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Physical Assessment > Female Genitalia > Flashcards

Female Genitalia Flashcards

1
Q

Things to avoid prior to exam

A

Intercourse

douching or suppositories 24 to 48 hours prior

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2
Q

Prep for exam

A

-raise head and shoulder with pillow, bed
-empty bladder
-arms down or crossed
-warn the pt!!!
lithotomy position: with buttocks beyond edge of bed and hips flexed, abduted and externally rotated

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3
Q

Tanner stages

A

1: no pubic hair
2. few dark hairs on labia (straight)
3. some pigmented hairs across pubes (curly)
4. has not spread to thighs
5. adult: spread to inner thighs

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4
Q

Nulliparous vs. multiparous cervix

A

nuliparous external os is a small circular opening, multiparous is slit shaped because of previous childbirths

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5
Q

Nabothian cyst location, prognosis

A

located on the cervix, normal variant

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6
Q

Papsmear screening

A
  1. within 3 years of first intercourse
  2. annually until 30 yo
  3. > 30 with 3 consecutive normal papsmear, do every 2-3 years
  4. continue in hysterectomy patients
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7
Q

What are you sampling in a papsmear?

A

Translocation junction or external os of cervix

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8
Q

What cells are located in the translocation junction? Ectocervix and endocervix

A

Ectocervix: simple squamous
Endocervix: columnar cells

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9
Q

What is the name of the system you retrieve results for PAPsmears

A

BETHESDA (CIN) system

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10
Q

What does CIN stand for?

A

Cervical Intraepithelial neoplasia

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11
Q

CIN 1

A

within normal limits
atypical squamous cells of undetermined significance (ASC-US)
mild dysplasia Low grade squamous intraepithelial lesion (LGSIL)

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12
Q

CIN2

A

high grade squamous intraepithelial lesion (HGSIL)

Moderate dysplasia

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13
Q

CIN 3

A

HGSIL with severe dysplasia or carcinoma in situ

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14
Q

In what direction do you insert the speculum

A

Obliquely

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15
Q

Which finger is placed in the anal canal for the rectovaginal exam

A

middle finger, feel wall for abnormal thickness in infection, fistula and malignancy

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16
Q

What is palpated in the bimanual exam

A 
fallopian tubes (adnexa)
pelvic side walls for nodularity of ovaries
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17
Q

What is the purpose of the bimanual exam?

A 
check the uterus for:
size
position
shape
contour
mobility
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18
Q

Where can adenocarcinoma arise from?

A

endocervix endometrium and extrauterine sites

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19
Q

AGC and treatment

A

atypical glandular cells

tx:colposcopy with our without biopsy

20
Q

HPV

A

human papillomavirus

21
Q

what does HPV infect

A

keratinocytes of skin and mucus membranes

22
Q

How is HPV transmitted

A

genital contact

23
Q

What is the leading cause of cervical cancer

A

HPV

24
Q

Who gets the HPV vaccine

A

before sexual activity begins

25
Q

What strains does the HPV vax cover

A

6, 11, 16, 18

26
Q

Anteverted uterus

A

normal position (anteriorly)

27
Q

retroverted uterus

A

body of the uterus and the cervix are tilted backwards

28
Q

Retroflexion of uterus

A

backward angulation of body of uterus in respect to cervix, cervix unmoved

29
Q

pH of bacterial vaginosis

A

> 4.5 (basic)

30
Q

Cause of bacterial vaginosis

A

imbalance of bacterial flora, may or may not be STI

31
Q

d/c of bacterial vaginosis

A

grey/white

32
Q

Diagnosis of bacterial vaginosis

A 
clue cells (bound to bacteria) 
positive whiff test
33
Q

pH of trichhomonal vaginitis

A

> 4.5

34
Q

infections with pH <4.5

A

Yeast

35
Q

Infections with pH >4.5

A

Bact Vaginosis, trichomonas, gonorrhea

36
Q

Cause of Trichomonal vaginitis

A

STI

Trichomonas vaginalis

37
Q

Discharge of Trich

A

greenish/white

38
Q

signs of trich

A

strawberry cervix, protozoa

39
Q

pH of yeast infection

A

<4.5

40
Q

discharge of yeast infection

A

thick white with itching and burning

41
Q

Lab of yeast infection

A

hyphae in KOH

42
Q

Colposcopy

A

illuminate cervix to take punches (biopsy)

43
Q

pH of gonorrhea

A

> 4.5

44
Q

Discharge of gonorrhea

A

green/yellow with pruritus

45
Q

PAP smear guidelines- NEW!
65
Hysterectomy
HPV vaccinated

A 
under 21, don't do
21-29: cytology every 3 yr
30-65: cytology every 3 years or co-testing (HPV and cytology every 5 yr)
>65: don't do unless prior concerns
Hysterectomy: don't do unless HGSIL
HPV vax: continue to screen

Physical Assessment (4 decks)

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