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279 Cards in this Set
- Front
- Back
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What structures make up the External genitalia in females?
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Mons Pubis
Labia majora, minora Clitoris Vestibular glands Vaginal vestibule Vaginal orifice Urethral opening |
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The pad of adipose tissue that covers the pubic symphysis in females =
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Mons pubis/mons veneris
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What is special about the mons pubis in postpubertal females
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its covered with coarse terminal hair
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What is the fourchette?
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Where the two labia minora meet posteriorly
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THe Vestibule contains 6 openings:
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1 Urethra
1 Vagina 2 Ducts of Bartholin Glands 2 Ducts of Skene glands |
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A CT membrane that may be circular, crescentic or fimbriated that surrounds the vaginal opening =
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Hymen
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During sexual excitement what secretes mucus into the introitus for lubrication?
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Bartholin Glands
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The vagina sits posteriorly at an incline of what angle?
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45 degrees
from the vertical plane of the body |
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What separates the anterior vagina from the bladder and urethra?
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Vesicovaginal Septum
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What separates the posterior wall of the vagina and the rectum?
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Rectovaginal Septum
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What is the Pouch of Douglas?
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a Deep recess formed by the peritoneum as it covers the lower posterior wall of the uterus and upper portion of the vagina, separating it from the rectum
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The uterus inclines forward at what angle?
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45 degrees
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What are the dimensions of a nulliparous woman's uterus?
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5.5 - 8 cm long
3.5 - 4 cm wide 2 - 2.5 cm Thick |
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Dimensions of a parous woman's uterus
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2 - 3 cm in all dimensions
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How much does the non-pregnant uterus weigh?
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60 - 90 g
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The uterus consists of what two main areas
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Corpus and Cervix
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What makes up the corpus?
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- Fundus
- Body - Isthmus |
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The uterus opens into the vagina via what structure?
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External Cervical Os
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How long are the fallopian tubes usually?
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8 - 14 cm
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What structure supports the fallopian tubes?
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Mesosalpinx
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At what level do the ovaries lie?
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ASIS
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How big are the ovaries during the reproductive years?
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3cm long
2 cm wide 1 cm thick |
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What 4 pairs of ligaments support the internal genitalia?
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- Cardinal
- Uterosacral - Round - Broad ligament |
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What 4 bones form the Pelvis
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2 innominates
sacrum coccyx |
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What are the 4 pelvic joints
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Pubic symphysis
Sacrococcygeal 2 sacro iliac joints |
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What hormones are released during pregnancy that relax the pelvic joints?
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Estrogen and Relaxin
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How long is the uterus of a female infant?
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35 mm long
the cervix is 2/3 of the entire length of the uterus |
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What shape is the hymen in an infant?
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Crescent shape
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When does menarche occure on average?
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age 11 - 14
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What's responsible for making the uterus enlarge in the first 3 months of pregnancy?
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High levels of Estrogen and Progesterone
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What about after the first trimester?
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the mechanical pressure of the growing fetus
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When does the uterus reach the abdominal in pregnancy?
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By 12 weeks
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How thick is the uterine wall at Term/at the end of the pregnancy?
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< 1.5 cm
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How much does uterine weight increase in pregnancy?
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more than 10-fold to ~100g
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How much does the capacity of the uterus increase in pregnancy?
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500 - 1000 times
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What color does the cervix take on during pregnancy?
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Takes on a Bluish appearance
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What happens to the cervix immed. after conception?
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A thick mucus plug keeps it closed
Glands near the external os proliferate w/eversion of the columnar endocervical glands which tend to be friable |
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What color does the vagina take on during pregnancy?
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Violet
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How does the length of the vagina change with pregnancy?
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Lengthens
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What does it mean if the papillae of the vaginal mucosa have a "hobnailed" appearance?
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Its normal with pregnancy
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How does the vaginal pH change during pregnancy and why?
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becomes more ACIDIC b/c of increased Lactic Acid secretion by vaginal epithelium
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When does menopause usu occur?
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Between 40 and 55
Period ends but fertility doesn't |
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What is the definition of Menopause?
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1 year with no menses
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What happens to adrenal androgens and testosterone after menopause
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they decrease along with estrogen
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How does the vagina change with menopause?
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- introitus gradually constricts
- vagina narrows - shortens - loses its rugation - mucosa becomes thin, pale, dry |
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When does ovulation usu. cease?
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1-2 years BEFORE menopause
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What are the systemic effects of menopause?
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- Increase body fat
- intraabdominal fat distribution and male fat distrib. pattern - increase in Total and LDL cholesterol - Thermoregulation altered --> hot flushes - Increased risk of cardiovascular disease |
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What is considered a SHORTENED interval between periods?
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less than 19 - 21 days
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What is considered a LENGTHENED time between periods?
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more than 37 days
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How long is a prolonged menses?
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longer than 7 days
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Risk Factors for Cervical Cancer
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- Not getting Pap's freguently
- HPV infxns - Sex before 16 y.o. - Multiple sexual partners - Smoking DOUBLES risk - HIV -> higher risk of HPV infxn - Diet LOW in fruits and veggies - Overweight - Blacks, Hispanics, Native Am. - Diethylstilbestrol (DES) 1940-1971 - Low social status |
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Risk Factors for Ovarian Cancer
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- Older age. half are older than 63
- Early Menarche before age 12 - Infertility, nulliparity, or preg. after 30y.o. - Menopause after age 50 - Family hx: first deg. relatives - FH of Breast, ovarian, colon CA - Personal hx of Breast, endometrial, colon CA - BRCA1 or 2 mutation - White 50% more freq. > blacks - High fat diet - HRT slightly increases risk |
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Risk Factors for Endometrial Cancer
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- Increases with the amt. of time endometrium is exposed to Estrogen
- Early menarche before 12 - Late Menopause after 50 - Combo of the 2 is worse = longer exposure to estrogen - Infertility or Nulliparity - Obesity - TAMOXIFEN - ERT (estrogen alone w/o progestin) - PCOS, & Granulose-theca cell tumors - Diet high in Animal fat - Diabetes Type I & II - age, 95% are in 40yo+ - FH: endometrial, breast, ovarian, colorectal - Personal hx: Breast, ovarian - BRCA1 or 2 mutation - Pelvic Radiation |
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If masturbation activity in a kid is occasional, discreet, private, and only external stimulation is involved, is that healthy? or abnormal?
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Healthy
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What is considered abnormal masturbation practices in children, and should be further assessed?
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- Frequent, compulsive
- No regard for privacy - Often preferred over other activity/play - Produces genital discomfort, irritation or pysical signs - Involves penetration of the genital orifices; includes bizarre practices or rituals |
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Is anxiety before a female pelvic exam normal?
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No, it usu means that something's wrong
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What should you maintain before and during the examination?
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Eye contact
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During the exam, when should the door to the room be opened?
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Only with BOTH the patient's and doctor's permission
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How should the examination table be positioned?
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So that the patient faces AWAY from it during the examination
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Which gender examiner should be chaperoned by a female assistant?
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Both sexes, male and female examiners
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What should you always have the patient do BEFORE the exam
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Empty the Bladder
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How should you drape the patient?
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Cover her knees and symphysis, depressing the drape between her knees
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When you actually start the exam, where you should you touch first?
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A neutral position like her thigh, working your way to her external genitalia
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** Labial swelling, redness or tenderness, esp. unilateral, can indicate what?
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Bartholin Gland Abcess
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Excoriation, rashes, or lesions of the Labia Majora may indicate what?
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Infectious or inflammatory processes
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What should the inner surface of the labia minora look like?
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moist and dark pink
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Inflammation, irritation, excoriation or cakng of discharge of the labia minora may indicate what?
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Vaginal infection or poor hygiene
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Discoloration or tenderness of the labia minora may indicate what?
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Traumatic bruising
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Ulcers or vesicles of the labia minora may indicate what?
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STI's
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How long is the clitoris normally?
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less than 2 cm
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Whats the diameter of the clitoris?
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0.5 cm
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What does enlargement clitoris indicate?
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Masculinization
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What can irritation, inflammation, or dilation of the urethral orifice indicate?
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Repeated UTI's, or insertion of foreign objects
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When you see something in the pelvic exam that catches your eye, when should you ask questions?
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the pt feels more vulnerable during the exam, so ask AFTER the exam is over.
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What are myrtiform caruncles?
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Hymenal remnants on the vaginal introitus
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When palpating the Skene gland how far should you put your finger in the vagina and in what position
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Palm up
put index finger, up to 2nd joint |
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What does discharge from the Skene gland or urethra indicate?
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Infection
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Whats the most common infection causing discharge from the Skene gland or urethra?
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Gonococcal
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Where are the Bartholin Glands located?
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in the Posterolateral part of the Labia MAJora
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painful Swelling, HOT to the touch, and fluctuant and pus-filled in the labia majora =
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Bartholin gland ABCESS
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What bugs usu cause Bartholin gland abcess?
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Gonococcal or Staphylococcal
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nontender mass in labia majora =
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Batholin cyst
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What causes Batholin cysts?
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Chronic inflammation of the gland
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When should you test muscle tone of a woman's vaginal area?
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If she's given birth, or complained of urinary incontinence or complaining of weak muscle tone
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When the pt bears down, what does bulging of the ANTERIOR wall and urinary incontinence indicate?
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Cystocele
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When the pt bears down, what does bulging of the POSTERIOR wall and urinary incontinence indicate?
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Rectocele
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What does protrusion of the cervix or uterus on straining indicate?
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Uterine Prolapse
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What does the perineum feel like in a Nulliparous woman?
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Thick and smooth
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What does the perineum feel like in a Multiparous woman?
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Thinner and rigid
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What should you do between the vaginal and rectal exams?
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Change your gloves :)
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When preparing the speculum for examination, what should you use to lubricate it?
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use Water or water-soluble lubricant on speculum and glove
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What color should the cervix be?
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Pink
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What does a Bluish cervix color indicate?
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Increased vascularity which may be a sign of pregnancy
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Symmetric, circumscribed erythema around the os indicates what?
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an expected finding, it indicates that the columnar epithelium from the cervical canal is exposed outwardly
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Any reddened areas should be considered what, to a beginning practitioner?
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an unexpected finding
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A PALE cervix =
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Anemia
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a Cervix that points ANTERIORLY =
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RETROVERTED Uterus
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a Cervix that points POSTERIORLY =
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ANTEVERTED Uterus
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Deviation of the Cervix to the Right or Left indicates what?
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Pelvic Mass
Uterine Adhesions Pregnancy |
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How much does the Cervix normally protrude into the Vagina?
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1 - 3 cm
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If the Cervix protrudes into the Vagina > 3cm then that =
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Pelvic / Uterine Mass
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How big is the Cervix of a woman of child-bearing age?
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2 - 3 cm diameter
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What does an enlarged cervix =
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Cervical infection
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A symmetric, reddened circle around the os of the cervix =
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Squamo-columnar epithelium junction
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What are small, white, yellow, raised, round areas on the cervix?
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Nabothian cysts
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What are Nabothian cysts? Are they pathological or normal?
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Retention cysts of the endocervical glands
NORMAL FINDING |
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What do infected Nabothian cysts look like?
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the cysts become swollen, with fluid and they distort the shape of the cervix
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What does Friable tissue, red patchy areas, granlar areas and white patches indicate?
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Cervicities
Infection Carcinoma |
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Normal Nulliparous cervix
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Parous cervix, note slit appearance of os
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Multigravidous, laterated
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Everted
Columnar mucosal cells usu found in the endocervical canal have extended out into the surface of the cervix --> raised circular erythematous look. Note that its non purulent and NORMAL |
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Eroded
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Nabothian cysts
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Odorless, creamy/clear, thick, thin/stringy discharge =
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Normal
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When is discharge normal?
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Midcycle or immed. BEFORE menstruation
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Discharge with odor, white-yellow/ green/gray =
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Bacterial or fungal
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When can a nulliparous woman have a slit-like os?
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- Induced abortion
- Difficult removal of an IUD |
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What is the cylindric-type brush used for?
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To collect ENDOcervical cells only
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What do you collect with the Spatula?
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ECTO-cervical cells
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How much do you rotate the spatula?
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360 degrees
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How much do you turn the brush?
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180 degrees
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Which device do you use first for taking cervical specimens?
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Ecto- first with Spatula - 360 deg.
Endo second with Brush - 180 deg. |
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What is the Broom used for?
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Both endo- and ecto-cervical specimens
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What's the benefit of using the broom?
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causes less blood spotting after the exam
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How many times do you turn the broom?
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3-4 times left and right
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Which test involves sticking a cotton swab into the cervical os for 10-30 sec and spreading it on a culture medium in a Z pattern?
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Gonococcal Culture specimen
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Which test involves using a Dacron swab into the cervival os, and turning it for 30 sec, avoiding the vaginal mucous membranes?
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DNA Probe for Chlamydia and Gonorrhea
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Trichomonads on Wet Mount =
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Trichomonas Vaginalis
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Bacterial "Clue" cells on Wet Mount =
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Bacterial vaginosis
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Fishy odor on KOH prep =
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Bacterial Vaginosis
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Mycelial fragments, hyphae, budding yeast cells on KOH prep =
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Candidiasis
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What should the vaginal wall look like?
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- same color pink as cervix or a little lighter
- Moist, Smooth, rugated and homogenous |
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Should you do Pap smears on women who have had hysterectomy?
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no you don't need to necessarily
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Where do you do pap smear on pts with Vaginal hysterectomy?
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From the Suture line in the posterior fornix.
It looks like a white or pink suture |
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What kind of pressure should you keep during the Speculum exam and why?
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Downward pressure to avoid trauma to the urethra
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How does the cervix feel in a NON-pregnant woman?
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Firm, like the tip of the nose
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What does the cervix feel like in a pregnant woman?
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Softer like lips
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On Cervical motion tenderness, how much should the cervix move?
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1 - 2 cm in each direction with minimal or no discomfort
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What does painful cervical movement suggest?
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Acute Pelvic Inflammatory disease
-or- Ruptured Tubal Pregnancy |
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What position is the uterus in most women?
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Anteverted, Anteflexed
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Which uterine position will allow you to feel the uterine fundus on bimanual palpation of the uterus?
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Anteverted, anteflexed
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Where are your fingers in in the fornix when palpating an anteverted or anteflexed uterus?
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in the ANTERIOR fornix
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Where are your fingers in in the fornix when palpating an retroverted or retroflexed uterus?
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in the POSTERIOR fornix
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When will you NOT be able to palpate the uterine fundus on bimanual exam?
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When its in the MIDPOSITION
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Why do you need to know the position of the Uterus?
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for intrauterine procedures like inserting an intrauterine device
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What is MITTELSCHMERZ?
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Lower abdominal pain associated wtih ovulation.
It may also have tenderness on the side ovulation took place that month and even U/L adnexal tenderness too (usu mild) Sudden onset, spontaneous remisison |
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What size and shape should normal non-pregnant uterus be?
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5.5 - 8 cm long
Pear-shaped |
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What does an unexpected enlarged uterus indicate?
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Pregnancy or Tumor
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The uterus should be mobile in which plane?
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Anteroposterior plane
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What does an immobile uterus indicate?
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Adhesions
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What does tenderness on movement of the uterus indicate?
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Pelvic inflammatory process
or Ruptured tubal pregnancy |
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Where are your fingers in the fornix when palpating the Adnexal areas and ovaries?
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in the Right or Left Lateral Fornix depending on the side you're palpating
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How should the Ovaries feel?
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Firm, smooth, ovoid
A healthy ovary is moderate to slightly tender on palp |
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What are the dimensions of the ovaries?
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3 x 2 x 1 cm
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What other structure around the ovaries can also be palpated soemtimes?
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Round ligament
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Are the fallopian tubes usu palpable?
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no
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Doing the Rectovaginal exam allows you to reach how much farther into the Pelvis?
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2.5 cm
(1 inch) |
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If a pt. refuses the rectovaginal exam, what should you tell her?
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Explain that it is important and why it is necessary
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An extra TIGHT anal sphincter =
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- Anxiety from the procedure
- Scarring - spasticity caused by fissures, lesions, or inflammation |
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A LAX sphincter =
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Neurological deficit
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An ABSENT Sphincter tone =
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improper repair of 3rd degree perineal laceration after childbirth
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When palpating the rectovaginal septum, you can feel the uterine body and fundus when?
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in a retroflexed uterus
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In what position do you examine an infant's external genitalia?
|
Frog position
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A premature/newborn baby girl is born, and with an enlarged clitoris. What does this indicate?
|
It may be normal, due to the influence of the mother's hormones
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What is the chance a baby will be born with an endocrine problem?
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1/5000
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How big is the central opening in the Hymen of an infant?
|
0.5 cm diameter
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An imperforated hymen can lead to what later?
|
hydrocolpos in the child
hematocolpos in the adolescent |
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How does breech delivery affect the baby's external genitalia?
|
It causes the genitalia to be swollen and bruised
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What does a Mucoid, Whitish vaginal Discharge in the infant indicate?
|
Passive transfer of hormones from the mother
An expected finding |
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How long does the vaginal discharge last for?
|
4 weeks after birth
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Newborn baby has adhesions between the labia minora which are difficult to separate. What does this indicate and how would you treat it?
|
Often happens, not abnormal
Tx with Estrogen cream or gentle teasing apart |
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What kind of discharge do infants or small children usu. have?
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Mucoid
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Which part of the exam do you do on a well child?
|
Inspection & Palpation of External genitalia only
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When would you do an internal exam on a child?
|
Sx of bleeding, discharge, trauma, or suspected sexual abuse
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What exam do you do on a girl with Bubble bath vaginitis?
|
just external exam, not internal exam
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When can a child lay on the examining table for genital exam?
|
Preschool age, with the bed raised to 30 degrees
|
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When does the child begin to feel vulnerable about genital exam?
|
School-age child
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How should a school-aged child be positioned for female genital exam?
|
On her back with knees flexed and drawn up
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Is it necessary to have a chaperone during the exam of a child?
|
yes.
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What do you use Anterior Labial Traction for?
|
To visualize an obscured hymenal opening in pre-pubertal children
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If Bartholin or Skene gland infection occurs in a child it is usually what?
|
Gonococcal infection
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A foul smell from the genital area in a preschool girl is most likely what?
|
A foreign body
|
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Where would you see signs of sexual abuse more?
|
On the softer tissues and more posteriorly
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Where would you see signs of a straddly injury from a bicycle seat?
|
over the Pubic symphysis or on more fixed structures
|
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Vaginal bleeding in a child is the result of what?
|
Injury
Forein bodies Sexual abuse |
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All sexually active teenagers should have what done annually?
|
Pelvic exam
Pap smear STI eval |
|
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Young women who are not sexually active should have their first exam by what age?
|
age 21
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What position do you use in the female GU exam on Adolescents?
|
Same as adults
|
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Which speculum would you use on a teen thats a virgin?
|
A pediatric speculum of 1 - 1.5 cm wide
|
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By menarche, how big should the vaginal opening be?
|
1 cm wide
|
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When does the cervix start softening in pregnancy?
|
2nd MONTH
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What does the cervix feel like in the first month of pregnancy?
|
still firm
|
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When does the cervix start turning blue??
|
2nd month
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What does the cervix feel like once it softens?
|
Like lips, instead of like the tip of a nose
|
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What are the four types of pelvis shapes?
|
Gynecoid
Android Anthropoid Platypelloid |
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When is the Size of the Bony Pelvis estimated?
|
During THIRD trimester of pregnancy
|
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What % of all women have Gynecoid pelvic type?
|
50%
|
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Which race has more ANDROID type pelvic shapes?
|
White women
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Which race has more ANTHROPOID type pelvic shapes?
|
Black women
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Round shaped pelvis =
|
Gynecoid
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Heart chaped pelvis =
|
Android
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Oval shaped pelvis =
|
Anthropoid
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Flattened shaped pelvis =
|
Platypelloid
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Which Pelvic shape has Moderate Depth?
|
Gynecoid
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Which Pelvic shape(s) are DEEP
|
Android and Anthropoid
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Which pelvic shape is shallow
|
Platypelloid
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Which pelvic chape has CONVERGENT side walls? What do the rest have?
|
ANDROID
The rest have STRAIGHT side walls |
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Which pelvic shapes have BLUNTED and widely separated ISCHIAL Spines??
|
GYNECOID
& PLATYPELLOID |
|
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Which Pelvic shapes have PROMINENT, NARROW interspinous diameter of ISCHIAL SPINES?
|
ANDROID
& ANTHROPOID |
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Which Pelvic shape has a DEEP and curved Sacrum?
|
GYNECOID
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Which pelvic shape has a "Beaked" terminal sacrum?
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ANDROID
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Which Pelvic shapes have a WIDE Subpubic Arch?
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GYNECOID
& PLATYPELLOID |
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Which Pelvic shapes have NARROW Subpubic Arch?
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ANDROID
& ANTHROPOID |
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****Which Pelvic Shape makes it really difficult to deliver the baby vaginally so C-section is done
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ANDROID
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What are the 6 "Early Signs of Pregnancy"?
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1. Goodell
2. Hegar 3. McDonald 4. Braun von Fernwald 5. Piskacek 6. Chadwick |
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Softening of the Cervix
4 - 6 weeks |
Goodell sign
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Softening of the uterine isthmus
6 - 8 weeks |
Hegar Sign
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Fundus flexes easily on the cervix
7 - 8 weeks |
McDonald Sign
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Fullness and softening of the fundus near the site of implantation
7 - 8 weeks |
Braun von Fernwald sign
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Palpable lateral bulge or soft prominence
7 - 8 weeks |
Piskacek sign
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Bluish color of the cervix, vagina, and vulva
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Chadwick sign
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The most important clinical measurement for estimating the AP diameter of the pelvic inlet?
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Diagonal Conjugate
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Diagonal Conjugate is from where to where?
Normal length = |
Inf. border of pubic symphysis to sacral promontory
12.5 - 13 cm |
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If the Pelvis is ABnormal, the AP diameter is usu.
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Shortened
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The AP Diameter of the Pelvic inlet obtained only by X-Ray or estimated from the Diagonal Conjugate
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Obstetric Conjugate
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Obstetric conjugate is measure from
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Posterior border of Pubic symphysis to Sacral promontory
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Normal length of Obstetric conjugate
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11 cm radiographically
The Diagonal conjugate minus 1.5-2cm depending on the pubic arch |
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What types of measurements do you use to measure the Pelvic Inlet?
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Diagonal Conjugate
& Obstetric Conjugate |
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What types of measurements do you use to measure the Midplane?
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Direct measurement is not possible
use the Transverse Diameter or Interspinous diameter |
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What is the Transverse diamter/Interspinous Diamter
Normal = |
The narrowest transverse diamter in the Midplane between teh interspinous processes
Nml = 10.5 cm |
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What types of measurement do you use to measure the Pelvic OUTLET?
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Biischial diameter
Intertuberous Diameter or Transverse Diameter of the Outlet |
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What tool do you use to measure the Biischial diameter?
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Thom Pelvimeter
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Where is the Biiischial diamter?
Normal = |
From the interior border of one ischial tuberosity to the other
(sits bones) Nml = >8 cm |
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**Uterus Positions with weeks of gestation**
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**Uterus Positions with weeks of gestation**
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Uterus within Pelvis
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Weeks 10 - 12
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Uterus palpable just above pubic symphysis
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Week 12
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Uterus palpable halfway between symphysis and umbilicus
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Week 16
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Uterine fundus at lower border of umbilicus
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Week 20
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Uterus changes from globular to avoid shape
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Weeks 24 - 26
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Uterus approx. halfway between umbilicus and xiphoid
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Week 28
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Uterine fundus just below xiphoid
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Week 34
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Fundal height drops as fetus begins to engage in pelvis
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Week 40
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** Fetal signs with weeks gestation **
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** Fetal signs with weeks gestation **
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Fetal heart-beat can be detected with Doppler
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Weeks 10 - 12
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Ballottement of fetus is possible by abdominal and vaginal examination
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Week 16
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Fetal Heartbeat can be auscultated with Fetoscope
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Week 20
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Fetus Palpable
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Weeks 24 - 26
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Fetus easily palpable
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Week 28
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** Uterine Lengths & Widths w/ Weeks Gestation **
all in cm's |
** Uterine Lengths & Widths w/ Weeks Gestation **
all in cm's |
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Week 6
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Length: 7.3 - 9.1 cm
Width: 3.9 |
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Week 8
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Length: 8.8 - 10.8 cm
Width: 5.0 |
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Week 10
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Length: 10.2 - 12.5 cm
Width: 6.1 |
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Week 12
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Length:11.7 - 14.2 cm
Width: 7.1 |
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Week 14
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Length: 13.2 - 15.9 cm
Width: 8.2 |
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Width: 5.0 cm
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Week 8
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Width: 6.1 cm
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Week 10
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Width: 7.1 cm
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Week 12
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Width: 8.2 cm
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Week 14
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Full dilation of the cervix during labor is how big?
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10 cm
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What is effacement during labor?
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Thinning of cervix from myometrial activity pulling the cervix upward, allowing the cervix to become part of the lower uterine segment during prelabor or early labor
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What happens to the cervix length throughout pregnancy? What is the length at the end of the THIRD Trimester
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It decreases in length
3 - 4 cm by the end off 3rd trimester |
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Shortening of the cervix less than what during midpregnancy indicates the risk for what?
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< 29 mm
Preterm Delivery |
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In which type of patient does Effacement precede Dilation?
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the Primipara woman
Happen together in the Multipara woman |
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The relationship of the presenting part to the Ischial Spines of the Mother's pelvis
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Station
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A station recording of +2 and -1 means what??
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the station is 2 cm BELOW the spines adn 1 cm ABOVE the spines
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In what order do you record the routine cervical exam findings during labor?
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Dilation, Cervical length, Station
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When can the position of the fetal head be determined?
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Once dilation has begun
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What may happen to the Uterus in the first 3 months/first trimester, causing what sx
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May become more anteflexed pressing on the urinary bladder --> frequency
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When doe Asymmetrical uterine enlargement occur?
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around Week 8 - 10
(Piskacek sign) |
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What may palpable ovaries in an elderly woman indicate?
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Tumor
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What should you look for in the rectal exam particularly in an older woman
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Stress incontinence
Prolapse of vaginal walls or uterus |
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Elderly are particularly susceptible to what
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Atrophic Vaginits
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What position should you use for a disable patient who prefers to lay on their side?
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Knee-Chest position
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Which direction should the speculum handle be pointing in the Diamond-shaped position?
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Handle UP
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Which direction should the speculum handle be pointing in the Obstetric Stirrups position?
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Handle DOWN
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Which direction should the speculum handle be pointing in the M-shaped position?
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Handle UP
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Which positions require the use of stirrups?
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Lithotomy and Obstetric stirrup positions
V-shape depends |
