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W Flashcards

1
Q

External structures of breasts include

A

Tail of Spence
Nipple
Areola

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2
Q

External-

Tail of Spence

A

superior lateral corner of breast tissue that projects up and laterally into the axilla

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3
Q

External-

Nipple

A
  • center of the breast
  • round with tiny milk duct openings
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4
Q

External-

Areola

A
  • surrounds nipple 1-2 cm in radius
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5
Q

Internal anatomy of breasts include:

A

Glandular tissue
Fibrous tissue
Adipose tissue

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6
Q

Glandular tissue

A

15-20 lobes radiating from the nipple; lobes consist of lobules that have clusters of alveoli that produce milk

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7
Q

Fibrous tissue

A

These are the ligaments (Cooper ligaments) that are fibrous connective tissue that support the breast tissue

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8
Q

Adipose tissue

A

Fatty tissue that constitutes the bulk of the breast

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9
Q

External:

Color- abnormal vs normal

A

Normal: Skin color is even; labia minora are a darker pink, moist, and usually symmetric
Abnormal: Excoriation, nodules, rash, or lesions

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10
Q

External:

Hair- abnormal vs normal

A

Normal:
Hair distribution is in the usual female pattern of inverted triangle, although it normally may trail up the abdomen toward the umbilicus.

Abnormal:
Consider delayed puberty if no pubic hair or breast development has occurred by age 14−15 years.Nits or lice at the base of pubic hair.

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11
Q

Normal finding:
Labia majora normally are symmetric, plump, and well formed. In the nulliparous woman labia meet in the midline; after a vaginal delivery the labia are gaping and slightly shriveled.

What is abnormal?

A

Swelling

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12
Q

Normal: * Urethral opening appears…
Abnormal?

A

stellate or slitlike and is midline.

Abnormal: Polyp. Discharge

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13
Q

Normal: Vaginal opening, or introitus, may appear as a narrow vertical slit or as a larger opening.

Abnormal:

A

Foul-smelling, irritating discharge.

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14
Q

The perineum should be

A

smooth

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15
Q

A normal finding of the anus

A

Anus has coarse skin of increased pigmentation

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16
Q

Assess area of Bartholin glands. Palpate the posterior parts of the labia majora with your gloved index finger in the vagina and your thumb outside at 5 and 7 o’clock positions (Fig. 27.8). Normally the labia feel ____ and _____

What about abnormally?

A

The labia should feel soft and homogenous

Abnormal: Swelling, indurations, pain, erythema, or discharge from duct opening

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17
Q

When palpating the perineum, it should normally feel

A

thick, smooth, and muscular in the nulliparous woman (who has not given birth) and thin and rigid in the multiparous woman.

Abnromal is tenderness or paper-thin perineum

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18
Q

Using your index and middle fingers, separate the vaginal orifice and ask the woman to strain down. Normally__ ______of vaginal walls or _____ _______occurs

A

no bulging of vaginal walls or urinary incontinence occurs

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19
Q

Using your index and middle fingers, separate the vaginal orifice and ask the woman to strain down. Normally no bulging of vaginal walls or urinary incontinence occurs.

What does bulging of the vaginal wall indicate?

A

cystocele, rectocele, or uterine prolapse

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20
Q

Normal:

There should be no lesions, except for occasional ______ ______ These are _______, 1-cm nodules that are ___, ______r, and often multiple

A

There should be no lesions, except for occasional sebaceous cysts. These are yellowish, 1-cm nodules that are firm, nontender, and often multiple

21
Q

Internal examination:

The color of the cervical mucosa is ____ and ____. During the 2nd month of pregnancy it looks blue (Chadwick sign), and after menopause it is ____

Abnormal would be redness, inflammation, and..

A

The color of the cervical mucosa is pink and even. During the 2nd month of pregnancy it looks blue (Chadwick sign), and after menopause it is pale.

Redness, inflammation, pallor with anemia, and cyanosis other than w pregnancy.

22
Q

Normally, the cervix position is _____ and projects 1 to 3 cm into the ____

A

midline; vagina

23
Q

Normal size of cervix is

A

2.5 cm

24
Q

Normal Cervical secretions—Depending on the day of the menstrual cycle, secretions may be clear and thin or thick, opaque, and stringy. They are always ____ and _____

A

odorless and nonirritating.

25
Q

The vaginal wall should feel

A

smooth

26
Q

What should the consistency of a cervix feel like

A

Consistency—Feels smooth and firm, like the consistency of the tip of the nose

27
Q

If a cervix is hard it indicates

A

malignancy

28
Q

Contour of cervix should be

A

evenly rounded

29
Q

Mobility—With a finger on either side, move the cervix gently from side to side. Normally this produces

A

no pain

30
Q

The uterine wall is normally

A

Firm, smooth, freely moveable and nontender

Contour of fundus is rounded

31
Q

Is the fallopian tube palpable

A

NO- suggests ectopic pregnancy- immediate referral

32
Q

HPV is transmitted by skin-to-skin contact, so the virus can be spread through women’s genital-to-genital, oral-genital, or digital-genital contact. Further, many lesbian women have had earlier male sex partners. Therefore, all women ages ___ to ___ years who have a cervix need cervical cancer screening by HPV testing from a cervical swab or P_______ ______ cotesting every __ years, or Pap testing alone every ___ years for ages 30 to 65 years.

A

Therefore, all women ages 25 to 65 years who have a cervix need cervical cancer screening by HPV testing from a cervical swab or Papanicolaou cytology cotesting every 5 years, or Pap testing alone every 3 years for ages 30 to 65 years.

33
Q

The breasts are also known as the

A

mammary glands

34
Q

The breasts lie ______ to the ________ _______ and ______ _______ muscles. They are located between the ___ and __th ribs, extending from the ____ of the ______ to the _______ line. The superior lateral corner of breast tissue, called the axillary tail of Spence, projects up and laterally into the axilla.

A

The breasts lie anterior to the pectoralis major and serratus anterior muscles (Fig. 18.1). They are located between the 2nd and 6th ribs, extending from the side of the sternum to the midaxillary line. The superior lateral corner of breast tissue, called the axillary tail of Spence, projects up and laterally into the axilla.

35
Q

The internal genitalia is composed of

A

Uterus and cervix
Fallopian tubes
Ovaries
Vagina

36
Q

Normal:

Note symmetry of size and shape (Fig. 18.6). It is common to have a slight asymmetry in size; often the left breast is slightly larger than the right.

Abnormal: A sudden increase in the size of one breast signifies..

A

inflammation or new growth.

37
Q

The skin of the breasts normally is smooth and of even color.

Abnormal?

A

Hyperpigmentation.
Redness and heat with inflammation.
Unilateral dilated superficial veins

38
Q

Normally no edema is present. Edema exaggerates the ____ _____, giving a “pigskin” or “orange-peel” look

A

Hair follicles

39
Q

The nipples should be placed symmetrically on the same plane on the two breasts. Nipples usually protrude, although some are flat and some are inverted. They tend to stay in their original condition. Distinguish a recently retracted nipple from one that has been inverted for many years or since puberty. Normal nipple inversion may be unilateral or bilateral and usually can be pulled out (i.e., it is not fixed).

Abnormal findings:

A

Deviation in pointing (see Table 18.3).
Recent nipple retraction signifies acquired disease

40
Q

A ____ ________ is a normal and common variation

A

supernumerary nipple

41
Q

Direct the woman to change position while you check the breasts for skin retraction signs. First ask her to lift her arms slowly over her head. Both breasts should move ___ ______

A

up symmetrically

Abnormal: retraction signs are caused by fibrosis, usually growing neoplasms- note a lag in movement

42
Q

Abnormal:
Note a________ or a pucker, which indicates skin retraction

A

Note a dimpling or a pucker, which indicates skin retraction

43
Q

Next ask her to push her hands onto her hips (Fig. 18.9). These maneuvers contract the pectoralis major muscle. A slight ______ of both breasts occurs.

A

lifting

44
Q

Abnormal:

Nodes ______ with any local infection of the breast, arm, or hand. Palpable nodes occur with breast _____metastases and _____

A

Nodes enlarge with any local infection of the breast, arm, or hand. Palpable nodes occur with breast cancer metastases and lymphomas.

45
Q

Breast tissue should feel

A

firm, smooth, and elastic

46
Q

In addition, normally you may feel a firm transverse ridge of compressed tissue in the lower quadrants (see Fig. 18.12). This is the ___________ ________, and it is especially noticeable in large breasts. Do not confuse it with an abnormal lump.

A

inframammary ridge

47
Q

Discharge: normal vs abnormal (nipple)

A

Normal (pregnancy): If any discharge appears, note its color and consistency. Physiologic (benign) discharge is usually bilateral. This galactorrhea is white, milky, present during pregnancy, breastfeeding, and up to 1 year after weaning.

Abnormal: Pathologic discharge is spontaneous, unilateral, has blood, or is clear, serous; it is sometimes associated with a mass

48
Q

Breast self examination (BSE)- best time to perform

A

The best time to perform BSE is right after the menstrual period (day 4 to 7 of the cycle), when the breasts are the smallest and least congested.

Instruct the woman not having menstrual periods (pregnant or menopausal) to choose a familiar date as a reminder, such as the first of the month.

49
Q
A

HA (3 decks)

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