Week 1 pt 2 highlights Flashcards
What are the 2 conjugates of the pelvis?
Diagonal and obstetric
What is the most common pelvic shape?
Gynecoid (round)
Define:
1) Urogenital diaphragm
2) Bulbocavernosus muscles
1) The muscles, blood supply, and nerve supply = external portion of pelvic floor
2) Act as a sphincter
1) What cell type makes up the vagina?
2) What shape is it?
3) What is the major blood supply?
1) Stratified squamous epithelium [surrounded by 3 smooth muscular layers]
2) “H”-shaped
3) Vaginal artery
1) Define fornix
2) What makes up the ectocervix?
3) What makes up the endocervix?
4) What is the area where >90% cervical neoplasia arise?
5) What is a nabothian cyst? Is it common?
1) Area around cervix; divided into 4 regions (ant/two lat/post)
2) Stratified squamous epithelium
3) Columnar epithelium
4) Active SCJ
5) Non-pathologic blockage of columnar cells (that continue to produce mucus) under stratified squamous cells
-Common in menstruating women, usually asymptomatic
What is the size of the uterus in nulliparous women?
7-8cm long, 4-5cm wide (at widest)
What are 2 positions of the top of the uterus?
May also fold forward (anteflexed) or backward (retroflexed)
There’s an increased risk of perforation in __________ and ___________ uteri with certain procedures
anteflexed & retroflexed
1) Are uterine and vaginal anomalies frequent or infrequent?
2) When do they occur?
3) Are ovarian dysgenesis (congenital absence) in chromosomal abnormalities common or rare?
1) Infrequent
2) Embryonic development
3) Rare
What is a more common uterine/ vaginal anomaly?
Müllerian abnormalities
Müllerian abnormalities:
1) What is Mullerian agenesis?
2) Can external genitalia appear normal?
1) Absence of uterus
2) Yes
Give an example of an external genitalia anomaly
Congenital adrenal hyperplasia (CAH) (causes masculinization)
___________________ ducts normally degenerate during development
Mesonephric
Gartner cysts are located in _________ wall or __________ ligament
vaginal; broad
1) Define empathic communication
2) Define motivational interviewing
1) Characterized by provider communicating with empathy & sympathy
2) “Reflective listening” replaces “advice giving”
(i.e. patient talks and provider actively listens)
What is a good rule in women’s health?
“Talk before you touch”
1) Menstrual history begins with what?
2) What is one aspect of periods you should ask about?
1) Menarche
2) Any recent change in periods?
What does perimenopause begin with?
increasing menstrual irregularity
What should you break parity down further to? Define it
TPAL: Term (>37wks), premature (20-36 6/7wks), abortion/miscarriage (<20wks), living
TPAL: Pregnancy ends with either:
1) _____ birth (>37wks)
2) ______ birth (< 37 weeks gestation)
3) miscarriage OR _________
# living children
1) term
2) premature
3) abortion
You should ask abt family history of illnesses in _______ degree relatives
1st
What are 3 exams of particular importance to OB/GYN care?
Breast
Pelvic
Abdomen
What are the vitals important to women’s health?
Temperature, heart rate (pulse), blood pressure, height, weight, BMI
Clinician breast exam + appropriately scheduled mammography is best means of wha
Early detection of breast cancer
List the parts of a breast exam in order
1) Visual inspection
2) Palpation
Breast palpation:
1) Up & down with wave-like motion with ___________.
2) Do not ___________ nipple.
1) finger pads
2) squeeze
Leathery, puckered appearance (aka _____________) caused by edema of lymphatics is concerning for advanced BC
peau d’orange
Clear/ milky discharge of nipples is called what?
Galactorrhea (normal, or high PRL)
1) Is a firm transverse inframammary ridge with large breasts abnormal or normal?
2) What are 2 things nipple discharge can be sent for?
1) Normal
2) Culture & sensitivity and cytopathology
Routine _________________________ not recommended (but considered for some)
breast self-examination (BSE)
Is an abd. exam done in every evaluation?
Not done in every evaluation
ACOG recommends annual pelvic exam in women ______ yrs & older
21
1) You should get a “_________catch” urine specimen from mid-stream if needed
2) What are some rules of pelvic exam?
1) Clean
2) “Talk before you touch”
Avoid being abrupt or stern
Rehearse what you will say and how you will say it.
In a women’s health PE, you should assist patient to assume _____________ position
lithotomy
Speculum insertion:
1) Insert horizontally/obliquely (45 degrees) with slight ___________pressure
2) Avoid ____________ pressure
3) Once inserted, you may tilt speculum _____ to view cervix
1) downward
2) superior
3) down
Failure to find cervix most commonly due to what?
Not advancing speculum far enough
What 3 aspects of the cervix require further eval?
Inflammation, masses, dysplasia
The pap test feels like a “slight scraping sensation”, and specimens are collected from the ____________ zone & __________
transformation; endocervix
When removing a speculum, why should you keep blades open slightly first?
Avoid pinching cervix
Bimanual Exam:
1) “Vaginal” hand (_______ and ________ fingers) & “abdominal” hand (use __________ not fingertips) to entrap & palpate pelvic organs
2) Rectovaginal exam is done when?
1) index and middle
2) finger pads
3) If indicated
