WVSOM -- CS1 -- Female Genetalia tips for success
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| Muscles of vagina | Pubovaginalis ,External urethral sphincter, Urethrovaginal sphincter,Bulbospongiosus
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| Blood supply of the vagina | Branches from the uterine arteries, Vaginal arteries & Internal pudendal arteries, Uterovaginal venous plexus
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| First sign of puberty | breast buds
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| When is pubic hair growth? | age 8-14
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| When does menarche start? | breast tanner stage 3 or 4; ages 9-16
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| What are menstrual cycles like for first 2 years? | common for irregularity
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| During physical exam when is inspection and palpation done? | at the same time
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| What is observed during general inspection? | Symmetry, skin lesions, hair distribution, labia major, labia minor
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| What kind of skin lesions are you looking for? | HSV, HPV, syphilis, Lymphogranuloma venereum, dermatitis and other malignancies
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| What do you inspect labia minora for? | Skene and Bartholin glands, clitoris, urethral orifice, perineum, vaginal introitus
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| What do you inspect the labia majora for? | , swelling, color, tenderness, Bartholin gland abcess/cyst, rash, lesions
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| What do you use for lubrication? | water
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| What angle to you enter vagina at? | 45 degrees
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| What are you going to examine on internal exam? | note the color, ectropion, lesions, discharge, and position
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| What is ectropion? | shiny red color ot tissue around the cervical os that bleeds easily
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| What does cervical os look like? | small and round in a nulliparous woman; horozontal slit-like in a parous woman
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| What is normal position of the cervix? | anteverted and anteflexed
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| What is Chadwick’s Sign? | blueish color to the cervix and may indicate pregnancy
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| What is primary screening test for cervical cancer? | PAP smear
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| What is a cervical broom? | collects both endocervical and ectocervical cells
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| What cells are collected during pap smear? | endocervical and ectocervical cells are collected
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| What is the precursor lesion for cervical cancer? | Cervical Intraepithelial Neoplasia
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| What is Colposcopy? | follow up for diagnosis after an abnormal pap smear
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| What is metrorrhagia? | irregular noncyclic intervals
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| What is oligomenorrhea? | interval > 35 days
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| What is polymenorrhea/hypermenorrhea? | interval < 21 days
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| What is PMB? | post menopausal bleeding
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| What is leucorrhea? | vaginal discharge
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| What is menorrhagus? | excessive bleeding +/or prolonged
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| What is Menometrorrhagia? | increased bleeding betwee3n cycles
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| What are the characteristics of normal physiologic discharge? | white, no oddor, nonhomogeneus consistency and normal cervix
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| What are the characteristics of bacterial vaginosis? | gray, fishy odor, homogenous consistency and normal cerivix
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| What are the characteristics of trichomonas? | grayish yellow, fishy odor, purulent consistency with bubbles and cervix may show red spots
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| What are the characteristics of candida? | white, fishy odor, cottage cheese consistency with patches of discharge
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| What are characteristics of gonococcal? | greenish yellow, no odor, nucopurulent consistency with pus in the os
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| 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!!!!
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| What virus causes cervical cancer? | HPV
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| What is the vaccine for HPV? | gardasil
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| 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,
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| 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
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| 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
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| 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
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| What are the characteristics of the fundus? | pear shaped 5-8 cm in length
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| Where is the fundus located? | usually at the level of the pubis
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| Where is fundus at 12 weeks pregnancy? | just above pubes
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| Where is fundus at 20 weeks? | fundus at level of the umbilicus
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| What is done in rectal exam? | inspect anal sphincter and rectal walls and perform a hemocult
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| FDLMP | First day of last menstrual period
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| What is EDC? | Estimated date of confinement
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| What is FPAL? | Full-term, Pre-term, Abortions, Living
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| What is gravida? | how many times pregnant
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| What is para? | how many live births
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| G3P2 | 3 pregnancies and 2 live births
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| G3P(3002) | pregnancies, 3 full term deliveries, but only 2 children are still living
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| G2P(1011) | 2 pregnancies, 1 full term delivery, 1 abortion/miscarriage, and 1 child living
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| G1P(0202) | 1 pregnancy, 2 pre-term deliveries, and 2 living children [twins:)]
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| What is normal uterine bleeding? | Interval between periods should be between 21-37 days
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| What is length of normal period? | 3-7 days
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| When may spotting occur? | Spotting may occur 1-2 days after period
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| Dysmenorrhea - | painful periods
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| Metrorrhagia – | Irregular noncyclic intervals
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| Oligomenorrhea – | Interval >37 days
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| Polymenorrhea/Hypermenorrhea – | Interval <21 days
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| Menorrhagia or Menorrhagis – | Excessive bleeding and/or prolonged bleeding
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| Menometrorrhagia – | Increased bleeding between cycles as well as heavier periods
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