Bates Chapter 14 - Female Genitalia Flashcards
The paraurethral glands are also called?
Skene’s glands
What are the glands that are located posterior to the vestibule?
Bartholin’s glands
What is the vaginal surface of the cervix called?
Ectocervix
What are the normal cell structures of the os?
Columnar epithelium (surrounds os) Squamous epithelium (continuous with vaginal lining)
During puberty the squamous epithelium replaces the columnar epithelium and creates a new transformation zone that is tested with what test?
Papanicolaou or Pap smear
What Latin term refers to the ovaries, tubes and the supporting tissues?
Adnexa
What are the two primary functions of the ovaries?
1) The production of ova
2) The secretion of hormones (estrogen, progesterone, testosterone)
What do you call the cul-de-sac that extends behind the uterus in the parietal peritoneum?
Rectouterine pouch or the pouch of Douglas
Which two muscles form the pelvic diaphragm?
Levator ani and the coccygeus muscles
What is the name of the key-like opening in the pelvic diaphragm through which the urethra, vagina, and anorectum pass?
Urogenital (levator) hiatus
What is the second supporting structure in the pelvis?
Urogenital diaphragm
What structures are part of the urogenital diaphragm?
Ischiocavernosus muscles
Bulbocavernosus muscles
Perineal membrane and body
Anal sphincter
The pelvic diaphragm and the urogenital diaphragm make up what structure?
The pelvic floor
What do you call the increased vaginal secretions just before menarche?
Leukorrhea
To which nodes do the lymph from the vulva and lower vagina drain?
Inguinal nodes
What are the common concerns for female genitalia?
1) Menarch, menstruation, menopause, post-menopausal bleeding
2) Pregnancy
3) Vulvovaginal symptoms
4) Sexual orientation and response
5) Pelvic pain (acute or chronic)
6) STIs
What is the term for the age at onset of menses?
Menarche
What is the term for the absence of menses >12 months and in age 48-55?
Menopause
When does post-menopausal bleeding occur?
6 months or more after the cessation of menses
What is the term for the absence of menses?
Amenorrhea
What is the term for pain with menses?
Dysmenorrhea
What do you call a cluster of symptoms that occur 5 days before menses for 3 consecutive cycles?
Premenstrual syndrome (PMS)
What is the term for bleeding between menses or infrequent, excessive, prolonged or post-menopausal bleeding?
Abnormal uterine bleeding
What are some causes of secondary amenorrhea?
Low body weight (malnutrition, anorexia nervosa, stress, chronic illness or hypothalamic-pituitary-ovarian dysfunction)
What are some causes of abnormal uterine bleeding?
Pregnancy, infection, cancer, polyps, fibroids, bleeding disorders, HRT including contraception
What is the term for less than 21-day intervals between menses?
Polymenorrhea
What is the term for infrequent bleeding greater than 35 days?
Oligomenorrhea
What is the term for prolonged or excessive flow of menses at normal intervals?
Menorrhagia
What is the term for uterine bleeding at irregular but frequent intervals?
Metorrhagia
GP-TPAL stands for
Gravida, Para - Term, Premature, Abortions, Living
Some may use F instead of T for Full-term
What are the most common vulvo-vaginal symptoms?
Discharge and itching
What is the term for pain with intercourse?
Dyspareunia
What is the term for involuntary spasm of the muscles surrounding the vaginal orifice?
Vaginismus
What are some causes of acute pelvic pain?
PID, ruptured ovarian cyst, ectopic pregnancy, ovarian torsion, appendicitis
What are the two types of cervical cancer?
Squamous cell (80-90%) and adenocarcinoma in glandular cells (10-20%)
What is the most important risk factor for cervical cancer?
Persistent infection with high-risk HPV subtypes (16 or 18). These two cause 70% of cancers
What are the low-risk HPV subtypes that cause genital warts?
6 and 11
What other risk factors are associated with HPV?
1) Failure to get screened
2) Multiple sex partners
3) Smoking
4) Immunosuppression
5) Long term use of oral contraceptives
6) Co-infection with Chlamydia
7) Parity
8) Prior cervical cancer
9) Genetic polymorphisms allowing HPV DNA into cervical cells
What drug is used for vaccination for HPV?
Gardisil, given in a three-dose series
What are risk factors for ovarian cancer?
Family history of ovarian cancer and BRCA1 or BRCA2 gene mutation
Untreated Chlamydia in women leads to:
PID (40%), infertility (20%)
What ethnic group has the highest risk for Chlamydia?
African American women and American Indian/Alaskan natives
What are the risk factors for STIs?
1) Age < 24 and sexually active
2) Prior infection with STI
3) New or multiple partners
4) Inconsistent condom use
5) Occupational sex work
What percentage of people have HIV/AIDS and have not been diagnosed?
25%
List the different methods for contraception:
1) Natural (abstinence, withdrawal, lactation)
2) Barrier (condom, diaphragm, cervical cap)
3) Implantable (IUD, subdermal implant)
4) Pharmacological (BCP, spermacide, patch, vag ring)
5) Surgical (TL, trans-surgical sterilization)
What are the purposes of the rectovaginal exam?
1) To palpate a retroverted uterus
2) To screen for colorectal cancer in women > 50
3) To assess pelvic pathology
