Gynecologic Assessment Flashcards
female anatomy anterior to posterior
pubic bone, bladder, uterus, bowel
which day is the first day of cycle
1st day of period
G-Gravida
total number of pregnancies
T-Term births
when the birth happens between 37-42 weeks of gestation
P-Preterm births:
Extreme:___weeks
Very:__ weeks
Moderate to late:__weeks
Extreme: <28 weeks
Very preterm: 28-32 weeks
moderate to late: 32<37 weeks
A-Abortions
loss of baby spontaneously or elective in utero to 20 weeks gestation
first gynecological visit for screening and preventative services should occur at which age
13-15
what should a first gynecological visit consist of
patient education
a pap is a patient choice under which circumstances?
total hysterectomy, no hx of vulvar neoplasia, not HIV positive, not exposed to diethylstilbestrol in utero
if a patient does not want a pap what should still continue?
external genitalia
adnexa
ovaries
bimanual exam is better for evaluating the uterus or adnexa (ovaries)
uterus
what age is a pap/cervical screening recommended regardless of sexual activity
21
do you have to have a pelvic exam/cervical cancer screening in order to get oral contraceptives?
no
how often should cervical screenings take place for 20-29 yr olds
q3 yrs
how often should cervical screenings take place for 30-65 yr olds?
q5 years
how often should cervical screenings take place for >65 yr olds?
as long as they have regular screening for last 10 years and everything normal for past 20 years, may discontinue pap if requested, if they have had precancerous findings then continue pap for 20 years
condylomata acuminatum
HPV lesions, white dry, painless growth
chancroid
painful ulcer with rough floor and purulent yellow exudate, it heals leaving a scar
cystocele
bulge of upper 2/3 of vaginal wall with bladder above (fingers go underneath) it
rectocele
herniation of rectum into the posterior wall of vagina (fingers go above)
what are you checking for when palpating the external genitalia?
checking for lymphadenopathy, bartholin’s glands, masses, nodules, discharge
are Nabothian cysts normal on a cervix?
yes
stellate cervix
tearing of the cervix
what does a squamous epithelium cervix tissue look like and where does it extend to?
shiny, smooth and pink, extends to vaginal lining
what does a columnar epithelium cervix tissue look like and where does it extend to?
deep red and granular, extends into the lining of the endo-cervical canal
how many layers does a squamous epithelium cervix tissue have?
4 layers
what does columnar epithelium cervix tissue secrete?
mucus
hormonal response or presence of inflammation or infections are noted in which cervix tissues?
squamous epithelium
squamous metaplasia cervix tissue
originally squamous epithelium which turns to columnar epithelium
what zone do you sample when doing a pap
transformation zone
when does cloudy, sticky or slightly yellow vaginal discharge appear normally?
several days before ovulation
when do you have a little vaginal discharge?
right after menses
when does heavy-egg white consistency vaginal discharge occur?
1-3 days after ovulation
when does clear, watery vaginal discharge occur?
before menses
frothy vaginal discharge is indicative of?
trichomoniasis
abnormal watery vaginal discharge is indicative of?
BV
curdy vaginal discharge is indicative of?
yeast
where do you collect a sample from if you think patient has chlamydia/trichomoniasis?
endocervical
where do you collect sample from if you think patient has yeast infection?
lateral walls of vagina
what are you palpating for when doing a bimanual exam
vagina, vaginal fornix, cervix, uterus, adnexa, vaginal walls
uterine position: anteverted (location of cervix and how you palpate it)
cervical os posterior, uterus palpated with vaginal hand in anterior fornix
uterine position: anteflexed (location of cervix and how you palpate it)
cervical os posterior, uterus palpated in anterior fornix
uterine position: midline (location of cervix and how you palpate it)
cervical os midline, uterus palpated between 2 hands deep in abdomen
uterine position: retroverted (location of cervix and how you palpate it)
cervical os anterior, uterus palpated posterior fornix of rectum
uterine position: retroflexed (location of cervix and how you palpate it)
cervical os anterior, uterus palpated posterior fornix or rectum
1 misdiagnosed reproductive cancer
ovarian cancer
s/s ovarian cancer
bloating, fullness, bowel changes
what do cysts feel like when palpating?
smooth and compressible
what do tumors feel like when palpating?
solid and nodular
hydrosalpinx
distention of the fallopian tube by clear fluid
when do you screen for colorectal cancer?
> 50 years old
exam findings in post-menopausal woman?
stinotic cervix( its pale), dry, vagina shortness
1 cause of cancer worldwide
breast cancer
concerning s/s of breast
change in skin texture, bloody nipple discharge, change in nipple position, hard immovable mass
which 3 positions do you inspect the breast?
- upright with hands relaxed in lap
- arms in air
- hands on hips or pushing each other
breast lymph node locations
supra/infra clavicular nodes, axillary nodes
fibroadenoma and cystic breast changes are what?
common benign causes of breast lumps
when should you do self exam?
after period is over
