Obstetrical & Gynecologic (test 1) Flashcards
1
Q
Amino -
A
Amniotic
2
Q
Cervic/o
A
Cervix
3
Q
Cop/o
A
Vagina
4
Q
Could/o
A
Could de sac /retrouterine pouch
5
Q
Fet/o
A
Fetus
6
Q
Gon/o
A
Gonad/ ovaries
7
Q
Gynec/o
A
Woman/ female
8
Q
Hyster/o
A
Uterus
9
Q
Lapar/o
A
Abdomen
10
Q
Mamm/o
A
Breast
11
Q
Mast/o
A
Breast
12
Q
Men/o
A
Menstruation/ mensus
13
Q
Metr/o
A
Uterus
14
Q
Myom/o
A
Muscle/ myometrium
15
Q
Nat/l
A
Birth
16
Q
Oophor/o
A
Ovaries
17
Q
Ovar/o
A
Egg/ ovum
18
Q
Par/o
A
to give birth
19
Q
Salping/o
A
Fallopian tubes
20
Q
Uter/o
A
Uterus
21
Q
Vagin/o
A
Vagina
22
Q
Vulv/o
A
Vulva
23
Q
Abortion
A
premature loss or expulsion of an embryo or fetus
spontaneous or induced
24
Q
Amnion
A
one of four extraembryonic membrane, surrounds developing embryo or fetus
25
Chorion
Blood vessels form, first step in functional placenta, platform between mother and fetus for nutrients, oxygen, and waste
26
Embryo
development stage week 1-8
27
Fertilization
gametes (egg and sperm) form zygote
28
Fetus
week 9 to birth
29
Gestation
period of intrauterine development
30
Gravity
of pregnancies
31
Implantation
attachment of blastocyst into endometrium of uterine wall
32
Parity
of births, viable births
(20 weeks gestation)
33
Placenta
structure permits diffusion between fetal and maternal circulatory systems
34
Premature
Born before 37 weeks
35
Vulva
External
all structure that make up female genitalia
36
Labia
external
majora- outside skin
minora- inside skin
37
Clitoris
external
short sensitive erectile tissue
38
Vestibule
external
area between urethra and vagina
39
Vagina
Internal
entry into female
40
Perineum
external
area between vagina and anus
41
Glands (2 types)
Internal
Skene's- paraurethral (upper)
Bartholin's- greater vestibular (lower)
42
What are the phases of the menstrual cycle?
28 days in length
Menstrual phase
Proliferation/ Follicular phase
Secretory/ Luteal phase
Progestational/ Ischemic phase
43
Ovaries
Internal
hormone production- estrogen and progesterone
Oocyte formation
Ovarian ligament keeps in place
44
Fallopian tubes
Internal
conduct release of ovum from the ovary to the uterusU
45
Uterus
Internal
protects, nourishes, and removes waste for embryo and fetus
46
What are the parts of the Uterus?
Fundus -top
Corpus/ Body- middle
Cervix-lowest
Ligaments- suspend uterus in place
47
What are the four types of ligaments?
Round
Broad (batwing)
Cardinal
Uterosacral (uterus to sacrum)
48
What are the three uterine layers?
Endometrium- highly vascular
Myometrium- thick muscular
perimetrium- outer layer
49
What do the umbilical veins do?
moves oxygenated blood
50
What do the umbilical arteries do?
move deoxygenated blood
51
What is the foramen ovale?
right and left atrium
closes when born
52
What is the patent ductus arteriosus?
pulmonary artery and aorta
blood bypasses the lungs
fetus doesn't breathe air
closes when born
53
What history should be ascertained?
obstetric history
menstrual
contraceptives
medical
surgical
social (sexual)
54
What instrument is used for physical inspection?
Graves bivalve speculum
55
What does bimanual mean?
one hand on abdomen and one hand in vagina
56
What does rectovaginal mean?
one finger in anus and one in vagina
57
What is inspected in a gyno visit?
external genitalia
vagina
cervix
pelvis
58
What is palpated in an examination?
cervix
uterus
adenexa (ovaries, fallopian tubes, and broad ligaments
59
What laboratory tests can be completed?
pregnancy
urinalysis
complete blood count (RBC, WBC, Hgb-hemoglobin- O2, Hct- hematocrit- red cells, and platelets)
Erythrocytes
blood chemistry
60
What is amenorrhea?
Absence of menstruation
61
What is dysmenorrhea?
Painful or difficult menstruation
62
What is menorrhagia
Excessive bleeding during menstruation
63
What is metrorragia?
Active uterine bleeding at times other then during menstruation
64
What is endometriosis?
Tissue implants outside of the uterus
Pain in abdomen during menstrual cycle
65
S/s of cervical cancer
Early- asymptomatic
Later- abnormal bleeding after intercourse- metrorrhagia
66
S/s of ovarian cancer
High mortality rate
Heavy menses, palpable abdominal mass
67
S/s uterine cancer
Watery discharge, menorragia
Dx- D&C
68
S/s of vulvar cancer
Menorrhagia, itching
69
What are 2 types of herniations?
Cystocele- bladder
Rectocele- rectum
Prolapse is another term
70
S/s of uterine prolapse
Weak pelvic support
Pain, incontinence, menstrual interruption, fertility problems
71
What is another name for a fibroid tumor?
Where are the 3 locations of fibroids?
Leiomyoma uteri
Originates in myometrium
Usually benign
Only removed if cause of pain
On fibrous connective tissue
Intramural (middle)
Submucosal (inner)
Subserous (outer)
72
What is an ovarian cyst?
Fluid filled sac attached to ovary
S/s unexplained pelvic pain, palpable mass
73
What is an ovarian torsion?
Ovary or fallopian tube twist on itself
Emergency- no blood supply
74
What is PID?
Pelvic inflammatory disease
STD (gonorrhea or chlamydia) migrated to fallopian tubes, uterus, and ovaries
Can cause adhesions, sterility, ectopic pregnancy
S/s lower abdominal pain, malaise, fever, purulent vag discharge
Tx- antibiotics
75
What is toxic shock syndrome?
Rare life threatening complication of bacterial disease infection
Recent surgery, open wounds, menstrual cups, tampons
Can spread to kidneys, CNS, gi system, hematologic system, CV system
S/s high fever low bp, vomit, diarrhea, rash on palms and soles
Tx- antibiotics, surgery
76
What are the 2 incisional approaches?
Abdominal and vaginal
77
What is the abdominal incision?
Vertical incision- midline or paramedics
Transverse incision-
30x stronger best cosmetic results, can compromise nerves,
Limits abdominal access,
78
What are the 3 types of transverse incisions?
Pfannenstiel
Marylard
Cherney
79
What is the vaginal incision?
Episiotomy
Can be straight from vagina to anus or at a 45 degree angle
80
What is cytology?
Exam of cells from fluid specimens
Pap smear- scrape cervix & endocervical tissue
Dx presence of cervical dysplasia
Endocervix and ectocervix
81
What is colposcopy?
Suspected carcinoma in-situ of cervix
Use binocular microscope
Many specimens taken
DO NOT prep patient
82
What is a colpotomy?
Incision into posterior cut-de-sac (vaginal wall)
Intraperitoneal palpation
Inspection pelvic organs
Determination of free fluid, blood, or pus You n pouch of Douglas
83
What is a culdoscopy?
Endoscopic exam of pelvic organs and structures
Small induction into posterior cut-de-sac
Investigate- unexplained pelvic pain, pelvic masses, ovarian disorders, infertility
84
What is culdocentesis?
Fluid removal- specimen- from posterior cul-de-sac
Spinal needle used
Dx- suspected ectopic pregnancy
85
What is Schillers test?
Vaginal vault and cervical squamous epithelium stained with Lugol’s solution- iodine based
Normal tissue -brown
Abnormal tissue- no stain
Biopsy on abnormal tissue
DO NOT prep patient
86
What is a biopsy punch?
Removes small pieces of tissue
Cervical biopsy forceps
(Look like the kerrisons)
87
What is LEEP?
Loop electrosurgical excision procedure
Excision of cone of tissue from cervix
Remove cancer lesion or obtain tissue bx
88
What is conization of cervix?
Aka cold knife biopsy
Dx or tx of cervical dysplasia
Lugol’s or acetic acid to stain tissue
Biopsy taken with colposcope and biopsy punch, ESU, blade, or LEEP
Multi sections examined
Excision of cone from cervix
89
What is Rubin’s test?
Aka- utero tubal insufflation
CO2 introduce to cervical canal
Checks patency of fallopian tubes
90
What are some indications of a hysteroscopy?
abnormal bleeding
locate and remove IUD
evaluation of infertility
Dx of pathologies
Tx of pathologies
91
What are some complications of a hysteroscopy?
perforation of the uterus
injury to intestines
injury to urinary tract
injury to uterine vessels
intravasation- absorption into body
92
What 5 solutions can be used and a hysteroscopy?
Which one is non-conductive?
1.5% Glycine
Dextran
Sorbitol *non-conductive*
0.9% NSS
Lactated ringers
93
What is a hysterosalpingography?
insertion of contrast into cervical canal
structure and function of uterus and tubes
can evaluate fertility
94
What is chromotubation?
determines patency of fallopian tubes
Methylene blue mixed with NSS
95
What areas of the body are seen in a laparoscopy/ Pelviscopy?
peritoneal cavity
pelvic anatomy
through anterior wall
96
Why are laparoscopy and pelviscopies performed?
unexplained pelvis pain
pelvic masses
ovarian disorder
infertility
97
What are some need to knows about a uterine manipulator?
usually placed before procedure
canula
*change gloves after placement and before procedure*
cannula and cone together makes up the instrument
98
What happens in a uterine curettage D&C?
tissue obtained for histogy
endocervical and endometrium tissues sent as specimens
99
What happens in a D,C, and E?
Dilation, curettage, and evacuation- remove tissue and products from conception
use curettes 7mm to 12mm
*keep machine covered till patient is under*
100
What are the 5 types of abortions?
Missed-
Incomplete-
Imminent-
Spontaneous-
Voluntary interrupted-
101
What are the 2 types of cervical cerclage techniques?
Shirodkar- closes the Internal Os
Macdonald- closed the outer Os
Tx of incompetent cervix- wont stay closed during pregnancy
Suture stays in place until vaginal delivery
102
What is Brachytherapy?
Internal radiation therapy
Tx cervical or endometrial malignancies
low or high dose
material placed in uterus or vagina
hospital stay 1-3 days, special precautions
103
What is endometrial ablation?
What 2 ways are used to perform procedure?
destroying of the uterine lining
Intrauterine thermal balloon kit- HOT H2O
or Novasure- electricity
104
What is a myomectomy?
removal of uterine muscle fibroids; without removing the uterus
105
What is a uterine fibroid embolization?
catheter placed in uterine arteries, small particles injected to block the branches, cuts off blood to the fibroids.
polyvinyl alcohol- course sand
gelatin sponge- gelfoam
microspheres
local anesthesia
106
What is an abdominal hysterectomy?
removal of uterus and cervix through an abdominal incision
107
What 4 ligaments are ligated in an abdominal hysterectomy?
Cardinal (posterior and anterior)
Uterosacral
Round
Broad
108
What is a subtotal hysterectomy?
removal of uterus
cervix stays
109
What is a vaginal hysterectomy?
removal of uterus through incision in vaginal wall and abdominal cavity
Auvard speculum used
indication of prolapsed uterus
110
What is an LAVH?
laparoscopic assisted vaginal hysterectomy-removal of uterus through vagina
endoscope used
if patient has endometriosis, nulliparity (no kids), pelvic adhesions
2 set ups usually
111
What is a robotic-assisted Hysterectomy?
LAVH and robot
112
What is a Wertheim-Meigs radical hysterectomy?
dissection and removal of all pelvic lymph nodes
removal of uterus, tubes, ovaries, ligaments, and upper vagina
113
What is a pelvic exenteration?
TX for persistent cancer
can tX vulvar, vaginal, rectal, endometrial cancer
complete removal of rectum, distal sigmoid colon, urinary bladder, internal iliac vessels, reproductive organs, lymph nodes, pelvic floor and peritoneum, levator muscles, and perineum
114
Define salpingectomy
removal of fallopian tubes
115
Define oophorectomy
removal of ovary
116
Define salpingoophorectomy
removal of fallopian tubes and ovaries
117
What is an ectopic pregnancy?
implantation in the fallopian tube
emergency surgery needed
risk factors:
history of PID
previous ectopic pregnancy
pregnant following sterilization
previous tubal reconstruction
IUD
infertility
118
What is a tuboplasty?
repair of the fallopian tubes
dilate with a balloon; free adhesions
repair with a suture
119
What is labiaplasty
Tx of protruding labia
120
What is a perineal laceration and what are the 4 degrees?
Tx of vaginal tear from childbirth, trauma
1st- vaginal mucosa torn
2nd- perineal muscles torn
3rd anal sphincter torn
4th rectum torn
121
What is a vulvectomy?
Tx of carcinoma of vulva
removal of labia majora, labia minora, glans clitoris, inguinal & pelvic lymph nodes
122
What is ablation of condyloma?
removal of genital warts with laser
*wear N95 mask*
123
What is marsupialization of Bartholin's glands?
removal of a cyst
pouch is sutured open
124
What is a colpcleisis procedure?
closing of the vagina
Tx of uterine prolapse
for women who are not sexually active
125
What is a fistula?
opening between the vagina and another space
Tx is anterior or posterior repair
126
What is a rectovaginal fistula?
opening between vagina and rectum
127
What is a vesicovaginal fistula?
opening between vagina and bladder
128
What is a vesicouterine fistula?
opening between vagina and uterus
129
What is a urethrovaginal fistula?
opening between the vagina and urthra
130
What is a colporraphy?
repair of weakness in the vagina walls
removal of excess tissue
Tx vaginal fistula, uterine prolapse
131
What is a cesarean section (c-section)?
removal of fetus through abdomen
scheduled or emergent
-count when uterus id closed
Pfannenstiel incision
132
How is baby delivered in a c-section?
head first
133
what is immediate action when baby is first delivered
suction the airway
134
What is the most significant cause of morbidity during a c-section?
anesthesia problems
135
What retractor is used during a c-section?
Balfour or DeLee
136
What is the most common reason for a c-section?
cervix will not dilate
137
What is cephalopelvic disproportion (CPD)?
mothers pelvis is to small for fetus head
138
What are 3 abnormal presentations of the fetus?
Breech- butt first
Transverse- fetus cross-wise
footling- feet first
139
What is abruptio placenta?
placenta separates prematurely from wall of uterus
140
What is placento previa?
placenta implanted on uterine segment- abnormally
covering os cervix
141
Can the cervix have cancer?
yes carcinoma of cervix
142
What is disseminated intravascular coagulation(DIC)?
serious emergency
coagulopathy-heavy bleeding
overstimulation of clotting and anticlotting process
seen in abruptio placent
143
What is preeclampsia?
sudden hypertension, albuminuria, and edema of hands, feet, and face
144
What is nochal cord?
umbilical cord wrapped around fetus neck
145
What does APGAR stand for?
Appearance, Pulse, Grimace, Activity, and respiration
146
What are the three levels of the APGAR scoring?
0-3 severely depressed
4-6 moderately depressed
8-10 good
147
What anelgesics are used in OB/GYN?
Lidocaine- numb cervix
Meperidine hydrochloride/Demerol- during c-section
148
What is acetic acid 3% used for?
remove mucous
facilitate visualization of cervix in colposcopy
149
What anti-infection cream is used?
Sulfa- vaginal packing
cauterize or laser ablations
150
What is methylene blue/ indigo carmine used for?
check for tubal patency
verify uterus not injured
151
What is the Lugols solution used for?
What is the name of the test?
Schiller's test
purple iodine
normal tissue turns brown
abnormal no change
152
What oxytocics are used?
Pitocin- stimulates uterus to contract
153
What lasers can be used in OB/GYN?
carbon dioxide
Holmium: YAG
wear proper PPE: glasses and mask
154
When doing a vaginal & abdominal procedures, which one is done first?
Diagnostic will be done first (D&C and TAH)
if both nondiagnostic (TAH and A&P repair)
155
What are some Special considerations when patient is catheterized?
prevents bladder distention
decompresses to prevent injury
can record urinalysis
bag checked for blood
156
