Exam 4: Female GU Flashcards
Accessory organs of the uterus (ovaries, fallopian tubes)
Adnexa
Absence of menstruation; termed secondary amenorrhea when menstruation has begun and then ceases, most common cause is pregnancy
Amenorrhea
Vestibular glands, located on either side of the vaginal orifice, that secrete a clear lubricating mucus during intercourse
Bartholin’s glands
Dislodging of thick cervical mucus plug at end of pregnancy, which is a sign of beginning labor
Bloody show
Small, deep red mass protruding from urethral meatus, usually due to urethritis
Caruncle
Bluish discoloration of cervix that occurs normally in pregnancy at 6-8 weeks gestation
Chadwick sign
Red, round, superficial ulcer with a yellowish serous discharge that is a sign of syphilis
Chancre
Small, elongated erectile tissue in the female, located at anterior juncture of labia minora
Clitoris
Prolapse of urinary bladder and its vaginal mucosa into the vagina with straining or standing
Cystocele
Abdominal cramping and pain associated with menstruation
Dysmenorrhea
Painful intercoarse
Dyspareunia
Painful urination
Dysuria
Aberrant growths of endometrial tissue scattered throughout pelvis
Endometriosis
Hard, painless nodules in uterine wall that cause uterine enlargement (myoma)
Fibroid
Sexually transmitted infection characterized by purulent vaginal discharge or may have no symptoms
Gonorrhea
Softening of cervix that is a sign of pregnancy, occuring at 10-12 weeks gestation
Hegar sign
Red-tinged or blood urine
Hematuria
Membranous fold of tissue partly closing vaginal orifice
Hymen
Whitish yellowish discharge from vaginal orifice
Leukorrhea
Onset of first menstruation, usually between the ages of 11 and 13
Menarche
Cessation of the menses, usually occurring around 48-51 years old
Menopause
Excessively heavy menstrual flow
Menorrhagia
Condition of having 2 or more pregnancies
Multipara
Condition of having first pregnancy
Nullipara
Painless test used to detect cervical cancer
Papanicolaou test
Bright red, soft, pedunculated growth emerging from os (bone?)
in cervix
Polyp
Prolapse of the rectum and its vaginal mucosa into vagina with straining or standing
Rectocele
Deep recess formed by the peritoneum between the rectum and cervix (culdesac of Douglas)
Rectouterine pouch
Inflammation of the fallopian tubes
Salpingitis
Paraurethral glands
Skene’s glands
Inflammation of the vagina
Vaginitis
External genitalia of female
Vulva
External genitalia of female
Vulva or pudendum
The fat covering the symphisis pubis (cartilage joint on pubic bone) (this is where the hair is)
Mons pubis
Connecting membrane/tissue on the underside of the vagina
Frenulum ro fourchette
From the clitoris to the frenulum, everything in between
Vestibule
The opening of the urethra
Urethral meatus
Where the baby will develop
Uterus
Where the eggs travel down
Fallopian tubes
Recess behind the cervix, forming an arch, the most superior part of the vagina
Anterior and poster fornix
Recess behind the cervix, forming an arch, the most superior part of the vagina
Anterior and poster fornix
What are the stages of menopause
1-2 years of a decline in ovarian functions, they will have irregular menses (periods) gradually becoming lighter and further apart
Ovaries stop producing progesterone and estrogen
Reproductive cells are estrogen dependent– so this decrease in estrogen brings dramatic physical changes
In an aging woman, these atrophy or shrink to 1-2 cm and are not palpable after menopause
Ovaries
In an aging woman, this shrinks because of decreased myometrium
Uterus
This may sometimes protrude or prolapse into the vagina
It shrinks, looks paler, thick, and glistens
It droops as the sacral ligaments relax and pelvic muscles become weak
Uterus
Its good to get a hysterectomy between the ages of..
35-50
In an aging woman, this becomes shorter, narrower, and less elastic because of an increased connective tissue
Vagina
Without sexual activity the vagina can atrophy to..
1/2 its original size
Vaginal epithelium atrophies, becoming thinner, itchier, and drier.. this sets the vagina up for..
Bleeding, vaginitis, irritation, and dyspareunia
What 12 subjective data points should you look at with the female GU
MOMS SUV Carries STIs
Menstrual history
Obstetric history
Menopause
Self care behaviors
Sexual activity
Urinary symptoms
Vaginal discharge
Contraceptives
STI contact
STI risk reduction
What 10 subjective data points should you look at with the female GU
MOMS SUV Carries STIs
Menstrual history
Obstetric history
Menopause
Self care behaviors
Sexual activity
Urinary symptoms
Vaginal discharge
Contraceptives
STI contact
STI risk reduction
What 10 subjective data points should you look at with the female GU
MOMS SUV Carries STIs
Menstrual history
Obstetric history
Menopause
Self care behaviors
Sexual activity
Urinary symptoms
Vaginal discharge
Contraceptives
STI contact
STI risk reduction
UTIs can look like ____ in older people
Dementia
A heavy flow could mean..
Something else is wrong, a different underlying problem
The # of times a woman has been pregnant
Gravida
This term means the # of pregnancies that were carried more than 20 weeks
Para
Hot flashes, night sweats, numbness, tingling, headache, palpitations, drenching sweats, mood swings, vaginal dryness and itching are signs/symptoms of..
Menopause
Menopause can last..
2 years
This can increase your risk for blood clots and breast cancer
Hormone replacements
How often should you get a breast and vaginal exam
Every year
Pap smear recommendation right now for a low risk pt is every ___ years
5 years
This can cause urination when sneezing, laughing, or coughing
Vaginal deliveries (stress incontinence)
Stress incontinence doesn’t really have a cure, but this type of incontinence has meds to help
Urge incontience
You can get a frequency or urge to urinate if you have
Inflammation
If you have the urge to pee in the middle of the night, what might it be
Inflammation/swelling has gone down making you feel like you have to go
When asking about vaginal discharges its important to look at a family history of diabetes because diabetics have a lot of sugar usually so they are more apt for..
Yeast infections
When asking about vaginal discharges its important to look at a family history of diabetes because diabetics have a lot of sugar usually so they are more apt for..
Yeast infections
Douching can change the vaginal..
pH levels
If a yeast infection comes back within 3 months you should..
See a doctor
It is important to accepting and non judgmental when asking about..
Sexual activity
Symptoms of this STI can go away for a while or remain dormant and than reappear later
Syphilis
Symptoms of this STI can go away for a while or remain dormant and than reappear later
Syphilis
This locks and unlocks with a resounding click and that can be alarming
A plastic speculum
This is inserted into the vagina to dilate it for examination of the vagina and cervix
Vaginal speculum
What are 2 types of vaginal speculums (note you should try both before using them so you can know which you like to use better, practice opening and closing)
Metal and plastic
What are 2 types of vaginal speculums (note you should try both before using them so you can know which you like to use better, practice opening and closing)
Metal and plastic
What is the difference between a graves and pederson speculum
Graves is wider and made for women who may be more sexually active (wider vagina)
Pederson is narrower for younger women, those who have never had sex, or post menopausal (older)
What is the difference between a graves and pederson speculum
Graves is wider and made for women who may be more sexually active (wider vagina)
Pederson is narrower for younger women, those who have never had sex, or post menopausal (older)
These are used to get samples from the cervix wall
Cyto brush
Ayre’s spatula
These are used to get samples from the cervix wall
Cyto brush
Ayre’s spatula
Initially the position of the women should be..
Sitting up facing you, establish trust
What position should she be in for examination
Lithotomy
What 5 techniques will make sure that the woman is relaxed
- have her empty her bladder first
- don’t put her private parts facing any open doors
- don’t abduct or spread legs too far apart
- ask if she wants someone at HOB with her
- have her head and shoulders elevated to maintain eye contact
What 5 techniques will make sure that the woman is relaxed
- have her empty her bladder first
- don’t put her private parts facing any open doors
- don’t abduct or spread legs too far apart
- ask if she wants someone at HOB with her
- have her head and shoulders elevated to maintain eye contact
This works well for teaching anatomy, to see abnormalities, and to see treatments
Mirror technique
This works well for teaching anatomy, to see abnormalities, and to see treatments
Mirror technique
The genitalia is usually an even skin color.. these may be a darker pink
labia minora
Labia majora are usually midline in ____ women
and gaping and shriveled in ____ women
Midline in nulliparous
Gaping in parous
Labia majora are usually midline in ____ women
and gaping and shriveled in ____ women
Midline in nulliparous
Gaping in parous
What should you do with the speculum before insertion
Warm under warm running water and lubricate, especially inferior blade?
Labia majora are usually midline in ____ women
and gaping and shriveled in ____ women
Midline in nulliparous (never given birth)
Gaping in parous (has given birth)
What should you do with the speculum before insertion
Warm under warm running water and lubricate, especially inferior blade?
This scans for cervical cancer but not endometrial or ovarian
Pap smear
You should not obtain a pap smear sample during..
Period or with heavy infectious discharge
Women should not douche, have sex, or put anything into their vagina, 24 hours before a …
Pap smear or collection of specimen
What is the order for obtaining cultures
Pap smear first
Bacterial culture for STIs 2nd
What is the order for obtaining cultures
Pap smear first
Bacterial culture for STIs 2nd
This screens for asymptomatic human papilloma virus (HPV) which can cause genital warts
Acetic acid wash (white vinegar)
Should be done after all other specimens are gathered
Paints the cervix
Temporarily dehydrates and coagulates proteins
Acetic acid wash with white vinegar
What is the normal response to an acetic acid wash with white vinegar
No change in cervical epithelium indicates no HPV
What is the normal response to an acetic acid wash with white vinegar
No change in cervical epithelium indicates no HPV
For patients with arthritis, what might ease the joint pain from the positioning
Ibuprofen, mild analgesic or anti-inflammatory
With aging women its best to schedule their exam when joint pain..
is at its least so maybe early morning when she wakes up
