Obstetrics And Gynecological Surgery Flashcards
(161 cards)
1
Q
Antepartum
A
Before delivery
2
Q
Effacement
A
Flattening and thinning of the cervix
3
Q
Engagement
A
Widest part of the fetus in the narrowest part of the mother’s pelvis
4
Q
Episiotomy
A
Incision in the perineum to facilitate delivery of the few us and avoid laceration
5
Q
Lightening
A
Descent of the fetus into the pelvis, usually occurs about 2 weeks before delivery.
6
Q
Lochia
A
Vaginal discharge after delivery
7
Q
Multiparous
A
Condition of a woman who has given birth to more than one child
8
Q
Preeclampsia
A
Toxemia of late pregnancy characterized by hypertension, edema, and proteinuria.
9
Q
Primigravida
A
First pregnancy
10
Q
Primiparous
A
A condition of a woman who has borne one child
11
Q
Quickening
A
First movement of the fetus felt by the mother
12
Q
Station
A
Presenting part of the fetus in relation to mother’s ischial spines, expressed in centimeters
13
Q
Where does fertilization usually take place?
A
Fallopian tube
14
Q
Where does implantation of the egg normally occur and when?
A
Implants in the funds (upper portion) of the uterus within 10 days.
15
Q
What does the placenta develop from?
A
Chorion (outer membrane of the zygote)
16
Q
Amnion
A
A sac that contains amniotic fluid that serves as a shock absorber for the developing fetus
17
Q
What does the amnion develop from?
A
The outer layer of the zygote.
18
Q
Chloasma
A
Brownish pigment
19
Q
Amenorrhea
A
Ovulation and menstural flow ceases.
20
Q
Describe the seven changes that occur during pregnancy.
A
- Uterus and breast enlarge
- Lines Alba becomes lines nigra
- Cervix becomes soft and bluish
- Chloasma of the face
- Amenorrhea
- Urinary frequency, nausea, vomitting, and general fatigue
- Pregnancy confirmed by HCG
21
Q
Induced labor is initiated by administration of?
A
Oxytocin (Pitocin)
22
Q
Braxton Hicks contractions
A
False labor, felt in the abdomen, with no cervical dilation, irregular, stopped by walking.
23
Q
The first stage of labor can be described by 5 things.
A
Regular contractions
Cervix extends to 10 cm
Effacement of cervix
Begin with ruptured membrane (gush of amniotic fluid)
May last 6 to 18 hr first time or 4 to 6 hr. Multiple birth
Vaginal bleeding
24
Q
A pregnant patient is encouraged to lay on what side? Why?
A
Left side to take pressure off the vena cava
25
If the fetal heart rate exceeds what or falls below what, the nurse should be notified.
160 or 100
26
The mothers blood pressure should not be higher than what?
140/90
27
What does APGAR stand for?
American Pediatric Gross Assessment Record
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What is assessed during APGAR score?
Respiratory rate, color, reflex response, heart rate, body tone at 1 and 5 minutes after birth.
29
What APGAR is considered normal? Severe depression?
7-10 good. 0-3 depressed.
30
It is important that the baby's temperature be maintained at what temperature?
98.6. F or 37 C
31
Describe the four different degrees of perineal lacerations.
1. Superficial laceration of the vaginal mucosa or perineal body.
2. Laceration of the vaginal mucosa and/ or perineal skin and deeper subcutaneous tissue.
3. (Incomplete) Second degree laceration plus laceration of the capsule and part of the anal sphincter muscle.
3. (Complete) As above with complete laceration at the anal sphincter.
4. Complete third degree with laceration of the rectal mucosa.
32
What is given to the mother after birth to help with uterine contractions?
Oxytocin or Ergotrate.
33
What types of anesthesia can be given during childbirth?
Epidural, continuous caudal, pundendal block, or spinal
34
Eclampsia
Pregnancy-induced hypertension accompanied by edema, albuminuria and sometimes convulsions.
35
Eclampsia is also called
Toxemia
36
Ectopic pregnancy
When the zygote implants outside the uterine cavity, most common site of implant is Fallopian tube.
37
Incompetent cervix
Spontaneous abortion occurring during the second trimester. Prevented surgically by cerclage.
38
Cerclage
Placement of a purse-string mersilene suture around the cervix
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Placenta previa
Painless bleeding during the second trimester or at the onset of labor due to positioning of the placenta near or over the cervical opening, an indication for c-section
40
Abruptio placenta
Painful bleeding caused by the premature separation of the placenta from the uterine wall, leads to rapid demise of the infant and hemorrhage of the mother, emergency c-section indicated.
41
Hyperemesis gravidarum
Excessive vomitting during pregnancy
42
Gestational diabetes
Elevated blood sugar in the mother and development of a large fetus.
43
Nuchal cord
An umbilical cord is wrapped around the baby's neck one or more times
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Cord prolapse
When the cord precedes the head.
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Breech presentation
When the baby's feet, knees, or buttocks enter the birth canal before the head.
46
Meconium
A nearly sterile fecal waste that accumulates while the fetus is in the uterus. It is passed within the first few days after birth.
47
Incomplete abortion
Patient bleeding but entire contents of conception are not discharged.
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Missed abortion.
Nonviable fetus that is not aborted.
49
therapeutic abortion
Artificially induced abortion for nonviable or abnormal fetus or for the welfare of the mother. Typically during the first trimester.
50
Dystocia
Difficult labor, contraction fail to expel the fetus, may be an indication for c-section
51
Cephalopelvic disproportion
Head of the infant too large to pass through the pelvis of the mother. Indication for a c-section
52
Retained placenta
Causes bleeding and is generally treated with D&C
53
Ruptured uterus
May occur during labor of a patient with pervious c-section or other uterine surgery
54
Amniotic fluid embolism
Clotting disorder that occurs when amniotic fluid destroys fibrinogen
55
Inversion of the uterus
During the third stage of labor, the uterus may prolapse inside out
56
What are the eight postpartum complications that may occur?
1. Infection
2. Subinvolution of the uterus
3. Hemorrhage due to uterine Antony or retained placenta.
4. Vulvar hematoma from the trauma of labor
5. Enlargement of breast
6. Cystitis
7. Puerperal psychosis
8. Thrombophlebitis and pulmonary embolism.
57
Subinvolution of the uterus
Uterus does not go back into normal position in the pelvis
58
What is the most common complication in the fourth stage of labor?
Hemorrhage due to uterine atony or retained placenta.
59
What 11 items are needed to perform a C-section?
1. Laparotomy drape
2. Scalpel
3. Lap sponges
4. Mayo clamps
5. Metz
6. Curved mayos
7. Bandage scissors
8. Bladder retractor
9. Hemostats
10. Abdominal suctions x2
11. Bulb syringe.
60
After a C-section, what is the uterus closed with?
A continuous stitch of 0 or 1 absorbable suture on a taper needle
61
Carcinoma in situ
Cancer in the endothelial layer that is not invasive
62
Chocolate cyst
Benign cyst of the ovary that contains dark syrupy contents from old blood, ovarian endometriosis
63
Cystocele
Herniation of the bladder into the vagina.
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Dermoid cyst
Sac filled with hair and sebaceous material found in the ovary of young females.
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Dysmenorrhea
painful or difficult mensturation.
66
Endometriosis
Occurrence of endometrial tissues outside the uterus which slough off during normal menses and cause pain and pelvic congestion.
67
enterocele
Hernias ion of the intestine into the cul-de-sac of Douglas
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Fornices
Regions in the vaginal vault created by the projections of the cervix into the proximal vagina
69
Leiomyoma uteri/ fibroid
Benign tumor arising from the muscle layer of the uterus.
70
Menometrorrhagia
Excessive uterine bleeding occurring both during menses and at irregular intervals
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Pelvic diaphragm
Levator ani and coccygeal muscles with facial coverings. Separates pelvic cavity from perineum and provides support to the abdominal pelvic viscera.
72
Pelvic Inflammatory disease
Inflammation of the uterus, fallopian tubes, ovaries, and related structures due to infection.
73
Rectocele
Herniation of the rectum into the vagina
74
Stress incontinence
Leakage of urine when intraabdominal pressure is increased, as with a cough or sneeze.
75
Uterine descensus/uterine prolapse/ procidentia
Laxity of the ligaments that suspend the uterus in the pelvic cavity resulting in the uterus falling into or out through the vagina, first degree may be treated with a pessary, while second and third degrees may be treated by hysterectomy.
76
Why may an enema be performed prior to gynecological surgery?
Due to the close proximity of the sigmoid colon and rectum to the uterus. Avoid inadvertent injury and decrease the chance of post operative constipation
77
Straight cath is used for? Give an example.
Drain bladder and then removed. Red Robinson
78
The lining of the uterus that changes under hormonal influence and with pregnancy is called
Endometrium
79
The thick muscular layer that is continuous with the muscle of the vagina and the fallopian tubes is called what/
Myometrium
80
The outer serous layer of the uterus is called
Perimetrium
81
The perimetruum is the reflection or folding back of what structure?
The abdominal peritoneum
82
The perimetrium forms a pouch called
Cul-de-sac
83
The broad ligaments suspend
The uterus from the pelvic wall
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The round ligaments suspend
The uterus anteriorly
85
The cardinal ligaments lie where and support what?
Below the broad ligaments and provide support for the uterus
86
The uterosacral ligaments lie where and attach what?
Curve along the bottom of the uterus and attach it to the sacrum
87
What are the four sections of the fallopian tube?
1. Interstitial section: connect to the uterus
2. Isthmus: narrow midportion
3. Ampulla: The widened portion of the tube
4. Infundibulum: the terminal end of the tube
88
Fimbriae
Small projections that extend from the end of the tube
89
Ovaries secrete what two hormones?
Estrogen and progesterone
90
The fibrous layer of the ovary which contains follicles that hold ova in different stages of maturity is the ________.
Cortex
91
The inner core of the ovary, which is composed of connective vascular tissue is called __________.
Medulla.
92
The development and release of ova is influenced by the ________ gland, which stimulates ___________ hormone and _________ hormone.
Pituitary gland
Luteinizing hormone
Follicle stimulating hormone
93
Introitus
AKA vestibule, opening to the outside of the body.
94
The job of the mons pubis is what?
To protect the symphysis pubis
95
The vestibular glands collectively include:
Skene glands and Bartholin glands
96
Where are skene glands found?
Two paired glands that lie beneath the floor of the urethra.
97
Where are the Bartholin glands located? What do they secrete and when?
On both sides of the vestibule and secrete mucus during sexual intercourse.
98
Menarche
Onset of mensturation
99
Sonohysterography
Injection of normal saline, lactated ringers, or 1.5% glycine into the uterine cavity through a small transcervical catheter before ultrasound imaging.
100
Heterosalpingography
A radiological contrast medium is injected into the uterus and fallopian tubes. Fluroscopy is used to visualize them.
101
Colposcopy
Microscopic examination and biopsy of the cervix, the cervix is painted with acetic acid, which causes preinvasive cells to appear white. They are then biopsied.
102
Cone biopsy of the cervix. What is this done to treat? What technique is used? What is done?
Epithelial carcinoma of the cervix or severe dysplasia.
Loop electrosurgical excision procedure (LEEP)
Removal of a circumferential core of tissue around the cervical canal.
103
Schiller's Test
Staining the cervix or vaginal vault with an iodine (Lugol's) solution to differentiate normal from abnormal tissue
104
Cervical tissue specimens may be obtained with what type of biopsy forceps?
Gaylor
105
Curettage
Scraping from the uterine cavity for examination
106
Culdocentesis
Aspiration of fluid from the cul-de-sac through the posterior vaginal fornix to determine the presence of blood or pus
107
Chomopertubation
Methylene blue or indigo carmine is introduced into the uterine cavity and fallopian tube through an iv tubing or syringe attached to a uterine manipulator to determine patency of fallopian tubes.
108
Vasopressin Give aka and use
Pitressin constriction of blood vessels, injected into uterus during hysterectomy or into a benign uterine tumor to prevent bleeding during removal
109
What is given after abortion to enhance uterine contractions and control uterine bleeding?
Methylergonovine Methergine
110
heteroscope is introduced where?
Vaginally
111
When using a heteroscope, what is used for distention?
Dextran, Gluscose, Glycine, or Hyskon solution
112
What is a heteroscope used for?
Endometrial ablation (rescetoscope or balloon therapy), removal of polyps, intrauterine adhesions, submucous fibroids, or to located lost IUD
113
What is a culdoscopy used for?
To investigate cervical/ vaginal tissues.
114
Oophorectomy
Surgical removal of the ovary.
115
Indications for oophorectomy.
Malignant condition or ovarian cyst (follicular, corpus lutenum, dermoid, or chocolate cyst)
116
A bilateral oophorectomy can also be called
Surgical menopause.
117
Salpingo-oophorectomy
Removal of the tube and ovary
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Indications for salpingo-oophorectomy
Damage from PID, endometriosis, cysts, or carcinoma.
119
Tubal ligation
Interruption in the continuity of the fallopian tubes for sterilization purposes.
120
What was the first minimally invasive surgery performed?
Tubal ligation
121
Tuboplasty
Reconstruction of fallopian tubes under microscopic assistance for infertility related to previous tubal sterilization
122
In-vitro fertilization
Oocytes are retrieved from the ovary through a laproscope and implanted in the uterine cavity following fertilization.
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Myomectomy
Surgical removal of uterine fibroids in premenopausal women wishing to preserve fertility.
124
Abdominal Hysterectomy
Removal of uterine body and cervix
125
Supracervical Hysterectomy
Removal of the uterine body with cervix left in place.
126
Indications for abdominal hysterectomy
Pain associated with pelvic congestion, PID, pervious pelvic surgery, endometriosis, fibroids, dysfunctional or postmenopausal bleeding, malignancy.
127
Abdominal or Vaginal procedure: oophorectomy
Abdominal
128
Abdominal or vaginal procedure: Salpingo-oophorectomy
Abdominal
129
Abdominal or vaginal procedure: tubal ligation
Abdominal
130
Abdominal or vaginal procedure: tuboplasty
Abdominal
131
Abdominal or vaginal procedure: myomectomy
Abdominal
132
Abdominal or vaginal procedure: supracervical hysterectomy
Abdominal
133
Abdominal or vaginal procedure: vesicourethral suspension
Abdominal
134
A vesicourethral suspension is also called
Marshall-Marchetti-Kranz procedure
135
Vesicourethral suspension
The periurethral tissues are sutured to the periosteum of the pubic symphysis to reposition the vesico-urethral angle.
136
Indication for vesicourethral suspension
To correct urinary stress incontinence
137
A radical hysterectomy is also called
Wertheim Procedure
138
Abdominal or vaginal procedure: wertheim procedure
Abdominal
139
Radical hysterectomy
Removal of uterus, tubes, ovaries, and upper one third of vagina
140
Anterior exenteration
Wertheim procedure plus cystectomy (removal of bladder) with ileal conduit
141
Posterior exenteration
Wertheim procedure plus abdominoperineal resection. Done when metastasis to rectum has occurred
142
Sims and Thomas curettes are what type of curettes?
Endometrial
143
Kevorkian curettes are what type of curettes?
Endocervical
144
Abdominal or vaginal procedure: vulvectomyb
Vaginal
145
Vulvectomy
Surgical removal of the labia majora and labia minora for carcinoma in situ of the vulva
146
Abdominal or vaginal procedure: Radical vulvectomy with lymphadenectomy
Vaginal
147
Radical vulvectomy with lymphadenectomy
En bloc excision of the labia majora and minora, cltoris, mons pubis, terminal protions of the urethera, vagina, large section of skin from the abdomen and groin, superficial and deep inguinal lymph nodes, portions of the round ligament, and saphenous vein along with the lesion.
148
D&C
Dilatation and curettage: bladder is emptied, vagina is retracted, cervix is grasp with tenaculum, uterine depth is probed, endocervix is curetted, cervix is gradually dilated, endometrium is curetted.
149
Vesico-vaginal, urethro-vaginal, or recto-vaginal fistula repair
Fistual is identified through vagina, dissected, closed with absorbable suture
150
Skirodkar procedure
Cervical cerclage: incompetent cervical os, placement of suture to prevent pregnancy.
151
Cesium rod insertion
Radioactive element, treatment of cervical and endometrial ablation.
152
marsupialization of a Bartholin's cyst
Incision into the vagional outlet into duct for drainage.
153
Perineorrhaphy
Surgical repair of laceration of the area between the vagina and rectum accompanying childbirth
154
Indications for vaginal hysterectomy.
Benign disease of the uterus, not greatly enlarged, poor pelvic muscular support, carcinoma in situ, uterine prolapse
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Indications for hysterscope
Abnormal uterine bleeding, displaced IUD, chronic pregnancy loss, infertility
156
Contraindication for hysteroscopy
Acute infection, cervical malignancy, and pregnancy
157
Complications of hysterscopy
Bleeding, perforation, fluid retention, infection.
158
What are five different ways to perform hysteroscopic endometrial ablation?
Laser, roller ball ablation, NovaSure, Hydro Thermablator, Her Option
159
After endometrial ablation is performed, what can the patient expect for several days?
Severe cramping and watery discharge.
160
Leiomyoma
Benign, smooth muscle tumor of the uterus
161
A dermoid cyst is also called
Teratoma
