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Maternity Chapter 4
Vocabulary and concepts
| Question | Answer |
|---|---|
| vulva | include all structures visible externally from the pubis to the perineum: the mons pubis, the labia majora, the labia minora, the clitoris, the vestibular glands, the vaginal vestibule, the vaginal orifice, and the urethral opening. |
| mons pubis | a fatty pad that lies over the anterior surface of the symphysis pubis. |
| vaginal vestibule | an almond-shaped area enclosed by the labia minora that contains openings to the urethra, Skene glands, vagina, and Bartholin glands. |
| perineum | a skin-covered muscular area that covers the pelvic structures. |
| Four pairs of ligaments support the uterus: | the cardinal, the uterosacral, the round, and the broad. |
| The uterus is divided into two major parts | an upper triangular portion called the corpus and a lower cylindric portion called the cervix |
| fundus | the dome-shaped top of the uterus and is the site at which the uterine tubes enter the uterus. |
| The isthmus (lower uterine segment) | is a short, constricted portion that separates the corpus from the cervix. |
| functions of the uterus: | reception, implantation, retention, and nutrition of the fertilized ovum and later of the fetus during pregnancy, and for expulsion of the fetus during childbirth. It also is responsible for cyclic menstruation. |
| The uterine wall comprises three layers: | the endometrium, the myometrium, and part of the peritoneum (membrane that covers the abdominal wall). |
| endometrium layers: | The endometrium is a highly vascular lining made up of three layers, the outer two of which are shed during menstruation. |
| myometrium | The myometrium is made up of layers of smooth muscles that extend in three different directions (longitudinal, transverse, and oblique) (Fig. 4-3). |
| outer layer of the myometrium | > longitudinal: assist in expelling fetus, and found on the outside of the myometrium |
| middle layer of the myometrium | > middle layer has all three types of fiber that assist in ligating blood vessels after childbirth and control blood loss. |
| inner layer of the myometrium | circular fibers of the inner myometrial layer are around the site where the uterine tubes enter the uterus and around the internal cervical os (opening). >>They help keep the openings close when needed |
| The cervix is made up of mostly... | fibrous connective tissues and elastic tissue, making it possible for the cervix to stretch during vaginal childbirth. |
| How does the cervix feel? | The cervix feels firm (like the end of a nose) with a dimple in the center, which marks the external os. |
| squamocolumnar junction | where the two types of cells meet, is usually located just inside the cervical os. >> also called the transformation juction >> the most common site for neoplastic changes >> cells from this site are scraped for the Pap test |
| uterine tubes are supported by | broad ligaments. |
| Four sections of the uterine tubes: | the -interstitial- portion is closest to the uterus; the -isthmus- and the -ampulla- are the middle portions; and the -infundibulum- is closest to the ovary. |
| Where is the ovum fertilized? | The ovum is usually fertilized by the sperm in the ampulla portion of one of the tubes. |
| Estrogen, progesterone, and androgen are the hormones produced by what? | The ovaries. |
| The bony pelvis serves three primary purposes: | protection of the pelvic structures, accommodation of the growing fetus during pregnancy, and anchorage of the pelvic support structures. |
| Once ovulation begins in puberty, what hormone levels increases? | Progesterone |
| The pelvis is divided into two parts: | the false pelvis and the true pelvis |
| false pelvis: | The false pelvis is the upper portion above the pelvic brim or inlet. |
| true pelvis: | The true pelvis is the lower, curved bony canal, which includes the inlet, the cavity, and the outlet through which the fetus passes during vaginal birth. |
| Pelvic ossification is complete at what age? | 20. |
| location of the breast | between the 2nd and 6th ribs |
| Estrogen effect on the breast--> | Estrogen stimulates growth of the breast by inducing fat deposition in the breasts,and growth of the extensive ductile system. Estrogen also increases the vascularity of breast tissue. |
| Full development of the breast: | After the end of the first pregnancy or in the early period of lactation. |
| When do the breasts grow the least? | The physiologic alterations in breast size and activity reach their minimal level about --5 to 7 days after menstruation stops--. |
| When should women do a breast-self examination? (best time) | --5 to 7 days after menstruation stops--. |
| FEMALE REPRODUCTIVE PHYSICAL ASSESSMENT ACROSS THE LIFE CYCLE | Refer to pg. 66 table 4-1 for details Growth of reproductive organs complete by age 20, except for the breast. Postmenopausal organs include smaller ovaries and uterus. |
| menarche | First menstruation. |
| Menstruation | the periodic uterine bleeding that begins approximately 14 days after ovulation. --1st day of bleeding is day one, followed by about 5 days of menstrual flow |
| Hypothalamic-Pituitary Cycle | Follicular phase and luteal phase (half-half) FSH makes estrogen until ovulation After ovulation, LH takes over |
| Ovarian Cycle | estrogen levels increase before ovulation, and decrease afterward. LH surge after ovulation, and decrease at menstruation. |
| Endometrial Cycle (4 phases) | The four phases of the endometrial cycle are (1) the menstrual phase, (2) the proliferative phase, (3) the secretory phase, and (4) the ischemic phase |
| what occurs during the menstrual phase of Endometrial Cycle? | shedding of the endometrium |
| what occurs during the proliferative phase of Endometrial Cycle? | The endometrial surface is completely restored in approximately 4 days, or slightly before bleeding ceases. From this point on, an eight- to tenfold thickening occurs, with a leveling off of growth at ovulation. (estrogen is responsible for this) |
| Secretory phase of the endometrial cycle | The secretory phase extends from the day of ovulation to about 3 days before the next menstrual period. >> Progesterone is produced and endometrial wall is ready to possibly support a fertilized ovum |
| Cervical Mucus consistency before and after ovulation | Very thick Discourages entry of the little guys (sperm) |
| Cervical Mucus consistency during ovulation | cervical mucus is thin and clear. It looks, feels, and stretches like egg white. |
| Menstrual blood and prostaglanding levels: | Menstrual blood is a potent prostaglandin source. |
| climacteric | transitional phase during which ovarian function and hormone production decline. |
| Menopause | Last menstrual period |
| Perimenopause | period preceding menopause that lasts about 4 years. During this time, ovarian function declines. Ova slowly diminish, and menstrual cycles may be anovulatory, resulting in irregular bleeding. Bleeding stops at decline of estrogen. |
| Sexual Response | divided into four phases: excitement phase, plateau phase, orgasmic phase, and resolution phase. |
Created by:
ekm
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