Vocabulary and concepts
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| 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.
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| mons pubis | a fatty pad that lies over the anterior surface of the symphysis pubis.
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| vaginal vestibule | an almond-shaped area enclosed by the labia minora that contains openings to the urethra, Skene glands, vagina, and Bartholin glands.
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| perineum | a skin-covered muscular area that covers the pelvic structures.
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| Four pairs of ligaments support the uterus: | the cardinal, the uterosacral, the round, and the broad.
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| The uterus is divided into two major parts | an upper triangular portion called the corpus and a lower cylindric portion called the cervix
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| fundus | the dome-shaped top of the uterus and is the site at which the uterine tubes enter the uterus.
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| The isthmus (lower uterine segment) | is a short, constricted portion that separates the corpus from the cervix.
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| 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.
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| The uterine wall comprises three layers: | the endometrium, the myometrium, and part of the peritoneum (membrane that covers the abdominal wall).
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| endometrium layers: | The endometrium is a highly vascular lining made up of three layers, the outer two of which are shed during menstruation.
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| myometrium | The myometrium is made up of layers of smooth muscles that extend in three different directions (longitudinal, transverse, and oblique) (Fig. 4-3).
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| outer layer of the myometrium | > longitudinal: assist in expelling fetus, and found on the outside of the myometrium
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| 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.
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| 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
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| The cervix is made up of mostly... | fibrous connective tissues and elastic tissue, making it possible for the cervix to stretch during vaginal childbirth.
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| 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.
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| 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
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| uterine tubes are supported by | broad ligaments.
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| 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.
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| Where is the ovum fertilized? | The ovum is usually fertilized by the sperm in the ampulla portion of one of the tubes.
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| Estrogen, progesterone, and androgen are the hormones produced by what? | The ovaries.
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| 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.
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| Once ovulation begins in puberty, what hormone levels increases? | Progesterone
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| The pelvis is divided into two parts: | the false pelvis and the true pelvis
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| false pelvis: | The false pelvis is the upper portion above the pelvic brim or inlet.
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| 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.
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| Pelvic ossification is complete at what age? | 20.
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| location of the breast | between the 2nd and 6th ribs
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| 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.
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| Full development of the breast: | After the end of the first pregnancy or in the early period of lactation.
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| 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--.
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| When should women do a breast-self examination? (best time) | --5 to 7 days after menstruation stops--.
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| 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.
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| menarche | First menstruation.
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| 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
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| Hypothalamic-Pituitary Cycle | Follicular phase and luteal phase (half-half)
FSH makes estrogen until ovulation
After ovulation, LH takes over
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| Ovarian Cycle | estrogen levels increase before ovulation, and decrease afterward.
LH surge after ovulation, and decrease at menstruation.
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| 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
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| what occurs during the menstrual phase of Endometrial Cycle? | shedding of the endometrium
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| 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)
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| 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
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| Cervical Mucus consistency before and after ovulation | Very thick
Discourages entry of the little guys (sperm)
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| Cervical Mucus consistency during ovulation | cervical mucus is thin and clear. It looks, feels, and stretches like egg white.
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| Menstrual blood and prostaglanding levels: | Menstrual blood is a potent prostaglandin source.
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| climacteric | transitional phase during which ovarian function and hormone production decline.
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| Menopause | Last menstrual period
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| 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.
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| Sexual Response | divided into four phases: excitement phase, plateau phase, orgasmic phase, and resolution phase.
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