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78 Cards in this Set
- Front
- Back
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What is the mons pubis?
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Hair-covered fat pad that cushions the symphysis pubis (i.e., pubic bone)
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What is the vestibule?
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Boat-shaped fossa between the labia minora
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What is the introitus?
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Vaginal opening
In some virgins, it may be hidden by the hymen |
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What is the perineum?
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Tissue between the introitus and anus
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What is the labia majora?
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Rounded folds of adipose tissue
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What are the labia minora?
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Folds interior to the labia majora that extend anteriorly to form the prepuce
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What is the structure of the uterus?
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Two parts: body and cervix
Uterus is a fibromuscular structure shaped like an inverted pear |
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What internal structure extends into the vagina?
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Cervix
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What is the vagina's position in the body?
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Extends upward and posteriorly between the urethra and the rectum
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What part of the reproductive system is palpable?
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The ovaries during the reproductive years
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What is the name of the area of the cervix where cancer commonly occurs?
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Transformation zone
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What test samples from the transformation zone?
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Pap smear
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Which area of the cervix resembles the uterine tissue?
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Columnar epithelium surrounding the external os
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How does vaginal childbirth affect the cervix?
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It changes the shape of the external os
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What is the squamous epithelium of the cervix continuous with?
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Vaginal tissue
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What is the normal age range for menarche in the U.S.?
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between 9 to 16 years old
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What three questions should you ask regarding menstruation patterns?
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1. How often do menses occur?
2. How long are the menses? 3. How heavy are the menses? |
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What is the normal duration for menses?
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3 to 7 days
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What is a normal time frame between menses?
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24 to 32 days
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How can you quantify the heaviness of the menses?
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Number of pads or tampons used
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What is the definition of menopause?
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No menses for 12 consecutive months
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What is the average age of menopause?
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45 to 52 years old
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What does "gravida" in the obstetrical history mean?
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Number of pregnancies
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What does "para" in the obstetrical history mean?
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Number of children from pregnancy
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What does "ab" in the obstestrical history mean?
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Miscarriages or induced abortions
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What vulvovaginal symptoms should you inquire about?
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1. Burning
2. Itching 3. Quantity and quality of discharge (including texture, amount, color, and smell) |
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What open-ended questions should you ask regarding a patient's sexual history?
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1. Are you sexually active?
2. Have you been sexually active within past 2 months or have you ever been sexually active? 3. With men, women, or both? 4. How many sexual partners have you had? More than 5? 5. Do you desire to become pregnant? 6. What contraceptive measures do you use? 7. Have you ever had any STIs? |
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Why is 5 significant for number of sexual partners?
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More than 5 partners puts women at increased risk for cervical problems
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What should you have patient do before genital exam?
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Have patient empty the bladder
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What external parts of the genitalia should you inspect?
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1. Mons pubis
2. Labia majora and minora (pink, symmetric and moist) 3. Clitoris 4. Urethral meatus 5. Introitus 6. Perineum |
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What should you note when viewing the female external genitalia?
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Any inflammation, discharge, swelling, or nodules
Palpate any lesions |
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When does prolapse of the urethral meatus most commonly occur?
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Before menarche or after menopause
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What is cystocele?
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Protrusion (prolapse) of the bladder into the vagina
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What is urethrocele?
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Protrusion (prolapse) of the urethra into the vagina
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What is rectocele?
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Protrusion (prolapse) of the rectum into the vagina
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In what position should you examine a woman for hernias?
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Woman should be standing
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Where should you palpate for hernias in women?
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Palpate the labia majora just upward and lateral to the pubic tubercles
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What is urethritis?
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Inflammation of the urethra
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What should you do if you suspect urethritis or inflammation of the paraurethral glands?
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Insert your index finger into the vagina and milk the urethra gently from inside outward. Culture any discharge that has been "milked out."
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What are the three columns of vascular erectile tissue in the shaft of the penis?
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1. Corpus spongiosum
--> contains the urethra 2. Two (2) corpora cavernosa |
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What part of the penis does the corpus spongiosum form?
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Bulb of the penis, which ends with the cone-shaped glans and its expanded base (corona)
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What is another name for foreskin?
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Prepuce
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What make accumulate between the glans and foreskin?
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Smegma, a cheesy, whitish material
It is a normal finding |
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What is the scrotum?
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A loose, wrinkled pouch divided into two compartments, each containing a testis
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What is the structure of the testes?
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Ovoid, somewhat rubbery structures, approximately 4.5 cm long
Left testis usually lies somewhat lower than the right |
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What are the basic landmarks of the groin in men?
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1. Anterior superior iliac spine
2. Pubic tubercle 3. Inguinal ligament |
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What is the purpose of the inguinal canal?
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Forms a tunnel for the vas deferens
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What causes the formation of inguinal hernias?
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Loops of bowel force their way through weak areas of the inguinal canal
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Besides the inguinal canal, where is another common place for hernias?
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Femoral canal
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What questions should you ask men during the genital health history?
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1. Frequency, urgency, and nocturia
2. Dysuria (painful urination) 3. Hesitancy and straining --> could be due to prostate enlargement 4. Urine color 5. Past GU history 6. Penis - pain, lesions, discharge 7. Scrotum, self-care behaviors, any lumps 8. Sexual activity and contraceptive use 9. STI contact and risk reduction |
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What position should a male patient be in for genital examination?
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Standing or supine
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What position should the patient be in for hernia assessment?
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Patient should stand
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What should you check for on the skin surrounding the penis?
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1. Excoriations
2. Inflammation |
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What should you look for when examining the glans?
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1. Ulcers
2. Scars 3. Nodules 4. Inflammation Sebaceous cysts on penis can be normal |
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How should you inspect the male urethra?
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Compress the glans gently between your index finger above and thumb below to open the urethral meatus.
Inspect for discharge. Normally there is none. |
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What should you look for when examining the scrotum?
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Lift the scrotum to view the posterior skin
Note any swelling, lumps, or torturous veins |
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What should you note when palpating the testes and epididymis?
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1. Size
2. Shape 3. Consistency 4. Any tenderness 5. Any nodules |
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What should you inspect the spermatic cord for?
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Nodules or swelling
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What might smaller testes indicate?
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1. Pituitary malfunction
or 2. Cirrhosis of the liver |
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What are some risks for testicular cancer?
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1. Age
--> greater risk between 18 and 35 years old 2. Undescended testicles at birth |
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How can the patient assist in helping you identify hernias?
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Strain and bear down
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What should you do if you suspect a scrotal hernia?
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1. Ask the patient to lie down. If the scrotal mass disappears, it is a hernia.
2. If the mass remains, listen to the mass with a stethoscope. If bowel sounds are heard, it is a hernia. |
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What is a direct hernia?
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Protrusion of the bowel into the external inguinal ring
No pain. Common later in life (>40 yo), obesity could be a factor |
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What is an indirect hernia?
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Protrusion of the bowel into the internal inguinal ring
Pain on straining May be congenital or acquired. Most common hernia. Can occur at any age in women or men (most often 16-20 yo for men). |
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Which hernia can move into the scrotum?
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Indirect hernia
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What is a femoral hernia?
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Protrusion of the bowel into the femoral canal
Extremely painful. May become incarcerated. Most common in women |
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What is an incarcerated hernia?
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A hernia whose contents cannot be returned to the abdominal cavity
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What is the location of the prostate?
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In front of the anterior wall of the anus
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When palpating the prostate, what should you feel for?
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The median sulcus. If you cannot feel, prostate is likely enlarged.
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What are the differences between the internal rectal sphincter and the external rectal sphincter?
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Internal sphincter: smooth muscle, under autonomic nervous system control (involuntary)
External sphincter: skeletal muscle, voluntary control |
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What questions should you ask the patient with respect to the rectum/anus?
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1. Usual bowel routine
2. Change in bowel habits 3. Rectal bleeding (hemorrhoids) vs. blood in the stool (also called occult blood; GI bleeding) 4. Medications (laxatives, stool softeners, iron) 5. Rectal conditions (pruritis, hemorrhoids, fissure, fistula) 6. Family history 7. Self-care behaviors (high-fiber diet, most recent examinations) |
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What should you inspect in the perianal area?
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1. Skin
2. Anal opening 3. Sacrococcygeal area 4. Watch person perform valsalva maneuver |
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What should you palpate for in the anus and rectum?
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1. Canal wall
2. Perianal tissue 3. Rectal wall 4. Prostate gland |
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What is anal winking?
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When you put your finger against the anus, the muscle contracts. (Absent anal winking would signal a neuro problem)
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What finding might make you suspect rectal cancer?
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A firm mass within the rectum that is raised with ulcerated edges
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If anything abnormal is found in the anus, what should you do?
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Biopsy the abnormal tissue
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What test assesses for occult blood?
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Hemoccult test
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What should you do before discussing any abnormal findings with the patient?
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Give patient time to clean up and get dressed before discussing findings
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