Female genitourinary system

Question 1

external female genitalia

Answer 1

• mons pubis
• labia majora and minora
• clitoris
• urethral meatus
• paraurethral glands
• vaginal orifice
• hymen
• vestibular (bartholin) glands

Question 2

internal genitalia

Answer 2

vagina- tubular canal that extends from the vestibule to the cervix

uterus - pear shaped muscular organ divided in three segments: the fundus (or top) of the uterus, the corpus (or body), and the cervix, which projects into the vagina

fallopian tubes- two pliable tubes that extend from the fundus of the uterus to the brim of the pelvis.

ovaries- are oval-shaped glandular structures close to the distal end of the fallopian tubes. They serve to develop ova (or eggs) and female hormones.

Question 3

developmental stages and anatomic changes female genitourinary

Answer 3

• At birth, the external genitalia are engorged because of the presence of maternal estrogen. The ovaries are located in the abdomen during childhood.
• During puberty, estrogens stimulate the growth of cells in the reproductive tract and the development of secondary sex characteristics.
• The first signs of puberty are breast and pubic hair development, with menarche occurring during the latter half of this sequence.
• Irregularity of the menstrual cycle is
  common during adolescence because of the occasional failure to ovulate.

Question 4

pregnancy; genitourinary system

Answer 4

• changes occur shortly after the first missed menstrual period. The cervix softens and looks cyanotic, due to the increased vascularity and hypertrophy and hyperplasia of the cervical glands.
• The increase in glycogen levels during pregnancy increases the risk for candidiasis.

Question 5

ovarian function

Answer 5

declines between the ages of 35-60

Question 6

subjective data for the female genitourinary system

Answer 6

• ask questions regarding menstrual and obstetric history; contraceptive use, sexual activity,sexually transmitted infection contact and selfcare behaviors; vaginal discharge, acute pelvic pain, and urinary symptoms; menopause and past pertinent history.

Question 7

objective data for the female genitourinary system

Answer 7

• first inspect the external genitalia noting skin color, hair distribution, symmetry and lesions; inspect the perineum, clitoris, labia minora, urethral opening, vaginal opening and anus.
• Palpate the urethra, Skene glands, Bartholin glands,and perineum. Assess vaginal tone, and for vaginal wall bulging or urinary incontinence.
• Using a vaginal speculum, inspect the cervix, noting its color, position, size, os, surface, and any cervical secretions. Obtain specimens for studies. Remove the speculum, and perform a bimanual examination.
• Palpate the uterus and attempt to palpate the ovaries for any mass or other abnormality.
• Change gloves and perform a rectovaginal
  examination. Assess the rectovaginal septum, rectovaginal pouch, uterine wall, fundus, rectal wall, and anal sphincter tone. If any stool remains on your glove, test it for occult blood.
• Examine female infants and school-age children on an examination table, and toddlers and preschoolers while in the parent’s lap.
• Examine the female adolescent without the mother present, and assure her of her privacy and confidentiality.
• In the pregnant woman, the genitalia show signs ofincreased vascularity and the vaginal mucosa thickens.

Chadwick sign and Hegar sign are present.

• When examining the older woman, lubricate
  instruments and the examining hand since natural lubrication decreases in this population.
• Consider comfort measures for the older woman, such as suggesting a mild analgesic for those with arthritis before the appointment.

Question 8

aging woman-menopause

Answer 8

• cessation of the meses
• 48-51 yrs
• ovaries stop producing progesterone and estrogen
• uterine changes in size
• vaginal changes–> shorter, narrower and less elastic

symptoms
* hair loss
* digestive problems
* brittle nails
* joint pain (osteoporosis)
* hot flashes
* breast pain
* night sweats

Question 9

HPV vaccine

Answer 9

11-12 years

Question 10

what position should the woman be placed in during a vaginal examination

Answer 10

• Lithotomy position
• supine position with feet in stirrups and knees apart buttocks at edge of table

Question 11

What are some measure to ease her discomfort or anxiety during an examination?

Answer 11

Empty bladder, don’t expose open legs to door, company?, elevate head and shoulders for eye contact, gentle, communicate

Question 12

abnormal findings for the female genitourinary system

Answer 12

• symptoms of a UTI
• herpes simplex virus– local pain, dysuria, fever, HA, malaise or symptomatic
• HPV–> painless wort growth
• uterine prolapse–> urterus protrudes into the vagina
• cystocele–> feeling of pressure in vagina
• rectocele–> feeling of pressure (poss consipation) buldge, vaginal mucosa