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MSS - PCM 2 Exam 1 > Female GU and Breast Exam > Flashcards

Female GU and Breast Exam Flashcards

1
Q

perineum

A

area between vagina and anus

may see scarring here - during baby delivery

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2
Q

adnexa

A

ovary and fallopian tube

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3
Q

menarche

A

age at onset of menses

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4
Q

menopause

A

absence of menses for 12 consecutive months

ages 48-55 usually

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5
Q

post-menopausal bleeding

A

occuring 6 month or more after cessation of bleeding

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6
Q

amenorrhea

A

absences of menses

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7
Q

dysmenorrhea

A

pain with menses

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8
Q

polymenorrhea

A

menses at abnormally frequent intervals

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9
Q

oligomenorrhea

A

abnormally scant or infrequent menses

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10
Q

menorrhagia

A

excessive bleeding

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11
Q

metrorrhagia

A

bleeding between periods

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12
Q

post-coital bleeding

A

bleeding after sex

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13
Q

gynecologic history

A 
last period
regularity of periods
time between periods
number of days of flow
amount of flow
pain with periods
bleeding between periods
age of menarche
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14
Q

sex history

A

current status
number of partners
gender of partners
any STDs

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15
Q

gravida-para notation

A

G - number of pregnancies
P - para-outcome of pregnancies

T = term
P = premature
A = abortion < 20 weeks (induced or spontaneous)
L = living
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16
Q

G3 P3003

A

3 pregnancies

3 term deliveries all living

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17
Q

G4 P2305

A

4 pregnancies

2 term, 3 preterm (premature), 5 living

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18
Q

urological history

A 
frequency
burning
incontinence
urgency
nocturia
hematuria
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19
Q

dyspareunia

A

painful intercourse

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20
Q

PMDD

A

premenstrual dysphoric disorder

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21
Q

bartholins glands

A

in labia majora

  • secrete lubrication
  • duct opening to labia minora
  • duct can get blocked and infected - abscess

4 and 8 oclock

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22
Q

skenes glands

A

paraurethral glands

  • adjacent to urethral opening
  • can get swelling/tenderness

10 and 2 oclock

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23
Q

cystocele

A

bladder descends and bulges out of vagina

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24
Q

rectocele

A

rectum bulges into vagina

25
Q

exam of internal genitalia - speculum insertion

A

warm and lube correct speculum

  • 45 degree angle and point down
  • gentle downward pressure on introitus
  • open slowly after advancing gently
26
Q

exam of internal genitalia

A

cervix - color, position, surface, discharge, size, shape

procedures - PAP smear, sample of vaginal secretions, GEN probe

27
Q

os

A

opening of cervix

-shape, polyps, pus, cancer, cysts

28
Q

transformation zone

A

columnar cells of uterus to squamous cells of cervix

important area to collect cells for paps

29
Q

cervical os

A

may have lacerations during delivery of child

30
Q

pap smear

A

right at os - transformation zone

31
Q

transformation zone

A

premalignant changes and neoplasia occur here

encompasses immature and mature squamous metaplasia

32
Q

true squamocolumnar junction

A

proximal limit of squamous metaplasia

  • usually not visualized
  • within endocervical canal
  • 3cm from observed SCJ
33
Q

fertile phase

A

os is open with fertile mucus

34
Q

nabothian cyst

A

cervix secretes a mucus
-they get plugged and can form cysts

can be confused with cancer

35
Q

bimanual exam

A

index and middle finger

palpate cervix, uterus, and each ovary

36
Q

version

A

relationship between fundus of uterus and vagina

37
Q

flexion

A

relationship between fundus of uterus and cervix

38
Q

anteverted

A

uterus less than 180 degrees from uterus

retroverted opposite

39
Q

anteflexed

A

uterus fundus less than 180 degress from cervix

retroflexed is opposite

40
Q

rectovaginal exam

A

3 purposes:

  • screen colorectal cancer for women > 50 yo
  • assess pelvic pathology in posterior rectovaginal pouch (pouch of douglas)
  • palpate a retroverted and retroflexed uterus and uterosacral ligaments
41
Q

female breast anatomy

A

level of 2nd rib to inframammary fold at 6th rib

transversely from lateral border of sternum to mid-axillary line

deep surface of breast rests on fascia of pectoralis major, serratus anterior and external obliqus, and upper extent of rectus sheath

axillary tail of spence - extends laterally across anterior axillary fold - upper outer quadrant of breast contains greater volume of tissue than other quadrants

42
Q

most volume in breast?

A

upper outer quadrants

43
Q

breast functional anatomy

A

15-20 lobes composed of lobules

fibrous bands of CT - suspensory ligaments of cooper - provide structural support

44
Q

breast ducts

A

each lobe terminates in major lactiferous duct - opens through orifice to ampulla of nipple

deep to nipple - major duct has dilated portion - lactiferous sinus - lined with stratified squamous

major ducts - two layers cuboidal
minor ducts -single layer columnar or cuboidal

45
Q

arterial supply of breast

A

perforating branch of internal mammary artery

lateral branches of posterior intercostal arteries

branches of axillary artery

2,3,4 anterior intercostal perforators of internal mammary - medial mammary arteries

lateral thoracic artery gives rise to lateral mammary branches

46
Q

lymph of breast**

A

axillary tail - subscapular group of axillary nodes

upper - infra clavicular nodes

medial - sub mammary plexus of opposite breast and lymph glands along internal thoracic artery and to mediastinal nodes

inferior - lymph of abdominal wall and extra peritoneal lymphatic plexus

most of lymph from subareolar and submammary plexus to anterior or pectoral group of axillary nodes

47
Q

axillary tail drainage

A

subscapular group of axillary nodes

48
Q

upper lymph drainage

A

infra clavicular nodes

49
Q

medial lymph drainage

A

sub mammary plexus of opposite breast and lymph glands along internal thoracic artery and to mediastinal nodes

50
Q

inferior lymph drainage

A

lymph of abdominal wall and extra peritoneal lymphatic plexus

51
Q

subareolar and submammary plexus drainage

A

anterior and pectoral group of axillary nodes

52
Q

best time for breast exam

A

5-7 days following last period

53
Q

4 quadrants of breast

A

upper outer - most cancers (most tissue)
upper inner
lower outer
lower inner

54
Q

breast inspection

A 
arms at side
arms over head
hands against hops
palms pressed together
arms extended and bent forward at waist
55
Q

palpation of breast

A

patient supine with sheet under shoulders

use pads of fingers
-palpate by quadrant and tail of spence

vertical or rotary pattern palpation

tail of spence can be palpated along axillary fold

56
Q

tail of spence

A

axillary tail of breast

57
Q

palpation of axilla

A

common site of cancer

58
Q

reading

A

Bates’ Guide to Physical Examination, 10th Edition, pages 389-411 & 521-544

MSS - PCM 2 Exam 1 (7 decks)

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