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115 Cards in this Set
- Front
- Back
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labia minora meet posteriorly to form what?
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forchette
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labia minora meet anteriorly to form what?
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frenulum and prepuce
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which ducts open on each side of the urethra?
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Skene ducts
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what glands open on each side of the vaginal orifice?
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Bartholin glands
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uterus of a parous women is how many cm larger than nulliparous woman?
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2-3 cm
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name the 3 parts of the corpus of the uterus
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fundus, body, isthmus
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what ligament supports the fallopian tube?
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mesosalpinx, a fold of the broad ligament
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what anatomical landmark is associated with the level of the ovaries?
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ASIS
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name the 4 ligaments that support the internal female genitalia
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cardinal, uterosacral, round and broad
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which 3 hormones cause relaxation of pelvic ligaments
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estrogen, progesterone and relaxin
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the upper border of the pelvic outlet is at the level of what landmark?
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ischial spines
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the lower border of the pelvic outlet is at the level of what 2 landmarks?
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pubic arch and ischial tuberosities
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average age range for menarche
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11-14 yo
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what is responsible for uterine enlargement during 1st trimester?
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estrogen and progesterone
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what is responsible for uterine enlargement after 1st trimester?
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mechanical pressure of growing fetus
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by how many weeks gestation does the uterus reach the abdominal cavity?
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12 weeks
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what causes the bluish color of the cervix?
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venous and lymph congestion during pregnancy
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what causes exaggerated uterine anteflexion during 1st 3 months of pregnancy? what is the result of this?
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softness and compressibility of isthmus; fundus presses on the bladder
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ovulation ceases how many years before menopause?
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1-2 years
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5 high risk types of HPV
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16, 18, 31, 33, 45
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Dx: labial swelling, redness or tenderness, mostly unilateral
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Bartholin gland abscess
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Dx: inflammation, irritation, excoriation or caking of discharge in tissue folds
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vaginal infection or poor hygiene
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Dx: discoloration or tenderness of labia minora
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traumatic bleeding
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Dx: irritation, inflammation or dilation or urethra
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repeated UTI or insertion of foreign object
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Def: myrtiform caruncle
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hymenal remnants
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most common cause of infection of Skene gland or urethra
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gonococcus
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2 most common causes of Bartholin gland abscess
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gonococcus and Staph
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Dx: nontender mass of Bartholin gland
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cyst, result of chronic inflammation
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normal color of cervix
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pink
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Dx: pale cervix
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anemia
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Dx: symmetric circumscribed erythema around os
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expected
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Def: cervix that points anteriorly
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retroverted
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Dx: deviation of cervix from midline (3)
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pelvic mass, pregnancy, uterine adhesions
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normal range of cervical projection into vagina
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1-3 cm
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Dx: enlarged cervix
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cervical infection
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Dx: small white or yellow raised round areas on cervix
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nabothian cysts, retention cysts of endocervical glands
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Dx: friable tissue, red patchy areas, granular areas, white patches of cervix (3)
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cervicitis, infection, carcinoma
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when is discharge the heaviest?
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midcycle/before menstruation
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Dx: bacteria-filled epithelial cells (clue cells)
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bacterial vaginosis
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Dx: fishy odor after addition of KOH to vaginal discharge
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bacterial vaginosis
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Dx: painful cervical motion (2)
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acute pelvic inflammatory disease or ruptured tubal pregnancy
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most common position of uterus
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anteverted, anteflexed, felt at the level of the pubis through anterior fornix
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Dx: unmoveable uterus
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adhesions
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Dx: slightly tender ovary on palpation
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normal
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Dx: extremely tight anal sphincter (2)
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anxiety or spasticity (from fissures, lesions or inflam)
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Dx: absent sphincter
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improper repair of 3rd degree perineal laceration after childbirth
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Dx: clitoromegaly (2)
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prematurity, CAH
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are Bartholin and Skene glands palpable in kids?
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no, only if infected
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Dx: perineal irritation (2)
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vaginal discharge or UTI
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4 pelvic types
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gynecoid, android, anthropoid and platypelloid
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Sign: Goodell
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softening of cervix, 4-6 weeks
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Sign: Hegar
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Softening of uterine isthmus, 6-8 weeks
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Sign: McDonald
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fundus flexes easily on cervix, 7-8 weeks
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Sign: Braun von Fernwald
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fullness and softening of fundus near site of implantation, 7-8 weeks
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Sign: Piskacek
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palpable lateral bulge or soft prominence of one uterine cornu, 7-8 weeks
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Sign: Chadwick
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bluish color of cervix, vagina and vulva, 8-12 weeks
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most common pelvic shape
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gynecoid
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which pelvic type most often requires C section delivery?
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android
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Def: the most important clinical measurement for estimating AP diameter of inlet
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diagonal conjugate, from symphysis (inferior border) to sacral promontary
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Def: AP diameter of pelvic inlet obtained only by xray or estimated from diagonal conjugate
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obstetric conjugate
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Def: opening of cervical canal
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dilation
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progression of cervical dilation:
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closed to 10 cm (full)
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Def: thinning of cervix that results when myometrial activity pulls the cervix upward
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effacement
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Dx: shortening (<29 mm) of cervix
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preterm delivery
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Dx: relationship of presenting part to ischial spines
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station
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# of cm "station" at ischial spines
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0 cm
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what can happen in older age due to relaxation of pelvic musculature?
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stress incontinence and prolapse of vaginal wall or uterus
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Dx: edema, HA, weight gain, behavioral disturbances
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PMS
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Dx: pelvic pain, dysmenorrhea, heavy/prolonged menstrual flow
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endometriosis
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endometriosis in adolescent can present with what types of pain?
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cyclic and non-cyclic
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Dx: flesh colored whitish pink to reddish brown discrete soft growths
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condylomata acuminatum (warts), HPV
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Dx: white or flesh-colored dome-shaped papules that are round or oval with central umbilication
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molluscum contagiosum
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cause of molluscum contagiosum
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poxvirus
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Dx: flat round or oval papules covered by gray exudate
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condylomata latum (secondary syphilis)
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Dx: painless ulcer, firm
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syphilitic chancre (primary)
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Dx: hot red tender fluctuant swelling that may drain pus
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inflammed Bartholin gland
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what accompanies more severe degrees of cystocele?
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urinary stress incontinence
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what is vaginal CA in young women related to ?
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DES exposure in utero
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Dx: vaginal discharge, lesions and masses, spotting, pain, change in urinary habits
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vaginal CA
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Dx: red polypoid growth that protrudes from urethral meatus
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urethral caruncle
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Dx: inflammed vaginal mucosa with petechial lesions
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trichomoniasis
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microbe that causes bacterial vaginosis
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Gardnerella vaginalis
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Dx: profuse frothy greenish discharge, pH 5-6.6
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trichomoniasis
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Dx: folded, clumped epithelial cells on wet mount
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atrophic vaginitis
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Dx: hard granular surface at or near cervical os, irregular cauliflower growth
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cervical carcinoma
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Dx: shiny red tissue around the cervical os that may bleed easily
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ectropion
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Degree of Prolapse: cervix remains within vagina
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1st deg
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Degree of Prolapse: cervix is at the introitus
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2nd deg
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Degree of Prolapse: cervix and vagina drop outside introitus
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3rd deg
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Def: menorrhagia
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excessive and longer menstruation
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Def: metorrhagia
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menstruation at irregular intervals
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Def: oligomenorrhea
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infrequent menstruation
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Def: polymenorrhea
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increased frequency of menstruation, often not associated with ovulation
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Common cause of midcycle spotting
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midcycle estradiol fluctuation associated with ovulation
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Common cause of delayed menstruation
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anovulation or threatened abortion with excessive bleeding
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Common cause of frequent bleeding (4)
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chronic PID, endometriosis, dysfunctional uterine bleeding, anovulation
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Common cause of profuse menstrual (5)
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endometrial polyps, dysfunction uterine bleeding, adenomyosis, submucous bleeding leiomyomas, IUD
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Common cause of intermenstrual or irregular bleeding (4)
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endometrial polyps, dysfunctional uterine bleeding, uterine or cervical CA, BCP
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Common cause of postmenopausal bleeding (3)
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endometrial hyperplasia, estrogen therapy, endometrial CA
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Dx: firm irregular nodules in contour of uterus
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myoma/leiomyoma/fibroid
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women taking Tamoxifen are at increased risk for what type of CA?
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endometrial
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ruptured ovarian cyst produces sx similar to what?
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ruptured tubal pregnancy
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Dx: persistent and unexplained vague GI sx in >= 40 yo
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ovarian CA
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Dx: marked pelvic tenderness with tenderness and rigidity of lower abdomen, tachycardia
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ruptured tubal pregnancy
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Dx: tender, bilateral adnexal areas
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acute PID
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Dx: bilateral tender irregular and fairly fixed adnexal areas
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chronic PID
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Dx: urinary meatus that is not located behind the clitoris
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presence of penis in ambiguous genitalia
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Dx: vaginal discharge, warm erythematous and swollen vulvar tissue
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vulvovaginitis
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rupture of membranes before onset of labor in a term pregnancy is considered preterm rupture is labor doesn't begin in how many hours?
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12 hr
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amniotic fluid has what pH and does what to Nitrazine paper?
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7.15, turns it blue-green
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5 predisposing factors for prolapse of umbilical cord
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prematurity, breech/transverse position, hydraminos, high/floating presenting part, multiple preg
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Dx: variable decelerations in fetal HR
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prolapse of umbilical cord
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Dx: leakage of urine due to increased abd pressure
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stress incontinence
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Dx: inability to hold urine once urge to void occurs
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urge incontinence
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Dx: mechanical dysfunction from overdistended bladder
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overflow incontinence
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