Ch 30-34 Ex 1 Repro

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mthompson17
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Ch 30-34 Ex 1 Repro
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2013-02-02 20:42:26
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Reproduction nursing pathophysiology
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chapters 30-34 Reproduction
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  1. 2 functions of the male urethra?
    conduit for urinary and genital systems
  2. 3 auxiliary genital glands of the male?
    prostate, seminal vesicles, and bulbourethral glands
  3. Function of the prostate?
    primarily forms fluid that supports the sperm along with help from the seminal vesicles

    also acts as a valve for the bladder
  4. Function of bulbourethral glands?
    add a mucoid secretion ot the semen
  5. Testes?
    male reproductive organs responsible for sperm production
  6. _____ cells in the male genitalia produce and secrete testosterone.
    leydig
  7. Epididymis?
    tightly coiled tue that lies along the top of and behind each testis where sperm develop the ability to swim
  8. The prostate is a key organ in the male genitourinary system with obth ___ & _____ functions.  I
    reproductive and continence
  9. 2 phases of ejaculation?
    • 1. emision
    • 2. ejaculation
  10. Emission?
    secretions from the periurethral glands, seminal vesicles, and prostate are deposited with sperm from the vasa deferentia and the cauda epididymis into the prostatic urethra
  11. Ejaculation?
    bladderneck or internal sphincter closes and muscles surrounding the blub of the corpus spongiosum contract and propel ejaculate from the urethra and through urethral meatus
  12. What happens to sperm once it is deposited in the vagina?
    cholesterol covering the sperm head is slowly lost and membrane of sperm becomes weaker, Ca ions are allowed in and strengthen the swimming of the sperm, enzymes are released to penetrate the zona pellucida of the ovum
  13. Causes of micropenis?
    defects in testosterone production
  14. What should pt with micropenis be evaluated for?

    How is this tested?
    endocrine abnormalities

    measure serum levels of testosterone, LH, & FSH
  15. How is micropenis treated?
    testosterone therapy
  16. Urethral valves/
    mucosal folds that resemble thin membranes and cause obstruction when a child attempts to void
  17. Clinical manifestations of urethral valves prenatally?
    may cause decreased amniotic fluid, incomplete lung development, stillbirth or extreme distress at the time of delivery
  18. oligohydramnios?
    decreased amniotic fluid
  19. hypoplasia/
    incomplete lung development
  20. Most frequent manifestation of urethral valves?
    inability to void notes shortly after birth with varying degrees of high levels of nitrogen-containing compounds, such as urea, creatinine, various body wastes and renal failure
  21. azotemia?
    condition characterized by abnormally high levels of nitrogen-containing compounds, such as urea, creatinine, various body wastes
  22. Manifestations of urethral valve in older children?
    UTi, poor stream with straining to void, or occasionally hematuria
  23. Tx of urethral valves?
    management of metabolic abnormalities (fluids/electrolytes), treatment o UTI, dranage o urine with a catheter, ablation of the valves with an endoscopic resctoscope
  24. Urethrorectal and vesicourethral fistula causes?
    failure of the urorectal sptm to develop completely lead to persistent communication b/t rectum and urogenital tract
  25. Clinical manifestations of urethrorectal and vesicourethral fistulas?
    pass fecal material and gas through the urethra and/or urine through the rectum
  26. How are urethrorectal and vesicourethral fistulas diagnosed and treated?
    diagnose with radiography and treated with surgery to resct the fistual and open the imperforate anus
  27. Hypospadias?
    urethral meatus is located on the ventral under surface of the penis or on the perineum
  28. Chordee?

    What is its relationship to hypospadias?
    curvature of the penis

    more proximal the hypospadias = more likely it will be accompanied by chordee
  29. Cause of hypospadias?
    incomplete fusion of the urethral folds
  30. What should be done in severe cases of hypospadias?
    eval for conditions of intersex
  31. Tx of hypospadias?
    surgical repair to allow normal urinary stream and sexual function
  32. Epispadias?
    urethra opens on the dorsal aspect of the penis at a point proximal to the glans penis
  33. Epispadias is related to what congenital condition?
    exstrophy of the bladder where abd wall fails to form below the level of the umbilicus
  34. Complications of epispadias?
    urine incontinence if the urinary sphincter is affected
  35. Tx of epispadias?
    surgical repair more complicated than hypospadias
  36. Priapism?
    painful, persistent erection
  37. Cause of priapism?
    idiopathic, sickle cell disease, use of anticoagulant therapy, DM, leukemia, and use of antidepressants, impotence treatments, obstruction of venous drainage
  38. What will occur if priapism is not treated?
    fibrosis that can cause impotence
  39. Tx of priapism r/t sickle cell?
    sedation and oxygen
  40. Tx of priapism not r/t sickle cell?
    aspiration of blood from penis and injection of a - adrenergic agents , surgical shunting if other measures do not work
  41. Phimosis?
    uncircumcised foreskin cannot be retracted
  42. Tx of phimosis?
    treat infections with antifungals or antibiotics and circumcision
  43. Paraphimosis?
    foreskin that has been retracted over glans up onto the shaft of the penis cannot be replaced in its normal position
  44. What causes paraphimosis?
    usually cohronic inflammation under foreskin causes constricting ring of skin to form around the base of the retracted glans causing venous congestion fo the glans with further swelling and edema
  45. Tx of paraphimosis?
    reducing the paraphimotic foreskin back over the glans or slit / normal circumcision may be necessary
  46. Peyronie disease?
    formation of palpable, fibrous plaque on the surface of the copora cavernosa that causes curvature of the penis with painful, incomplete erections
  47. Tx of peyronie disease?
    no good Tx - some meds, procedures to excise plaque and repair defect with graft
  48. Urethral strictures?
    fibrotic narrowings of the urethra and are uaually composed of scar tissue
  49. Causes of urethral structures/
    usually due to prior infection sucah as gonorrhea or trauma (catheters, straddle injuries)
  50. Clinical manifestations of urethral strictures?
    decreased urinary stream, urethral discharge, infection, and urine retention
  51. How are urethral strictures diagnosed and treated?
    cytoscopy or radiography that demonstrateds narrowing ot the urethra

    procedures to dilate, incise, or reconstruct the urethra
  52. Health conditions ass. with erectile dysfunction
    hypertension, high cholesterol, DM, and bad lifestyle
  53. Primary and secondary impotence?
    primary - inability to attain an erection throughout life usually r/t psychiatric probs but may be due to vascular trauma sutained in early childhood

    secondary - have had an erection but can't anymore
  54. ED?
    erectile dysfunction
  55. Causes of secondary ED?
    peripheral vascular diseae, meds, endocrine probs, trauma, iatrogenic causes, and psych, arterial insufficincy due to arteriosclerosis, DM, excessive venous dranage from the penis
  56. Meds that cause ED?
    antihypertensives, phenothiazines antihistamines, and some antidepressants
  57. Endocrinopathy that causes ED?
    any disturbance that causes low levels of testosterone:  low secretion of LH hormone, excessive secretion of prolactin
  58. Assessments needed to determine the cause of ED?
    must first differentiate organic auses from psychogenic causes then find the physical cause if there is one
  59. Tx of ED caused by physical factors?
    insertion of inflatble or semirigid prosthtic device into the corpora caernosa, intracavernous injection of vasoactive substances, viagra, levitra, and cialis, vaccum device, procedures to revasculate the penis
  60. Contraindication for ED meds?
    not to be used with nitrate meds
  61. PE?
    premature ejaculation
  62. Causes and Tx of PE?
    may be biological and psychosocial and there are no approved Tx at this time
  63. Neoplasms of the penis?
    cancer
  64. What is thought to be a primary etiologic factor causing cancer of penis?
    phimosis of the foreskin accompanied by chronic inflammation
  65. The majority of penile cnacer cases are ___ ___ ___ and usually occur on the ____ or the inner surface of the ____.
    squamous cell carcinoma

    glans

    foreskin
  66. How does penile cancer metastasis occur?
    lymphatic dissemination with initial involvement of the palpable inguinal lymph nodes
  67. Stages of penile cancer?
    • I - lesion is limited to glans or foreskin
    • II - tumor involves shaft of penis
    • III - inguinal nodes are involved but lesion is operable
    • IV - disease is disseminated
  68. Manifestations of penile cancer?
    lesion that is usually ulcerative and fungating in appearance and may be associated with pain, bleeding, and urethral discharge, inguinal adenophathy may be present
  69. Tx of penile cancer?
    depends on stage:  topical chemotherapy and radiation therapy for superficial lesions, partial or total penectomy with perineal urethrostomy, removal of inguinal lymph nodes, systemic chemotherapy
  70. Cryptorchidism?
    congenital condition where testis occupies an extrascrotal position
  71. Cause of cryptorchidism?
    unknown - may be due to intrinsic testicular defect or a subtle hormonal deficiency
  72. Complications of cryptorchidism?
    fibrotic tubules, deficiency of spermatogenesis  with infertility & increased incidence of testicular malignancy
  73. Tx of cryptorchidism?
    treat at an early age to bring testis into a normal position - procedure usually required but may use admin of human chorionic gonadotropin by IM injection
  74. orchiopexy?
    surgery to repair cryptorchidism
  75. Hypogonadism?
    an acquired disorder  that causes androgen deficiency in the aging male
  76. Causes of hypogonadism?
    usually primary testicular failure
  77. S/S of hypogonadism?
    ED, loss of muscle tone, osteoporosis, and lipid metabolism changes, metabolic syndrome
  78. Diagnosis of hypogonadism?
    serum testosterone, prolactin, and LH levels
  79. Tx of hypogonadism?
    testosterone therapy
  80. Pt receiving testosterone therapy need to be monitored for ___ ____ and ______.
    prostate cancer and polycythemia
  81. Polychythemia?
    excess RBC's
  82. Hydrocele?
    fluid collection surrounding the testicle or spermatic cord and contained withing the tunica or processus vaginalis
  83. How may hydrocele be indicated in infants or young boys?
    scrotal swelling
  84. Tx of hydrocele?
    if fluid becomes uncomfortable or restricts blood flow may drain the fluid and resection or plication of the hydrocele sac to prevent reaccumulation of fluid or aspirate fluid
  85. Spermatocele?
    painless, cystic masses containing sperm
  86. Tx of spermatoceles?
    procedure to excise the spermatocele
  87. Testicular torsion?
    twisting of the spermatic cord with subsequent compromise of testicular vasular supply and testicular ischemia followed by infarction
  88. What age group does teticular torsion most occur in
    adolescents
  89. Clinical manifestations of testicular torsion?
    severe pain in one testis, followed by swelling of the scrotum, lower abd pain accompanied by N/V,
  90. How is testicular torsion differentiated from epididymitis?
    ultrasound, ischemia present in torsion,
  91. Lab testing for male infertility?
    2 semen analyses that show sperm concentration& number, motility, and morpholigy

    endocrine eval

    med history and assessment
  92. Tx of male infertility?
    procedures that correct morphological issues that restrict sperm flow, hormone therapies, intrauterine insemination or in vitro fertilizaiton
  93. Epididymitis?
    inflammation of the testis
  94. Causes of epididymitis?
    trauma, reflux of steril urine up the vas deferens, bacterial causes / STI's
  95. Clinical manifestations of epididymitis?
    inflamed scrotum with pain that may radiate along the spermatic cord into the inguinal area, fever, urethral discharge, cystitis, cloudy urine, elevated WBC count and bacteria in urine
  96. Tx of epididymitis?
    bed rest, scrotal support, and admin of anitbiotics

    incision and drainage in extreme cases or removal of testicle
  97. Fournier gangrene?
    severe condition involving gangrenous necrosis of the scrotum
  98. S/S of fournier gangrene?
    pain and swelling of the scrotum, fecver, chills, and sepsis
  99. What may predispose a person to fournier gangrene?
    DM, alcoholism, or other debility
  100. What may be the source of infection that causes fournier gangrene?
    extravasation of infected urine from urethral trauma, perforated urethral diverticulum, non-urinary tract source such as perirectal abscess
  101. Tx of fournier gangrene?
    incision and dranage and debridement of necrotic tissue, admin of antibiotics
  102. What is the most important factor in Tx of fournier gangrene?
    fast Tx or death can occur
  103. The most common solid tumors of US men ages 20 t0 34 years are caused by?
    testicular cancer
  104. Causes of testicular cancer/
    strong ass. b/t cryptochidism and malignancy, other factors are unknown
  105. 2 groups of testicular cancer?
    nongerminal neoplasms - tumores that originate from the leydig cells or other stromal tissue cells of the testis

    germinal neoplasms - derived from the germinal cells of the testis
  106. Stages of testicle cancer?
    • I - tumor is confined to the testis
    • II - tumor has spread to retroperitoneal lymph nodes
    • III- tumor has spread to nodes above the diaphragm
    • IV - tumore has spread to other organs
  107. Tx of testicular tumor
    removal of the testicle and possible lymph nodes associated
  108. BPH?
    benign prostatic hyperplasia - hyperplasia of the glands surrounding the prostatic urethra that compresses the urethra and produces symptoms of bladder outlet obstruction
  109. What is main cause of benign prostatic hyperplasia?
    aging
  110. Clinical manifestations of BPH?
    may progress to complete obstruction and urinary retention, decrease in force of urinary stream, hisitncy or difficulty initiating stream, and interruption of stream, UTI due to bladder not emptying completely
  111. Tx of BPH?
    first line of Tx is with meds to decrease tnesion in prostate by relaxing the muscle fibers in the gland and reducing presssure in the bladder neck and urethra (a - blockers) or meds that decrease size of the gland by blocking the conversion of testosterone to dihydrotstoterone and shrinking the gland (5a-reductase inhibitors)

    next line of Tx are minimally invasive office procedures not very successful

    last Tx is surgery TURP or laser to remove excess tissue that is blocking flow
  112. Prostatitis?
    inflammation of the prostate
  113. 4 types of prostatistis?
    acute bacterial, chronic bacterial, nonbacterial, and prostatodynia
  114. Causative organism in bacterial prostatitis is usually ___ ___.
    E coli
  115. Clinical manifestations of acute bacterial prostatitis?
    fever, chills, low back pain, voiding frequency, urgency, and dysuria, tnder, swollen prostate, and WBC & bacteria in urine
  116. Difference in S/S of chronic bacterial prostatitis and acute?
    chills and fever usually do not occur in chronic
  117. Differnece in S/S of nonbacterial prostatitis and bacterial prostatitis/
    no bacteria or WBC in urine,
  118. Prostatodynia?
    symptoms of prostatis but no hiostory of urinary tract infeionandno evidence of inflammation in prostatic scretions
  119. What age men are most at risk for prostate cancer?
    50 and up
  120. Stages of prostate cancer?
    • 1 - tumor is microscopic and intracapsular
    • 2. - tumor is palpable on rectal exam but confined to the prostate
    • 3 - tumor has extended beyond the capsule of the prostate
    • 4- tumor has metastasized to distant organs
  121. If a pt has symptoms from prostate cancer what does this indicate?
    no Tx because the symptoms usually indicate extensive disease
  122. S/S of advanced prostate cancer?
    hematuria, weght loss, malaise, anorexia, and back pain
  123. Tx of prostate cancer?
    removal of prostate and surrounding tissue, radiation therapy, removal of pelvic lymph nodes, hormonal manipulation,
  124. What is considered the first day of the menstrual cycle?
    the first day of menstruation
  125. When does ovulation occur?
    in the middle of the menstual cycle (14 days in )
  126. Menstrual cycle process?
    on day one the thickened layer of the endometrium is sloughed off and 35 mL of blood is lost as FSH is released by pituitary gland and stimulates a goup of follicles to develop in the ovary -> preovulatory phase where theca and granulos cells in developing follicles in ovary serete estrogen that stimulates growth of the uterine endmetrium again -> at midpoint of cycle increase in estrogen secretion from follicles occurs -> anterior pit more responsive to LH and produces a burst of LH and FSH lvel also increases -> rapid swelling of follicle and ovulation-> postovulatory pahse - site of the ruptured follicle becomes corpus luteum which secretes estrogen and progestoerone and thicken uterine endometriu
  127. If fertilization of the ovum occurs the embryo arrives in the uterus on about the ___ day of development and on about the ____ day of fertilization the embryo implants itself in the endometrium and development of the ___ occurs.
    4th

    7th

    placenta
  128. What does the placenta secrete that signals the corpus luteum to continue to function?
    human chorionic gonadotropin hCG
  129. What stimulates the brast to develop glands and ducts for lactation?
    progesterone and estrogen released from the corpus luteum and placenta
  130. What happens to breast ducts in the first & second trimester of pregnancy?
    • first - proliferate
    • second - group together to form large lobules with new alveoli formation
  131. What occurs in breasts at the end of the third trimester?
    alveoli dilate in prepartation for lactation and at end of pregnancy and until 1 to 3 dyas after childbirth mamary glands form colostrum
  132. What does colostrum contain?
    protein and lactose but little fat
  133. What stimulates milk production?
    prolactin from the anterior pituitary gland and oxytocin from the posterior pituitary gland
  134. Fertilization of the ovum occurs in the ____.  Withing 24 hours after fertilization what occurs?
    oviduct

    zygote begins a series of divisions by the process of mitosis called cleavage
  135. What occurs as cleavage takes place?
    embryo is transported through the oviduct until it arrives at the uterus on day 4
  136. Where does embryo receive nutrition on days 4 - 7 of fertilization?
    secretions released by the endometrial glandsstimulated by progesterone
  137. When doe implantation occur
    day 7 after fertilization occurs
  138. 2 basic functions of the placenta?
    • 1. exchange b/t developing fetus and themother
    • 2. endocrine organ that produces several hormones
  139. Important hormone secreted by the placenta?
    hCG - human chorionic growth hormone
  140. Which hormone during pregnancy is responsible for inhibiting contractility of the uterus?  What is the purpose of this?
    progesterone

    prevents spontaneous abortion
  141. Why is hCG needed for pregnancy?

    Where is it secreted from?
    it signals the corpus luteum that a pregnancy has occured and causes it to continue secreting hormones that keep endometrium in place

    the placenta
  142. Embryo?
    fertilization to the end of the eight week
  143. fetus?
    ninth week until birth
  144. What occurs at 36 hours from fertilization?
    embryo has achieved 2-cell stage
  145. By 2.5 weeks fertilization the ___ & ___ ___ are formed and will eventually give rise to the ___ ____ ____.  The tissue that will form the ____ has differentiated also.
    notochord and neural plate

    CNS

    heart
  146. When will the heart be beating and the primary vesicles of the brain be formed?
    by the end of the first month
  147. When do the gonads start to develop into male or female?
    around the seventh week
  148. What causes male and female differentiation?
    presence of dihydrotestosterone causes male genitalia to form and absence causes female
  149. What occurs in the second month of development?
    embryo becomes capable of mevement, major blood vessels assume final postions, heart assumes final shape, brain begins to transmit impules to regulate function of organ systems, and a few reflexes are present, rudiments of all organs are present
  150. What occurs during the third month of development?
    ears and eyes approach final positions, some bones become distinct, fetus performs breathing movements, sucking movements,
  151. What occurs during the second trimester?
    fetus achieves independent mobility, heartbeat is audible with stethoscope,
  152. What occurs during third trimester of development?
    weight almost doubles in last 2 months, final differentiation of tissues and ogans takes place,
  153. Parturition?
    process by which the infant is born
  154. Hormonal changes that cause labor?
    estrogen increases while progesterone stays or decreases - estrogen increases uterine contractions and progesterone decreases them

    oxytocin is secreted and causes uterine contraction
  155. Changes in metabolism during pregnancy?
    BMR increases by 15% and affects other organ systems
  156. Changes in reproductive organs during pregnancy/
    all are enlarged
  157. Changes in circulatory system during pregnancy?
    increase in blood volume and metabolism causes increase in maternal cardiac output by week 27 of pregnancy -

    cardiac output decreases to a little above normal during last 8 weeks of pregnancy
  158. What causes increase in blood volume of pregnancy?
    increase in aldosterone and estrogens promote increased fluid retention by the kidnesy and bone marrow increases its activity to produce excess RBC
  159. Changes in respiratory system during pregnancy?
    increased BMR and size reult in increase in O2 utilization wit net result of increase in minute ventilation and a decrease in arterial PCO2 to slightly below normal
  160. Changes in urninary system of pregnant?
    increaed load of excretory products = increased rate of urine produduction

    renal tubule reabsorption of Na, Cl, and water is increased due to production of steroidal hormones by the placenta and adreanl cortex

    glomerular riltration rate increases to increase rate of water and electrolyte loss in urince to balance out water increases
  161. What occurs in the urinary system with toxemia?
    excess water and salt accumulation with life-threatening consequences
  162. Avg weight gain during pregnancy?
    24 pounds
  163. What vitamin helps prevent neural tube defects in the developing fetus?
    folic acid
  164. Whe does menopause occur?
    about 45-52 years
  165. Amenorrhea?
    absence or suppression of mensration in a female age 16 or older

    missing 3 or more periods
  166. dysmenorrhea
    painful menstruation
  167. Primary amenorrhea?
    failue to begin menses by age 16
  168. Secondary amenorrhea?
    cessation of est regular menstrutaiton for 6 months or longer
  169. Causes of amenorrhea?
    abnormal hormonal functioning, physical or emotional stress, neoplasms of the ovaries or adrenal and pitutiray glands
  170. Tx of amenorrhea/
    hormonal supplementation, surgery for tumor removal
  171. Metrorrhagia and its causes?
    bleeding b/t menstrual perids

    usually from slight physiolgic bleeding from the endometrium during ovulation

    may be due to uterine malignancy, cervical erosions, and endmetrial plyps or estrogen therapy
  172. Hypomenorrhea?

    Causes?
    deficient amnt of menstrualflow

    endocrine systemic disorders, partial obstruction of menstrual flow by the hymen or narowing of cervical os
  173. Oligomenorrhea?
    infrequent menstruation

    usually failure to ovulate b/c of endocrine sytemic disorder
  174. Polymenorrhea?

    Causes?
    increased frequency of menstruation

    associated with ovulation and may be caused by endocrine or systemic factors
  175. Menorrhagia?

    Causes?
    often debilitating increase in amount or duration of menstrual bleeding

    usually from lesions of the female reproductive organs
  176. dysfunctional uterine bleeding?

    When is it most common?
    abnormal endometrial bleeding not associated with tumor, inflammation, pregnancy, trauma, or homrnal effects

    around menarche and menopause
  177. Dysmenorrhea?
    menstruation that is painful enough to limit normal activity or to cause a woman to seek health care
  178. Primary dysmenorrhea?
    not r/t any identifiable patholigic condition
  179. Secondary dysmenorrhea?
    r/t an underlying patholigic condition
  180. Tx of dysmenorrhea?
    ibuproen and naproxen for pain and to inhibit prostaglandin-induced uterine contractions that cause pain

    steroid hormones / oral contraceptives
  181. Uterine prolapse?
    descent of the uterus due to supporting structures relaxing
  182. Complication of uterine prolapse?
    pressure of abd organs on the uterus will force it downward through the vagina into the introitus
  183. Usual cause of uterine prolapse in infants and ppl who havent given birth?
    congenital defects
  184. Usual cause of uterine prolapse in women who have given birth?
    trauma to the ligaments druing childbirth
  185. Who is most at risk for uterine prolapse?
    women who have delivered multiples
  186. S/S of uterine prolapse?
    1st degree - sensation of bearing down and sicomfort in vagina

    2nd or 3rd degree - discomfot while walking or sitting and difficulty urinating, cervix protuding outside the body with friction and ulceration and bleeding of ulceration
  187. Tx of uterine prolapse?
    hysterectomy,

    pessary - small supportive device inserted to hold the uterus in place
  188. Retrodisplacemnt of the uterus?
    body of the uterus is displaced from its usual locatin overlying the bladder  to a position in the posterior of the pelvis
  189. Manifesttions and Tx of retrodisplacement of the uterus?
    may be asymptomatic, pelvic pain or pressure, dysmenorrhea, and painful intercourse

    Tx with pessary or surgical correction with laparoscopy
  190. Dyspareunia?
    painful intercourse
  191. Cystocele?
    protrusion of a portion of the urninary bladder into the anterior of the vaina at a weakened part of the vaginal muculature that causes the vaginal wall to bulge in a downward direction
  192. What causes cystocele?
    weakening of an area of the vaginal wall due to injury during childbirth or surgery or again process
  193. Predisposing factors for cystocele?
    obesity and history of lifting heavy objects
  194. Manifesations and Tx of cystocele?
    sensation of pressure in vagina, dysuria, incontinence, and back pain, fullness at the vag opening,

    surgical repair and placement of bladder
  195. Rectocele?
    protursion of the anterior rectal wall into the posterior of the vagina at a weakended part of the vaginal muscualture
  196. Causes of rectocele?
    same as cystocele
  197. Predisposing factors to rectocele?
    obesity, multips, postmenapausal
  198. Complications of rectocele?
    retum may be torn from its fascial and muscular attachment to the pelvic wall
  199. Manifestations and Tx of rectocele?
    • difficulty in BM, chronic constipation, pressure, painful intercourse,
    • \
    • surgical repair
  200. PID?
    pelvic inflammatory disease - any infection of the oviducts and ovaries with involvement of the adjacent reproductive organs
  201. Parametritis?
    PID with connective tissue involvement
  202. S/S of PID and associated problems?
    chronic pelvic pain, dsypareunia, pelvic adhesions, chronic inflammation andabscesses of the oviducts

    infertility, ectopic pregnancies
  203. Causes of PID?
    caused by bacterial infections introduced by procedures, abortions, and other infections that spread to this area
  204. 2 most common causitive agents for PID?
    Neisseria gonorrhoeae and chlamydia trachomatis
  205. S/S of PID?
    abd tenderness, cervical pain or adnexa on palaption, fever, WBC elvated, pelvic abxcess, inflammatory mass, purulent vag discharge
  206. Tx of PID?
    antibiotics,
  207. Life-threatening complication of PID?

    TX?
    rupture of pelvic abscess

    total abd hysterectomy and bilateral salpingo-oophorectomy
  208. Vulvovaginitis?
    inflammation of the vulva and vagina
  209. Causes of vulvovaginitis?
    infection by candida albicans, trichomans vaginalis, haemophlus vagninalis, and n. gonnorhea
  210. Viruses that can cause vulvovaginitis?
    HPV, herpes,
  211. Non-infectious causes of vulvovaginitis?
    allergic reactions and trauma
  212. Conditions that are good for C. albicans?

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