Lecture 9: Approach to Reproductive Topics Flashcards
What is puberty?
Developmental stage characterized by transition from sexual immaturity to sexual maturity
What is gonadarche activation?
Stimulation of gonads by FSH and LH from anterior pituitary
What is adrenarche?
Increase in androgen production by adrenal cortex
What is thelarche?
Development of breast tissue due to estrogen from ovaries
What is menarche?
First menstrual cycle
What is spermarche?
First sperm production
What is pubarche?
Pubic hair development
When do females normally undergo puberty?
What is developing then?
Ages 10-14
- breast/areolar development
- menarche
When do males normally undergo puberty?
What is developing then?
Ages 11-16
- penile growth
- pubic hair development
What are the Tanner stages for the development of external genitalia in boys?
Stage 1: Prepubertal
Stage 2: Enlargement of testes and scrotum (scrotal skin reddens and changes in texture)
Stage 3: Enlargement of penis lengthwise and growth of testes
Stage 4: Increased size of penis and development of glans; testes and scrotum larger, scrotal skin darker
Stage 5: Adult genitalia
What are the Tanner stages for the development of breast development in girls?
Stage 1: Prepubertal
Stage 2: Breast bud stage w/ elevation of breast and papilla, enlargement of areola
Stage 3: Further enlargement of breast and areola - no separation of their contour
Stage 4: Areola and papilla form a secondary mound above level of breast
Stage 5: Mature stage: projection of papilla only
What are the Tanner stages for the development of pubic hair in both boys and girls?
Stage 1: Prepubertal (vellus hair)
Stage 2: Sparse growth of long, slightly pigmented hair at base of penis or labia
Stage 3: Darker, coarser, curlier hair sparesley over junction of pubes
Stage 4: Hair adult in smaller area
Stage 5: Adult hair with horizontal upper border
What should be included in a menstrual history?
Age of menarche
Duration: how many days each period lasts
Flow: heavy/light
Cycle: length of each menstrual cycle
What should be included in a gynecologic history?
Breast history Last mammogram GYN surgeries Infertility Last pap smear
What should be included in an obstetrical history regarding pregnancies?
Gravida: number of pregnancies Para: number of viable births/offsprings -T: Term deliveries (>37 weeks) -P: Preterm deliveries (20-37 weeks) -A: Abortion (<20 weeks) -L: Live delivery regardless of gestational age
What would be the obstetrical history of a patient who had 6 pregnancies: 1 spontaneous abortion at 17 weeks, 2 fetal demise at 22 and 23 weeks?
G6P3213
What would be the obstetrical history of a patient who had one pregnancy and twins born at 38 weeks?
G1P2
What is other information that should be noted in an obstetrical history?
Mode of delivery Gestational age at delivery Maternal complications Fetal complications Delivery/operative complications
What is information that should be noted in a contraceptive/sexual history?
Contraception methods Currently sexual active Number of partners New partners in last 3 months Condom use History of sexual abuse
At what age should women get pap smears?
Ages 21-65
How often should women get pap smears?
Yearly: abnormal pap smears
Every 3 years: normal pap smears
Every 5 years: normal pap smears with negative HPV testing
What is the purpose of a pap smear?
Screen for cervical cancers
-mostly caused by HPV
Where is a sample taken in a pap smear?
Ectocervix
Endocervix
Transitional Zone: between original and new SCJ
Squamocolumnar Junction (SCJ)
What is the most important area to take a sample when testing for cervical cancer?
Transitional zone
