Exam 3: Key Terms Flashcards
What are some nonsurgical treatment options for pelvic relaxation?
- Bladder training and biofeedback
- Medical therapy (Anticholinergics, beta agonist, dopamine agonist, antidepressants)
- Kegel exercises
What is the only definitive treatment option for pelvic relaxation and prolapse?
Surgical Treatment
- Anterior vaginal wall repair
- retropubic suspension procedure
- sling procedure
Define endometriosis
Presence of endometrial tissue in extrauterine locations
What is the most common benign tumor in the female genital tract?
Leiomyoma (fibroids)
What are the symptoms of Leiomyomas (fibroids)?
- Bleeding (most common)
- Pain
- Pressure symptoms
What is the most common form of GYN cancer that also has the highest survival rate among American women?
Cervical cancer
-Routine Pap smears make identification of precursor lesions easier
What form of GYN cancer has the highest mortality rate?
Ovarian cancer
Much harder to detect, symptomatic only after extensive metastasis
What is pelvic relaxation/pelvic organ prolapse?
When there is descending or prolapsing into the vaginal wall.
(Urethrocele, cystocele, rectocele)
Where is endometriosis commonly found and what is the widely excepted cause?
Ovaries (60%)
Retrograde menstruation is widely excepted cause
How is diagnosis of endometriosis made and what is the definitive treatment?
Diagnosis under direct visualization (surgery)
Definitive treatment = TAH w/ BSO & removal of adhesions
{TAH w/ BSO = Total Abdominal Hysterectomy with Bilateral Salpingo-Oophorectomy}
Growth potential of fibroids is related to what? And what generally stops their growth?
Growth potential is related to estrogen production
Menopause generally stops it
What does it mean when a fibroid is pedunculated and what effect does it have on the patient?
Pedunculated = on stalk, twists, loses blood supply
Extremely painful
What are the surgical treatment options for fibroids?
Myomectomy = more complications, attempt to preserve fertility
Hysterectomy = Definitive treatment for women who have completed childbearing
What is the most common indication for hysterectomy?
Leiomyomas (fibroids)
What does the depth of penetration of malignant cells tell you about cervical cancer?
Depth of penetration of malignant cells predicts extent of the cancer and likelihood of metastases
How does laparoscopy differ from laparotomy?
Laparoscopy = inspection and manipulation of tissue within abdominal cavity using endoscopic instruments
Laparotomy = inspection and manipulation of tissue via an incision that permits good exposure
What is the difference between a total and radical hysterectomy?
Total = removal of all of uterus Radical = removal of uterus with very wide margins of surrounding tissue
How does pregnancy affect blood volume?
Blood volume increases from
Normal = 60-65 mL/kg
Pregnancy = 90 mL/kg (3rd Trimester)
What are the normal values for PaCO2 in 3rd trimester?
Normal PaCO2 = 40 mmHg
1st/2nd/3rd trimester = 30 mmHg
What effect does pregnancy have on cardiovascular measurements?
CO = +40% SV = +30% HR = +15-30%
SVR = -20% PVR = -30%
What affect does caval compression have on hemodynamics and how is this alleviated?
Decreases cardiac output 25 to 40%
(Hypotension)
Alleviated most often by left uterine displacement
What is Methergine used for?
Stimulates contractions, given after delivery to reduce size/blood loss by making the uterus “clamp down”
What effect does pregnancy have on lung volumes and respiration?
TV = +40% RR = +0-15% MV = +40% VO2 = + 60%
FRC = -20% (desat. faster)
What are the determinants of uterine bloodflow at term gestation?
Uterine bloodflow is PRESSURE DEPENDENT, NOT auto-regulated
From 50mL/min -> 600-700mL/min @ term
(Increase pressure, increase flow)
