Ch 6 Physical Exam of the Female Genitalia Flashcards
1
Q
Amenorrhea
A
Absent menstrual cycle
2
Q
The Vulva, External female genital organs include:
A
Mons pubis
Labia majora
Labia minora
Clitoris
Vaginal Vestibule
Vaginal Orifice
Urethral opening
3
Q
Primary center of sexual excitement
A
Clitoris
4
Q
In the labia minor is a vestibule containing the:
A
Urethra
Vagina
Skene glands
Bartholin glands
5
Q
Bartholin glands, located posteriorly on each side of the vaginal orifice, open onto the sides of the vestibule in the groove between the:
A
Labia minora and the hymen
6
Q
During sexual excitement, what glands secrete mucus into the introitus for lubrication?
A
Bartholin glands
7
Q
The vagina inclines:
A
Posteriorly
8
Q
Musculomembranous tube that is transversely rugated
A
Vagina
9
Q
Anterior wall of the vagina is separated from the bladder and urethra by the ________ septum
A
Vesicovaginal septum
10
Q
The posterior wall of the vagina is separated from the rectum by the ______ septum
A
Rectovaginal
11
Q
Pelvic organs may be palpated through pockets around the cervix called:
A
Fornices
12
Q
The nonpregnant uterus is usually positioned anteroposteriorly and weighs:
A
60-90 g
13
Q
The uterus is divided anatomically into the:
A
Corpus and cervix
14
Q
The uterine corpus consists of the:
A
Fundus
Body
Isthmus
15
Q
Convex upper portion between the fallopian tubes
A
Fundus
16
Q
Main portion of the uterine corpus
A
Body
17
Q
Constricted lower portion adjacent to the cervix
A
Isthmus
18
Q
The cervix extends from the _____ into the vagina
A
Isthmus
19
Q
The adnexa of the uterus are composed of the:
A
Fallopian tubes
Ovaries
20
Q
Pair of oval organs resting in a slight depression on the lateral pelvic wall at the anterosuperior iliac spine
A
Ovaries
21
Q
What controls the menstrual cycle and supports pregnancy?
A
Ovaries
22
Q
The internal genitalia are supported by what ligaments?
A
Cardinal
Uterosacral
Round
Broad
23
Q
Prolonged menses is defined as greater than how many days?
A
> 7 days
24
Q
The pelvis is formed by what four bones?
A
2 Innominate
Sacrum
Coccyx
25
What are the four pelvic joints?
2 Sacroiliac joints
Symphysis pubis
Sacrococcygeal
26
What contributes to the strengthening and elasticity of pelvic ligaments and softening cartilage?
Increased levels of the circulating hormones Estrogen and Relaxin
27
Later in pregnancy the symphysis pubis _______
Separates
28
Shallow upper section of the pelvis
False pelvis
29
Lower curved bony canal of the pelvis
True pelvis
30
Term pregnancy is longer than ___ weeks
37 weeks
31
Infant/Child
The cervix is ______ of the entire length of the uterus
Two-thirds
32
Infant/Child
Thin covering inside the introitus, giving the vaginal opening a crescent-shaped appearance
Hymen
33
During childhood, what part of the genitalia does not grow incrementally at varying rates?
Clitoris
34
Adolescents
If the hymen is intact, the vaginal opening is __ cm
1 cm
35
Average age of menarche
11-14
36
Pregnant women
Muscular walls become more elastic, and the uterus rises out of pelvis into the abdominal cavity by __ weeks of gestation
12 weeks
37
Pregnant women
Uterine weight at term, excluding the fetus and placenta
1000 g
38
Pelvic congestion and edema during pregnancy occur from:
Increases in blood volume
39
The cervix becomes bluish during:
Pregnancy
40
"Waddle gait" is due to:
Pelvic joint separation
41
Pregnant women
The papillae of the mucosa have a ______ appearance
Hobnailed
42
Ovarian function diminishes around age ___
40
43
Menopause occurs between:
40 and 55 years of age
44
Ovulation ceases about how long prior to menopause
1-2 years
45
Menopause is conventionally defined as:
1 year with no menses
46
After menopause, women experience an increased risk of:
Cardiovascular disease
47
Prescribed to reduce the impact of menopausal symptoms and sequalae
Hormone replacement (estrogen with or without progestin)
48
Examination:
Patient expresses what before an examination may be a sign that something is not quite right
Marked anxiety
49
Patient should have an empty ______ during exam
Bladder
50
Examination position.
Supine with knees bent, legs spread apart, and feet placed in metal stirrups at the foot of the exam table
Lithotomy
51
Woman lies on her back with her knees bent so that both legs are spread flat and her heels meet at the foot of the table
Diamond-shaped position
52
Obstetric stirrups support the legs under the:
Knee
53
Woman lies on her back, knees bent and apart, feet resting on the exam table close to her buttocks
Does not require the use of stirrups
M-Shaped Position
54
The woman lies on her back with her straightened legs spread out wide to either side
V-position
55
Which variable position allows the women to place one foot in the stirrup and one leg straightened?
V-Shaped position
56
Women with sensory impairment may do what during exam?
Elevate the head to see the clinician
57
Length of the clitoris
<2 cm
58
Glands that are milked during exam to look for discharge and note any tenderness
Skene glands
59
Glands that are palpated to look for discharge, swelling that is painful, hot to touch indicates an abscess
Bartholin glands
60
Bartholin gland abscess are usually what in origin?
Gonococcal
Staphylococcal
61
Bulging of the anterior wall and urinary incontinence indicate the presence of a:
Cystocele
62
Bulging of the posterior wall indicates a:
Rectocele
63
Marked by protrusion of the cervix or uterus on straining
Uterine prolapsed
64
Use ______ to inspect cervix and vaginal walls
Speculum
65
Lubricate the speculum with:
Water or water-soluble lubricant
66
Used to warm a cold speculum
Water
67
Slowly insert the speculum along the path of _________
Least resistance
| often slightly downward
68
Inspect the cervix for:
Position
Size
Surface characteristics
Discharge
Size and shape of the Os
69
A cervix pointing anteriorly indicates a:
Retroverted uterus
70
A cervix pointing posteriorly indicates an:
Anteverted uterus
71
Deviation of the cervix to the right or left may indicate a:
Pelvic mass
Uterine adhesions
Pregnancy
72
Vaginal smears and cultures from a pelvic exam
PAP smears
Gonococcal
Chlamydia and Gonorrhea DNA Probe
Wet Prep
KOH
73
The ovaries if palpable should feel:
Firm, smooth, ovoid
74
Rectovaginal exam allows the provider to reach ____ higher into the pelvis
2.5cm (1 inch)
75
After hymen tears, ______ may be visible
Hymen tags
76
Uterus is usually flattened and anteroposterior at a __-degree angle
45-degree angle
77
The perineum is ________ in multiparous women
Thinner and more rigid
78
Perineum is more thick and smooth in ______ women
Nulliparous women
79
Pale cervix suggests:
Anemia
80
Os of nulliparous women may be_____
Small, round, oval
81
Os found in ______ women may be more horizontal, irregular, or stellate
Multiparous
82
External labia swelling, pain, warmth, and redness may mean:
Bartholin gland abscess
83
In newborns, labia majora are separate and clitoris is prominent up to ___ weeks of gestation
36 weeks
84
Newborn
Hymen often protrudes and central opening is about __cm
0.5 cm
85
Newborns
Genitalia may be swollen and bruised for many days from:
Breech delivery
86
Mucoid whitish vaginal discharge may be seen from birth to 1 month of age as a result of:
Hormonal transfer in utero
87
Internal vaginal exam is performed on a young child only when there is a specific problem such as:
Bleeding, discharge, trauma, or sexual abuse
88
Infants
Vaginal discharge problems should be assessed for possible relationship to use of:
Diapers, powders, or lotions
89
Infants/Children
Swelling of vulvar tissues with bruising suggests:
Sexual abuse
90
Enlarged clitoris in newborn suggests:
Adrenal hyperplasia
91
In children a foul odor is more likely indicative of a:
Foreign body
92
All ______ teenagers should have an annual pelvic exam, pap smear, and STI evaluation
Sexually active
93
Young women who are not sexually active should have their first exam by age:
21
94
Vaginal secretions ______ before menarche
Increase
95
By menarche, vaginal opening should be at least __ cm wide
1 cm
96
Menstrual cycle characteristics may include:
Dysmenorrhea (painful periods)
Breast tenderness
Headaches
97
Vaginal discharge (yellow, green, or gray) with odor suggests:
Infection
98
Ulcers or vesicles may be from:
STI
99
Urethral inflammation or dilation suggests:
Repeated UTIs
100
Discharge from ____ glands suggests infection
Skene
101
Regar sign
Softening of the isthmus
102
Chadwick sign
Bluish cervix
103
Cervical softening
Goodell sign
104
The relationship of the presenting part of the ischial spines
Station
105
The uterus may be more anteflexed (pressing more on the bladder) during:
First 3 months
106
The uterus deviates at ____ weeks of gestation (Piskacek sign)
8-10 weeks
107
Enlarged uterus suggests:
Pregnancy
Tumor
108
With older adults, the cervix becomes:
Smaller, paler, and less mobile
109
Premenstrual Syndrome (PMS) usually begins at what age?
Late 20s
110
Characterized by edema, headache, weight gain and behavioral disturbances such as irritability, nervousness, dysphoria, and lack of coordination
Symptoms lasts 5-7 days
Premenstrual Syndrome
111
Infertility is defined as:
Inability to conceive over a period of 1 year of unprotected regular intercourse
112
Factors that cause infertility other than anatomical
Stress
Nutrition
Chemical substances
Certain Diseases/Sexual/Immunological responses
113
Presence of growth of endometrial tissue outside the uterus causes pelvic pain, dysmenorrhea, and heavy or prolonged menstrual flow
Endometriosis
114
Warty lesions on the labia from HPV.
Flesh-colored, whitish pink to reddish brown, discrete, soft growths and may form cauliflower-like masses
Condyloma Acuminatum
115
Benign skin infection caused by poxvirus
Incubation period is 2-7 weeks
Dome shaped papules
Molluscum Contagiosum
116
Lesions secondary syphilis appear about 6-12 weeks after infection
Flat, round, or oval papules covered by gray exudates
Condyloma latum
117
A firm, painless ulcer
In women develop internally
Syphilitic chancre
118
Small red vesicles
Lesions may itch and are painful and usually confined to a small localized patch on the vulva, perineum, vagina or cervix
Herpes
119
Caused by gonococcal infection
Hot, red, tender, fluctuant swelling that may drain pus
Chronic inflammation results in a nontender cyst on the labium
Inflammation of Bartholin gland
120
A hernial protrusion of the urinary bladder through the anterior wall of the vagina
Bulging can be seen as the women bears down
Cystocele
121
Hernial protrusion, part of the rectum through the posterior wall of the vagina
Rectocele
122
Findings include vaginal discharge, lesions, and masses
Vulva appears as ulcerated or raised red lesions on the vulva
Carcinoma
123
A bright red polypoid growth that protrudes from the urethral meatus
Urethral carbuncle
124
Watery discharge usually not foul smelling; dysuria, profuse frothy, greenish discharge
Trichomoniasis
125
Purulent discharge from the cervix; skene/Bartholin inflammation
Gonorrhea
126
Homogenous thin, white or gray discharge
Positive KOH with clue cells
Bacterial vaginosis
127
Enlarged fluid-filled retention cysts that vary in size
Infected Nabothian cysts
128
Bright red, soft and fragile arise from the endocervical canal
Cervical polyps
129
Appear as shiny red tissue around the Os that may bleed easily
Columnar epithelium
130
Result of weakening of the supporting structures of the pelvic floor, often occurring with a cystocele or rectocele
Uterine prolapsed
131
In second-degree prolapse, the cervix is at the:
Introitus (opening)
132
In third-degree prolapsed the cervix is:
Outside the introitus
133
Are common, benign, uterine tumors that appear as firm, irregular nodules in the contour of the uterus
Myomas
134
Growths that can occur unilaterally or bilaterally
Smooth in nature
Ovarian cysts
135
Causes marked pelvic tenderness, with tenderness and rigidity of the lower abdomen
A tender, unilateral adnexal mass may indicate the site of pregnancy
Surgical emergency
Ruptured tubal pregnancy
136
Pelvic inflammatory disease is often caused by:
Gonococcal or Chlamydial infection
137
Inflammation or infection of the fallopian tube and associated with Pelvic inflammatory disease
Salpingitis
138
Vaginal secretions that collect behind an imperforate hymen and manifested by small midline lower abdominal mass or small cyst between the labia
Hydrocolpos
139
Vaginal discharge accompanied by warm, erythematous, and swollen vulvar tissue
Vulvovaginitis
140
A loop of cord may advance with the presenting part
Usually occurs with rupture of the membranes
Prolapse of the umbilical cord
141
Common during pregnancy and may involve both the vulva and rectal area. Pressure from the pregnant uterus contribute to the formation.
Vulvar varicosities
142
Caused by lack of estrogen. Vaginal mucosa is dry and pale.
The accompanying vaginal discharge may be white, gray, yellow, green or blood-tinged.
Atrophic vaginitis
