Woman Exam Flashcards

1
Q

The female breast lies against

A

anterior thoracic wall

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2
Q

The female breast extends from

A

clavicle and 2nd rib down to the 6th rib and from the sternum across to the midaxillary line

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3
Q

What does the breast overlie

A

pectoralis major and the serratus anterior at the inferior margin

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4
Q

What is physiologic nodularity

A

uneven texture (granular, nodular, lumpy) in the adult breast that is normal

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5
Q

Where do most breast lymphatics drain

A

toward to axilla

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6
Q

What axillary lymph node is palpable most often

A

central nodes

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7
Q

Where does lymph drain

A

from the central axillary node to the infra and supraclavicular nodes

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8
Q

Where do malignant cells of breast cancer drain to

A

spread to infraclavicular nodes or into the internal mammary chain of lymph nodes

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9
Q

How often should a self breast exam be done and when?

A

once a month after age 20; 5-7 days after onset of menses; in the shower is best

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10
Q

Instructions for BSE supine

A
  • lying supine with pillow under right shoulder and right arm behind head
  • use finger pads of three middle finger of left hand to feel for lumps in the right breast
  • press firmly enough and firmest on tissue closest to chest and ribs
  • check entire area using up and down or circular pattern
  • Repeat on left side
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11
Q

Instructions for BSE standing

A
  • stand in front of mirror with hands pressed firmly down on hips, observe breasts for changes in size, shape, contour, dimpling, or redness or scaliness of nipple of breast skin
  • examine each underarm and with your arm only slightly raise so you can easily feel this area
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12
Q

What are provacative maneuvers in clinical breast exam

A
Patient seated for al the moves below:
arms at side
hands on hips
arms above head
hands pressed together and leaning forward
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13
Q

How do you inspect the breasts?

A

patient needs to be sitting

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14
Q

What is the best validated technique for palpation of the breast?

A

patient supine and vertical strip pattern

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15
Q

Findings consistent with malignancy

A
Hard consistency
Irregular shape
Dimpling of overlying skin
Associated retraction of nipple (inverted)
Non-tender
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16
Q

What characteristic is least suggestive of malignancy

A

Tenderness

17
Q

When palpating the central nodes, what is normal?

A

one or more soft, small (<1cm), non tender nodes

18
Q

When palpating the axilla, the patient should be?

A

In sitting position

19
Q

Abnormal central nodes

A

large, hard, tender

20
Q

What must you always do if you are male examining a female?

A
  • you must have a female assistant/chaperone
  • does not have to be nurse
  • should not be someone who came with person
21
Q

What if you are a female examining a female

A

female assistant/chaperone is optional but suggested

22
Q

What other scenario should you have an assistant?

A

examining and child or patient who is mentally or physically handicapped

23
Q

What do assistants do?

A
  • protect you against allegations or inappropriate conduct
  • expedite exam
  • make patient feel more comfortable
24
Q

Bulge of the upper 2/3 of the anterior vaginal wall and bladder

A

Cystocele

25
Q

Causes cystocele

A

Due to weakened supporting tissues

26
Q

Small, red benign tumor visible at the posterior part of the urethral meatus

A

Urethral caruncle

27
Q

Who gets Urethral caruncle

A

postmenopausal women and casues no sx

28
Q

How to assess urethral caruncle to determine if not a tumor

A

palpate the urethra through the vaginal wall for thickening, nodularity or tenderness and feel for inguinal lymphadenopathy

29
Q
  • Tense, hot, very tender abscess
  • Look for pus comingout of the duct or erythema around the duct opening
  • non-tender cyst felt
A

Bartholin gland infection

30
Q

Causes of Bartholin gland infection

A

trauma,gonocooi anaerobes (bacteriods and peptostrepto, chlamydia)

31
Q
  • Present when the anterior vaginal wall, bladder and urethra all involved in the bulge
  • A groove defines the border between urethrocele and cystocele, but is not always present
A

Cystourethrocele

32
Q

Forms a swollen red ring around the urethral meatus

A

Prolapse of urethral mucosa

33
Q

How to diagnose Prolapse of urethral mucosa

A

look for urethral meatus at center of swelling

34
Q

When does Prolapse of urethral mucosa

A

before menarche or after menopause

35
Q

Herniation of the rectum into the posterior wall or the vagina

A

Retrocele

36
Q

Cause retrocele

A

weakness of defect in the endopelvic fascia