N202 Female Genitalia

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N202 Female Genitalia
2010-12-09 16:35:21
N202 Female Genitalia

N202 Female Genitalia
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  1. 2 other medical terms for external female genitalia
    • vulva
    • pudenda
  2. mons pubis is ...
    pad of adipose tissue covering the symphysis pubis
  3. labia majora are ...
    outside folds of adipose tissue
  4. labia minora are
    smaller, hairless fold of skin inside the labia majora
  5. labia minora are joined anteriorly at the ___ & posteriorly at the ___
    clitoris, fourchette
  6. prepuce is
    hood of skin over the clitoris
  7. clitoris is made of ___ tissue
  8. vestibule is
    portion between the inner labia of the external female genitalia containing the openings to the structures and glands
  9. urethral meatus is sometimes within
    the vagina
  10. paraurethral glands are also called
    Skene's glands
  11. Are Skene's glands visible
    not usually
  12. urethral ducts on each side of urethra that secrete fluid and drain into the urethra
    Skene's glands
  13. introitus is another name for
    the vaginal orifice
  14. Fold of tissue at vaginal opening
  15. Bartholin's glands are located
    at 4 and 8 o'clock at the posterior vaginal opening
  16. What do Bartholin's glands do
    Secrete a clear lubricating mucus during sexual excitement phase
  17. Perineum is the
    tissue between fourchette & anus
  18. rugae are
    folds along the walls of the vagina during reproductive years
  19. after menopause, the walls of the vagina become
    smooth and slick (loss of rugae)
  20. the cervix is part of the
  21. the cervix protrudes how far into the vagina
    1-3 cm unless there is uterine prolapse
  22. uterus muscle is lined on the inside with the
  23. adnexa refers to
    the ovaries and fallopian tubes
  24. what hormone stimulates growth of the female secondary sexual characteristics
  25. female puberty begins between the ages of __ and __ and lasts ___ years
    8.5, 13, 3
  26. first sign of female puberty is
    breast and pubic hair development
  27. menarch occurs between the ages of __ and ___
    10 and 14
  28. precocious puberty refers to sexual development before the age of
  29. for precocious puberty or late puberty (what age?), refer patient to
    late puberty is past 13.5 years with lack of initial development. Refer to endocrinologist
  30. the menstrual cycle during puberty is regular or irregular
  31. menopause is defined as
    12 consecutive months without a menstrual cycle
  32. at what average age range does menopause occur
    48-55 yrs, single number average is 51
  33. if a patient should go < 12 mos (for example, 10 mos) and then menstruate, this phase is called
  34. for peri-menopausal women, advise to continue with
    birth control
  35. changes with the older adult female reproductive system after menopause
    Pubic hair thins & grays

    Atrophy of labia, clitoris, vagina, ovaries & uterus

    Ligaments relax & uterus may slightly prolapse

    • decreased elasticity and lubrication of the vagina
    • Increased vaginal pH (alkaline)
  36. atrophic vaginitis is
    atrophy of the vagina: decrease elasticity and lubrication
  37. dyspareunia is
    painful sexual intercourse
  38. increased vaginal pH is significant because
    the patient is more prone to infection
  39. age of menarch is important because
    increases lifetime exposure to estrogen which increases risk of breast cancer
  40. birth control pills do what to the regularity of the menstrual cycle
    they control it and thus regularize the cycle
  41. dysmenorrhea is
    painful menstruation
  42. why do very thin females have amenorrhea
    Amenorrhea = absence of menses. Very thin people don’t have enough fat tissue to store hormones
  43. Hypomenorrhea is
    very light menstrual bleeding
  44. Menorrhagia is associated with
    Menorrhagia is heavy bleeding during periods (associated with dysmenorrheal – as cramping helps get rid of the blood)
  45. Metrorrhagia is caused by
    Metrorrhagia – bleeding at irregular intervals (e.g., hormonal imbalance, uterine cancer)
  46. Dysfunctional uterine bleeding diagnosis is made after what is ruled out
    diagnosis made after tumor, inflammation, pregnancy, trauma or hormonal imbalance ruled out
  47. why is postmenopausal bleeding considered serious
    menstrual bleeding 6 months after menopause … {usually serious and a sign of endometrial cancer}
  48. classic menopause symptoms
    hot flashes, insomnia, mood changes, vaginal dryness are the classic signs
  49. patient with what will go through menopause immediately
    bilateral salpingo-oophorectomy
  50. patients undergoing bilateral salpingo-oophorectomy almost usually get what other procedure
  51. oophorectomy is
    removal of an ovary
  52. A patient with a hysterectomy without BSO (bilateral salpingo-oophorectomy) will no longer have what
    bleeding during menstrual period
  53. salpingo-oophorectomy is
    removal of fallopian tube and ovary
  54. If uterus is present, the patient is given progesterone with estrogen hormone replacement therapy ... why?
    must give both estrogen and progesterone because progesterone prevents uterine cancer
  55. estrogen increases the risk of ___ but decreases what other common age related (mostly female) problem
    breast cancer, osteoporosis
  56. gravida is
    # of pregnancies
  57. para is
    # of births
  58. cervical cancer is an STI from
  59. increase risk of abnormal PAP smear
    • multiple sex partners
    • partners that have / had multiple sex partners
    • early sexual activity (increases # of partners)
    • oral contraceptives (less likely to use condoms)
    • STIs (prior infections)
    • smoking (increases risk of all cancers)
  60. Why no PAP smear before age 21
    the female body clears the virus
  61. Guidlines for PAP: females in 20s, 30+
    • 20s: every 2 years if prior PAP is normal
    • 30s: every 3 years if prior 3 consecutive PAPs are normal
    • annually otherwise or more frequently if indicated
  62. No need to get a PAP smear unless the __ is present
  63. colposcopy is
    an instrument to see the cervix used when obtaining a biopsy
  64. what is Loop Electrocautery Excision Procedure and what is it for?
    zapping the abnormal cervical cells
  65. surgery to inactivate / kill abnormal cervical cells by freezing is called
  66. for an abnormal PAP smear w/ procedure to kill the bad cells, how frequently is next PAP smear done
    every 3 months until shows no abnormality
  67. How long after a procedure to kill abnormal cervical cells should PAP smear show normal - or else procedures must be repeated
    <= 1 year
  68. Under new guidelines, test for both __ and __ under age 26
    chlamydia and gonorrhea
  69. immunizations are available for which 2 STIs
    Hepatitis B virus (HBV) and Human papilloma virus (HPV)
  70. HBV can develop into
    liver cirrhosis and liver cancer
  71. HBV schedule for immunization dosing
    0,1,6 mos
  72. what are Gardisil and Cervarix
    HPV vaccines
  73. Gardisil protects against
    HPV subtypes 16, 18 which causes 70% of cervical cancer and HPV subtypes 6, 11 which causes 90% of genital warts. Also protects against precancers of vaginal and vulva.
  74. dosing schedule for Gardisil
    0,2,6 mos
  75. recommended ages for immunizing males and females with Gardisil
    girls: 11-12 yo (catch up 13-26 yo if not given previously)

    boys/men: 9-26 yo
  76. Cervarix protects against what? Not recommended for ___.
    HPV subtypes 16 and 18 only (cervical cancer). Does not protect against genital warts.
  77. Cervarix dosing schedule
    0,1,6 mos
  78. condyloma is (are)
    genital warts
  79. Why do patients with DM get more frequent yeast infections?
    glucose in vagina
  80. why avoid douching?
    raises vaginal pH increasing risk of infection, where normally it is acidic which prevents infection
  81. Clothing recommendation to avoid bacterial vaginosis
    avoid tight clothing
  82. why ask patients to stay on same birth control for 3 mos if there are minor problems
    it takes 3 mos for the body to adjust and the problems frequently moderate or disappear
  83. emergency contraception: where to find, how soon to take, what is it
    found at pharmacies but not on the shelf

    take as soon as possible < 72 hrs from event

    is basically a megadose of contraceptive drugs
  84. important to have patient do what before pelvic exam
    empty bladder
  85. what is the position for the female patient for the pelvic exam
  86. external genitalia drains to what lymph nodes
  87. insert index & middle finger into vagina--ask pt to contract muscles... weakness may indicate
    neurologic problems (for example multiple sclerosis)
  88. cystocele, rectocele, uterine prolapse
    • cystocele = bladder lapsed into vaginal wall
    • rectocele = rectum lapsed into vaginal wall
    • uterine prolapse = uterus pushing into (in some cases through) the vagina
  89. nulliparous
    has not given vaginal birth
  90. parous
    has given vaginal birth
  91. graves speculum is used for
    women with larger vagina -- usually those that have given birth ("graves for gravida")
  92. pederson speculum is used for
    women with smaller vagina (smaller narrower blade on speculum): nulliparous and post-menopausal
  93. lubricate speculum with ___ only. Why?
    tap water only. Does not disturb the resident bacteria which may be needed for specimen.
  94. what is the significance of the following vaginal discharges
    clear w/o odor
    white, curd-like
    yellow, foamy
    gray, malodorous
    • normal
    • yeast
    • trichomonous
    • bacterial vaginosis
  95. cervical opening shapes: (identify significance)
    • round = nulliparous (not had childbirth vaginally)
    • slit-like = parous (had childbirth vaginally)
  96. significance: color of cervix
    dark pink
    • premenopausal
    • menopausal
    • pregnancy
  97. What is Chadwick's sign?
    bluish-purple cervix which indicates pregnancy
  98. 5 positions of the uterus in the patient's body
    • anteverted uterus (tilted toward bladder - cervix posterior)
    • retroverted uterus (tilted posteriorly - cervix anterior) cannot palpate from abd
    • midposition uterus (horizontal cervix)
    • anteflexed uterus (uterus curves anteriorly)
    • retroflexed uterus (uterus curves posteriorly) cannot palpate from abd, examiner should attempt to palpate from the rectum
  99. if there are suspected abnormal cervical cells, squirt what on them? what happens?
    • if suspected abn cells, squirt vinegar (same as
    • acetic acid) on the cervix and the abn cells will turn white
  100. a wet mount is what?
    preparation of a slide for microscopic evaluation of vaginal discharge
  101. must use fixative immediately after taking a sample of cervical cells ... why?
    cells must be preserved for observation and will degrade almost immediately
  102. efor a thin prep collection (cervical cell sample for PAP smear), how many times should the spatula or broom be twirled in solution?
    >= 10 times
  103. Where are the hands in Bimanual Abdominal-Vaginal Exam
    insert index & middle finger in vagina/place other hand on ABD wall (and palpate uterus)
  104. ovary premenopausal and postmenopausal size. Can they be palpated?
    • premenopausal 3x2x1 cm - palpable
    • postmenopausal 1-2 cm - should not be palpable
  105. are fallopian tubes normally palpable
  106. classic sign of pelvic inflammatory disease is CMT (which stands for... ?). This is also called the ___ sign because ..
    cervical motion tenderness, colloquially called the "Chandelier's sign" because it hurts so much the patient will jump off the table and grab the chandelier.