancer after a routine mammogram. Warning signs can be:[29][30]

  • New lump in the nipple, or breast or armpit
  • Thickening or swelling of part of the breast, areola, or nipple
  • Irritation or dimpling of breast skin
  • Redness or flaky skin in the nipple area or the breast
  • Pulling in of the nipple or pain in the nipple area
  • Nipple discharge other than breast milk, including blood
  • Any change in the size or the shape of the breast or nipple
  • Pain in any area of the breast[29][30]

Changes in the nipple are not necessarily symptoms or signs of breast cancer. Other conditions of the nipple can mimic the signs and symptoms of breast cancer.[29]

Vertical transmission

Some infections are transmitted through the nipple, especially if irritation or injury to the nipple has occurred. In these circumstances, the nipple itself can become infected with Candida that is present in the mouth of the breastfeeding infant. The infant will transmit the infection to the mother. Most of the time, this infection is localized to the area of the nipple. In some cases the infection can can progress to become a full-blown case of mastitis or breast infection.[31] In some cases, if the mother has an infection with no nipple cracks or ulcerations, it is still safe to breastfeed the infant.

Herpes infection of the nipple can go unnoticed because the lesions are small but usually are quite painful. Herpes in the newborn is a serious and sometimes fatal infection.[22] Transmission of Hepatitis C and B to the infant can occur if the nipples are cracked.[32]

Other infections can be transmitted through a break of the skin of the nipple and can infect the infant.

Other disorders

Surgery

A nipple-sparing/subcutaneous mastectomy is a surgical procedure where breast tissue is removed, but the nipple and areola are preserved. This procedure was historically done only prophylactically or with mastectomy for benign disease over fear of increased cancer development in retained areolar ductal tissue. Recent series suggest that it may be an oncologically sound procedure for tumors not in the subareolar position.[35][36][37]

Society and culture

Duplessis's semi-topless portrait of the Princess of Lamballe dates from 18th Century France
Duplessis's portrait of a semi-topless Marie Thérèse Louise of Savoy dates from 18th century France.

Exposure

The culture tendency to hide the female nipple under clothing has existed in Western culture since the 1800s.[38][5][4] As female nipples are often perceived an intimate part, covering them might originate as a Victorian taboo just as was riding side saddle. Exposing the entire breast and nipple is a form of protest for some and a crime for others.[39][38] The exposure of nipples is usually considered immodest and in some instances is viewed as lewd or indecent behavior.[40]

A case in Erie, Pennsylvania concerning the exposure of breasts and nipple proceeded to the Supreme Court in the US.[41] The Erie ordinance was regulating the nipple in public as an act that is committed when a person "'... knowingly or intentionally, ... appears in a state of nudity commits Public Indecency.'" Later in the statute, nudity is further described as an uncovered female nipple. But nipple exposure of a man was not regulated. A commentator expressed this opinion on the statute by noting: "Ponder the significance of that. A man walks around bare-chested and the worst that happens is he won't get served in restaurants. But a woman who goes topless is legally in the same boat as if she'd had sex in public. That may seem crazy, but in the U.S. it's a permissible law. — Cecil Adams"[39]

Namibie Himba 0716a
A Namibian woman

The legality around the exposure of nipples are inconsistently regulated throughout the US. Some states do not allow the visualization of any part of the breast. Other jurisdictions prohibit any female chest anatomy by banning anatomical structures that lie below the top of the areola or nipple. Such is the case in West Virginia and Massachusetts. West Virginia's regulation is very specific and is not likely to be misinterpreted and states: "[The] display of 'any portion of the cleavage of the human female breast exhibited by a dress, blouse, skirt, leotard, bathing suit, or other wearing apparel provided the areola is not exposed, in whole or in part.'"[39]

Instagram has a 'no nipples' policy with exceptions: material that is not allowed includes "...some photos of female nipples, but photos of post-mastectomy scarring and women actively breastfeeding are allowed. Nudity in photos of paintings and sculptures is OK, too".[42] Previously, Instagram had removed images of nursing mothers. Instagram removed images of Rihanna and had her account cancelled when she posted selfies with nipples. This was incentive for the Twitter campaign #FreeTheNipple.[43] Another recent development is the Instagram page that invites users to post images of nipples from both sexes. The account called @genderless_nipples displays close ups of both the nipples of men and women for the purpose of spotlighting what may be inconsistency.[44] Some contributors have found 'a way around' this policy.[45][46] Facebook has also been struggling to define its nipple policy.[44][47][48]

Filmmaker Lina Esco made a film entitled Free The Nipple, which is about "...laws against female toplessness or restrictions on images of female, but not male, nipples", which Esco states is an example of sexism in society.[49]

Sexuality

Nipples can be sensitive to touch, and nipple stimulation can incite sexual arousal.[50] Few women report experiencing orgasm from nipple stimulation.[51][52] Before Komisaruk et al.'s functional magnetic resonance (fMRI) research on nipple stimulation in 2011, reports of women achieving orgasm from nipple stimulation relied solely on anecdotal evidence.[53] Komisaruk's study was the first to map the female genitals onto the sensory portion of the brain; it indicates that sensation from the nipples travels to the same part of the brain as sensations from the vagina, clitoris and cervix, and that these reported orgasms are genital orgasms caused by nipple stimulation, and may be directly linked to the genital sensory cortex ("the genital area of the brain").[53][54][55]

In business

Some companies and non-profit organisations have used the word nipple or images of nipples to draw attention to their product or cause.[49][56]

Etymology

The word "nipple" most likely originates as a diminutive of neb, an Old English word meaning "beak", "nose", or "face", and which is of Germanic origin.[57] The words "teat" and "tit" share a Germanic ancestor. The second of the two, tit, was inherited directly from Proto-Germanic, while the first entered English via Old French.[58][59]

See also

References

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  2. ^ a b c Hansen 2010, p. 80.
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  6. ^ "The Wonder of Milk". Earthlife.net. Retrieved 2013-05-09.
  7. ^ Grabb & Smith's Plastic Surgery 6th edition. Chapter 59 page 593
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  31. ^ "Nepal art" (PDF). www.who.int.
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  33. ^ Walker 2011, p. 524.
  34. ^ Walker 2011, p. 530.
  35. ^ Gerber B, Krause A, Reimer T, et al. (2003). "Skin-sparing mastectomy with conservation of the nipple-areola complex and autologous reconstruction is an oncologically safe procedure". Ann. Surg. 238 (1): 120–7. doi:10.1097/01.SLA.0000077922.38307.cd. PMC 1422651. PMID 12832974.
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  37. ^ Sacchini V, Pinotti JA, Barros AC, et al. (2006). "Nipple-sparing mastectomy for breast cancer and risk reduction: oncologic or technical problem?". J. Am. Coll. Surg. 203 (5): 704–14. doi:10.1016/j.jamcollsurg.2006.07.015. PMID 17084333.
  38. ^ a b "Toplessness - the one Victorian taboo that won't go away". BBC News. 15 November 2014. Retrieved 13 August 2017 – via www.bbc.com.
  39. ^ a b c "Why Are Women Expected to Keep Their Nipples Covered?". Retrieved 13 August 2017.
  40. ^ D. Leder, The Body in Medical Thought and Practice, page 223, Springer Science & Business Media, 1992, ISBN 978-0-7923-1657-2
  41. ^ "Erie v. Pap's A. M., 529 U.S. 277 (2000)". Justia Law. Justia. March 2000. Retrieved 15 February 2018. Nudity cannot be considered an inherent form of expression.
  42. ^ "Community Guidelines". help.instagram.com. Instagram. Retrieved 15 February 2018.
  43. ^ "Instagram Clarifies Its No-Nipple Policy". 17 April 2015. Retrieved 13 August 2017.
  44. ^ a b Toor, Amar (6 December 2016). "Genderless Nipples exposes Instagram's double standard on nudity". The Verge. Retrieved 13 August 2017.
  45. ^ "Art student challenges 'sexist' ban on nipples on Instagram with new project - BBC Newsbeat". 6 June 2017. Retrieved 14 August 2017.
  46. ^ Shire, Emily (9 September 2014). "Women, It's Time to Reclaim Our Breasts". The Daily Beast – via www.thedailybeast.com.
  47. ^ "Community Standards". m.facebook.com. Retrieved 14 August 2017.
  48. ^ "Is Facebook going to start freeing the nipple?". 24 October 2016. Retrieved 14 August 2017.
  49. ^ a b Shire, Emily (9 September 2014). "Women, It's Time to Reclaim Our Breasts". The Daily Beast.
  50. ^ Harvey, John H.; Wenzel, Amy; Sprecher, Susan (2004). The Handbook of Sexuality in Close Relationships. Psychology Press. p. 427. ISBN 978-1135624705. Retrieved August 12, 2017.
  51. ^ Kinsey, Alfred C.; Pomeroy, Wardell B.; Martin, Clyde E.; Gebhard, Paul H. (1998). Sexual Behavior in the Human Female. Indiana University Press. p. 587. ISBN 978-0253019240. Retrieved August 12, 2017. There are some females who appear to find no erotic satisfaction in having their breasts manipulated; perhaps half of them derive some distinct satisfaction, but not more than a very small percentage ever respond intensely enough to reach orgasm as a result of such stimulation (Chapter 5). [...] Records of females reaching orgasm from breast stimulation alone are rare.
  52. ^ Boston Women's Health Book Collective (1996). The New Our Bodies, Ourselves: A Book by and for Women. Simon & Schuster. p. 575. ISBN 978-0684823522. Retrieved August 12, 2017. A few women can even experience orgasm from breast stimulation alone.
  53. ^ a b Merril D. Smith (2014). Cultural Encyclopedia of the Breast. Rowman & Littlefield. p. 71. ISBN 978-0759123328. Retrieved August 12, 2017.
  54. ^ Justin J. Lehmiller (2013). The Psychology of Human Sexuality. John Wiley & Sons. p. 120. ISBN 978-1118351321. Retrieved August 12, 2017.
  55. ^ Komisaruk, B. R.; Wise, N.; Frangos, E.; Liu, W.-C.; Allen, K; Brody, S. (2011). "Women's Clitoris, Vagina, and Cervix Mapped on the Sensory Cortex: fMRI Evidence". The Journal of Sexual Medicine. 8 (10): 2822–30. doi:10.1111/j.1743-6109.2011.02388.x. PMC 3186818. PMID 21797981. Lay summaryCBSnews (August 5, 2011).
  56. ^ "This New Bushwick Bar Is The Most Literal Boobie Trap We've Ever Seen".
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  58. ^ Harper, Douglas (2001–2010). "teat". Online Etymological Dictionary. Retrieved 15 August 2011.
  59. ^ Harper, Douglas (2001–2010). "tit (1)". Online Etymological Dictionary. Retrieved 15 August 2011.

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Adenoma

An adenoma is a benign tumor of epithelial tissue with glandular origin, glandular characteristics, or both. Adenomas can grow from many glandular organs, including the adrenal glands, pituitary gland, thyroid, prostate, and others. Some adenomas grow from epithelial tissue in nonglandular areas but express glandular tissue structure (as can happen in familial polyposis coli). Although adenomas are benign, over time they may transform to become malignant, at which point they are called adenocarcinomas. Most adenomas do not transform. But even while benign, they have the potential to cause serious health complications by compressing other structures (mass effect) and by producing large amounts of hormones in an unregulated, non-feedback-dependent manner (causing paraneoplastic syndromes). Some adenomas are too small to be seen macroscopically but can still cause clinical symptoms. The term is from Greek αδένας, adeno-, "gland" + -ώμα, -oma, "tumor".

Areola

The human areola (areola mammae, or ) is the pigmented area on the breast around the nipple. Areola, more generally, is a small circular area on the body with a different histology from the surrounding tissue, or other small circular areas such as an inflamed region of skin.

The mature human female nipple has several small openings arranged radially around the tip of the nipple (lactiferous ducts) from which milk is released during lactation. Other small openings in the areola are sebaceous glands, known as Montgomery's glands.

Body modification

Body modification (or body alteration) is the deliberate altering of the human anatomy or human physical appearance. It is often done for aesthetics, sexual enhancement, rites of passage, religious beliefs, to display group membership or affiliation, in remembrance of lived experience, traditional symbolism such as axis mundi and mythology, to create body art, for shock value, and as self-expression, among other reasons. In its broadest definition it includes plastic surgery, socially acceptable decoration (e.g., common ear piercing in many societies), and religious rites of passage (e.g., circumcision in a number of cultures), as well as the modern primitive movement.

Breast

The breast is one of two prominences located on the upper ventral region of the torso of primates. In females, it serves as the mammary gland, which produces and secretes milk to feed infants. Both females and males develop breasts from the same embryological tissues. At puberty, estrogens, in conjunction with growth hormone, cause breast development in female humans and to a much lesser extent in other primates. Breast development in other primate females generally only occurs with pregnancy.

Subcutaneous fat covers and envelops a network of ducts that converge on the nipple, and these tissues give the breast its size and shape. At the ends of the ducts are lobules, or clusters of alveoli, where milk is produced and stored in response to hormonal signals. During pregnancy, the breast responds to a complex interaction of hormones, including estrogens, progesterone, and prolactin, that mediate the completion of its development, namely lobuloalveolar maturation, in preparation of lactation and breastfeeding.

Along with their major function in providing nutrition for infants, female breasts have social and sexual characteristics. Breasts have been featured in notable ancient and modern sculpture, art, and photography. They can figure prominently in the perception of a woman's body and sexual attractiveness. A number of Western cultures associate breasts with sexuality and tend to regard bare breasts in public as immodest or indecent. Breasts, especially the nipples, are an erogenous zone.

Breast pain

Breast pain is the symptom of discomfort in the breast. Pain that involves both breasts and which occurs repeatedly before the menstrual period is generally not serious. Pain that involves only one part of a breast is more concerning. It is particular concerning if a hard mass or nipple discharge is also present.Causes may be related to the menstrual cycle, birth control pills, hormone therapy, or psychiatric medication. Pain may also occur in those with large breasts, during menopause, and in early pregnancy. In about 2% of cases breast pain is related to breast cancer. Diagnosis involves examination, with medical imaging if only a specific part of the breast hurts.In more than 75% of people the pain resolves without any specific treatment. Otherwise treatments may include paracetamol or NSAIDs. A well fitting bra may also help. In those with severe pain tamoxifen or danazol may be used. About 70% of women have breast pain at some point in time. Breast pain is one of the most common breast symptom, along with breast masses and nipple discharge.

Breast torture

Breast torture or tit torture is a BDSM sexual activity involving the application of pain or constriction to the breasts.

The nipples are the part of the breast that is commonly used for this type of activity. Pain is typically applied to them using nipple clamps, a type of sex toy which can be attached to erect nipples to pinch them and to restrict the blood flow to them by applying pressure. When nipple clamps are removed, further pain is caused by the return of normal blood flow. Men's as well as women's nipples of can receive such treatment.

Erotic electrostimulation of the breasts is also practiced although such activity around the chest area may carry risks of electrocution.

Painful activities such as wax play, spanking, squeezing, or flogging can also be applied to breasts.

The recipient of such activities may receive direct physical pleasure via masochism, or emotional pleasure through erotic humiliation, or knowledge that the play is pleasing to a sadistic dominant.

Note that many of these practices, as with pussy torture for women and cock and ball torture for men, carry health risks. Adequate precaution is needed to prevent trauma or loss of blood flow.

Cracked nipple

Cracked nipple (or nipple trauma) is a condition that can occur in breastfeeding women as a result of a number of possible causes. Developing a cracked nipple can result in soreness, dryness or irritation to, or bleeding of, one or both nipples during breastfeeding. The mother with a cracked nipple can have severe nipple pain when the baby is nursing. This severe pain is a disincentive for continued breastfeeding. The crack can appear as a cut across the tip of the nipple and may extend to its the base. Cracked nipples develop after the birth of the infant and is managed with pharmacological and nonpharmacological treatment.

Fissure of the nipple

Fissure of the nipple is a condition that is the result of irritation of one or both nipples as the result of the friction of clothing against the nipple during physical exercise. This condition can develop in surfers who do not wear rash guards.

Gong

A gong (from Indonesian and Malay: gong; Javanese: "gong" "ꦒꦺꦴꦁ"; Chinese: 鑼; pinyin: luó; Japanese: 鑼, translit. ra; Khmer: គង - Kong; Thai: ฆ้อง Khong; Vietnamese: cồng chiêng; Assamese: কাঁহ kãh) is an East and Southeast Asian musical percussion instrument that takes the form of a flat, circular metal disc which is hit with a mallet.

The gong traces its roots back to the Bronze Age around 3500 BC. The term 'gong' traces its origins in Java and scientific and archaeological research has established that Burma, China, Java and Annam were the four main gong manufacturing centres of the ancient world. The gong later found its way into the Western World in the 18th century when it was also used in the percussion section of a Western-style symphony orchestra. A form of bronze cauldron gong known as a resting bell was widely used in ancient Greece and Rome, for instance in the famous Oracle of Dodona, where disc gongs were also used.Gongs broadly fall into one of three types: Suspended gongs are more or less flat, circular discs of metal suspended vertically by means of a cord passed through holes near to the top rim. Bossed or nipple gongs have a raised centre boss and are often suspended and played horizontally. Bowl gongs are bowl-shaped and rest on cushions. They may be considered a member of the bell category. Gongs are made mainly from bronze or brass but there are many other alloys in use.

Gongs produce two distinct types of sound. A gong with a substantially flat surface vibrates in multiple modes, giving a "crash" rather than a tuned note. This category of gong is sometimes called a tam-tam to distinguish it from the bossed gongs that give a tuned note. In Indonesian gamelan ensembles, some bossed gongs are deliberately made to generate in addition a beat note in the range from about 1 to 5 Hz. The use of the term "gong" for both these types of instrument is common.

Grannys Nipple

Grannys Nipple is a summit in Grand County, Colorado, in the United States. With an elevation of 8,238 feet (2,511 m), Grannys Nipple is the 3257th tallest mountain in Colorado.

Hyperkeratosis

Hyperkeratosis is thickening of the stratum corneum (the outermost layer of the epidermis), often associated with the presence of an abnormal quantity of keratin, and also usually accompanied by an increase in the granular layer. As the corneum layer normally varies greatly in thickness in different sites, some experience is needed to assess minor degrees of hyperkeratosis.

It can be caused by vitamin A deficiency or chronic exposure to arsenic.

Hyperkeratosis can also be caused by B-Raf inhibitor drugs such as Vemurafenib and Dabrafenib.It can be treated with urea-containing creams, which dissolve the intercellular matrix of the cells of the stratum corneum, promoting desquamation of scaly skin, eventually resulting in softening of hyperkeratotic areas.

Inverted nipple

An inverted nipple (occasionally invaginated nipple) is a condition where the nipple, instead of pointing outward, is retracted into the breast. In some cases, the nipple will be temporarily protruded if stimulated. Both women and men can have inverted nipples.

List of school pranks

A school prank is a prank primarily occurring in a school setting. The effect and intent of school pranks may range from everyday play and consensual bonding behavior to crimes including hazing, bullying and assault, including sexual assault.

Nipple piercing

A nipple piercing is a body piercing, centered usually at the base of the nipple. It can be pierced at any angle but is usually done horizontally or, less often, vertically. It is also possible to place multiple piercings on top of one another.

Nipple stimulation

Nipple stimulation or breast stimulation is a common human sexual practice, either by itself or as part of other sexual activities. The practice may be performed upon, or by, people of any gender or sexual orientation. Adult women and men report that breast stimulation may be used to both initiate and enhance sexual arousal.

Paget's disease of the breast

Paget's disease of the breast is a type of cancer that outwardly may have the appearance of eczema, with skin changes involving the nipple of the breast. The condition is an uncommon disease accounting for 1 to 4.3% of all breast cancers and was first described by Sir James Paget in 1874. The condition in itself often appears innocuous, limited to a surface appearance and it is sometimes dismissed, although actually indicative of underlying breast cancer.

Raynaud syndrome

Raynaud syndrome, also known as Raynaud's phenomenon, is a medical condition in which spasm of arteries cause episodes of reduced blood flow. Typically, the fingers, and less commonly the toes, are involved. Rarely, the nose, ears, or lips are affected. The episodes result in the affected part turning white and then blue. Often, numbness or pain occurs. As blood flow returns, the area turns red and burns. The episodes typically last minutes, but can last several hours.Episodes are often triggered by cold or emotional stress. The two main types are primary Raynaud's, when the cause is unknown, and secondary Raynaud's, which occurs as a result of another condition. Secondary Raynaud's can occur due to a connective-tissue disorder, such as scleroderma or lupus, injuries to the hands, prolonged vibration, smoking, thyroid problems, and certain medications, such as birth control pills. Diagnosis is typically based on the symptoms.The primary treatment is avoiding the cold. Other measures include the discontinuation of nicotine or stimulants use. Medications for treatment of cases that do not improve include calcium channel blockers and iloprost. Little evidence supports alternative medicine. Severe disease may rarely be complicated by skin sores or gangrene.About 4% of people have the condition. Onset of the primary form is typically between ages 15 and 30 and occurs more frequently in females. The secondary form usually affects older people. Both forms are more common in cold climates. It is named after the French physician Maurice Raynaud, who described the condition in 1862.

Supernumerary nipple

A supernumerary nipple (also known as a third nipple, triple nipple, accessory nipple, polythelia or the related condition: polymastia) is an additional nipple occurring in mammals, including humans. Often mistaken for moles, supernumerary nipples are diagnosed in humans at a rate of approximately 1 in 18 people.The nipples appear along the two vertical "milk lines," which start in the armpit on each side, run down through the typical nipples and end at the groin. They are classified into eight levels of completeness from a simple patch of hair to a milk-bearing breast in miniature.

Wardrobe malfunction

A wardrobe malfunction is accidental exposure of a person's intimate parts due to a temporary failure of clothing to do its job. It is different from indecent exposure or flashing, as the latter are deliberate, although some "malfunctions" are alleged to have been planned. There has been a long history of such incidents, though the term itself was only coined in the mid-2000s and has become one of the most common fashion faux pas. Justin Timberlake first used the term referring to the Super Bowl XXXVIII halftime-show controversy, issuing a scripted apology at the 2004 Grammy Awards. The phrase "wardrobe malfunction" has since been used by the media to refer to the incident and has entered pop culture.

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