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Advanced Health Assessment > Female Genitalia TEST 2 > Flashcards

Female Genitalia TEST 2 Flashcards

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1
Q

What positions can be used for pelvic examination?

A

Lithotomy
Knee Chest
Diamond
M
V
OB stirrups
Modified (Lateral)

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2
Q

What are the 4 components to the female genital exam?

A

External
Internal
Bimanual
Rectovaginal

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3
Q

What is assessed during an external female genital exam?

A

Mons (inspect and palpate)

Labia Majora (Inspect and Palpate)

Labia Minora (Inspect and Palpate)

Urethral Meatus (Inspect, palpate during bimanual)

Perineum (Inspect and Palpate)

Skene Glands (Inspect and Palpate during bimanual)

Bartholin Glands (Inspect and palpate)

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4
Q

What is assessed during an external Mons exam?

A

-Hair distributions
-Lesions
-Infestations

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5
Q

What is assessed during a Labia Majora exam?

A

-Hair distribution
-Lesions
-Symmetry
-Discharge
-Erythema
-Edema

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6
Q

What is assessed during a Labia Minora exam?

A

-Lesions
-Symmetry
-Discharge
-Erythema
-Edema

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7
Q

What is assessed during a Urethral meatus exam?

A

Discharge
Erythema
Edema
Fissure

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8
Q

What is assessed during a perineum/anal exam?

A

Tenderness
Fistulas
Growths
Lesions
Skin characteristics
Excoriations
Repairs
Hemorrhoids

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9
Q

What glands are assessed during an external female genital exam?

A

Skene Glands (during bimanual)
-discharge
-Erythema
-Edema

Bartholin Glands (only as needed)

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10
Q

What is assessed during the internal female genital exam?

A

Cervix

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11
Q

What do you assess during cervical exam?

A

Color (pink normal, pale post meno)
Position
Size
Surface
Discharge (clear likely ovulation)
Punctate (looks like strawberry)
Shape of OS
Lesions
Formation of cock’s comb or additional thickening of the upper (cervix shaped (loosely) like a roosters comb. Associated with neoplastic activity??

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12
Q

What specimens are collected during speculum exam?

A

Pap
Gonorrhea, chlamydia, HSV, HPV, Wet prep

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13
Q

What is assessed during the speculum vaginal exam?

A

Color (pink, pale after Meno)
Surface characteristics
Tone (cystocele or rectocele)
Discharge
Lesions

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14
Q

What is assessed during a bimanual exam?

A

Vagina
Cervix
Uterus
Adnexa

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15
Q

What is assessed during the vaginal bimanual exam?

A

Rugae
Tone
Tenderness
Lesions
Masses

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16
Q

What is assessed during the bimanual cervical exam?

A

Characteristics
Tone
Tenderness
Lesions
Masses
Length
Position
Mobility (if movement is painful infection suspected in pelvic region, chandelier test)

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17
Q

What is assessed during the Uterus bimanual exam?

A

Location
Position
Size
Shape
Contour
Mobility
Tenderness
Masses

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18
Q

What is assessed during the bimanual adnexa exam?

A

Ovaries and fallopian tubes

Size
shape
consistency
tenderness
masses

Generally nonpalpable when they are normal size shape. If they are it indicates they are enlarged.

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19
Q

What is assessed during a rectovaginal exam?

A

Sphincter tone
Recto-vaginal septum
Posterior uterus
Anterior and posterior rectal wall
-Collect any needed specimen

CHANGE GLOVE BEFORE, don’t take vaginal secretions into the rectum

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20
Q

What is condyloma Acuminatum? Symptoms? Cause?

A

Genital Warts

Soft, painless, wartlike lesions, flesh colored or whitish pink to reddish brown, may be in clusters or single.

HPV

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21
Q

What is Molluscum Contagiosum? Symptoms? Cause?

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A

Viral infection (STI though can be non-sexually transmitted in young children)

Painless lesions, white or flesh colored, some shaped papules round or oval. Surface has a characteristic central umbilication from which a thick creamy core can be expressed

Pox Virus - enters through hair follicles or broken skin. Can be transmitted via fomites.

22
Q

What is a syphilitic chancre? How is it identified? What stage?

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A

Lesion associated with primary syphilis

Painless genital ulcer, solitary lesion, firm, round, small, indurated borders with clear base.

Scrapings will show spirochetes microscopically

BACTERIUM TREPONEMA PALLIDUM

23
Q

What is condyloma latum? What causes it? How is it identified?

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A

Lesions of secondary syphilis

Flat, round or oval papules covered by gray exudate

24
Q

Where is the Bartholin gland? What does it do? What are the abnormal symptoms? What typically causes them?

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A

Gland on the lower labia minora

Secrete mucus for sexual lubricant

Inflammation, pain, swelling, hot, red, may drain pus. If chronic may be nontender

Commonly, but not always, caused by gonorrhoeae

25
What are the types of vaginal carcinoma? What are the symptoms/exam findings?
Squamous cell, adenocarcinoma, melanoma, sarcoma Abnormal vaginal bleeding Painful or difficult urination Pain during sex Pelvic, back or leg pain Leg edema Vaginal discharge/lesions/masses Melanoma tends to affect lower outer portion of the vagina Tumor of varied size/color/growth pattern Only diagnosed through biopsy
26
What are the types of vulvar carcinoma? What are the symptoms/exam findings?
Squamous cell, adenocarcinoma, melanoma, basal cell Lump/growth in vulvar area -ulcerated or raised lesion (typically on labia, vaginal opening) -dark colored lesion on clitoris or labia minora (usually melanoma) Patch of skin that is differently colored/textured Ulcer that lasts longer than 1 month Vulvar bleeding Mole change (melanoma) Persistent itching, pain, soreness, or burning in the vulva Painful urination Only diagnosed on biopsy
27
What are the types of cervical cancer? What are the symptoms/exam findings?
Squamous cell, adenocarcinoma Usually asymptomatic, generally no findings on exam If seen on exam: -Hard granular surface at or near the cervical OS -Lesion that has extensive irregular cauliflower growth that bleeds easily -Early cancer only detected via PAP
28
What is a myoma? What are the symptoms? Exam findings?
Leiomyomas/Fibroids/common benign uterine tumors Heavy menses Abdominal cramping (usually during mensuration) -Urinary frequency, urgency, and/or incontinence from pressure -Abdominal cramping from pressure on the small bowel -Pelvic and or abdominal discomfort On exam: firm, irregular nodules on bimanual uterine exam Uterus may be enlarged
29
What are the symptoms of endometrial cancer?
Post menopausal vaginal bleeding is #1!! only diagnosed via biopsy
30
What are the symptoms/exam findings of ovarian cancer?
-Suspect ovarian ca in >40 with persistent unexplained vague gastrointestinal symptoms such as generalized abdominal discomfort and/or pain, gas, indigestion, pressure, swelling, bloating, cramps, or feeling of fullness even after a light meal May have no findings on exam -Palpable ovary always suspicious after menopause -Premenopausal enlarged ovary
31
What typically causes pelvic inflammatory disease? What are the symptoms/exam finding of it?
gonorrhoeae and chlamydia unusual vaginal discharge (may have an odor) painful sex painful urination irregular menstrual bleeding pain in the upper abdomen Very tender adnexal areas, generally can not tolerate bimanual exam
32
What is hydrocolpos? What are the exam findings?
Distention of the vagina caused by accumulation of fluid due to congenital vaginal obstruction. Exam: -small midline lower abdominal mass OR small cystic mass between the labia
33
What is vulvovaginitis? What causes it? What are the symptoms/exam findings?
Inflammation of the vulvar and vaginal tissues Causes: -sexual abuse -trichomonal, monilial, or gonococcal infection -Secondary infection from foreign body -Non specific infection from bubble baths, diaper irritation, urethritis, injury or pinworm infection Subjective: -Parent report discharge on diaper/panties, abnormal vaginal odor, or redness of the vulva -May wipe from posterior to anterior, wear tight fitting synthetic underwear, or use vaginal irritants such as bubble bath Exam: Vaginal discharge Discomfort, pain, pruritis Vulvar irritation Burning urination Erythema Swollen vulvar tissue Bleeding vulva Bloody/foul smelling discharge may suggest vaginal foreign body (typically from young children experimentation)
34
What is atrophic vaginitis? What are the symptoms/exam findings?
Inflammation of the vagina due to the thinning and shrinking of the tissues, as well as decreased lubrication caused by lack of estrogen during perimenopause and menopause Vaginal soreness or itching Discomfort or bleeding with vaginal intercourse Pale/dry vaginal mucosa OR red with petechiae and superficial erosions Vaginal discharge may be white, gray, yellow, green or blood tinged, can be thick or watery and in various amounts though rarely profuse
35
What bony pelvic structure is an important landmark for evaluation of fetal station in a laboring patient?
Ischial spines
36
What parts are considered part of the labia minora?
Urethra Hymen Skene Glands Bartholin Glands
37
What structures are considered part of the bony pelvis?
Symphysis pubis Sacrum Ischial tuberosities
38
What signs would be present in a 5 year old who has been sexually abused?
-Fecal incontinence -Vaginal Bleeding -Unusual skin color changes in the perineum -Enuresis
39
What condition causes urethritis or spotting after intercourse?
Chlamydia
40
What condition is associated with frequent vaginal bleeding?
Endometriosis
41
What causes post menopausal bleeding?
Endometrial hyperplasia
42
What are the symptoms of ruptured tubal pregnancy?
Tachycardia and hypotension
43
What would you be likely to diagnose on an older woman with reddened vaginal mucosa and superficial erosions?
Atrophic vaginitis
44
What are causes of vulvovaginitis?
-Diaper irritation -Sexual abuse -Monilial infection (trichomonal, monilial or gonococcal infection) -Pinworm infection
45
What infectious agent would cause inflammation of the Bartholin gland?
Neisseria gonorrhoeae
46
What is Menometrorrhagia?
Irregular time interval between periods with excessive flow
47
What is Hypermorrhea?
Excessive flow during normal periods
48
What is polymenorrhea?
Menstrual cycle with less than 21 day intervals
49
What patient is at highest risk for developing ovarian cancer?
Post menopausal
50
What patient is at highest risk for developing endometrial cancer?
Polycystic ovarian syndrome patients
51
What symptoms are associated with menopause?
Itching Mood changes Sleep disturbances Dyspareunia
52

Advanced Health Assessment (22 decks)

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