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pcm ii exam 1 > Female GU Exam + Breast (king-10) > Flashcards

Female GU Exam + Breast (king-10) Flashcards

1
Q

menarche

A

age at onset of menses

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2
Q

menopause

A

absence of menses for 12 consecutive months

usually 48-55 yrs old

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3
Q

post-menopausal bleeding

A

bleeding occuring 6 months or more after cessation of bleeding

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4
Q

amenorrhea

A

absence of menses

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5
Q

dysmenorrhea

A

pain with menses

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6
Q

polymenorrhea

A

menses at abnormally frequent intervals

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7
Q

oligomenorrhea

A

abnormally scant or infrequent menses

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8
Q

menorrhagia

A

excessive bleeding

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9
Q

metrorrhagia

A

bleeding between periods

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10
Q

post-coital bleeding

A

bleeding after sexual intercourse

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11
Q

sexual history as part of GYN visit

A

current sexual status
number of partners
gender of partners
any STDs

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12
Q

gravida

A

number of pregnancies

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13
Q

para

A 
outcome of pregnancies
usually four numbers
1. term >37 wks
2. premature
3. aborted <20wks
4. living
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14
Q

urologic hx as part of GYN visit

A 
frequency
burning
incontinence (stress, urge, overflow)
urgency
nocturia
hematuria
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15
Q

common CC

A 
amenorrhea
dysmenorrhea
metrorrhagia
vaginal d/c or itching
abd/pelvic pain
dyspareunia
infertility
PMS or PMDD
change in urinary pattern
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16
Q

dyspareunia

A

pain with intercourse

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17
Q

PMDD

A

pre-menstrual dysphoric disorder

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18
Q

materials for exam

A 
gloves
spec
lgiht
cotton tipped swabs
lube
Pap materials (brush/spatula)
slide and fixative
pH paper, culture, slides, KOH/saline
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19
Q

inspect external genitalia

A 
labia majora
labia minora
mons pubis
urethral opening
clitoris with prepuce
vaginal entrance/introitus
vestibule (surrounds vaginal opening)
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20
Q

inspection of glands

A

Skene’s

Bartholin’s (more important)

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21
Q

cystocele

A

prolapsed bladder through vaginal wall

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22
Q

rectocele

A

prolapsed rectum through vaginal wall

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23
Q

inspection of internal genitalia

A 
warm and lube correctly sized spec
hold at 45 angle pointing down
gentle pressure on posterior introtus
once in, straighten and advance
open to see cervix
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24
Q

cervical exam

A

look for: cervical color, position, suurface appearance, d/c, size and shape of os
test: Pap smear

25
Q

Pap smear

A

examines cervix
samples vaginal secretions for wet mount
checks for STDs with GEN probe

26
Q

os of cervix

A 
inspect:
shape
polyps
pus
cancer
cysts
TZ
27
Q

cervical lacerations from delivery

A

bilateral transverse
stellate
unilateral transverse

28
Q

cervical os shapes

A

nulliparous: oval
gravid: slit

29
Q

transformation zone

A

where premalignant changes and neoplasia occur

encompass immature and mature squamous metaplasia

30
Q

true squamocolumnar junction

A

proximal limit of squamous metaplasia

usually not seen b/c its within endocervical canal, 3 cm from observed SCJ

31
Q

Nabothian cysts

A

mucus filled cyst on cervix

cause: sq epith of ectocervix grows on col epith of endocervix

32
Q

palpation: bimanual exam

A

lube index and middle fingers and insert:

  1. palpate cervix
  2. palpate uterus
  3. palpate both ovaries
  4. strength of pelvic floor
33
Q

palpating cervix

A

for position, shape, consistency, regularitty, mobility, tenderness

34
Q

palpating uterus

A

elevate cervix and uterus with pelvic hand
press abdominal hand down to grasp uterus b/w both hands
palpate for size, shape, consistency, mobility, tenderness, masses/fibroids

35
Q

palpating ovaries b/l

A

abdominal hand on RLQ
pelvic hand in R lat fornix
press abdominal hand down to push contents to pelvic hand
OFTEN NOT PALPATED

36
Q

version

A

relatioship between fundus of uterus and vagina

37
Q

flexion

A

relationship between fundus of uterus and cervix

38
Q

rectovaginal exam

A

3 purposes:

  1. palpated retroverted/flexed uterus and uterosacral ligaments
  2. screen for CRC in women >50
  3. assess pelvic path in post rectovaginal pouch (of Douglas)
39
Q

female breast extends from?

A
  • 2nd rib to 6th rib (inframammary fold)

- sternum to MAL

40
Q

posterior breast rests on?

A

fascia of pec major, serratus anterior, ext abd oblique mm, upper extent of rectus sheath

41
Q

axillary tail of Spence

A

extends laterally
crosses anterior axillary fold
contains greatest volume of breast tissue at attachment site (upper outer quadrant)

42
Q

breast anatomy

A

15-20 lobes

CT bands insert perpendiculary to dermis and provide support

43
Q

CT bands of breast called?

A

suspensory ligaments of Cooper

44
Q

breast anatomy: lobes

A

each terminate into major lact duct opening into constricted orifice into ampulla of nipple
each duct has lact sinus lined w/ st sq epith
major ducts lined with 2 layers of cuboidal cells
minor ducts lined with 1 layer col/cub cell

45
Q

arterial supply of breast (3)

A
  1. internal mammary (perf branches)
  2. post. intercostals (lat branches)
  3. axillary a (esp: highest thoracic, lat thoracic, pec branch of thoracoacromial a)
46
Q

medial mammary arteries

A

free, repeating branches from 2, 3, 4, anterior intercostal aa

47
Q

lateral mammary branches

A

from lateral thoracic a

48
Q

axillary tail drains into?

A

subscapular group (of axillary LN)

49
Q

upper breast drains into?

A

infraclavicular LN

50
Q

medial breast drainage

A

submamaary plexus of OPP breast
lymph along int thor a
then to mediastinal LN

51
Q

inferior breast drainage

A

lymphatics of abd wall to extraperiotneal lymphatic plexus

52
Q

subareolar and submammary plexuses drain to?

A

anterior or pectoral group of axillary LN

53
Q

best time to examine breasts?

A

5-7 d post LMP

54
Q

inspection of breast (4)

A

inspect w/ arms at side
inspect w/ arms overhead
inspect w/ palms pressed together
inspect w/ arms extended and bent forward at waist

55
Q

observe breast for (6)

A 
development
size/symmetry
contour
retractions/dimpling of skin
skin color/texture
venous engorgement
56
Q

inspect nipple for (5)

A 
retraction u/l or b/l
d/c
darkening
ras/crusting/ulcerations
supernumerary nipples
57
Q

breast palpation technique

A
  • pt supine, ipsilat arm above head
  • finger pads, not tips
  • in circles or strips
  • flatten tissue against chest wall
  • keep motion continous
  • palpate breast by quadrant and tail of spence
58
Q

breast palpation pressure

A 
3 levels:
light to feel close to skin
med to feel deeper
firm to feel chest/ribs
Do all 3 pressures at one spot, then move on
59
Q

movement of breast during palpation

A

up and down at imaginary line from axilla to sternum

check entire breast going down until ribs and up to neck/clavicle

pcm ii exam 1 (7 decks)

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