Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
70 Cards in this Set
- Front
- Back
|
what is prolapse?
|
movement of urethra, bladder, rectum, uterus, or small bowel into or out of the vaginal canal after deterioration of supporting tissues
|
|
|
what are the main supports of the vagina?
|
perineal body and levator ani muscles (muscle tone is very important)
|
|
|
what are 7 risk factors for prolapse?
|
multiparity
prolonged/traumatic delievry advanced age/atrophy of supporting tissues postmenopausal status chronic cough or constipation obesity heavy lifting |
|
|
what will we not typically see in the supine position?
|
mild to moderate prolapse
|
|
|
when is prolapse pain worse?
|
with standing and late in the day
|
|
|
when is prolapse pain relieved?
|
immediately with lying down
|
|
|
what are 2 main symptoms of prolapse?
|
none
pressure like something is falling out |
|
|
what is cystocele/cystourethrocele?
|
bulging or descent of the bladder/bladder and urethra into the upper, anterior vaginal wall
|
|
|
what is cystocele associated? (2)
|
stress urinary incontinene
urinary retention |
|
|
what is cystocele due to?
|
defect in the vaginal tissues
|
|
|
what is rectocele?
|
prolapse of the lower posterior vaginal wall
|
|
|
what is rectocele often associated with?
|
constipation
|
|
|
what is rectocele due to?
|
defect in the vaginal tissues
|
|
|
what is enterocele?
|
prolapse of the upper, posterior vaginal wall, usually associated with herniation of the pouch of douglas
|
|
|
if you are examining a women for rectocele and see/feel peristalsis, what is it?
|
enterocele
|
|
|
what is uterine prolapse?
|
descent of the uterus toward or past the introitus
|
|
|
what is procidentia?
|
complete uterine prolapse
|
|
|
what are pessaries?
|
tools to keep the uterus in
|
|
|
what is the most critical surgery for prolapse?
|
the first one
|
|
|
what is urinary incontinence defined as?
|
complaint of any involuntary loss of urine
|
|
|
what is most important to keep in mind with urinary incontinence?
|
most common complaint may not be the loss of urine
|
|
|
what is the most common complaint with urinary incontinence?
|
nocturia
|
|
|
what is the crede maneuver?
|
pressure applied to the bladder
|
|
|
what is important to ask in regards to nocturia?
|
is it the urge to urinate that wakes you up?
|
|
|
what is functional bladder capacity?
|
the amount you empty; determines how much you can retain
|
|
|
what is transient urinary incontinence due to?
|
reversible causes
|
|
|
what is urge urinary incontinence due to?
|
overactive detrusor muscle
|
|
|
what is stress urinary incontinence due to?
|
occurs with stress maneuvers (coughing, laughing, etc)
|
|
|
what is mixed urinary incontinence?
|
stress + urge
|
|
|
what is functional urinary incontinence?
|
simply taking too long to get to the toilet due to mobility issues
|
|
|
what is most important to keep in mind with urinary incontinence?
|
most common complaint may not be the loss of urine
|
|
|
what is the most common complaint with urinary incontinence?
|
nocturia
|
|
|
what is the crede maneuver?
|
pressure applied to the bladder
|
|
|
what is important to ask in regards to nocturia?
|
is it the urge to urinate that wakes you up?
|
|
|
what is functional bladder capacity?
|
the amount you empty; determines how much you can retain
|
|
|
what is transient urinary incontinence due to?
|
reversible causes
|
|
|
what is urge urinary incontinence due to?
|
overactive detrusor muscle
|
|
|
what is stress urinary incontinence due to?
|
occurs with stress maneuvers (coughing, laughing, etc)
|
|
|
what is mixed urinary incontinence?
|
stress + urge
|
|
|
what is functional urinary incontinence?
|
simply taking too long to get to the toilet due to mobility issues
|
|
|
to take advantage of muscle remodeling, what must the patient have?
|
an urge
|
|
|
what is the DIAPERS evaluation for transient urinary incontinence?
|
delirium
infection atrophic vaginitis/urethritis pharmaceuticals psychologcial excess urine output restricted mobility stool impaction |
|
|
what 6 lower urinary tract symptom questions should you ask at an initial evaluation?
|
dysuria
dysparnuria urgency frequency nocturia hesitancy |
|
|
if someone wakes up even once at night what must we ask about?
|
orthopnea
|
|
|
when you insert the speculum and ask the patient to cough, if the tissue moves forward what is it?
|
mild cystocele
|
|
|
what is the first thing to do in the genitourinary exam?
|
anal wink
|
|
|
what are 5 signs of estrogen deficiency in a pelvic exam?
|
vaginal stenosis
pallor loss of rugae erosions telangiectasias |
|
|
what are you looking for on a rectal exam? (2)
|
rectal tone and volitional control
|
|
|
what is the bulbocavernous reflex?
|
applying gentle pressure to the clitorus and looking for an anal wink
|
|
|
why is anal wink important?
|
because if it is present it pretty much ensures that neuro is intact
|
|
|
what is the problem with anal wink?
|
if is highly estinguishable
|
|
|
what is the dominant voiding hormone during the day?
|
atrionaturitic peptide
|
|
|
what is the dominant voiding hormone at night?
|
ADH
|
|
|
what is the stress test?
|
patient stands over a chuck (make sure butt is relaxed) and coughs vigorously 3 times and then bear down
make sure to ask if they felt a leak |
|
|
what 3 labs should we get for UTI?
|
creatine
calcium glucose |
|
|
what are 3 treatments for stress incontinence?
|
kegels
weight loss removing offending drugs |
|
|
what are behavioral and biofeedback strategies for urge incontinence?
|
don't rush to the bathroom, squeeze the sphincter
|
|
|
how should people with silent urinary incontinence be treated?
|
void schedule
|
|
|
what does uroflometry measure?
|
flow rate
|
|
|
what does uroflometry not distinguish between?
|
obstruction and underactive detrusor
|
|
|
if someone has an obstruction and an overactive bladder, what should you treat first?
|
obstruction
|
|
|
what should be starred on a bladder diary?
|
when the patient got up for the day (getting up at 4am to void counts as the previous night)
|
|
|
what are 4 causes of polyuria?
|
uncontrolled diabetes
hypercalcemia diabetes insipidus primary polydipsia |
|
|
what are 3 causes of nocturia?
|
overproduction of urine at night
poor functional capacity causes outside the urinary tract |
|
|
what are 2 causes of overproduction of urine at night?
|
mobilization of fluid
endocrine blunting or reversal of diurnal center |
|
|
what should you address with nocturia? (3)
|
peripheral edema via leg elevation and compression stockings
|
|
|
what are 2 pharm treatments for nocturia?
|
afternoon diuretic
bedtime vasopressin |
|
|
what can you not administer if a patient has CHF or polyuria?
|
vasopressin
|
|
|
what can rapidly cause hyponatremia?
|
vasopressin
|
|
|
what are 3 comorbid illnesses that affect urinary incontinence and its treatment?
|
BPH
glaucoma parkinsons |
