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PD II > Female GU > Flashcards

Female GU Flashcards

1
Q

Mons Pubis

A

This is the rounded area in front of the pubic bones at the lower part of the abdomen.
It becomes covered with hair at puberty.

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2
Q

Female Vestibule

A

The vulva vestibule contains the opening to the urethra and the vaginal opening. The borders of the vulva vestibule are formed from the edge of the labia minora.

Contains the bartholin’s glands

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3
Q

Labia Minora

A

Two inner folds of skin that surround the opening of thevagina.

Thelabia minoraare part of the external femalegenitals, or genitals present in individuals assigned females at birth, which also includes themons pubis, labia majora,vaginalopening, hymen, andclitoris.

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4
Q

Labia Majora

A

prominent pair of cutaneous skin folds that will form the lateral longitudinal borders of the vulval clefts.

The labia majora forms the folds that cover the labia minora, clitoris, vulva vestibule, vestibular bulbs, Bartholin’s glands, Skene’s glands, urethra, and the vaginal opening.

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5
Q

Labia majora function

A

protect vagina from mechanical irritation, dryness and infection.

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6
Q

Forchette

A

Labia unite here posteriorly. A thin fork-shaped fold of skin designed to stretch at the bottom of the entrance to thevagina.

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7
Q

Vaginal Introitis

A

The entrance to the vagina, encompassing the anterior and posterior vestibules and the perineum.

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8
Q

Vaginal Anatomy specifics

A

Musculomembranous tube between the urethra and rectum

Vagina mucosa lies in transverse folds called rugae.

Protrusion of cervix into the vagina divides into 4 fornixes:

Anterior
Posterior: Deep and ant to rectovaginal cul-de-sac (pouch ) of douglas

TWO lateral: broad ligaments, Ovaries and fallopian tubes are palpable here

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9
Q

Arterial Supply of the vagina + ovaries

A
  1. Internal Iliacs
  2. Uterine Artery
    and
  3. Ovarian artery
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10
Q

Vagina Lymphatics

A
  1. lower 2/3 vagina - inguinal lymph nodes
  2. upper 1/3 vagina hypogastric and sacral nodes/ abdominal and pelvic nodes
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11
Q

Uterine cavity

A

Triangular 6-7cm
Normal=Anteverted
Can be retroverted or anteflexed
Lies at almost right angle of vagina

Fundus: Convex upper surface of the body
Cervix: Lower part protrudes into vagina

Blood supply: Uterine and Ovarian Arteries
Lymphatics: to lumbar nodes

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12
Q

TAH and TVH

A
  1. Total abdominal hysterectomy
  2. Total Vaginal hysterectomy
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13
Q

The adnexa are

A

made up of the fallopian tubes and ovaries. Cysts are fluid-filled structures that can develop in the adnexa.

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14
Q

Ovary anatomy specifics

A

Almond shape
Palpable on pelvic exam 50% time

Two primary functions:
Production of ova
Secretions of hormones
Estrogen/Progesterone/Testosterone

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15
Q

HPA hormone secretion

A

Hypothalamic pituitary axis - Releases factors from hypothalamus: controls secretion of hormones from anterior pituitary: FSH/ LH

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16
Q

Ovarian Graafian follicles

A

secretes estrogen in response to FSH / LH

17
Q

Corpus Luteum

A

Ovarian follicle after ovulation
Secretes estrogen and progesterone

18
Q

Pituitary gland influence on menses

A

pituitary secretes FSH and LH,a process which actually begins before the onset of your menses.

These hormones in turn stimulate the growth of several ovarian follicles, each containing one egg.

The number of follicles in the monthly “cohort” of developing follicles is unique to each individual

19
Q

FSH, LH, and Estrogen integration for ovulation

A

Positive feedback triggers the anterior pituitary to release more FSH and LH.

More FSH and LH cause the ovary to produce more estrogen. The ensuing LH surge is responsible for ovulation.

20
Q

Estrogen Birth control action

A

prevents pituitary gland from releasing LH, with no LH, egg does not mature and ovulation does not occur.

21
Q

Polymenorrhea

A

less than 21 day intervals between menses

22
Q

Oligomenorrhea

A

Infrequent bleeding

23
Q

Menorrhagia

A

excessive flow

24
Q

Metrorrhagia

A

intermenstrual bleeding

25
Q

Postcoital bleeding

A

bleeding after sexual relations

26
Q

GPFPAL

A

G=Gravida=>total # of pregnancies
P=Para=>outcomes of pregnancies
F=Full term
P=Premature
A=Abortion or Miscarriage
L=Living child/children

27
Q

Female GU relavent Hx questions

A

Family history

Menarche (first menses-ovulation begins after 1-2 years)

Menstruation
Menopause (last uterine bleeding induced by ovulation
Postmenopausal bleeding (after 608 months of amenorrhea)

Pregnancy
Vulvovaginal symptoms: m/c sxs=discharge and vaginal itch, Lesions/rashes

Sexual activity: Dyspareunia, vaginismus, Hx STI’s

28
Q

Vaginal Inspection

A

Discharge
Inflammation
Edema
Ulceration
Lesions
Prolapse
Stress Incontinence

29
Q

Phases of the Pelvic exam

A

Inspection/Palpation ext genitalia
Examination with a speculum
Bimanual Examination
Rectovaginal Palpation

30
Q

External genitalia inspection

A

External genitalia
Masses, lesions, discharge, infection, Bartholin’s cyst, rashes, moles, ulcers, warts, scarring, trauma

Lichen Sclerosis: uniformed reddened, smooth , shinny appearance

31
Q

Cervix inspection

A

Cervix:
Nullipara vs Multipara
Color, erythema, lesions, masses, discharge, erosion

32
Q

Vaginal mucosa - Inspection

A

Color, inflammation, discharge, ulcers, masses, atrophy

33
Q

Pap smear screening elements

A

Two primary types of cervical cancer
Squamous cell 80-90%
Adenocarcinoma 10-20%

Risk Factors for cervical cancer
Behavioral
Sexual activity at a young age, Failure to do proper screening

Multiple partners, h/o STIs

Viral
HPV (oncogenic strains 16,18)
Present in 95-100% squamous cell cancers in the cervix

34
Q

Pap Screening Guidelines

A

Start at age 21, regardless of sexual activity

Screen every 3 years in 20’s, unless more often when indicated

Pap smear: cells are scraped from the cervix and checked for diseases or other problems under a microscope

35
Q

PE palpation

A

Cervix: Soft, firm, nodule, friable, pain with motion

Uterine body/Bimanual exam: Position, size, shape, mobility, consistency, tenderness

Adnexa: Ovaries, masses, tenderness

Posterior fornix: Pouch of Douglas

Rectovaginal exam

36
Q

PE write up

A

BUS: Bartholin, Urethral, Skene’s glands normal
Vagina: Atrophy, lesions, color, moisture, discharge, bleeding

Cervix: Appearance, lesions, erythema, petechiae, discharge, strawberry cervix, laceration, nulliparity vs multiparity, cervical motion tenderness (Chandelier sign with PID)

Uterus: size, shape, anteverted, retroverted, mobility, tenderness

Adnexa: masses, tenderness (?ovaries palpated)

Rectum: confirms retroversion, posterior fibroid, endometriosis, size, rectal masses

37
Q

Protrusion of cervix into the vagina divides into 4 fornixes:

A

Anterior
Posterior: Deep and ant to rectovaginal cul-de-sac (pouch ) of douglas

38
Q

Lichen Sclerosis

A

uniformed reddened, smooth , shinny appearance

Usually in girls before period onset
and post menopausal women.

39
Q

Two primary types of cervical cancer

A

Squamous cell 80-90%
Adenocarcinoma 10-20%

PD II (4 decks)

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