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Female Genitourinary > Physical Examination of the Female Genitalia > Flashcards

Physical Examination of the Female Genitalia Flashcards

1
Q

Describe the two types of abnormal menstrual bleeding assessed during physical examination?

A

Amenorrhea - absent menstrual cycle.

Prolonged menses - 7+ days.

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2
Q

What are the premenstrual symptoms?

A

Headaches, weight gain, edema, breast tenderness, irritability or mood changes, and their frequency.

Also note if these symptoms interfere with daily living.

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3
Q

What should be assessed in a patient being seen for infertility?

A

Length of time attempting pregnancy.

Sexual activity pattern.

Knowledge of fertile period.

Length of cycle.

Any abnormalities of the vagina, cervix, uterus, Fallopian tubes or ovaries.

Contributing factors and partner factors.

Any diagnostic evaluations to date.

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4
Q

What is menarche?

A

The age at first menstrual cycle.

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5
Q

What should be assessed in regards to obstetric history?

A

Gravida, parida, spontaneous or induced abortions, pregnancy complications, number of living children, and complications of pregnancy, delivery, abortion, or fetus/neonate.

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6
Q

What are the components of the vulva (female external genitalia)?

A

Mons pubis

Labia majora

Labia minora

Clitoris

Vestibular gland

Vaginal vestibule

Vaginal orifice

Urethral opening

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7
Q

The labia minora form to form what structure?

A

The fourchette.

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8
Q

The labia minora has a vestibule that contains what?

A

The hymen, urethra, the vagina, skene glands for draining urethral glands, and bartholin glands that secrete lubricant during sexual arousal.

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9
Q

This structure of the internal genitalia is a musculomembranous tube that is transversely rugated during the reproductive phase of life.

A

The vagina.

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10
Q

How is the anterior wall of the vagina separated from the bladder and urethra, and how is the posterior wall separated from the rectum?

A

Anterior: Vesicovaginal septum.

Posterior: Rectovaginal septum.

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11
Q

Where in the female genitalia can pelvic organs be palpated?

A

Through pockets around the cervix called fornicles.

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12
Q

How is the non-pregnant uterus positioned in the body, and how much does it weigh? How is it divided anatomically?

A

Anterioposteriorly.

60-90g.

Corpus and cervix.

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13
Q

What are the portions of the uterine corpus?

A

The fundus, body, and isthmus.

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14
Q

What does the adnexa consist of, and what does it do?

A

Fallopian tubes and ovaries.

Contractions of the tubal musculature move the ovum to the uterus.

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15
Q

The bony pelvis supports a fetus during pregnancy. What are the four bones and four joints that support?

A

Bones:
2 Innominate
Sacrum
Coccyx

Joints:
Symphysis pubis
Saccrococcygeal
2 Sacroiliac

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16
Q

What is the onset of puberty in females referred to as, and what age range does it typically occur?

A

Menarche.

11-14 years.

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17
Q

Uterine pressure during pregnancy causes what changes to the cervix?

A

It obstructs lymph and bloodflow causing the cervix to appear bluish.

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18
Q

At what age does ovarian function begin to diminish, and when does menopause typically occur?

A

Ovarian function diminishes around age 40, menopause occurs between 40 and 55.

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19
Q

What is menopause defined as?

A

1 year without menses.

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20
Q

How do you typically place a female patient for a genital exam?

A

Lithotomy position.

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21
Q

What examining equipment provides much more support to a woman who can’t use traditional foot stirrups during a pelvic exam?

A

Obstetric stirrups.

22
Q

Describe the M-shaped position.

A

Woman lies on her back, knees bent and apart, feet on the table, heels touching buttocks. This does not use stirrups.

23
Q

Describe V-shaped position.

A

Woman lies flat on her back, legs are straight out and spread apart.

She can also hold one leg up with the other foot in a stirrup.

24
Q

What indicates an infection of the Skene or Bartholin glands, and what should be examined and noted?

A

Discharge upon palpation/milking of the glands.

Note the color, consistency and odor.

*For the Bartholin glands, also assess for swelling that is painful, hot to touch and fluctuant. This can indicate an abscess. The abscess is usually gonococcal or staphylococcal and pus-filled.

25
Q

Bulging of the anterior wall and urinary incontinence in a woman who has borne children indicates what?

Bulging of the posterior wall indicates what?

A

Anterior: Cystocele.

Posterior: Rectocele.

26
Q

Describe typical findings of the cervix.

A

A bluish color indicates increased vascularity and may be a sign of pregnancy.

A cervix pointing anteriorly indicates a retroverted uterus.

One pointing posteriorly indicates an anteverted uterus.

Deviation to the right or left may indicate a pelvic mass, uterine adhesions, or pregnancy.

27
Q

What is the benefit of a rectovaginal exam?

A

It allows you to reach almost 2.5cm higher into the pelvis to feel pelvic structures and organs.

28
Q

What are normal female genital exam findings?

A

1) Skin is smooth.

2) Hair is in a triangular pattern.

3) Majora are symmetrical, soft, and homogenous.

4) Minora are moist and dark pink.

5) Clitoris is 2cm in length and .5cm in diameter.

6) No swelling, mass,or pain is present.

29
Q

Non-sexually active women should have their first pelvic exam by what age?

A

21.

30
Q

What is Regar sign?

A

Softening of the isthmus during pregnancy.

31
Q

What is Chadwick sign?

A

Bluish cervix during pregnancy.

32
Q

What is Goodell sign?

A

Cervical softening during pregnancy.

33
Q

What is Piskacek sign?

A

When the uterus deviates at 8 to 10 weeks of gestation.

34
Q

How is infertility defined?

A

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

35
Q

Define endometriosis.

A

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

36
Q

Define Condyloma Acuminatum.

A

Warty lesions on the labia, within the vestibule, or in the perianal region as a result of HPV infection.

Sexually transmitted and appear as flesh colored, whitish pink to reddish brown, discrete, soft growths that may form a cauliflower like mass.

37
Q

Define Condyloma Contagiosum.

A

Benign skin infection caused by poxvirus, may be sexually transmitted. Incubation period is 2-7 weeks.

Lesions are white or flesh colored, dome shaped papules that are round or oval. Surface characteristic is central umbilication from a thick creamy core that can be expressed.

38
Q

Define Condyloma Latum.

A

Lesions of secondary syphilis that appear about 6 to 12 weeks after infection. Flat, round or oval papules covered by gray exudates.

39
Q

This STI produces small red vesicles on the vulva, perineum, vagina or cervix and are itchy and painful.

A

Herpes lesions.

40
Q

This condition occurs when a woman bears down during physical exam, and appears as a hernial protrusion of the urinary bladder through the anterior wall of the vagina.

A

Cystocele

41
Q

What is a rectocele?

A

Hernial protrusion of part of the rectum through the posterior vaginal wall.

42
Q

This is a bright red polypoid growth that protrudes from the urethral meatus.

A

Urethral carbuncle.

43
Q

What is Trichomoniasis?

A

Water discharge; usually not foul smelling.

Dysuria

Profuse, frothy, greenish discharge.

44
Q

This STI produces purulent discharge from the cervix and inflammation of the skene and bartholin glands.

A

Gonorrhea

45
Q

What is columnar epithelium?

A

Shiny red tissue around the os that bleeds easily.

46
Q

A uterine prolapse can commonly occur secondary to what conditions that weaken the pelvic floor?

A

Cystocele or rectocele.

47
Q

A tubal pregnancy is a surgical emergency. How does it appear, and how can the provider determine the possible location of the tubal pregnancy?

A

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

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

48
Q

What are the two common causes of pelvic inflammatory disease?

A

Gonococcal or chlamydial infection.

49
Q

This condition is inflammation or infection of the fallopian tubes associated with PID.

A

Salpingitis

50
Q

What is vulvovaginitis?

A

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

Female Genitourinary (4 decks)

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