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Genitourinary > Ch 6 Physical Exam of the Female Genitalia > Flashcards

Ch 6 Physical Exam of the Female Genitalia Flashcards

1
Q

Amenorrhea

A

Absent menstrual cycle

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2
Q

The Vulva, External female genital organs include:

A

Mons pubis

Labia majora

Labia minora

Clitoris

Vaginal Vestibule

Vaginal Orifice

Urethral opening

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3
Q

Primary center of sexual excitement

A

Clitoris

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4
Q

In the labia minor is a vestibule containing the:

A

Urethra

Vagina

Skene glands

Bartholin glands

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5
Q

Bartholin glands, located posteriorly on each side of the vaginal orifice, open onto the sides of the vestibule in the groove between the:

A

Labia minora and the hymen

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6
Q

During sexual excitement, what glands secrete mucus into the introitus for lubrication?

A

Bartholin glands

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7
Q

The vagina inclines:

A

Posteriorly

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8
Q

Musculomembranous tube that is transversely rugated

A

Vagina

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9
Q

Anterior wall of the vagina is separated from the bladder and urethra by the ________ septum

A

Vesicovaginal septum

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10
Q

The posterior wall of the vagina is separated from the rectum by the ______ septum

A

Rectovaginal

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11
Q

Pelvic organs may be palpated through pockets around the cervix called:

A

Fornices

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12
Q

The nonpregnant uterus is usually positioned anteroposteriorly and weighs:

A

60-90 g

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13
Q

The uterus is divided anatomically into the:

A

Corpus and cervix

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14
Q

The uterine corpus consists of the:

A

Fundus

Body

Isthmus

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15
Q

Convex upper portion between the fallopian tubes

A

Fundus

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16
Q

Main portion of the uterine corpus

A

Body

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17
Q

Constricted lower portion adjacent to the cervix

A

Isthmus

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18
Q

The cervix extends from the _____ into the vagina

A

Isthmus

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19
Q

The adnexa of the uterus are composed of the:

A

Fallopian tubes

Ovaries

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20
Q

Pair of oval organs resting in a slight depression on the lateral pelvic wall at the anterosuperior iliac spine

A

Ovaries

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21
Q

What controls the menstrual cycle and supports pregnancy?

A

Ovaries

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22
Q

The internal genitalia are supported by what ligaments?

A

Cardinal

Uterosacral

Round

Broad

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23
Q

Prolonged menses is defined as greater than how many days?

A

> 7 days

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24
Q

The pelvis is formed by what four bones?

A

2 Innominate

Sacrum

Coccyx

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25
Q

What are the four pelvic joints?

A

2 Sacroiliac joints

Symphysis pubis

Sacrococcygeal

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26
Q

What contributes to the strengthening and elasticity of pelvic ligaments and softening cartilage?

A

Increased levels of the circulating hormones Estrogen and Relaxin

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27
Q

Later in pregnancy the symphysis pubis _______

A

Separates

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28
Q

Shallow upper section of the pelvis

A

False pelvis

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29
Q

Lower curved bony canal of the pelvis

A

True pelvis

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30
Q

Term pregnancy is longer than ___ weeks

A

37 weeks

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31
Q

Infant/Child

The cervix is ______ of the entire length of the uterus

A

Two-thirds

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32
Q

Infant/Child

Thin covering inside the introitus, giving the vaginal opening a crescent-shaped appearance

A

Hymen

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33
Q

During childhood, what part of the genitalia does not grow incrementally at varying rates?

A

Clitoris

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34
Q

Adolescents

If the hymen is intact, the vaginal opening is __ cm

A

1 cm

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35
Q

Average age of menarche

A

11-14

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36
Q

Pregnant women

Muscular walls become more elastic, and the uterus rises out of pelvis into the abdominal cavity by __ weeks of gestation

A

12 weeks

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37
Q

Pregnant women

Uterine weight at term, excluding the fetus and placenta

A

1000 g

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38
Q

Pelvic congestion and edema during pregnancy occur from:

A

Increases in blood volume

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39
Q

The cervix becomes bluish during:

A

Pregnancy

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40
Q

“Waddle gait” is due to:

A

Pelvic joint separation

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41
Q

Pregnant women

The papillae of the mucosa have a ______ appearance

A

Hobnailed

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42
Q

Ovarian function diminishes around age ___

A

40

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43
Q

Menopause occurs between:

A

40 and 55 years of age

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44
Q

Ovulation ceases about how long prior to menopause

A

1-2 years

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45
Q

Menopause is conventionally defined as:

A

1 year with no menses

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46
Q

After menopause, women experience an increased risk of:

A

Cardiovascular disease

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47
Q

Prescribed to reduce the impact of menopausal symptoms and sequalae

A

Hormone replacement (estrogen with or without progestin)

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48
Q

Examination:

Patient expresses what before an examination may be a sign that something is not quite right

A

Marked anxiety

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49
Q

Patient should have an empty ______ during exam

A

Bladder

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50
Q

Examination position.

Supine with knees bent, legs spread apart, and feet placed in metal stirrups at the foot of the exam table

A

Lithotomy

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51
Q

Woman lies on her back with her knees bent so that both legs are spread flat and her heels meet at the foot of the table

A

Diamond-shaped position

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52
Q

Obstetric stirrups support the legs under the:

A

Knee

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53
Q

Woman lies on her back, knees bent and apart, feet resting on the exam table close to her buttocks

Does not require the use of stirrups

A

M-Shaped Position

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54
Q

The woman lies on her back with her straightened legs spread out wide to either side

A

V-position

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55
Q

Which variable position allows the women to place one foot in the stirrup and one leg straightened?

A

V-Shaped position

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56
Q

Women with sensory impairment may do what during exam?

A

Elevate the head to see the clinician

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57
Q

Length of the clitoris

A

<2 cm

58
Q

Glands that are milked during exam to look for discharge and note any tenderness

A

Skene glands

59
Q

Glands that are palpated to look for discharge, swelling that is painful, hot to touch indicates an abscess

A

Bartholin glands

60
Q

Bartholin gland abscess are usually what in origin?

A

Gonococcal

Staphylococcal

61
Q

Bulging of the anterior wall and urinary incontinence indicate the presence of a:

A

Cystocele

62
Q

Bulging of the posterior wall indicates a:

A

Rectocele

63
Q

Marked by protrusion of the cervix or uterus on straining

A

Uterine prolapsed

64
Q

Use ______ to inspect cervix and vaginal walls

A

Speculum

65
Q

Lubricate the speculum with:

A

Water or water-soluble lubricant

66
Q

Used to warm a cold speculum

A

Water

67
Q

Slowly insert the speculum along the path of _________

A

Least resistance

often slightly downward

68
Q

Inspect the cervix for:

A

Position

Size

Surface characteristics

Discharge

Size and shape of the Os

69
Q

A cervix pointing anteriorly indicates a:

A

Retroverted uterus

70
Q

A cervix pointing posteriorly indicates an:

A

Anteverted uterus

71
Q

Deviation of the cervix to the right or left may indicate a:

A

Pelvic mass

Uterine adhesions

Pregnancy

72
Q

Vaginal smears and cultures from a pelvic exam

A

PAP smears

Gonococcal

Chlamydia and Gonorrhea DNA Probe

Wet Prep

KOH

73
Q

The ovaries if palpable should feel:

A

Firm, smooth, ovoid

74
Q

Rectovaginal exam allows the provider to reach ____ higher into the pelvis

A

2.5cm (1 inch)

75
Q

After hymen tears, ______ may be visible

A

Hymen tags

76
Q

Uterus is usually flattened and anteroposterior at a __-degree angle

A

45-degree angle

77
Q

The perineum is ________ in multiparous women

A

Thinner and more rigid

78
Q

Perineum is more thick and smooth in ______ women

A

Nulliparous women

79
Q

Pale cervix suggests:

A

Anemia

80
Q

Os of nulliparous women may be_____

A

Small, round, oval

81
Q

Os found in ______ women may be more horizontal, irregular, or stellate

A

Multiparous

82
Q

External labia swelling, pain, warmth, and redness may mean:

A

Bartholin gland abscess

83
Q

In newborns, labia majora are separate and clitoris is prominent up to ___ weeks of gestation

A

36 weeks

84
Q

Newborn

Hymen often protrudes and central opening is about __cm

A

0.5 cm

85
Q

Newborns

Genitalia may be swollen and bruised for many days from:

A

Breech delivery

86
Q

Mucoid whitish vaginal discharge may be seen from birth to 1 month of age as a result of:

A

Hormonal transfer in utero

87
Q

Internal vaginal exam is performed on a young child only when there is a specific problem such as:

A

Bleeding, discharge, trauma, or sexual abuse

88
Q

Infants

Vaginal discharge problems should be assessed for possible relationship to use of:

A

Diapers, powders, or lotions

89
Q

Infants/Children

Swelling of vulvar tissues with bruising suggests:

A

Sexual abuse

90
Q

Enlarged clitoris in newborn suggests:

A

Adrenal hyperplasia

91
Q

In children a foul odor is more likely indicative of a:

A

Foreign body

92
Q

All ______ teenagers should have an annual pelvic exam, pap smear, and STI evaluation

A

Sexually active

93
Q

Young women who are not sexually active should have their first exam by age:

A

21

94
Q

Vaginal secretions ______ before menarche

A

Increase

95
Q

By menarche, vaginal opening should be at least __ cm wide

A

1 cm

96
Q

Menstrual cycle characteristics may include:

A

Dysmenorrhea (painful periods)

Breast tenderness

Headaches

97
Q

Vaginal discharge (yellow, green, or gray) with odor suggests:

A

Infection

98
Q

Ulcers or vesicles may be from:

A

STI

99
Q

Urethral inflammation or dilation suggests:

A

Repeated UTIs

100
Q

Discharge from ____ glands suggests infection

A

Skene

101
Q

Regar sign

A

Softening of the isthmus

102
Q

Chadwick sign

A

Bluish cervix

103
Q

Cervical softening

A

Goodell sign

104
Q

The relationship of the presenting part of the ischial spines

A

Station

105
Q

The uterus may be more anteflexed (pressing more on the bladder) during:

A

First 3 months

106
Q

The uterus deviates at ____ weeks of gestation (Piskacek sign)

A

8-10 weeks

107
Q

Enlarged uterus suggests:

A

Pregnancy

Tumor

108
Q

With older adults, the cervix becomes:

A

Smaller, paler, and less mobile

109
Q

Premenstrual Syndrome (PMS) usually begins at what age?

A

Late 20s

110
Q

Characterized by edema, headache, weight gain and behavioral disturbances such as irritability, nervousness, dysphoria, and lack of coordination

Symptoms lasts 5-7 days

A

Premenstrual Syndrome

111
Q

Infertility is defined as:

A

Inability to conceive over a period of 1 year of unprotected regular intercourse

112
Q

Factors that cause infertility other than anatomical

A

Stress

Nutrition

Chemical substances

Certain Diseases/Sexual/Immunological responses

113
Q

Presence of growth of endometrial tissue outside the uterus causes pelvic pain, dysmenorrhea, and heavy or prolonged menstrual flow

A

Endometriosis

114
Q

Warty lesions on the labia from HPV.

Flesh-colored, whitish pink to reddish brown, discrete, soft growths and may form cauliflower-like masses

A

Condyloma Acuminatum

115
Q

Benign skin infection caused by poxvirus

Incubation period is 2-7 weeks

Dome shaped papules

A

Molluscum Contagiosum

116
Q

Lesions secondary syphilis appear about 6-12 weeks after infection

Flat, round, or oval papules covered by gray exudates

A

Condyloma latum

117
Q

A firm, painless ulcer

In women develop internally

A

Syphilitic chancre

118
Q

Small red vesicles

Lesions may itch and are painful and usually confined to a small localized patch on the vulva, perineum, vagina or cervix

A

Herpes

119
Q

Caused by gonococcal infection

Hot, red, tender, fluctuant swelling that may drain pus

Chronic inflammation results in a nontender cyst on the labium

A

Inflammation of Bartholin gland

120
Q

A hernial protrusion of the urinary bladder through the anterior wall of the vagina

Bulging can be seen as the women bears down

A

Cystocele

121
Q

Hernial protrusion, part of the rectum through the posterior wall of the vagina

A

Rectocele

122
Q

Findings include vaginal discharge, lesions, and masses

Vulva appears as ulcerated or raised red lesions on the vulva

A

Carcinoma

123
Q

A bright red polypoid growth that protrudes from the urethral meatus

A

Urethral carbuncle

124
Q

Watery discharge usually not foul smelling; dysuria, profuse frothy, greenish discharge

A

Trichomoniasis

125
Q

Purulent discharge from the cervix; skene/Bartholin inflammation

A

Gonorrhea

126
Q

Homogenous thin, white or gray discharge

Positive KOH with clue cells

A

Bacterial vaginosis

127
Q

Enlarged fluid-filled retention cysts that vary in size

A

Infected Nabothian cysts

128
Q

Bright red, soft and fragile arise from the endocervical canal

A

Cervical polyps

129
Q

Appear as shiny red tissue around the Os that may bleed easily

A

Columnar epithelium

130
Q

Result of weakening of the supporting structures of the pelvic floor, often occurring with a cystocele or rectocele

A

Uterine prolapsed

131
Q

In second-degree prolapse, the cervix is at the:

A

Introitus (opening)

132
Q

In third-degree prolapsed the cervix is:

A

Outside the introitus

133
Q

Are common, benign, uterine tumors that appear as firm, irregular nodules in the contour of the uterus

A

Myomas

134
Q

Growths that can occur unilaterally or bilaterally

Smooth in nature

A

Ovarian cysts

135
Q

Causes marked pelvic tenderness, with tenderness and rigidity of the lower abdomen

A tender, unilateral adnexal mass may indicate the site of pregnancy

Surgical emergency

A

Ruptured tubal pregnancy

136
Q

Pelvic inflammatory disease is often caused by:

A

Gonococcal or Chlamydial infection

137
Q

Inflammation or infection of the fallopian tube and associated with Pelvic inflammatory disease

A

Salpingitis

138
Q

Vaginal secretions that collect behind an imperforate hymen and manifested by small midline lower abdominal mass or small cyst between the labia

A

Hydrocolpos

139
Q

Vaginal discharge accompanied by warm, erythematous, and swollen vulvar tissue

A

Vulvovaginitis

140
Q

A loop of cord may advance with the presenting part

Usually occurs with rupture of the membranes

A

Prolapse of the umbilical cord

141
Q

Common during pregnancy and may involve both the vulva and rectal area. Pressure from the pregnant uterus contribute to the formation.

A

Vulvar varicosities

142
Q

Caused by lack of estrogen. Vaginal mucosa is dry and pale.

The accompanying vaginal discharge may be white, gray, yellow, green or blood-tinged.

A

Atrophic vaginitis

Genitourinary (8 decks)

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