2nd sem: CLINICAL CASE 1

Question 1

In cystocele, where can you palpate the bulge?

Answer 1

A̲n̲t̲e̲r̲i̲o̲r̲ part of vaginal canal

⮞ urinary bladder prolapse towards vagina 🡫

Question 2

In rectocele, where can you palpate the bulge?

Answer 2

P̲o̲s̲t̲e̲r̲i̲o̲r̲ part of vaginal canal

⮞ rectum prolapsing towards vaginal canal 🡩

Question 3

In uterine prolapse, the cervix is felt and seen _____ of the vagina

Answer 3

halfway

⮞ Patient has weak levator ani

Question 4

The levator ani and coccygeus is useful for what mechanism?

Answer 4

⮞ continence mechanism, used as constrictors for urethra and anal-vaginal orifices

Question 5

Parts of the levator ani muscle:

Answer 5

SIPP  
⮞Sphincter vaginae/ levator prostae 
⮞ Iliococcygeus 
⮞ pubococcygeus 
⮞ puborectalis

Question 6

function of the coccygeus muscle

Answer 6

⮞ assists the levator ani (supporting)

⮞ flexes the coccyx

Question 7

In urinary incontinence, what kind of stress is it associated with?

Answer 7

PHYSICAL stress

Question 8

Urinary incontinence leads to _______

Answer 8

involuntary leaks of urine

Question 9

clinical manifestation:
⮞ Dysuria 
⮞ abdominal pain 
⮞ strong smelling urine, cola urine, cloudy 
⮞ increased WBC in urine

Answer 9

UTI (urinary track infection)

Question 10

How long is the urethra of a female?

Answer 10

4cm

Question 11

How long is the urethra of a male?

Answer 11

20cm

Question 12

What is CYSTITIS?

Answer 12

Infection of the urinary bladder

Question 13

Why is cystitis more frequent to the elderly?

Answer 13

Elderly 🡪 less acidic vagina 🡪 prone to bacterial infection

Question 14

The prostatic urethra of a MALE, is situated where?

Answer 14

Within the prostate gland

Question 15

The membranous urethra of male, is found where?

Answer 15

Within the urogenital diaphragm

Question 16

Penile/ spongy urethra is from

Answer 16

bulb penis to glans penis

Question 17

In IVC syndrome of pregnancy, what explains the low BP?

Answer 17

Fetus impinge IVC 🡪 less blood in RA 🡪 less in, less out 🡪 BP🡫 🡪 HYPOTENSION 🡪 compensate HR (tachycardia)

Question 18

In IVC syn. of pregnancy, why would there be swelling of legs?

Answer 18

hirap umakyat yung blood from femoral vein 🡪 external iliac vein so babalik siya doon 🡪 (+) hydrostatic pressure 🡪 fluids leaks out interstitial tissues 🡪 PEDAL EDEMA

Question 19

The route of blood from IVC to femoral vein?

Answer 19

IVC 🡪 common iliac vein 🡪 external iliac vein 🡪 femoral vein

Question 20

Internal hemorrhoids involves the ff.

Answer 20

Superior RECTAL V. drains sa 🡪 Inferior Mesenteric V. if impinged by fetus 🡪 backflow
Trapped flood sa superior rectal v. 🡪 columns of Morgani distended

Question 21

External hemorrhoids involves the ff.

Answer 21

Middle, Inferior RECTAL V. drains 🡪 Internal Iliac V. 🡪 fetus impinges results to backflow 🡪 distended Inferior R. V. 🡪 external H.M.

Question 22

MYOMA: tumor sa muscle
LEIOMYOMA: __________

Answer 22

tumor sa smooth muscle

Question 23

clinical manifestations:
⮞ nulliparous (not given birth)
⮞ excessive menstruation
⮞ anemic

Answer 23

Uterine fibroid/myoma/Leiomyoma

Question 24

Hysterectomy is the process of

Answer 24

removing the uterus

Question 25

How many folds does the broad ligament have?

Answer 25

2

Question 26

where is the cervical ligament situated?

Answer 26

on the LATERAL side

Question 27

3 D’s of pain related to UF?

Answer 27

⮞ Dysuria (pain umihi)
⮞ Dyspareunia ( pain sa sex)
⮞ Dyschezia (pain tumae)

Question 28

Raised androgen levels can lead to

Answer 28

HIRSUTISM (excessive hair growth)

Question 29

clinical manifestations: 
⮞ irregular menstruation 🡪 every 3-6 mos
⮞ excessive hair growth 
⮞ excessive weight gain 
⮞ multiple cyst sa ovaries/ovary

Answer 29

PCOS ( PolyCystic Ovarian Syndrome)

Question 30

flow of PCOS outcome

Answer 30

PCOS 🡪 no follicle develops 🡪 no ovulation 🡪 no egg release 🡪 🡫 progesterone 🡪 excessive mens

Question 31

Laproscopy is to examine the

Answer 31

abdominal contents

Question 32

sigmoid colon is from the

Answer 32

pelvic inlet to S3

Question 33

Causes of sigmoid volvulus?

Answer 33

⮞ colonic obstruction
⮞ death of tissue 🡪 spill of fecal to peritoneal cavity 🡪 SEPSIS (infection spreads to blood)
⮞ blood supply to sigmoid compromised

Question 34

clinical manifestations: 
⮞ Dysuria 
⮞ weak urine flow
⮞ low frequency of urine 
⮞ 🡩 PSA sa blood 
⮞ asymmetrical prostate gland with hard nodules

Answer 34

Prostatic cancer

Question 35

Prostate Gland:
Base 🡪 neck of __________
Axis 🡪 urogenital diaphragm

Answer 35

urinary bladder

Question 36

➥ Anterior fibrous stroma 🡢 no glands
➥ Transition zone (prostatic urethra) 🡢 BPH
➥ Central zone: ________
➥ peripheral zone

Answer 36

ejaculatory duct

Question 37

palpating the hard nodules:
60 yr old: GOLF BALL
20 yr old: ________

Answer 37

walnut