Female Genitalia Flashcards
LH acts
Luteal phase (post-ovulation)
Condyloma Latum
Lesions of secondary syphilis STI caused by Trepnema pallidum Appear 6-12 weeks after infection Healed solitary genital lesion Flat, round, oval papules covered by gray exudate
Rectocele
Bulge on the posterior wall of the vagina
Hernial protrusion of part of the rectum through the posterior vaginal wall
Trichomoniasis
Watery discharge, foul odor
Dysuria and dyspareunia with severe infection
Profuse frothy greenish discharge
pH 5-6
Red friable cervix with petechiae (strawberry cervix)
pH of vagina during pregnancy
More acidic
Prevents bacteria from multiplying
May cause Candidad infection
Mucoid, whitish vaginal discharge is
Commonly seen during the newborn period and sometimes as late as 4 weeks after birth
Occasionally mixed with blood
Endometriosis
Growth of endometrial tissue outside the uterus
Retrograde reflux of menstrual tissue from fallopian tubes during menstruation
Pelvic pain, dysmenorrhea, heavy/long period
May palp tender nodules along uterosacral ligaments
Station
Presenting part in relation to ischial spines of mother’s pubis
Physiologic vaginitis
Increase in discharge
Clear or mucoid
Anterior pituitary secretes
Follicle stimulating hormone (FSH) Luteinizing hormone (LH)
Leopold maneuvers
Four steps:
1) Place hands over fundus and identify fetal part. 2) Use palmar surface of one hand to locate back of fetus, use other hand to feel irregularities (hands, feet). 3) Thumb and third finger to grasp presenting part over symphysis pubis. 4) Use both hands to outline fetal head.
Foreign body
Red/swollen vulva
Vaginal discharge
Tampon/condom/diaphragm
Bloody or foul-smelling discharge
Measure strength of contraction
Feel (tense, firm, rigid) and ability to indent with fingers
Mild, moderate, strong
Syphilitic Chancre
Skin lesion with primary syphilis STI via bacterium Treponema pallidum 2 weeks after exposure Last 3-6 weeks, heals Painless ulcer
Days 13-14
Ovulation
Egg expelled from follicle into abdominal cavity and drawn into the uterus by fimbriae and cilia
Progesterone causes further thickening of uterine wall
Genital herpes
Caused by HSV
Painful lesion in genital area after sexual contact
Burning or pain with urination
Superficial vesicles in genital area
Nabothian cysts
Small, white, yellow raised round areas on the cervix
Mucinous retention
Expected finding
May be infected if vary in size
Vulvar carcinoma
According to type of tissue from which cancer arises Lump or growth in or on the vulvar area Ulcer persists longer than one month Bleeding in vulva Dysuria, itching, pain, soreness
Candida vulvovaginitis
Pruritic discharge; itching of labia to thigh
White, curdy discharge
pH 4-5
Cervic red, perineum, thighs may be red too
Infertility
Inability to conceive over a period of 1 year of unprotected sexual intercourse
Causes: stress, nutrition, chemicals, chromosomal abnormalities, diseases, sexual/relationship problems, hematologic and immunologic disorders
Allergic vaginitis
New bubble bath, soap
Foul smell, erythema
Altered pH
Days 15-20
Secretory phase
Egg (ovum) moved by cilia into the uterus
After egg release, follicle becomes corpus luteum
Piskacek sign
Palpable lateral bulge or soft prominence of one uterine cornu at 7-8 weeks
Days 5-12
Postmenstrual, preovulatory phase
Ovary and follicle produce estrogen
Follicular phase - egg develops in follicle
Proliferative phase - uterine lining thickens
Measuring uterus size
Measure from upper part of public symphysis to superior of the uterine fundus
Most accurate 20-32 weeks
1 cm increase per week in fundal height is expected
Cervical CA
Classify by type of tissue from which CA arises
Usually asymptomatic
Vaginal bleeding or spotting
Hard, granular surface at or near cervical os
Lesion can evolve to form extensive irregular cauliflower growth that bleeds
Early lesions indistinguishable from ectropion
Braun von Fernwald
Fullness and softening of the fundus near the site of implantation at 7-8 weeks
Bacterial vaginosis (Gardnerella vaginalis)
No foul odor, itching or edema
Foul-smelling discharge
Thin, white or gray discharge
pH >4.5
Hegar sign
Softening of the uterine isthmus at 6-8 weeks
Mittelschmerz
Lower abdominal pain associated with ovulation (may be on the side of ovulation)
Sudden onset
May have some adnexal tenderness; all else negative
Days 21-28
Premenstrual, Luteal phase
If no implantation, CL degenerates
Menstruation around Day 28
FSH acts during
Follicular phase (pre-ovulation)
Goodell sign
Softening of the cervix from increase in vascularity
At 4-6 weeks
Vaginal carcinoma
Squamous, adenocarcinoma, melanoma, and/or sarcoma
Sqaumous = epithelial lining of vagina; may be caused by HPV
Adenocarcinoma = in glandular tissue
Malignant melanoma = from melanocytes
Sarcoma = form deep in wall
Sx: abnormal bleeding, dysuria, painful sex, pelvic pain, BLE edema, discharge, lesions, masses
Days 1-4
Menstrual phase
Adnexa
of the uterus comprises the fallopian tubes and ovaries
Bartholin glands
During excitement, secrete mucus into introitus for lubrication
Cystocele
Hernial protrusion of the urinary bladder through the anterior wall of the vagina
May exit the introitus
McDonald sign
Fundus flexes easily on the cervix at 7-8 weeks
During pregnancy, softening of the pelvic cartilage
D/t relaxin and progesterone
Also strengthens the pelvic ligaments
Develop waddle gait
Condyloma Acuminatum
Genital warts
Via HPV
Soft, painless, wartlike lesions
Whitish pink to reddish brown, discrete soft growths on labia, vestibule or perianal area
Naegele rule
Calculate EDD: add 1 year to first day of last normal menstrual period, subtract 3 months, add 7 days
Average 40 weeks gestation
Fetal movement
Around 16-20 weeks
Mother to note any decrease from normal or cessation of movement
Atrophic vaginitis
Dysareunia; vaginal dryness
Perimenopausal or postmenopausal
Pale, thin vaginal mucosa pH>4.5
Molloscum Contagiosum
Viral infection of skin and mucous membranes, STI in adults (non-sexual common in children)
Poxvirus, enters via hair follicles
White, flesh-colored
Last months to years
Piskacek sign
Uterine irregularity around 8-10 weeks
Gonorrhea (Neisseria gonorrhoeae)
Partner with STI
Asymptomatic or sx of PID
Purulent discharge from cervix (Skene/Bartholin gland)
Inflammation of cervix and vulva
Chlamydia
Partner with nongonococcal urethritis
Asymptomatic or spotting after intercourse
With or without purulent discharge
Cervix may or may not be red or friable
Discharge from Skene glands
Commonly infection, gonorrhea
Milk by exerting upward pressure
Uterine prolapse
1st degree: cervix remains within the vagina
2nd degree: cervix at the introitus
3rd degree: cervix and vagina drop outside introitus
May report urine leakage, incontinence
Pouch of Douglas
Rectouterine cul-de-sac, deep recess formed by the peritoneum that covers the lower posterior wall of the uterus and upper portion of the vagina separating it from the rectum
Other positions (eg. disabilities)
Knee-chest, obstetric stirrups, M-shaped, V-shaped
Chadwick sign
Cervix takes on bluish color
At 8-12 weeks
Skene ducts
Drain a group of urethral glands and open onto the vestibule on each side of the urethra
Cardiff count to 10
Note the length of time for 10 movements
Inflammation of Bartholin Gland
Commonly associated with gonorrhea
Acute or chronic
Hot, red, tender, fluctuant swelling; may drain pus
Chronic inflammation results in nontender cyst on labium
Uterine bleeding
Abnormality in menstrual bleeding, inappropriate uterine bleeding common
