objective 18 Flashcards
round, firm pad of adipose tissue which covers the symphysis
pubis
mons pubis
two rounded folds of adipose tissue
* Extends down from the mons pubis and around the perineum
labia majora
two smaller, darker folds of skin inside of the labia majora
* Joined anteriorly at the clitoris and posteriorly by the frenulum
labia minora
small, pea-shaped erectile body
clitoris
looks like a dimple
* It is 2.5 cm posterior to the clitoris and is surrounded by multiple
paraurethral (Skene’s) glands
urethral meatus
Posterior to the urethral meatus
* Appearance depends on the presentation of the hymen
vaginal orifice
what are the developmental considerations at birth>
The external genitalia is engorged with the presence of
maternal estrogen
what are the developmental considerations during childhood?
Ovaries are located in the abdomen; uterus small with
a straight axis, no anteflexion
what are the developmental considerations during puberty?
Estrogens - stimulate the growth of cells in the
reproductive tract, development of secondary sex characteristics
* First signs of puberty – breast and pubic hair development. This begins
between 8 ½ years old to 13 years old
* Menstrual cycle irregularity is common during adolescence – occasional
failure to ovulate
* With menarche – uterine body flexes on the cervix, ovaries have
migrated to the pelvic cavity
what are the developmental considerations during pregnancy>
*Shortly after the first missed menstrual period – genitalia show
signs of pregnancy
* Goodell’s sign - cervix softens at 4-6 weeks
* Chadwick’s sign – vaginal mucosa and cervix look cyanotic at
6-8 weeks
* Hegar’s sign – isthmus of the uterus softens at 6-8 weeks
*Uterus changes shape as pregnancy progresses
*Mucous plug forms in the spaces of the cervical canal (protects
the fetus from infection)
* This plug dislodges when labor begins
*Vaginal secretions – increase during pregnancy and are thick,
white, and more acidic
what are the developmental considerations for older adults?
- Menopause and the associated changes:
- External:
- Fat pad of mons pubis atrophies
- Labia and clitoris smaller
- Less pubic hair
- Internal:
- Uterus shrinks
- Ovaries atrophy (not palpable after menopause)
- Vaginal changes – due to increased connective tissue
- Physiological changes in sexual response due to declining levels of
estrogen
body supine, feet in stirrups, knees apart,
buttocks at the edge of the examining table
* The examiner will need to assist the client into the correct
position
lithotomy position
what is the positioning for examination>
- Place the client’s arms at her sides or across her chest
- Do not place the arms above the head (this will tighten the
abdominal muscles) - The lithotomy position leaves many clients feeling helpless and
vulnerable - Ensure that the client is draped appropriately (protects modesty
for all clients of all cultural backgrounds) and that the client’s
head is elevated so that their face can be seen - Drape the client fully, covering the stomach and legs,
exposing only the vulva to the examiner’s view - The drape should be down between the client’s legs
what equipment do you need>
- For an external examination:
- Gloves
- Goose-necked lamp with a strong light
how do we relax the client during exam?
- Ask client to empty bladder prior to the examination
- Ensure privacy
- Elevate the head and shoulders to maintain eye contact
- Ask whether the client would like someone present
- Place the stirrups so that the legs are not abducted too far
- Explain each step of the examination before it is done
- Use a gentle, firm touch and gradual movement
- Communicate throughout the examination
