external genitalia Flashcards
Which vertebrae does the uterosacral ligaments attach
Sacral
What type of secretions does estrogen produce
watery
What type of secretions does progesterone secrete
thick
What are the difference in cells between the cervical Os and portio vaginalis
Portio vaginalis is made of squamous epithelium
Os/canal contained glandular cells
What do the glandular cells in the cervix secrete
stringy mucus in response to hormonal changes
What is leukorrhea
normal monthly vaginal discharge
How much vaginal discharge is secreted a day
1-4mL
What is the pH of vaginal discharge
4-4.5
Where is neoplasia of the cervix most likely
squamocolumnar junction
Why is vaginal discharge acidic
lactobacilli in vaginal flora causing conversion of glycogen to lactic acid
If estrogen wasn’t present, what would the pH of the vagina be
7
What is the purpose of the vagina being acidic
keeps majority of pathologic bacteria colonization down
What is the most common bacteria within the vagina
lactobacillus
What is vulvovaginitis
inflammatory reaction of the vulva and vagina
What are the causes of vulvovaginitis
STI
abx
hormonal imbalance
douching
sexual activity
What occurs with vulvovaginitis
inflammation causing erythema, pruritic, burning, dyspareunia
What are the causes of infectious vulvovaginitis
candidiasis
bacterial vaginosis
trichomoniasis
What is cervicitis commonly associated with
gonorrhea
chlamydia
What is the most common cause of non-infectious vulvovaginitis
menopause
What are some common causes of non-infectious vulvovaginitis
atrophy (menopause)
topical irritants
systemic disorders (SLE/RA)
Where is cervicitis most common
columnar cells
What is acute cervicitis most commonly due to
STI
*consider PID
What are non infectious sources of cervicitis
inserted FB (tampons, condoms etc)
What symptoms do patients have with cervicitis
Spotting
dyspareunia
pruritis
vaginal discharge
If someone has a strawberry cervix, what is their likely diagnosis
trichomoniasis
If the cervix has ulcerative lesions on it, what is the likely cause
HSV
What is the most common STI
anogenital warts associated with HPV
What are the most common subtypes of HPV that leads to genital warts
6 and 11
What is condylomata acuminata
Genital warts
What is the latent period after inoculation for HPV
3wk - 9months
When will HPV generally clear
within 1-2 years
What subtype of HPV is particularly carcinogenic
16
What is the most common cause of cervical cancer
HPV (16 & 18)
What is an indicator of cellular changes concerning for early cancer
dysplasia
Where is the most common area of infection with cervical dysplasia
squamocolumnar junction
Where is the most common area of infection with cervical dysplasia
squamocolumnar junction
What is associated with cervical dysplasia
HPV
What is condylomata lata
Form of secondary syphilis with painless anogenital warts
What is contained within the warts of condylomata lata
Spirochetes
making them very infectious
What equipment do you need to use to be able to see spirochetes
dark field microscopy
What is the sign of primary syphilis
painless chancre
What is secondary syphilis and when does it occur
6wks after resolution of primary
Widespread rash
bacteremia
resolves in 6 weeks
What nerve dysfunction can lead to pelvic organ prolapse
pudendal
What can cause a
Bartholin cyst
vulvar edema
*Gland becomes blocked
What is a small (<3cm) tear drop shaped lump on the cervix called
Endocervical polyp
*cause unknown
What are the most common causes of anovaginal fistulas
trauma from childbirth
*prolonged labor leading to necrosis from pressure on the vaginal wall
*3rd or 4th degree tearing
How will you diagnose an anovaginal fistula
fecal discharge from the vaginal orifice
