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Female GU Powerpoint
Terms in this set (159)
routine physical examination has caused a significant decline in mortality from this
have not had regular Pap tests
most invasive cervical carcinomas are found in women who...
young age at first sexual intercourse
multiple sexual partners
infection with HPV or HSV
history of cervical dysplasia
risk factors for cervical cancer
before a person becomes sexually active
when should immunizations for cervical cancer be administered?
rounded prominence of fat tissue overlying the pubic symphysis
two wide skinfolds that form lateral boundaries of the vulva
the labia majora meet anteriorly at the mons veneris to form the ___
the labia majora and the mons veneris have ___ and ___
the labia majora correspond to what in the man?
two narrow, pigmented skinfolds that lie between the labia majora and enclose the vestibule
the area lying between the labia mniora
anteriorly, the two labia minora form the prepuce of the ___
what is the clitoris analogous to in the male?
consists of erectile tissue and a rich supply of nerve endings
two corpora cavernosa
what are the components of the clitoris?
external urethral meatus
located in the anterior portion of the vestibule below the clitoris
paraurethral glands (Skene's glands)
small glands that open lateral to the urethra
aka paraurethral glands
secretion of ___ lateral to the urethra protects the vulnerable tissues against urine
aka vulvovaginal glands
Bartholin's glands (vulvovaginal glands) are pea sized glands corresponding to what male structure?
where do Bartholin's glands lie in relation to the vaginal orifice?
during sexual intercourse, ___ secrete a ___ that serves as a vaginal lubricant
inferiorly, the labia minora unite at the posterior commissure to form this
the area between the fourchette and the anus
circular fold of tissue that partially occludes the vaginal introitus
the border between the external and internal genitalia, located in the lower portion of the vestibule
internal pudendal arteries
blood supply to the vulva
superficial and deep inguinal nodes
lymphatic drainage from the vulva
muscularly walled, hollow canal that passes upward and slightly backward, at a right angle to the uterus
urinary bladder (anteriorly)
what two structures does the vagina lie between?
transverse rugae (folds)
the vaginal walls are lined by these
the lower portion of the cervix projects into the upper portion of the vagina and divides it into four ___
shallow and just poterior to the bladder
deep and just anterior to the rectovaginal pouch
pouch (cul-de-sac) of Douglas
aka rectovaginal pouch
what lies immediately above the pouch of Douglas?
what do the lateral fornices contain?
where can the fallopian tubes and ovaries be palpated?
the superficial cells of the vagina contain this, which is acted on by the normal vaginal flora to produce lactic acid
vaginal flora acts on glycogen from vaginal superficial cells to produce lactic acid
what is partly responsible for the resistance of the vagina to infection?
internal iliac artery
blood supply to the internal genitalia
composed of fallopian tubes plus ovaries
the uterus and adnexa are under the influence of the hypothalamus via what hormones?
abnormal vaginal bleeding
changes in hair distribution
changes in urinary pattern
most common symptoms related to female GU system
Dysfunctional Uterine Bleeding (DUB)
aka abnormal vaginal bleeding
cessation/nonappearance of menstruation
excessive menstrual bleeding (flow and/or duration)
irregular, noncyclic bleeding
increased bleeding between cycles with heavier periods
occurs over 6-8 months after menopause
menstruation has never occurred
menstruation has occurred but has ceased
abnormally low body fat
conditions associated with secondary amenorrhea
diseases of the hypothalamus, pituitary gland, ovary, uterus, and thyroid gland are associated with ___
milk discharge from the nipples
what condition may cause galactorrhea
also associated with secondary amenorrhea
more common, begins shortly after menarche, associated with colicky uterine contractions, occurs with every period. Childbirth frequently alleviates this state permanently
caused by acquired disorders within the uterine cavity, obstruction to flow, or disorders of the pelvic peritoneum. usually occurs after years of painless periods
examples of disorders within uterine cavity
example of disorder causing obstruction to flow
pelvic inflammatory disease
examples of disorders of the pelvic peritoneum
chancre on the labia
small, painless nodule or ulcer with a sharply demarcated border resulting from syphilis
chancroid or genital herpes
small, acutely painful ulcers may be what?
may present with an extremely tender mass in teh vulva
abscess of Bartholin's gland
benign tumors such as venereal warts (condylomata acuminata), and malignant conditions manifest as a mass where?
the descent or protrusion of the vaginal walls or uterus through the vaginal introitus. this is caused by a weakening of the pelvic supports
some patients affected by masses/lesions complain of a sensation of fullness or mass in the pelvis as a result of this
cystocele that triggers urinary symptoms (frequency and stress incontinence)
what is produced by descent of the anterior vaginal wall?
rectocele, which triggers bowel symptoms (constipation, tenesmus, incontinence)
what is produced by descent of the posterior vaginal wall?
result of descent of the uterus
severe state of uterine prolapse when the uterus may lie outside the vulva with complete vaginal inversion
aka vaginal discharge
color of physiologic vaginal discharge
color of nonspecific vaginitis
color of Trichomonas-related vaginal discharge
color of Candida-related vaginal discharge
color of gonococcal vaginal discharge
presence/absence of fishy odor in physiologic vaginal discharge
presence/absence of fishy odor in nonspecific vaginitis
presence/absence of fishy odor in Trichomonas discharge
presence/absence of fishy odor in Candida discharge
presence/absence of fishy odor in gonococcal discharge
consistency of physiologic vaginal discharge
consistency of nonspecific vaginitis discharge
purulent, often with bubbles
consistency of Trichomonas discharge
consistency of Candida discharge
consistency of gonococcal discharge
location of physiologic vaginal discharge
adherent to walls
location of nonspecific vaginitis discharge
often pooled in fornix
location of Trichomonas discharge
adherent to walls
location of Candida discharge
adherent to walls
location of gonococcal discharge
discharge at introitus with physiologic discharge?
discharge at introitus with nonspecific vaginitis discharge?
discharge at introitus with Trichomonas discharge?
discharge at introitus with Candida discharge?
discharge at introitus with gonococcal discharge?
how do the vulva, vaginal mucosa, and cervix present in the case of physiologic vaginal discharge?
how do the vulva, vaginal mucosa, and cervix present in the case of nonspecific vaginitis discharge?
how do the vulva and vaginal mucosa present in the case of Trichomonas vaginal discharge?
may have red spots
how does the cervix present in the case of Trichomonas vaginal discharge?
how do the vulva and vaginal mucosa present in the case of Candida vaginal discharge?
has patches of discharge
how does the cervix present in the case of Candida vaginal discharge?
how does the vulva present in the case of gonococcal vaginal discharge?
how does the vaginal mucosa present in the case of gonococcal vaginal discharge?
has pus in os
how does the cervix present in the case of gonococcal vaginal discharge?
associated with monoilial infections, glycosuria, vulvar leukoplakia, and any condition that predisposes a woman to vulvar irritation
pruritis may also be a symptom of this
intense lower abdominal pain
what is produced by acute inflammation by gonococci of the fallopian tubes and ovary (salpingo-oophoritis)?
acute lower abdominal pain localized to one side that occurs at the time of ovulation
related to a small amount of intraperitoneal bleeding at the time of ovum release
chronic abdominal pain
may result from ectopic endometrial tissue, chronic PID of the fallopian tubes and ovaries, and pelvic muscle relaxation w/protrusion of the bladder, rectum, or uterus
excessive growth of hair on the upper lip, face, earlobes, upper pubic triangle, trunk, or limbs
extensive hirsutism with receding temporal hair, a deepening of the voice, and clitoral enlargement
increased androgen production by adrenals or ovaries
may be responsible for hirsutism and/or virilization
tumors of the ovary
commonly associated with amenorrhea, rapidly developing hirsutism, and virilization
polycystic ovarian disease
most common ovarian cause of hirsutism, dysfunctional uterine bleeding, infertility, acne, and obesity
loss of hair
urinary incontinence that occurs with straining or coughing
may result from cerebral dysfunction, spinal cord disease, and peripheral nerve lesions; most individuals suffer from an episode of temporary loss of vision as an early symptom
a chronic relapsing neurologic disorder causing urinary incontinence
when the pressure in the bladder exceeds the urethral pressure in the absence of bladder contraction, may occur in patients with diabetes and an atonic bladder
individuals have been known to urinate in bed at night to "warm" themselves or during the daytime in group settings to draw attention to themselves
pain during or after sexual intercourse
physiologic dyspareunia can result from...
associated with history of painful pelvic examinations, fear of pregnancies, "penetration anxiety", dryness
severe pelvic pain and spasm when the labia are touched
failure to ovulate, can cause infertility
infertility can also result from dysfunction of the ___
basal body temperature
charting this is a reliable method for detecting ovulation
may lead to salpingo-oophoritis with scarring of the fallopian tubes and infertility
well-known cause of infertility
refers to the menstrual history and summarizes the age at menarche, the cycle length, and duration of flow
CAT 12 x 29 x 5
catamenia of a woman who reached menarche at age 12, has had regular periods every 29 days lasting for 5 days
recurrent, midcyclic symptoms associated with the menstrual period, such as breast tenderness, bloating
molimina are specific but nonsensitive signs of ___
number of pregnancies
total number of deliveries
full term infants, premature, abortions, living children
use of this during mother's pregnancy indicates risk of vaginal clear cell carcinoma
position of examination used in the USA
common inflammatory condition of external genitalia
this part of the external genitalia is inspected for lesions and swelling
relatively common condition in which the genital skin shows a uniform reddening
normal, yellow-white papules of inner labia
normal size of clitoris
small benign tumor at urethral orifice, relatively common in postmenopausal women; appears as a bright red or flesh-colored mass extending through the urethral orifice; may be asymptomatic or may cause pain or bleeding
how to differentiate between urethral caruncles and other tumors
inflammation of the vagina and vulva that is marked by pain, itching, and vaginal discharge
mucous secretions from cervix and vagina
exfoliated vaginal cells
components of normal vaginal discharge
21 (regardless of age of onset of sexual activity)
at what age is cervical cancer screening necessary?
cervical cancer screening should not be done annually
when should annual screening start?
21-29 years of age
cytologic exam every 3 years
HPV co-test should not be performed yet
30-65 years of age
cytologic exam every 3 years or
cytologic exam + HPV co-testing every 5 years
>65 years with adequate screening history
when to stop screening for cervical cancer
not needed unless cervix is still present
method and interval for screening posthysterectomy
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