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Chapter 17

Female reproductive system

Woman ovulate from one side each month If ovulation from both sides together in one month you may have twins
MENARCHE First menses
First menses usually occurs Between 11 - 15 But can be as early as 9 y o
Monthly cycle will continue for 35 yrs or until menopause
Average monthly cycle occurs every 28 days But can be between 21 - 35 days
Cycle is counted From the first day of menses until the first day of the next menses
Average length of bleeding 3 - 8 days
Amenorrhea Absence of menstrual flow
Dysmenorrhea Painful menstrual flow
AUB Abnormal uterine bleeding
Abnormal uterine bleeding Refers to excessive bleeding / bleeding between periods
AUB ( abnormal urterine bleeding) REPLACES THE TERM Menorrhagia and metorrhagia
MENOPAUSE Defined as the cessation of menses for at least 12 months
MENOPAUSE USUALLY OCCURS Around age 52 But can occur anytime after 40
MENOPAUSE 3 phases Phase 1 peri menopause Phase 2 menopause Phase 3 post menopause
Phase 1 peri menopause Estrogen product decreases Can last 1 - 2 years Most woman will begin to have S&S
Phase 2 menopause No period for 12 consecutive months / Most symptoms occur during this time / Estrogen production has stopped / Eggs are no longer released
Phase. 3 post menopause Refers to the time after menopause occurs/ S&S start to subside / long term health issues of menopause may begin
Signs and symptoms # 1 complaint hot flashes - nite sweats - irritability -poor bladder function - fatigue - mood swings - Vaginal dryness - head aches - insomnia - low concentration - depression
SBE Self breast exams Monthly by age 20 ( 7-10 ) days after LMP - SAME TIME EVERY MONTH
Breast cancer risk factors Age / female / (greater then or equal to age 55 - braci and brcaz gene) First menses/ FX /less then 12 and Caucasian/
Secondary risk factors Dense breast tissue/ lifestyle Lazy / zero pregnancy after 30 yo/ smoking /heavy alcohol consumption/HRT/ chemical exposure/ radiation exposure/
GYN EXAM Info needed date of first menses/ LMP INCLUDING LENGTH AND TYPE OF FLOW
GRAVIDA How many pregnancy
Para How many live births
More info abtained at GYN VISIST Date of LAST PAP SMEAR / any abnormal apps / contraception/ HRT / Mammo if acceptable / STD's/ GYN SURGERIES/ sexual HX/
Pelvic exam Visual inspection/ collection of tissue for Pap smear/ bimanual pelvic/rectal exam
Pap smear testing for cervical cancer Collection of tissues from the cervix for cytological examination Cells are collected from the cervix and endo cervical canal
Liquid prep method ( Most common) cells are suspended in the liquid for more inclusive testing CANCER / HPV /GONNORRHEA / CHLAMYDIA
ENDOMETRIAL ABLATION Use of cautery or hot water to destroy endometrial tissue TX : excessive bleeding
Essure Metal coil with heat that scars the Fallopian tube TX: permanent BC
Hysterectomy with bilateral SALPINGO-OOPHERECTOMY Removal of uterus Fallopian tubes and ovaries TX : cancer excessive bleeding
TUBAL LIGATION Disruption of Fallopian tubes that prevent the eggs from getting to the uterus TX : PCN / flagyl/ doxycycline
ANTIESTROGEN Prevents the effects of estrogen on tumors Meds: tamoxifen ( blocks estrogen to keep from growing )
ANTIFUNGALS TX yeast infections Meds: ministrations / diflucan
Estrogen based contraception ESTROGEN AND PROGESTERONE "mimic "natural cycle Preventing ovulation Meds: othrotricyole/ nuvaring
OB Obstetrician cares for the pregnant woman
GYN Gynecologist treats disease and disorders of the female reproductive system
Menstruation Process where the lining of the uterus sheds and flows out of the body Through the vagina
Average age for menses to begin 11-15 yrs o
Average menstrual cycle 28 days
Average days that a woman bleeds during the cycle 3-8 days
Amenorrhea Absence of menstrual flow
Dysmenorrhea Painful mensuration
Dysfunctional uterine bleeding Excessive menstrual flow and / or days of flow / bleeding or spotting Between regular cycle
MENOPAUSE Cessation of menses
Average age of Menopause 52 yrs o , but can occur any time after 40
Average length of time a woman has her menstrual cycle until menopause occurs 35 yrs
Phase 1. Peri menopause This begins when estrogen production by the ovaries gradually decrease
Phase 2 menopause Complete cessation of menstrual flow for at least 12 months
Phase 3 post menopause The years after menopause when symptoms subside
Symptoms of menopause Headache/ joint pain / vaginal dryness/ bladder control problems/ Fatigue/ mood swings/ insomnia/depression/irritability/ hot flashes/and nite sweats
Most common Hot flashes
Long term issues linked to menopause Heart disease/poor bowel and bladder functions/ poor brain functions/ Osteoporosis/increased wrinkles of the skin/ gingivitis/loss of muscle tone / vision problems
HRT9 hormone replacement therapy may be linked to Breast cancer/ blood clots/dementia/cardiovascular disease
A complete GYN exam includes Breast exam / pelvic and vaginal exam/PAP smear and cultures/ bimanual pelvic-abdominal exam / rectal exam
GRAVIDA Term that refers to how many times a woman has been pregnant
PARA Refers to how many live births/ abortion/ miscarriages/ pre-term births and Full term births
Mammograms X-ray of breast tissue to detect breast cancer
BSE - breast self exam should be done Every month at the same time about 7-10 days after the LMP
MAMOGRAMs are done yearly after the age of 40 yrs old
Most common and reliable method of PAP TEST Liquid prep method
Cervix Is dilated and endometrial lining is scraped D & C ( dilation and curettage)
Visualization of the vaginal and cervical tissue with a colposcope Colposcopy
Full term pregnancy is considered to be 37- 40 weeks gestation
Pregnancy is divided into three Trimesters
Prenatal visit will include a Complete medical history/ physical exam including a pelvic exam/ blood work/ pap smear and vaginal cultures/ PT EDUCATION and blood work
NAGELES RULE EDD / 1st day of LMP + 7 days - 3 months + 1 year
Hypertension of pregnancy is called Preeclampsia or toxemia
GESTATIONAL DIABETES Diabetes that occurs during pregnancy
Placenta previa Low lying placenta that may block the cervical opening
Placenta abruptio Placenta that prematurely detaches for the wall of the uterus
Hyperemsis GRAVIDARUM Excessive nausea and vomiting that causes dehydration
Miscarriage/ abortion Pregnancy that ends prior to the fetus being viable
GTT Lab test that is done to screen for gestational diabetes
Ultrasound High frequency sound waves that produce an image of the fetus
Amniocentesis Amniotic fluid aspirated from the amniotic sac using a needle under ultrasound guidance
Lochia Vaginal discharge that occurs after delivery
Lochia ruba Bright red discharge for the first three days postpartum
Lochia serosa Pink or brownish discharge that occurs around day four of postpartum
Lochia alba Yellowish white discharge that continues up to 3-6 weeks post pardum
Postpartum visit is done 6 weeks after delivery
VULVADYNIA Vulvar pain / burning /stinging/irritated or rawness/ Difficult mot treat due to extensive differential diagnosis
Vaginitis Irritation of the vaginal region inflammation often associated with vaginal Discharge
Uterine fibroids Benign myometrail tumor can lead to severe cramping and uterine bleeding
BREAST CANCER Abnormal breast cells that can grow and spread through out the body
STD's Are now REFFERED to as STI - sexually transmitted infections
VIRAPAP Detects presence of HPV ( human papilloma virus)
Braxton hicks contractions False labor
Labor of parturition Begins when uterus begins to contract and ends with delivery of the bby
Stage 1 dilation 10 cm completely enffaced or thinned out to facilitate delivery
Stage 2 expulsion Cervix completely dilated and effaced and birth occurs
Stage 3 placental Placenta is expelled
MECONIUM Earliest stool of the new born
Postpartum/ postnatal begins Upon delivery Last from 4-6 weeks
Menstrual flow resumes After 2 months of non- nursing And after 3-6 months in nursing mother
Ovalations agents Promotes ovulation Med/clomid
IDU Intrauterine device/ low dose estrogen/ prevents fertilization and implantation / ( check for string to make sure it is still in MEDS / mirena/skyla/parayerd
Labs estradiol Estrogen level ( low level suggest ovarian cancer)
Labs FSH FOLLICLE STIMULATING HORMONE Elevated suggest estrogen secretions Elevated trying to get you to ovulate
Created by: Tbella



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