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PD Block 3 > pelvic exam > Flashcards

pelvic exam Flashcards

1
Q

cervical motion tenderness

A
  • during the bimanual exam, locate the cervix with the palmar surface of fingers.
  • Grasp the cervix between your fingers and ,move it from side to side while watching the patient for any pain or discomfort.
  • Pain suggests a pelvic inflammatory process.
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2
Q

vaginal discharge

A
  • during the external exam, while inspecting and palpating the labia minora, look for caking of discharge in the tissue folds, which suggests vaginal infection or poor hygiene.
  • Discharge from the skene glands, bartholin glands, or urethra usually indicates infection.
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3
Q

abnormal vaginal bleeding

A
  • abnormality in menstrual bleeding or inappropriate uterine bleeding are common gynecologic problems caused by a variety of issues (hormone changes throughout cycle, chronic PID, endometrial polyps, etc).
  • In pregnancy, may have little consequences or may be life-threatening, and should be evaluated.
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4
Q

cystocele

A

a bladder hernia that protrudes into vagina

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5
Q

rectocele

A

protrusion or herniation of the posterior vaginal wall with the anterior wall of the rectum through the vagina

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6
Q

urethrocele

A

pouchlike protrusion of the urethral wall

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7
Q

uterine prolapse

A

descent or herniation of the uterus into or beyond the vagina

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8
Q

cervical stenosis

A

narrowing of cervical opening (

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9
Q

friable cervix

A

fragile, easily irritable, prone to bleeding cervix

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10
Q

cyanotic cervix

A

bluish in color, may indicate early pregnancy as new vascularity forming

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11
Q

ectropion

A

endocervical columnar epithelium protrudes out through external os of cervix

  • Has a red, shiny appearance. May bleed easily.
  • Common in adolescents and pregnant women
  • Not an abnormality, BUT appears similar to early cervical cancer, so more tests are needed to make sure.
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12
Q

tanner stages for female

A
  • Stage I: (Preadolescent) Nipple is raised above the level of the breast, as in a child
  • Stage II: (Budding stage) Bud shaped elevation of the areola; areola increased in diameter and area slightly elevated
  • Stage III: Breast and areolar enlargement. No contour separation
  • Stage IV: Increasing fat deposit. Areola forms secondary elevation above that of the breast
  • Stage V: (Adult Stage) Areola is usually part of general breast contour and is strongly pigmented. Nipple projects
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13
Q

anteverted/anteflexed uterus

A

Normal position of the uterus- fundus will be felt between two fingers at level of pubis.

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14
Q

gravida/gravidity

A

Total number of pregnancies, regardless of outcome.

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15
Q

para/parity

A

Number of births over gestational age of 24 weeks. Alive or stillborn, does not account for multiples

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16
Q

retroverted/retroflexed uterus

A

Abnormal position of uterus- Uterus tilted toward coccyx. Palpate through rectocvaginal exam.

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17
Q

multiparous

A

More than 1 birth over gestational age of 24 weeks. Grand multip 4-6 births, great grand multip- >7 births

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18
Q

multigravida

A

more than 1 preg

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19
Q

corpus

A

body of uterus (fundus and isthmus)

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20
Q

fundus

A

convex upper portion of uterus- extends to insertions of fallopian tubes. Fundal height is used to estimate stage of pregnancy

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21
Q

cervix

A

extends from Isthmus of uterus into vagina. Assessed during speculum exam. epithelial collection (pap smear) at cervical os.

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22
Q

adnexa

A

FT and ovaries

23
Q

nulliparous/nulliparty

A

AKA Nullip- has not carried a pregnancy to 24 weeks

24
Q

menstrual phase

A

-days 1-4
-ovary: estrogen begins to rise as new follicle develops
-uterus: Progesterone stimulates vasoconstriction;
Menstrual bleeding occurs
-CNS: FSH and LH decrease

25
Q

postmenstral/preovulatory phase

A

-days 5-12
-ovary: Estrogen produced
Follicular phase- egg develops within follicle
-uterus: Progesterone produced
Proliferative phase- uterine lining thickens
-CNS: FSH stimulates ovarian follicular growth

26
Q

ovulation

A

-days 13 or 14
-ovary: Egg released from follicle & drawn into uterine tube (fertilization may occur in outer third of tube)
-uterus: Progesterone cause further thickening of uterine wall
-CNS: LH & estrogen increase rapidly
LH stimulates release of egg

27
Q

secretory phase

A
  • days 15-20
  • ovary: Egg (ovum) moved into uterus by cilia
  • uterus: Follicle becomes corpus luteum; progesterone increase & predominates
  • CNS: FSH & LH decrease
28
Q

premenstrual/luteal phase

A
  • days 21-28
  • ovary: If implantation doesn’t occur, corpus luteum degenerates; decreased progesterone & estrogen
  • uterus: Menstruation starts day 28
  • CNS: GnRH causes increased FSH secretion
29
Q

pediatric pederson

A

child, adolescent, or virginal adult

30
Q

pederson

A

sexually active women with adequate vaginal wall tone

31
Q

graves

A

parous women with relaxed and and collapsing vaginal walls

32
Q

nulliparous cervix

A

woman (one who has not carried a fetus to 24 weeks) the os will be a much smaller opening.

33
Q

parous cervis

A

patient (one who has carried a fetus to at least 24 weeks) the cervix will have a slit appearance

34
Q

where is cervix tilted normally

A

towards sacrum

35
Q

anteverted uterus

A

uterus tilted forward toward the pubic symphysis (most common)

36
Q

anteflexed

A

uterus is curved forward so the anterior is concave

37
Q

gravida

A

woman who is pregnant

38
Q

gravidity

A

preg a woman has had

39
Q

para

A

woman who has given birth

40
Q

parity

A

of completed pregnancies >24 weeks gestation (viable or nonviable)

41
Q

retroverted

A

uterus and cervical axis oriented toward the sacrum

42
Q

retroflexed

A

the uterus is curved backwards so uterus oriented toward the sacrum, with the anterior portion of uterus convex

43
Q

nulliparous

A

woman who has not carried a pregnancy to 24 weeks previously

44
Q

nulliparity

A

condition of never having given birth to a child

45
Q

older women: physical exam findings

A
  • Estrogen levels decrease causing the labia and clitoris to become smaller.
  • Labia majora becomes flatter as body fat is lost, vaginal introitus gradually constricts and vagina narrows/shortens.
  • Uterus decreases in size, cervix becomes smaller/paler, vaginal walls may lose some of their structural integrity.
  • Ovaries shrink to 1-2 cm.
46
Q

children: physical exam findings

A

the genitalia, except for the clitoris, grow incrementally at varying rates in children compared to an infant. Anatomic and functional development accelerate with onset of puberty and hormonal change.

47
Q

pregnant women: physical exam findings

A

high levels of estrogen and progesterone are responsible for uterine enlargement. As the uterus enlarges, the muscular wall strengthen and become more elastic and ovoid. Increase in uterine blood flow and lymph causes pelvic congestion and edema; cervix can take on a bluish color (Chadwick sign).

48
Q

adolesents: physical exam findings

A

during puberty, external genitalia increase in size and begin to assume adult proportions. Clitoris becomes more erectile, labia minora more vascular, labia majora/mons pubic more prominent and develop hair. The endometrial lining thicken in preparation for onset of menstruation.

49
Q

measurements of clitoris

A

2cm in length and 0.5 cm in diameter

50
Q

urethral caruncle

A

bright red polyp like growth that protrudes from urethral meatus (most cause no symptoms)

51
Q

vaginal introitus

A

vaginal opening

52
Q

endotropion

A
  • when squamous cells of exterior cervix move inward towards endocervical canal.
  • Shifts vaginal transformation zone from Squamous cells → Columnar cells.
  • Makes it more difficult to obtain pap smear
53
Q

nabothian cyst

A

benign cyst on cervix

PD Block 3 (7 decks)

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