Female GU and Breast Exams - King Flashcards
Define menarche
age at onset of menses
Define menopause
absence of menses for 12 consecutive months (usually 48 – 55 years old)
Define post-menopausal bleeding
bleeding occurring 6 months or more after cessation of bleeding
Define amenorrhea
absence of menses
Define dysmenorrhea
pain with menses
Define polymenorrhea
menses at abnormally frequent intervals
Define oligomenorrhea
abnormally scant or infrequent menses
Define menorrhagia
excessive bleeding
Define metrorrhagia
bleeding between periods
Define post-coital bleeding
bleeding after sexual intercourse
Things to include in a gynecologic history:
Last menstrual period Regularity of periods Usual time between periods Number of days of flow Amount of flow Pain with periods Bleeding between periods Age of menarche
Ask about ________ (4) in sexual history taking:
Current sexual status
Number of partners
Gender of partners
Any sexually transmitted diseases
G5P2032 means what?
5 pregnancies, 2 term deliveries, (0 pre-term deliveries), 3 abortions, 2 living offspring
G4P3105 means what?
4 pregnancies, 3 term deliveries, 1 preterm deliveries, 5 living
G3P3002?
3 pregnancies, 3 term deliveries, 2 living
The GU exam is performed best (better exam and pt comfort) after the pt has _______?
Voided their bladder
Skene’s glands are located where in the vaginal opening?
10 and 2 o’clock
Location of Bartholin’s glands?
4 and 8 o’clock
When doing a pap smear, the physician “scrapes” cells from this portion of the cervix:
The transformation zone (TZ)
What occurs at the TZ?
premalignant changes and neoplasia occur (Encompasses immature and mature squamous metaplasia)
What is the true squamocolumnar junction (SCJ) and where is it located?
It is the proximal limit of squamous metaplasia
It usually not visualized because it is located within the endocervical canal, approximately 3 cm from observed SCJ
Define flexion of the uterus
the relationship between the fundus of the uterus and the cervix
Define version of the uterus
the relationship between the fundus of the uterus and the vagina
When doing a rectovaginal exam, what are you trying to palpate and assess?
A retroverted and retroflexed uterus and the uterosacral ligaments; assess pelvic pathology in the posterior rectovaginal pouch (Pouch of Douglas)
If you can palpate an ovary during a bimanual exam…
“something is wrong”…. if bimanual is normal, document “ovaries are non palpable”
Bimanual examination can reveal pelvic floor….
strength
Which quadrant of breast contains the most breast tissue? What is this area called?
The upper outer quadrant does compared to the other three quadrants… it contains the axillary tail “of Spence” which extends laterally across the anterior axillary fold
Axillary tails drains into…
the subscapular group of axillary nodes
Upper portion of breast drains into…
the infraclavicular nodes
Most of the lymph from the subareolar and submammary plexus is drained to…
the anterior or pectoral group of axillary nodes
Medial part of the breast is drained by…
the submammary plexus of the opposite breast, the lymph nodes along the internal thoracic artery and then to mediastinal nodes
The inferior portion of the breast is drained by the…
lymphatics of the abdominal wall and to the extra peritoneal lymphatic plexus
When is the best time to do a breast exam?
Around 5-7 days post-menses (5-7 days following the end of the LMP)… this is when the secretory tissue are at their lowest size
Things to look for during inspection of the breasts:
Development Size and symmetry Contours ***Retractions or dimpling (of skin) Skin color and texture Venous engorgement
Where else should you palpate for enlarged nodes during a breast exam?
The axilla
