Female Genitalia Flashcards
What structures make up the vulva? (8)
mons pubis labia majora labia minora clitoris vestibular glands vaginal vestibule vaginal orifice urethral opening
The clitoris is tucked between the ____ and the ____.
frenulum and the prepuce
Posteriorly the labia minor meet as two judges that fuse to form the _____.
fourchette
The labia minor enclose the area designated as the _____.
vestibule
What are the 6 openings of the vestibule?
urethra
vagina
2 ducts of Bartholin glands
2 ducts of Skene glands
Which ducts drain a group of urethral glands and open onto the vestibule on each side of the urethra?
Skene ducts
Which glands open onto the sides of the vestibule in the groove between the labia minor and the hymen?
Batholin glands
What is the connective tissue that separate the anterior wall of the vagina from the bladder and urethra?
vesicovaginal septum
What separates the posterior vaginal wall from the rectum?
rectovaginal septum
The pocket formed around the cervix is divided into what?
anterior, posterior and lateral fornices
What is the deep recess formed by the peritoneum as it covers the lower posterior wall of the uterus and the upper portion of the vagina separating it from the rectum
rectouterine cul de sac (pouch of Douglas)
The uterus is a flattened _____ and usually inclines forward at a ____ degree angle.
anteroposteriorly
45 degree
What is the size of the uterus in nulliparous patients?
5.5 to 8 cm long
3.5 to 4cm wide
2-2.5 cm thick
weighs: 40-50g
How does the uterus differ in a parous pt compared to a nulliparous patient?
parous patient may be larger by 2 to 3 cm in any dimension
weighs 20-30 MORE than nulliparous patient
The uterus is divided anatomically into the ___ and the ____.
corpus and cervix
What are the 2 parts of the corpus?
the funds and the isthmus
The ____ extends from the isthmus into the vagina.
cervix
The uterus opens into the vagina via the _____
external cervical os
What comprises the adnexa of the uterus?
Fallopian tubes and ovaries
Each Fallopian tubes ranges from ___ to ___ cm long and is supported by a fold of the broad ligament called the ______.
8 to 14 cm long
mesosalpinx
The isthmus end of the Fallopian tube opens into the _____
uterine cavity
What transports the ovum to the uterus?
rhythmic contractions of the tubal musculature
The ovaries are at the level of the ____ iliac spine.
anterosuperior
How big is an ovary during the reproductive years?
3cm x 2cm x 1cm
What happens during the menstrual phase days 1-4 at the ovary?
estrogen levels begin to rise, preparing follicle and egg for next cycle.
What happens during the menstrual phase days 1-4 in the uterus?
(decreased?) progesterone stimulates endometrial prostaglandins that cause vasoconstriction; upper layers of endometrium shed
What happens during the menstrual phase days 1-4 in the breast?
cellular activity in the alveoli decreases; breast ducts shrink
What happens during the menstrual phase days 1-4 with the CNS hormones?
FSH and LH decrease
What happens during the post menstrual, preovulatory phase (days 5-12) in the ovary?
ovary and maturing follicle produce estrogen; follicular phase (egg develops within follicle)
What happens during the post menstrual, preovulatory phase (days 5-12) in the uterus?
Proliferative phase-uterine lining thickens
What happens during the post menstrual, preovulatory phase (days 5-12) in the breast?
parenchymal and proliferation of breast ducts occurs
What happens during the post menstrual, preovulatory phase (days 5-12) with the CNS hormones?
FSH stimulates ovarian follicular growth
What happens during ovulation (day 13 or 14) in the ovary?
egg is expelled from follicle into abdominal cavity and drawn into the fallopian tine by fimbriae and cilia. follicle closes and begins to form corpus lute; fertilization of egg may occur in outer third of tube if sperm are unimpeded
What happens during ovulation (day 13 or 14) in the uterus?
end of proliferative phase; progesterone causes further thinking of the uterine wall
What happens during ovulation (day 13 or 14) with the CNS hormones?
LH and estrogen levels increase rapidly; LH surge stimulates release of egg
What are the symptoms during ovulation (day 13 or 14) ?
Mittelschmerz may occur with ovulation; cervical mucus is increased and is stringy and elastic (spinnbarkeit)
What happens during the secretory phase (days 15-20) in the ovary?
egg (ovum) is moved by cilia into the uterus
What happens during the secretory phase (days 15-20) in the uterus?
after the egg is released, the follicle becomes a corpus luteum; secretion of progesterone increases and predominates
What happens during the secretory phase (days 15-20) with the CNS hormones?
LH and FSH decrease
What happens during the premenstrual, luteal phase (days 21-28) in the ovary?
if implantation does not occur, the corpus lute degenerates; progesterone production decreases and estrogen production drops and then begins to rise as a new follicle develops
What happens during the premenstrual, luteal phase (days 21-28) in the uterus?
menstruation starts around day 28, which begins day 1 of the menstrual cycle
What happens during the premenstrual, luteal phase (days 21-28) in the breast?
alveolar breast cells differentiate into secretory cells
What happens during the premenstrual, luteal phase (days 21-28) with the CNS hormones?
increases levels of GnRH cause increased secretion of FSH
What are the symptoms during the premenstrual, luteal phase (days 21-28)?
vascular engorgement and water retention may occur
What are the 4 ligaments that support the internal genitalia?
cardinal
uterosacral
round
broad ligaments
What is necessary to support the pregnancy for uterine enlargement during the first trimester?
high levels of estrogen and progesterone
After the third month what is the primary cause of uterine enlargement?
mechanical pressure of the growing fetus
At term the uterus will have increased more than ____ fold and the capacity increases ____ to ___ times that go the non pregnant uterus.
10
500-1000x
What level is the uterus at 20 weeks?
level of the umbilicus
When does the uterus reach into the abdominal cavity?
12 weeks
Immediately after delivery the uterus is the size of what?
20 week pregnancy (umbilicus level)
How big is the uterus 1 week after delivery?
12 week pregnancy and palpable at the symphysis pubis
What is responsible for the softening of the pelvic cartilage and the strengthening of the pelvic ligaments?
relaxin and progesterone
What is the result of the pelvic joints separating from relaxin and progesterone?
waddle gait
When does the symphysis pubs return to the prepregnancy state postpartum?
within 2-5 months
during pregnancy what is the result of increased uterine blood flow and lymph?
pelvic congestion and edema
the uterus, cervix, and isthmus soften and the cervix takes on a bluish color
What is it called when the isthmus softens during pregnancy?
Goodell sign
What is it called when the cervix takes on a blue color in pregnancy?
Chadwick sign
The cervical canal is obstructed by ____ ___ soon after conception, protecting the infant from infection.
thick mucus
When the thick mucus plug dislodges at the beginning of labor what is that sign called?
bloody show
What causes the increased length of vaginal walls so that at times they can be seen protruding from the vulvar opening?
mucosa of the vaginal walls and the connective tissue thicken and smooth muscle cells hypertrophy
In pregnant females the papillae of the mucosa have what appearance?
hobnailed appearance
What causes an increase in vaginal pH during pregnancy?
an increase in lactic acid production by the vaginal epithelium to keep bacteria from multiplying but may cause Candida infection
What is the median age of menopause in the US?
51 years
What is menopause defined as?
1 year with no menses (amenorrhea)
What is the result of a decrease in estrogen levels in menopause?
the labia and cliotris become smaller
What might account for the decrease in libido and in muscle mass in menopause?
both adrenal androgens and ovarian testosterone markedly decrease after menopause
What happens to the vagina after menopause?
the vaginal Introits gradually constricts. The vagina narrows, shortens and loses its rugae and the mucosa becomes thin, pale and dry which can result in dyspareunia (pain with intercourse)
What happens to the cervix after menopause?
smaller and paler
What happens to the uterus after menopause?
it decreases in size and the endometrium thins
What happens to the ovaries after menopause?
they decrease in size to 1-2 cm, follicles gradually disappear and the surface od the ovary convolutes
What are the systemic effects of menopause?
increase in body far and intraabdominal deposition of body fat
levels of total and LDL cholesterol increase
thermoregulation is altered producing hot flashes
What is the absence of menstruation?
amenorrhea
shortened interval between periods-less than 19-21 days?
polymenorrhea
lengthened internal between periods- more than 35 days?
oligomenorrhea
excessive flow during normal duration of regular periods?
hypermenorrhea
decreased flow during normal duration of regular periods?
hypomenorrhea
regular and normal interval between periods, excessive flow and duration?
menorrhagia
irregular intervals between periods, prolonged duration with expected amounts
metrorrhagia
irregular or excessive bleeding during periods and between periods?
menometrorrhagia
What are the risk factors for cervical cancer? (12)
HPV Infection (16,18,31,33,45) No HPV Vaccination Lack of pap smear three or more full term pregnancies patients younger than 17 cigarette smoking HIV infection Chlamydia infection Overweight (less fruits and veggies) DES exposure Long term OCP use Low socioeconomic status
What are the risk factors for ovarian cancer? (10)
increased age BRCA1 BRCA2 or PTEn gene family history obesity nulliparity or parity after 35 use of fertility drugs increased with h/o breast, endometrial or colon cancers hormone replacement therapy 50% reduction with OCPs High fat diet
What are the risk factors of endometrial cancer? (11)
# of menstrual cycles nulliparity obesity tamoxifen estrogen replacement therapy Ovarian diseases (polycystic ovaries, granulosas) high animal fat diet increased age FMH of endometrial, breast or ovarian, or colorectal cancers BRCA1 or BRCA2 gene prior pelvic radiation therapy
What is the size of the clitoris?
2cm or less and 0.5cm in diameter
What is a bright red polypoid growth that protrudes from the urethral meatus; and usually cause no symptoms
caruncle
Discharge from the scene glands or the urethra usually indicate what?
an infection-most commonly gonococcal
What indicates a Bartholin cysts?
a nontender mass
What indicates a Bartholin infection?
painful, hot to the touch and fluctuant that is usually filled with pus (gonococcal or staphylococcal)
What is a pale cervix associated with?
anemia
What is a blue cervic associated with?
increased vascularity and may be a sign of pregnancy
A cervix that is pointing anteriorly indicates a ____ uterus.
retroverted uterus
A cervix that is pointing posterior indicates an ____uterus
anteverted uterus
If the cervix is not midline and deviates to the left or right, what might that indicate?
a pelvic mass
uterine adhesions
pregnancy
If the cervix projects greater than ____ it may indicate a pelvic or uterine mass.
3 cm
What is the size of the cervix at child bearing age?
2-3 cm in diameter
What is the transformation zone of the cervix?
the junction of squamous and columnar epithelium
When does cervical ectropion occur?
when eversion of the endocervix exposes columnar epithelium
When is ectropion of the cervix most commonly seen?
adolescents, pregnant patients or those taking estrogen containing contraceptives
What might be observed as small, white or yellow raised, round areas on the cervix that are mutinous retention cysts of the endocervical glands that are considered an expected finding?
Nabothian cysts
How do nabothian cysts occur?
during the process of metaplasia at the transformation zone when endocervival columnar cells continue to secrete but are covered by squamous epithelium
What should you look for on the cervix that could indicate cervicitis, infection or carcinoma?
friable tissue
red patchy areas
granular areas
white patches
What type of discharge might indicate a bacterial or fungal infection compared to normal discharge?
will more likely have an odor and will vary in color from white to yellow, green or gray
What is a hernial protrusion of the urinary bladder through the anterior wall of the vagina, sometimes exiting the introitus?
cystocele
What is a hernial protrusion of part of the rectum through the posterior vaginal wall?
rectocele (proctocele)
What is the size of the uterus?
pear shaped and 5.5 to 8cm
What does a fixed uterus indicate?
adhesions
What does tenderness on movement of the uterus with bimanual exam indicate?
pelvic inflammatory process or ruptured tubal pregnancy
Are Fallopian tubes usually palpable?
NO
What is the Naegele rule used to calculate EDD?
add 1 year to the first day of the last normal menstrual period, subtract 3 months, and add 7 days
What is the average duration of pregnancy?
280 days or 40 weeks
What is Piskacek sign?
uterine irregularity that occurs around weeks 8 to 10 as initial uterine enlargement may deviate to one side and an irregularity in its contour at the site of implantation
How can you estimate the size of the uterus?
with tape measure measure from the upper part of the pubic symphysis to the superior uterine fundus in centimeters
When is uterine measurement the most accurate?
between 20 and 32 weeks of gestation when the fundal height in centimeters correlates well with the gestational age in weeks (+ or - 2cm)
What is an expected pattern of fundal height?
a 1 cm increase per week is expected
What should you consider if the uterine size is smaller than expected?
consider the possibility of intrauterine growth restriction
What factors can affect the accuracy of fundal height measurement?
obestiy amount of amniotic fluid myxomata multiple gestation fetal size position the uterus
What is the uterus within the pelvis?
weeks 10-12
When is the uterus palpable just above symphysis pubis?
week 12
When is the uterus palpable halfway between the symphysis and umbilicus; balloteement of fetus is possible by abdominal and vaginal exam
week 16
When is the uterine fungus at the lower border of the umbilicus?
week 20
When does the uterus change from globular to ovoid shape; fetus palpable?
weeks 24-26
When is the uterus approximately halfway between umbilicus and xiphoid?
week 28
When is the uterine fungus just below xiphoid?
week 34
When does the fundal height drop as the fetus begins to engage in pelvis?
week 40
What is Goodell sign? When is it seen?
softening of the cervix
4-6 weeks
What is Hegar sign? When is it seen?
softening of the uterine isthmus
6-8 weeks
What is McDonald sign?
Fundus flexes easily on the cervix
7-8 weeks
What is Brain von Fernwalk sign?
fullness and softening of the fundus near the site of implantation
7-8 weeks
What is Piskacek sign?
palpable lateral bulge or soft prominence of one uterine Cornu
7-8
What is Chadwick sign?
bluish color od the cervix, vagina, and vulva
8-12
What is the thinning of the cervix that results when myocetrial activity pulls the cervix upward, slowing the cervix to become part of the lower uterine segment during prelabor or early labor?
effacement
What is the result of effacement?
cervix is reduced in length
What is the length of the cervix at the end of the third trimester?
3-4cm
If there is shortening of the cervix (less than 29mm) noted on vaginal US in mid pregnancy, what does that indicate?
risk for preterm delivery
When does effacement precede cervical dilation?
effacement precedes cervical dilation in the primipara and often occurs with dilation in the multipara
What involves opening of the cervical canal to allow to the passage of the fetus?
dilation
Shortening of the cervic (less than 29mm) noted on vaginal US indicates the risk of what?
preterm delivery
what is detected by doppler by 11 to 12 weeks of gestations and heard by fetoscope at 19-20 weeks gestation
fetal heart rate (FHR)
When is fetal movement (FM) appreciated by pregnant patients?
between 16 and 20 weeks gestation
What is the Cardiff count to 10 method?
a patient sounds 10 movements, noting the length of time for them o occur.
Are there universally accepted FM count criteria?
No but the standard ranges from 12 times in 1 hour to 10 times in 12 hours
If there is no FM technique used when should the patient notify the healthcare professional?
the occurrence of 3 or fewer FMs in 2 hours for 2 consecutive days while the patient is at rest in left lateral position
If there are risks involved whens would FM be monitored?
start as early as 28 weeks
What are the Leopold maneuvers used for?
in the latter half of the 3rd trimester, assessment of fetal position can be performed using the four steps of Leopold maneuvers
How are you supposed to stand for the Leopold maneuver?
After positioning the patient supine with the head slightly elevated and knees slightly flexed, place a small towel under the right hip. If you are right-handed, stand at the right side facing the patient and perform the first three steps, then turn and face the feet for the last step
When do you use step 4 of the Leopold maneuver?
if the present part is not engaged
What is step 1 of the Leopold maneuver?
place hang over the fundus and identify
head-feels round firmed freely moveable
buttocks- feels softer and less mobile
What is step 2 of the Leopold maneuver?
use palmar surface to locate the back of the fetus. back will feel convex and small parts will feel irregular
What is step 3 of the Leopold maneuver?
with the right hand using thumb and third finger grasp the presenting part over the symphysis pubis.
How will the head feel if its not engaged in step 3?
it will be firm and moveable from side to side and easily displaced upward
What is step 4 of the Leopold maneuver?
turn and face the patients feet and use two hands to outline the fetal head.
What suggests that the head is flexed and the vertex is present on palpation? (opitmal position)
palpation of the cephalic prominence on the same side as the small parts
What suggests on palpation that the the presenting part is extended?
palpation of the cephalic prominence on the same side as the back
What should be recorded from abdominal palpation?
presenting part- vertex (head) or breach (buttocks)
The lie- longitudinal, transverse(perpendicular), or oblique
altitude (flexed or extended)
How can FHR be used to estimate the position of the fetus?
the area of maximal intensity of the fetal heart rate
Presentation is breech is FHR is heard _____ umbilicus and presentation is vertex if FHR is heard ______ umbilicus.
above; below
What is the relationship of the presenting part to the ischial spines of the pregnancy patients pelvis?
station
How is station measured?
determined by cm above and below the ischial spines and it recorded by a plus(below spine) or minus sign (above spine). (0=at the spines)
What are the routine cervical exam findings?
dilation, cervical length and station
What are Braxton-Hicks contractions?
uterine contractions as early as the third month of gestation
When can Braxton-Hicks become more painful?
as the pregnancy progresses and with increased gravidity
When do contractions require evaluation?
the regular occurrence of more than four to six uterine contractions per hour before 27 weeks gestation
How can uterine contractions be assessed accurately?
either indirectly through the abdominal wall or directly with the placement of an intrauterine pressure catheter
If palpating uterine contraction what is a mild classification?
slightly tense finds that is easy to indent with the fingertips.
If palpating uterine contraction what is a moderate classification?
firm fundus that is difficult to indent with the fingertips
If palpating uterine contraction what is a strong classification?
rigid or hand, birdlike fundus or one that does not indent with fingertips
How is contraction duration measured?
measures in seconds from the beginning until relaxation occurs
How is contraction frequency measured?
from the beginning of one contraction to the beginning of the next
What are the intervals of frequency of contractions used to asses regularity?
regular
irregular
sporadic
The uterus may become more ____ during the first 3 months from softening of the isthmus.
anteflexed
What is the result of the uterus becoming more anteflexed?
the fundus may press on the urinary bladder causing the patient to experience urinary frequency
In older adults what should be considered if the ovaries are palpable?
suspicious for tumor
What are the alternate position for pelvic examination in patients with mobility impairments?
knee chest position diamond shape position obstetric stirrups position M-shaped position V shaped position
What is a collection of physical, psychological and mood symptoms related to a patients menstrual cycle?
Premenstrual syndrome (PMS)
What are the symptoms of PMS?
breast swelling and tenderness acne bloating and weight gain headache or joint pain food cravings irritability difficulty concentrating mood swings crying spells depression
What do PMS symptoms occur?
5-7 days before menses (luteal phase)
What is the presence and growth of endometrial tissue outside the uterus?
endometriosis
What are the symptoms of endometriosis?
pelvic pain
dysmenorrhea
heavy or prolonged menstrual flow
What is it called when HPV invades the basal layer of the epidermis; virus through skin and causes mucosal microabrasions. Painless
Condyloma acuminatum (genital warts)
What is a viral infection of the skin and mucous membranes considered an STD infection in adults. in contrast to the non sexually transmitted infection occurring in young children?
Molluscum Contagiosum
What is caused by the poxvirus, the virus enters the skin through small breaks of hair follicles and spreads person to person. painless
Molluscum Contagiosum
What are the white or flesh colored, dome shaped papules that are round and oval with central umbilication from which thick creamy core can be expressed
Molluscum Contagiosum
What are the skin lesions associated with primary syphillis?
Syphilictic Chancre
What is the bacteria, STI that causes Syphilictic Chancre?
Treponema pallidum
When do Syphilictic Chancre occur and how are they treated?
generally 2 weeks after exposure
last 2-6 weeks and heals without treatment
What is a painless solitary lesion that is firm, small, round and ulcerated with indurated borders and a clear base?
Syphilictic Chancre
What are the lesions of secondary syphilis?
Condyloma Latum
What is the bacteria that causes Condyloma Latum?
Treponema pallidum
When do Condyloma Latum appear?
about 6-12 weeks after infection
What is the appearance of Condyloma Latum ?
flat, round or oval papules covered by a gray exudate
What is a sexually transmitted viral infection of the skin and mucosa caused by herpes simplex virus?
genital herpes
What are painful lesions in the genital area that may cause burning or pain with urination that are usually transmitted in the absence of symptoms
genital herpes
What is the appearance of genital herpes?
superficial vesicles in the genital area; internal or external and may be eroded
How does initial infection compare to recurrent infection of genital herpes?
initial infection is often extensive whereas recurrent is usually confined to small patch
What is the common cause of inflammation of the Batholin gland?
Neisseria gonorrhea
What are the types of vaginal carcinoma and where do they begin?
squamous cell carcinoma- epithelial lining
adenocarcinoma-glandular tissue
malignant melanoma- melanocytes
sarcomas- deep in the wall of the vagina
How does squamous cell ca of the vagina begin?
IN the epithelial lining of the vagina; maybe caused by HPV develops over a period of many years from precancerous changes called vaginal intraepithelial neoplasia (VAIN)
What is the subjective data of vaginal carcinoma?
abnormal vaginal bleeding difficult or painful urination pain during sexual intercourse pain in the pelvic area back or legs edema in the legs RISK: exposure to in utero DES
What are the types of vulvar cancer?
squamous cell-epithelial cells (MC)
adenocarinoma- Bartholin glands
Melanoma
Basal cell ca
What type of vaginal infection is associated with an increase in clear or mucous discharg?
Physiologic vaginitis
What is the diagnostic test for physiologic vaginitis?
wet mount up to 3-5 WBCs and epithelial cells
What is a type of vaginal infection with foul-smelling (fishy) discharge with homogenous thin, white or gray discharge. pH>4.5
Bacterial vaginosis (Gardnerella vaginalis)
How is Bacterial vaginosis (Gardnerella vaginalis) diagnosed?
+KOH “whiff test”
wet mount + clue cells
What type of vaginal infection has a pruritic discharge, itching of the labia that may extend into the thighs
white curdy discharge
pH 4.0-5.0
Candida vulvovaginitis
Candida albicans
How is Candida vulvovaginitis
Candida albicans diagnosed?
KOH prep: budding, branching yeast, pseudohyphae
What type of vaginal infection has a watery discharge with a foul odor, dysuria and dyspareunia with severe infection
profuse, frothy, greenish discharge
strawberry cervix
pH 5.0-6.6
Trichomoniasis (Trichomonas vaginalis)
How is Trichomoniasis (Trichomonas vaginalis) diagnosed?
wet mount: round or pear shaped protozoa motile “gyrating” flagella
What type of vaginal infection has a parter with an STI and may be asymptomatic or symptoms of PID
purulent discharge from cervix, skene/batholin gland inflammation
cefrvix and uvula may be inflamed
Gonorrhea (Neisseria gonorrheae)
How is Gonorrhea (Neisseria gonorrheae) diagnosed?
gram stain
culture
DNA probe
What vaginal infection is a parter with nongonococcal urethritis; often asymptomatic but may complain of spotting after intercourse or urethritis
may have purulent discharge, cervix may be red
Chlamydia
Chlamydia trachomatis
How is Chlamydia
(Chlamydia trachomatis) diagnosed?
DNA probe
What type of vaiginal infection involves dyspareunia, vaginal dryness, peri or post menopausal
pale, thin vaginal mucosa
pH >4.5
atrophic vaginitis
How is atrophic vaginitis diagnosed?
wet mount: folded, clumped epithelial cells
What type of vaginal infection involved new bubble bath, soap, douche
with fell smell and erythema
maybe altered pH
allergic vaginitis
How is allergic vaginitis diagnosed?
wet mount :WBCs
What originates from dysplastic or premalignant lesions present at the active squamocolumnar junction?
cervical cancer
What is the most important causative agent in cervical cancer at the molecular level?
HPV
What is the result of weakening of the supporting structures of the pelvic floor, often occurring with a cystocele and rectocele?
uterine prolapse
What is first degree prolapse?
the cervix remains within the vagina
What is second degree prolapse?
the cervix is at the Introitus
What is third degree prolapse?
the cervix and vagina drop outside the introitus
What is a common cause of mid cycle spotting?
midcycle estradiol fluctuation associated with ovulation
What is a common cause of delayed menstruation?
anovulation or threatened abortion with excessive bleeding
What is a common cause of frequent bleeding?
chronic PID, endometriosis, DUB, anovulation
What is a common cause of profuse menstrual bleeding?
endometrial polyps, DUB, adenomyosis, sub mucous bleeding leiomyomas, IUD
What is a common cause of intermenstrual or irregular bleeding?
endometrial polyps, DUB, uterine or cervical cancer, oral contraceptives
What is a common cause of postmenopausal bleeding?
endometrial hyperplasia, estrogen therapy, endometrial cancer
What is the main cause of dysfunctional uterine bleeding?
90% caused by anovulation
10% ovulatory in origin- can be caused by dysfunction of corpus lute or mid cycle bleeding
What arises from the overgrowth of smooth muscle and connective tissue in the uterus?
myomas
leiomyomas, fibroids
What type of cancers most often appears in postmenopausal patients?
endometrial cancer
What is the most known risk factor for endometrial cancers?
imbalance between estrogen and progesterone in the body
Follicle undergoes varying rates of maturation and cysts can occur as the result of the hypothalamic-pituitary dysfunction or because of native anatomic defects in the reproductive system
ovarian cysts
When can ovarian cysts be present?
from neonatal period to menopause
most occur during infancy and adolescence
What are the types of tumors associated with ovarian cancer?
epithelial ** MC
stromal (connective tissue)
germ cell (cells that produce the egg)
When a pt is over 40 years old when should you suspect ovarian cancer?
with persistent and unexplained vague GI symptoms such as generalized abdominal discomfort, gas, pain, indigestion pressure, swelling, bloating, cramps and fullness even after a light meal
What is inflammation of the uterus, Fallopian tubes and other reproductive organs. A common and serious complicated of some STIs
Pelvic inflammatory disease (PID)
What are the two STIs that commonly cause PID?
gonorrhea and chlamydia
What is inflammation or infection of the fallopian tubes often associated with PID, can be acute or chronic?
Salpingitis
What is the first stage of salpingitis?
acquisition of a vaginal or cervical infection
What is the second stage of salpingitis?
involves ascent of the infection to the upper genital tract
What are the organisms most commonly associated with acute salpingitis?
Neisseria gonorrheae and Chlamydia trachomatis
same as PID
What is the presentation of salpingitis?
LQ pain- constant and dull or cramping pain may be accentuated by motion of sexual activity. coexisting purulent vaginal discharge NV & Fever abnormal vaginal bleeding
Inflammation of the vagina sue to the thinning and shrinking of the tissues as well as decreased lubrication from the lack of estrogen during perimenopause and menopause?
atrophic vaginitis
