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Microbiology > Obstetrics And Gynecological Surgery > Flashcards

Obstetrics And Gynecological Surgery Flashcards

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1
Q

Antepartum

A

Before delivery

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2
Q

Effacement

A

Flattening and thinning of the cervix

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3
Q

Engagement

A

Widest part of the fetus in the narrowest part of the mother’s pelvis

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4
Q

Episiotomy

A

Incision in the perineum to facilitate delivery of the few us and avoid laceration

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5
Q

Lightening

A

Descent of the fetus into the pelvis, usually occurs about 2 weeks before delivery.

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6
Q

Lochia

A

Vaginal discharge after delivery

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7
Q

Multiparous

A

Condition of a woman who has given birth to more than one child

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8
Q

Preeclampsia

A

Toxemia of late pregnancy characterized by hypertension, edema, and proteinuria.

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9
Q

Primigravida

A

First pregnancy

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10
Q

Primiparous

A

A condition of a woman who has borne one child

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11
Q

Quickening

A

First movement of the fetus felt by the mother

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12
Q

Station

A

Presenting part of the fetus in relation to mother’s ischial spines, expressed in centimeters

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13
Q

Where does fertilization usually take place?

A

Fallopian tube

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14
Q

Where does implantation of the egg normally occur and when?

A

Implants in the funds (upper portion) of the uterus within 10 days.

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15
Q

What does the placenta develop from?

A

Chorion (outer membrane of the zygote)

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16
Q

Amnion

A

A sac that contains amniotic fluid that serves as a shock absorber for the developing fetus

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17
Q

What does the amnion develop from?

A

The outer layer of the zygote.

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18
Q

Chloasma

A

Brownish pigment

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19
Q

Amenorrhea

A

Ovulation and menstural flow ceases.

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20
Q

Describe the seven changes that occur during pregnancy.

A
  1. Uterus and breast enlarge
  2. Lines Alba becomes lines nigra
  3. Cervix becomes soft and bluish
  4. Chloasma of the face
  5. Amenorrhea
  6. Urinary frequency, nausea, vomitting, and general fatigue
  7. Pregnancy confirmed by HCG
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21
Q

Induced labor is initiated by administration of?

A

Oxytocin (Pitocin)

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22
Q

Braxton Hicks contractions

A

False labor, felt in the abdomen, with no cervical dilation, irregular, stopped by walking.

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23
Q

The first stage of labor can be described by 5 things.

A

Regular contractions
Cervix extends to 10 cm
Effacement of cervix
Begin with ruptured membrane (gush of amniotic fluid)
May last 6 to 18 hr first time or 4 to 6 hr. Multiple birth
Vaginal bleeding

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24
Q

A pregnant patient is encouraged to lay on what side? Why?

A

Left side to take pressure off the vena cava

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25
Q

If the fetal heart rate exceeds what or falls below what, the nurse should be notified.

A

160 or 100

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26
Q

The mothers blood pressure should not be higher than what?

A

140/90

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27
Q

What does APGAR stand for?

A

American Pediatric Gross Assessment Record

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28
Q

What is assessed during APGAR score?

A

Respiratory rate, color, reflex response, heart rate, body tone at 1 and 5 minutes after birth.

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29
Q

What APGAR is considered normal? Severe depression?

A

7-10 good. 0-3 depressed.

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30
Q

It is important that the baby’s temperature be maintained at what temperature?

A

98.6. F or 37 C

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31
Q

Describe the four different degrees of perineal lacerations.

A
  1. Superficial laceration of the vaginal mucosa or perineal body.
  2. Laceration of the vaginal mucosa and/ or perineal skin and deeper subcutaneous tissue.
  3. (Incomplete) Second degree laceration plus laceration of the capsule and part of the anal sphincter muscle.
  4. (Complete) As above with complete laceration at the anal sphincter.
  5. Complete third degree with laceration of the rectal mucosa.
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32
Q

What is given to the mother after birth to help with uterine contractions?

A

Oxytocin or Ergotrate.

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33
Q

What types of anesthesia can be given during childbirth?

A

Epidural, continuous caudal, pundendal block, or spinal

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34
Q

Eclampsia

A

Pregnancy-induced hypertension accompanied by edema, albuminuria and sometimes convulsions.

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35
Q

Eclampsia is also called

A

Toxemia

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36
Q

Ectopic pregnancy

A

When the zygote implants outside the uterine cavity, most common site of implant is Fallopian tube.

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37
Q

Incompetent cervix

A

Spontaneous abortion occurring during the second trimester. Prevented surgically by cerclage.

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38
Q

Cerclage

A

Placement of a purse-string mersilene suture around the cervix

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39
Q

Placenta previa

A

Painless bleeding during the second trimester or at the onset of labor due to positioning of the placenta near or over the cervical opening, an indication for c-section

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40
Q

Abruptio placenta

A

Painful bleeding caused by the premature separation of the placenta from the uterine wall, leads to rapid demise of the infant and hemorrhage of the mother, emergency c-section indicated.

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41
Q

Hyperemesis gravidarum

A

Excessive vomitting during pregnancy

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42
Q

Gestational diabetes

A

Elevated blood sugar in the mother and development of a large fetus.

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43
Q

Nuchal cord

A

An umbilical cord is wrapped around the baby’s neck one or more times

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44
Q

Cord prolapse

A

When the cord precedes the head.

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45
Q

Breech presentation

A

When the baby’s feet, knees, or buttocks enter the birth canal before the head.

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46
Q

Meconium

A

A nearly sterile fecal waste that accumulates while the fetus is in the uterus. It is passed within the first few days after birth.

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47
Q

Incomplete abortion

A

Patient bleeding but entire contents of conception are not discharged.

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48
Q

Missed abortion.

A

Nonviable fetus that is not aborted.

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49
Q

therapeutic abortion

A

Artificially induced abortion for nonviable or abnormal fetus or for the welfare of the mother. Typically during the first trimester.

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50
Q

Dystocia

A

Difficult labor, contraction fail to expel the fetus, may be an indication for c-section

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51
Q

Cephalopelvic disproportion

A

Head of the infant too large to pass through the pelvis of the mother. Indication for a c-section

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52
Q

Retained placenta

A

Causes bleeding and is generally treated with D&C

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53
Q

Ruptured uterus

A

May occur during labor of a patient with pervious c-section or other uterine surgery

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54
Q

Amniotic fluid embolism

A

Clotting disorder that occurs when amniotic fluid destroys fibrinogen

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55
Q

Inversion of the uterus

A

During the third stage of labor, the uterus may prolapse inside out

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56
Q

What are the eight postpartum complications that may occur?

A
  1. Infection
  2. Subinvolution of the uterus
  3. Hemorrhage due to uterine Antony or retained placenta.
  4. Vulvar hematoma from the trauma of labor
  5. Enlargement of breast
  6. Cystitis
  7. Puerperal psychosis
  8. Thrombophlebitis and pulmonary embolism.
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57
Q

Subinvolution of the uterus

A

Uterus does not go back into normal position in the pelvis

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58
Q

What is the most common complication in the fourth stage of labor?

A

Hemorrhage due to uterine atony or retained placenta.

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59
Q

What 11 items are needed to perform a C-section?

A
  1. Laparotomy drape
  2. Scalpel
  3. Lap sponges
  4. Mayo clamps
  5. Metz
  6. Curved mayos
  7. Bandage scissors
  8. Bladder retractor
  9. Hemostats
  10. Abdominal suctions x2
  11. Bulb syringe.
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60
Q

After a C-section, what is the uterus closed with?

A

A continuous stitch of 0 or 1 absorbable suture on a taper needle

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61
Q

Carcinoma in situ

A

Cancer in the endothelial layer that is not invasive

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62
Q

Chocolate cyst

A

Benign cyst of the ovary that contains dark syrupy contents from old blood, ovarian endometriosis

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63
Q

Cystocele

A

Herniation of the bladder into the vagina.

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64
Q

Dermoid cyst

A

Sac filled with hair and sebaceous material found in the ovary of young females.

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65
Q

Dysmenorrhea

A

painful or difficult mensturation.

66
Q

Endometriosis

A

Occurrence of endometrial tissues outside the uterus which slough off during normal menses and cause pain and pelvic congestion.

67
Q

enterocele

A

Hernias ion of the intestine into the cul-de-sac of Douglas

68
Q

Fornices

A

Regions in the vaginal vault created by the projections of the cervix into the proximal vagina

69
Q

Leiomyoma uteri/ fibroid

A

Benign tumor arising from the muscle layer of the uterus.

70
Q

Menometrorrhagia

A

Excessive uterine bleeding occurring both during menses and at irregular intervals

71
Q

Pelvic diaphragm

A

Levator ani and coccygeal muscles with facial coverings. Separates pelvic cavity from perineum and provides support to the abdominal pelvic viscera.

72
Q

Pelvic Inflammatory disease

A

Inflammation of the uterus, fallopian tubes, ovaries, and related structures due to infection.

73
Q

Rectocele

A

Herniation of the rectum into the vagina

74
Q

Stress incontinence

A

Leakage of urine when intraabdominal pressure is increased, as with a cough or sneeze.

75
Q

Uterine descensus/uterine prolapse/ procidentia

A

Laxity of the ligaments that suspend the uterus in the pelvic cavity resulting in the uterus falling into or out through the vagina, first degree may be treated with a pessary, while second and third degrees may be treated by hysterectomy.

76
Q

Why may an enema be performed prior to gynecological surgery?

A

Due to the close proximity of the sigmoid colon and rectum to the uterus. Avoid inadvertent injury and decrease the chance of post operative constipation

77
Q

Straight cath is used for? Give an example.

A

Drain bladder and then removed. Red Robinson

78
Q

The lining of the uterus that changes under hormonal influence and with pregnancy is called

A

Endometrium

79
Q

The thick muscular layer that is continuous with the muscle of the vagina and the fallopian tubes is called what/

A

Myometrium

80
Q

The outer serous layer of the uterus is called

A

Perimetrium

81
Q

The perimetruum is the reflection or folding back of what structure?

A

The abdominal peritoneum

82
Q

The perimetrium forms a pouch called

A

Cul-de-sac

83
Q

The broad ligaments suspend

A

The uterus from the pelvic wall

84
Q

The round ligaments suspend

A

The uterus anteriorly

85
Q

The cardinal ligaments lie where and support what?

A

Below the broad ligaments and provide support for the uterus

86
Q

The uterosacral ligaments lie where and attach what?

A

Curve along the bottom of the uterus and attach it to the sacrum

87
Q

What are the four sections of the fallopian tube?

A
  1. Interstitial section: connect to the uterus
  2. Isthmus: narrow midportion
  3. Ampulla: The widened portion of the tube
  4. Infundibulum: the terminal end of the tube
88
Q

Fimbriae

A

Small projections that extend from the end of the tube

89
Q

Ovaries secrete what two hormones?

A

Estrogen and progesterone

90
Q

The fibrous layer of the ovary which contains follicles that hold ova in different stages of maturity is the ________.

A

Cortex

91
Q

The inner core of the ovary, which is composed of connective vascular tissue is called __________.

A

Medulla.

92
Q

The development and release of ova is influenced by the ________ gland, which stimulates ___________ hormone and _________ hormone.

A

Pituitary gland
Luteinizing hormone
Follicle stimulating hormone

93
Q

Introitus

A

AKA vestibule, opening to the outside of the body.

94
Q

The job of the mons pubis is what?

A

To protect the symphysis pubis

95
Q

The vestibular glands collectively include:

A

Skene glands and Bartholin glands

96
Q

Where are skene glands found?

A

Two paired glands that lie beneath the floor of the urethra.

97
Q

Where are the Bartholin glands located? What do they secrete and when?

A

On both sides of the vestibule and secrete mucus during sexual intercourse.

98
Q

Menarche

A

Onset of mensturation

99
Q

Sonohysterography

A

Injection of normal saline, lactated ringers, or 1.5% glycine into the uterine cavity through a small transcervical catheter before ultrasound imaging.

100
Q

Heterosalpingography

A

A radiological contrast medium is injected into the uterus and fallopian tubes. Fluroscopy is used to visualize them.

101
Q

Colposcopy

A

Microscopic examination and biopsy of the cervix, the cervix is painted with acetic acid, which causes preinvasive cells to appear white. They are then biopsied.

102
Q

Cone biopsy of the cervix. What is this done to treat? What technique is used? What is done?

A

Epithelial carcinoma of the cervix or severe dysplasia.
Loop electrosurgical excision procedure (LEEP)
Removal of a circumferential core of tissue around the cervical canal.

103
Q

Schiller’s Test

A

Staining the cervix or vaginal vault with an iodine (Lugol’s) solution to differentiate normal from abnormal tissue

104
Q

Cervical tissue specimens may be obtained with what type of biopsy forceps?

A

Gaylor

105
Q

Curettage

A

Scraping from the uterine cavity for examination

106
Q

Culdocentesis

A

Aspiration of fluid from the cul-de-sac through the posterior vaginal fornix to determine the presence of blood or pus

107
Q

Chomopertubation

A

Methylene blue or indigo carmine is introduced into the uterine cavity and fallopian tube through an iv tubing or syringe attached to a uterine manipulator to determine patency of fallopian tubes.

108
Q

Vasopressin Give aka and use

A

Pitressin constriction of blood vessels, injected into uterus during hysterectomy or into a benign uterine tumor to prevent bleeding during removal

109
Q

What is given after abortion to enhance uterine contractions and control uterine bleeding?

A

Methylergonovine Methergine

110
Q

heteroscope is introduced where?

A

Vaginally

111
Q

When using a heteroscope, what is used for distention?

A

Dextran, Gluscose, Glycine, or Hyskon solution

112
Q

What is a heteroscope used for?

A

Endometrial ablation (rescetoscope or balloon therapy), removal of polyps, intrauterine adhesions, submucous fibroids, or to located lost IUD

113
Q

What is a culdoscopy used for?

A

To investigate cervical/ vaginal tissues.

114
Q

Oophorectomy

A

Surgical removal of the ovary.

115
Q

Indications for oophorectomy.

A

Malignant condition or ovarian cyst (follicular, corpus lutenum, dermoid, or chocolate cyst)

116
Q

A bilateral oophorectomy can also be called

A

Surgical menopause.

117
Q

Salpingo-oophorectomy

A

Removal of the tube and ovary

118
Q

Indications for salpingo-oophorectomy

A

Damage from PID, endometriosis, cysts, or carcinoma.

119
Q

Tubal ligation

A

Interruption in the continuity of the fallopian tubes for sterilization purposes.

120
Q

What was the first minimally invasive surgery performed?

A

Tubal ligation

121
Q

Tuboplasty

A

Reconstruction of fallopian tubes under microscopic assistance for infertility related to previous tubal sterilization

122
Q

In-vitro fertilization

A

Oocytes are retrieved from the ovary through a laproscope and implanted in the uterine cavity following fertilization.

123
Q

Myomectomy

A

Surgical removal of uterine fibroids in premenopausal women wishing to preserve fertility.

124
Q

Abdominal Hysterectomy

A

Removal of uterine body and cervix

125
Q

Supracervical Hysterectomy

A

Removal of the uterine body with cervix left in place.

126
Q

Indications for abdominal hysterectomy

A

Pain associated with pelvic congestion, PID, pervious pelvic surgery, endometriosis, fibroids, dysfunctional or postmenopausal bleeding, malignancy.

127
Q

Abdominal or Vaginal procedure: oophorectomy

A

Abdominal

128
Q

Abdominal or vaginal procedure: Salpingo-oophorectomy

A

Abdominal

129
Q

Abdominal or vaginal procedure: tubal ligation

A

Abdominal

130
Q

Abdominal or vaginal procedure: tuboplasty

A

Abdominal

131
Q

Abdominal or vaginal procedure: myomectomy

A

Abdominal

132
Q

Abdominal or vaginal procedure: supracervical hysterectomy

A

Abdominal

133
Q

Abdominal or vaginal procedure: vesicourethral suspension

A

Abdominal

134
Q

A vesicourethral suspension is also called

A

Marshall-Marchetti-Kranz procedure

135
Q

Vesicourethral suspension

A

The periurethral tissues are sutured to the periosteum of the pubic symphysis to reposition the vesico-urethral angle.

136
Q

Indication for vesicourethral suspension

A

To correct urinary stress incontinence

137
Q

A radical hysterectomy is also called

A

Wertheim Procedure

138
Q

Abdominal or vaginal procedure: wertheim procedure

A

Abdominal

139
Q

Radical hysterectomy

A

Removal of uterus, tubes, ovaries, and upper one third of vagina

140
Q

Anterior exenteration

A

Wertheim procedure plus cystectomy (removal of bladder) with ileal conduit

141
Q

Posterior exenteration

A

Wertheim procedure plus abdominoperineal resection. Done when metastasis to rectum has occurred

142
Q

Sims and Thomas curettes are what type of curettes?

A

Endometrial

143
Q

Kevorkian curettes are what type of curettes?

A

Endocervical

144
Q

Abdominal or vaginal procedure: vulvectomyb

A

Vaginal

145
Q

Vulvectomy

A

Surgical removal of the labia majora and labia minora for carcinoma in situ of the vulva

146
Q

Abdominal or vaginal procedure: Radical vulvectomy with lymphadenectomy

A

Vaginal

147
Q

Radical vulvectomy with lymphadenectomy

A

En bloc excision of the labia majora and minora, cltoris, mons pubis, terminal protions of the urethera, vagina, large section of skin from the abdomen and groin, superficial and deep inguinal lymph nodes, portions of the round ligament, and saphenous vein along with the lesion.

148
Q

D&C

A

Dilatation and curettage: bladder is emptied, vagina is retracted, cervix is grasp with tenaculum, uterine depth is probed, endocervix is curetted, cervix is gradually dilated, endometrium is curetted.

149
Q

Vesico-vaginal, urethro-vaginal, or recto-vaginal fistula repair

A

Fistual is identified through vagina, dissected, closed with absorbable suture

150
Q

Skirodkar procedure

A

Cervical cerclage: incompetent cervical os, placement of suture to prevent pregnancy.

151
Q

Cesium rod insertion

A

Radioactive element, treatment of cervical and endometrial ablation.

152
Q

marsupialization of a Bartholin’s cyst

A

Incision into the vagional outlet into duct for drainage.

153
Q

Perineorrhaphy

A

Surgical repair of laceration of the area between the vagina and rectum accompanying childbirth

154
Q

Indications for vaginal hysterectomy.

A

Benign disease of the uterus, not greatly enlarged, poor pelvic muscular support, carcinoma in situ, uterine prolapse

155
Q

Indications for hysterscope

A

Abnormal uterine bleeding, displaced IUD, chronic pregnancy loss, infertility

156
Q

Contraindication for hysteroscopy

A

Acute infection, cervical malignancy, and pregnancy

157
Q

Complications of hysterscopy

A

Bleeding, perforation, fluid retention, infection.

158
Q

What are five different ways to perform hysteroscopic endometrial ablation?

A

Laser, roller ball ablation, NovaSure, Hydro Thermablator, Her Option

159
Q

After endometrial ablation is performed, what can the patient expect for several days?

A

Severe cramping and watery discharge.

160
Q

Leiomyoma

A

Benign, smooth muscle tumor of the uterus

161
Q

A dermoid cyst is also called

A

Teratoma

Microbiology (12 decks)

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