Female Genetalia

Description:	WVSOM -- CS1 -- Female Genetalia tips for success
Category:	Clinical Skills
Created by:	null on 2008-12-09

Question	Answer
Muscles of vagina	Pubovaginalis ,External urethral sphincter, Urethrovaginal sphincter,Bulbospongiosus
Blood supply of the vagina	Branches from the uterine arteries, Vaginal arteries & Internal pudendal arteries, Uterovaginal venous plexus
First sign of puberty	breast buds
When is pubic hair growth?	age 8-14
When does menarche start?	breast tanner stage 3 or 4; ages 9-16
What are menstrual cycles like for first 2 years?	common for irregularity
During physical exam when is inspection and palpation done?	at the same time
What is observed during general inspection?	Symmetry, skin lesions, hair distribution, labia major, labia minor
What kind of skin lesions are you looking for?	HSV, HPV, syphilis, Lymphogranuloma venereum, dermatitis and other malignancies
What do you inspect labia minora for?	Skene and Bartholin glands, clitoris, urethral orifice, perineum, vaginal introitus
What do you inspect the labia majora for?	, swelling, color, tenderness, Bartholin gland abcess/cyst, rash, lesions
What do you use for lubrication?	water
What angle to you enter vagina at?	45 degrees
What are you going to examine on internal exam?	note the color, ectropion, lesions, discharge, and position
What is ectropion?	shiny red color ot tissue around the cervical os that bleeds easily
What does cervical os look like?	small and round in a nulliparous woman; horozontal slit-like in a parous woman
What is normal position of the cervix?	anteverted and anteflexed
What is Chadwick’s Sign?	blueish color to the cervix and may indicate pregnancy
What is primary screening test for cervical cancer?	PAP smear
What is a cervical broom?	collects both endocervical and ectocervical cells
What cells are collected during pap smear?	endocervical and ectocervical cells are collected
What is the precursor lesion for cervical cancer?	Cervical Intraepithelial Neoplasia
What is Colposcopy?	follow up for diagnosis after an abnormal pap smear
What is metrorrhagia?	irregular noncyclic intervals
What is oligomenorrhea?	interval > 35 days
What is polymenorrhea/hypermenorrhea?	interval < 21 days
What is PMB?	post menopausal bleeding
What is leucorrhea?	vaginal discharge
What is menorrhagus?	excessive bleeding +/or prolonged
What is Menometrorrhagia?	increased bleeding betwee3n cycles
What are the characteristics of normal physiologic discharge?	white, no oddor, nonhomogeneus consistency and normal cervix
What are the characteristics of bacterial vaginosis?	gray, fishy odor, homogenous consistency and normal cerivix
What are the characteristics of trichomonas?	grayish yellow, fishy odor, purulent consistency with bubbles and cervix may show red spots
What are the characteristics of candida?	white, fishy odor, cottage cheese consistency with patches of discharge
What are characteristics of gonococcal?	greenish yellow, no odor, nucopurulent consistency with pus in the os
How often should PAP and pelvic exams be done?	yearly at 21 or first sexual encounter after 3 negative exams may decrease pap smears to every 2-3 years after 3 negative tests. Always do a yearly pelvic exam!!!!
What virus causes cervical cancer?	HPV
What is the vaccine for HPV?	gardasil
What are the risk factors for cervical cancer?	Sexually Transmitted Disease (especially HPV, which is by far the most significant!), Early age of First Coitus (<15 years), Smoking,
What are endometrum cancer risk factors?	Postmenopausal, Late Menopause (>52 years), Early Menarche (<12 years), Low Parity, Liver disease, Personal history of hypertension or diabetes, Obesity, Endometrial hyperplasia, Family history of breast, colon, or uterine cancer
What are ovarian cancer risk factors?	Nulliparity, Endometriosis, Ovarian dysfunction, Spontaneous abortion, Exposure to talc or asbestos, Irradiation of pelvic organs, Anovulation, Breast or endometrial cancer, Family history of ovarian/breast cancer with BRCA1/BRCA2 genetic markers
How do you do a bimanual exam?	Insert 2 fingers full length into the vagina, Palpate cervix – assess size, shape, consistency, and mobility, Palpate fundus of the uterus – assess size, shape, and consistency, Palpate Uterine Tubes and Ovaries
What are the characteristics of the fundus?	pear shaped 5-8 cm in length
Where is the fundus located?	usually at the level of the pubis
Where is fundus at 12 weeks pregnancy?	just above pubes
Where is fundus at 20 weeks?	fundus at level of the umbilicus
What is done in rectal exam?	inspect anal sphincter and rectal walls and perform a hemocult
FDLMP	First day of last menstrual period
What is EDC?	Estimated date of confinement
What is FPAL?	Full-term, Pre-term, Abortions, Living
What is gravida?	how many times pregnant
What is para?	how many live births
G3P2	3 pregnancies and 2 live births
G3P(3002)	pregnancies, 3 full term deliveries, but only 2 children are still living
G2P(1011)	2 pregnancies, 1 full term delivery, 1 abortion/miscarriage, and 1 child living
G1P(0202)	1 pregnancy, 2 pre-term deliveries, and 2 living children [twins:)]
What is normal uterine bleeding?	Interval between periods should be between 21-37 days
What is length of normal period?	3-7 days
When may spotting occur?	Spotting may occur 1-2 days after period
Dysmenorrhea -	painful periods
Metrorrhagia –	Irregular noncyclic intervals
Oligomenorrhea –	Interval >37 days
Polymenorrhea/Hypermenorrhea –	Interval <21 days
Menorrhagia or Menorrhagis –	Excessive bleeding and/or prolonged bleeding
Menometrorrhagia –	Increased bleeding between cycles as well as heavier periods