GN 4 PFD Flashcards
True about pelvic organ prolapse EXCEPT
a. POP is a condition characterized by failure of various anatomic structures to support the pelvic viscera
b. It is defined as the descent of one or more of the vaginal walls or cervix.
c. urethrocele, enterocele, and rectocele are examples of posterior vaginal wall prolapse.
d. cystocele is an example of anterior vaginal wall defect
C.
Anterior vaginal wall prolapse:
- cystocele
- urethrocele
- paravaginal defect
Posterior vaginal wall prolapse
- rectocele
- enterocele
True about POP EXCEPT
a. symptoms can include vaginal bulging, pelvic pressure, vaginal bleeding or discharge, low backache, need to replace the prolapse in order to void or defecate
b. POP can be asymptomatic. Symptoms are more common when the prolapse extends beyond the hymen.
c. POP usually involves only one wall of the vaigina
d. AOTA
C; usually involves more than one wall of the vagina
True about POP
a. POP is common in nulliparous women
b. prevalence is 20-40%
c. symptomatic POP prevalence is close to 3%
d. pelvic support structure defects are not associated with vaginal childbirth-related injury
C.
a. common in parous women
b. prevalaence is 30-50%
c. pelvic support structure defects have been associated with age, vaginal childbirth-related injury (neurologic or msucular or both), obesity, diabetes, connective tissue disorders, genetics/family history, and neurologic diseases
support of midvagina
a. Level I
b. Level II
c. Level III
B
Level II - support of the mid-vagina is provided by connective tissue attachments to the arcus tendineus fasciae pelvis on the lateral pelvic side walls
Support of vaginal apex
a. Level I
b. Level II
c. Level III
Level I - support of the vaginal apex and cervix provided by the uterosacral and cardinal ligaments and associated connective tissue
The ff provide level III support EXCEPT
a. perineal membrane
b. perineal muscles
c. attachments through endo-pelvic connective tissue
d. connective tissue attachments to the arcus tendineus fasciae pelvis on the lateral pelvic side walls
D
3 layes of vagina
NLM
Nonkeratinizing stratified epithelium
Lamina propria
Muscularis
True about pelvic organ support
a. Anteriorly, the vagina supports the base of the bladder and the ureter
b. Th recutm is located posterior to the vagina behnid the rectovaginal septum anteriorly.
c. The perineal body is fused with the vaginal muscularis
d. AOTA
C
A. bladder and urethra
B. superiorly
Classic symptoms of prolapse (4)
Belated Happy Birthday Po
Vaginal..
Bleeding
Heaviness and pressure
Bulge
Pain, pelvic
T/F back pain and pelvic pain are reliably associated with prolapse
F
Urinary symptoms in POP can include (4)
urinary incontinence, difficulty voiding, slow urinary stream, or a sensation of incomplete bladder emptying
SUDS Slow urinary stream Urinary incontinence Difficulty voiding Sensation of incomplete bladder emptying
Bowel symptoms in POP include: constipation, straining, incomplete evacuation, fecal incontinence, or splinting (reducing the prolapse) to achieve bowel movements can be present
CSI Full Series Constipation Straining Incomplete evacuation Fecal incontinence Splinting
Sexual symptoms in POP may include
DID
Discomfort
Irritation
Decreased Sexual desire
Prolapse into the upper barrel of the vagina
a. first degree
b. second degree
c. third degree
d. fourth degree
A
Prolapse through the introitus
a. first degree
b. second degree
c. third degree
d. fourth degree
C
Prolapse to the introitus
a. first degree
b. second degree
c. third degree
d. fourth degree
B
Complete eversion of the vagina
a. first degree
b. second degree
c. third degree
d. fourth degree
D
Baden-Walker System normal position of vagina a. Grade 0 b. Grade 1 c. Grade 2 d. Grade 3 e. Grade 4
A
Descent to the level of the hymen
a. Grade 0
b. Grade 1
c. Grade 2
d. Grade 3
e. Grade 4
C
Descent halfway to the hymen
a. Grade 0
b. Grade 1
c. Grade 2
d. Grade 3
e. Grade 4
B
Descent halfway past the hymen
a. Grade 0
b. Grade 1
c. Grade 2
d. Grade 3
e. Grade 4
D
Maximum possible descent
a. Grade 0
b. Grade 1
c. Grade 2
d. Grade 3
e. Grade 4
E