2nd sem: CLINICAL CASE 1 Flashcards
In cystocele, where can you palpate the bulge?
A̲n̲t̲e̲r̲i̲o̲r̲ part of vaginal canal
⮞ urinary bladder prolapse towards vagina 🡫
In rectocele, where can you palpate the bulge?
P̲o̲s̲t̲e̲r̲i̲o̲r̲ part of vaginal canal
⮞ rectum prolapsing towards vaginal canal 🡩
In uterine prolapse, the cervix is felt and seen _____ of the vagina
halfway
⮞ Patient has weak levator ani
The levator ani and coccygeus is useful for what mechanism?
⮞ continence mechanism, used as constrictors for urethra and anal-vaginal orifices
Parts of the levator ani muscle:
SIPP ⮞Sphincter vaginae/ levator prostae ⮞ Iliococcygeus ⮞ pubococcygeus ⮞ puborectalis
function of the coccygeus muscle
⮞ assists the levator ani (supporting)
⮞ flexes the coccyx
In urinary incontinence, what kind of stress is it associated with?
PHYSICAL stress
Urinary incontinence leads to _______
involuntary leaks of urine
clinical manifestation: ⮞ Dysuria ⮞ abdominal pain ⮞ strong smelling urine, cola urine, cloudy ⮞ increased WBC in urine
UTI (urinary track infection)
How long is the urethra of a female?
4cm
How long is the urethra of a male?
20cm
What is CYSTITIS?
Infection of the urinary bladder
Why is cystitis more frequent to the elderly?
Elderly 🡪 less acidic vagina 🡪 prone to bacterial infection
The prostatic urethra of a MALE, is situated where?
Within the prostate gland
The membranous urethra of male, is found where?
Within the urogenital diaphragm
Penile/ spongy urethra is from
bulb penis to glans penis
In IVC syndrome of pregnancy, what explains the low BP?
Fetus impinge IVC 🡪 less blood in RA 🡪 less in, less out 🡪 BP🡫 🡪 HYPOTENSION 🡪 compensate HR (tachycardia)
In IVC syn. of pregnancy, why would there be swelling of legs?
hirap umakyat yung blood from femoral vein 🡪 external iliac vein so babalik siya doon 🡪 (+) hydrostatic pressure 🡪 fluids leaks out interstitial tissues 🡪 PEDAL EDEMA
The route of blood from IVC to femoral vein?
IVC 🡪 common iliac vein 🡪 external iliac vein 🡪 femoral vein
Internal hemorrhoids involves the ff.
Superior RECTAL V. drains sa 🡪 Inferior Mesenteric V. if impinged by fetus 🡪 backflow
Trapped flood sa superior rectal v. 🡪 columns of Morgani distended
External hemorrhoids involves the ff.
Middle, Inferior RECTAL V. drains 🡪 Internal Iliac V. 🡪 fetus impinges results to backflow 🡪 distended Inferior R. V. 🡪 external H.M.
MYOMA: tumor sa muscle
LEIOMYOMA: __________
tumor sa smooth muscle
clinical manifestations:
⮞ nulliparous (not given birth)
⮞ excessive menstruation
⮞ anemic
Uterine fibroid/myoma/Leiomyoma
Hysterectomy is the process of
removing the uterus
How many folds does the broad ligament have?
2
where is the cervical ligament situated?
on the LATERAL side
3 D’s of pain related to UF?
⮞ Dysuria (pain umihi)
⮞ Dyspareunia ( pain sa sex)
⮞ Dyschezia (pain tumae)
Raised androgen levels can lead to
HIRSUTISM (excessive hair growth)
clinical manifestations: ⮞ irregular menstruation 🡪 every 3-6 mos ⮞ excessive hair growth ⮞ excessive weight gain ⮞ multiple cyst sa ovaries/ovary
PCOS ( PolyCystic Ovarian Syndrome)
flow of PCOS outcome
PCOS 🡪 no follicle develops 🡪 no ovulation 🡪 no egg release 🡪 🡫 progesterone 🡪 excessive mens
Laproscopy is to examine the
abdominal contents
sigmoid colon is from the
pelvic inlet to S3
Causes of sigmoid volvulus?
⮞ colonic obstruction
⮞ death of tissue 🡪 spill of fecal to peritoneal cavity 🡪 SEPSIS (infection spreads to blood)
⮞ blood supply to sigmoid compromised
clinical manifestations: ⮞ Dysuria ⮞ weak urine flow ⮞ low frequency of urine ⮞ 🡩 PSA sa blood ⮞ asymmetrical prostate gland with hard nodules
Prostatic cancer
Prostate Gland:
Base 🡪 neck of __________
Axis 🡪 urogenital diaphragm
urinary bladder
➥ Anterior fibrous stroma 🡢 no glands
➥ Transition zone (prostatic urethra) 🡢 BPH
➥ Central zone: ________
➥ peripheral zone
ejaculatory duct
palpating the hard nodules:
60 yr old: GOLF BALL
20 yr old: ________
walnut
