chapter 12- female reproductive system

Gynecology

anatomy and physiology of the female genital system

Obstetrics

studies female reproduction, pregnancy, and childbirth

function of reproductive system

secrete female hormones, develop female secondary sexual characteristics, produce ova (eggs), menstruate, conceive and bear children, and produce milk to nourish infants

ovary

small, egg-shaped gland- the female gonads

uterus / womb

inverted pear-shaped organ held in place by ligaments

The fundus is the rounded top. \n –The body is the wide, central part. \n –The cervix is the narrow neck

Anovulation

Failure of the ovaries to release a mature ovum even though the menstrual cycle is normal

Ovarian cancer

Cancerous tumor of an ovary; rarely symptomatic until quite large and metastasized

Salpingitis

infection or inflammation of the uterine tube

Polycystic ovary syndrome (PCOS)

Ovaries contain many semisolid cysts; follicles enlarge but fail to release an ovum. \n • Enlarged follicles turn into painful cysts. \n • Cysts eventually fill the ovaries

Endometrial cancer

Cancerous tumor of the endometrium of the uterus; earliest symptom is abnormal bleeding

Leiomyosarcoma

Cancerous tumor of the smooth muscle of the uterus

Endometriosis

Development of endometrial tissue in the uterine tubes and pelvic cavity; caused by upward flow of sloughed off endometrium

Myometritis

Inflammation or infection of the uterine muscle; when accompanied by pus, it is pyometritis

Pelvic inflammatory disease (PID)

Infection that spreads from the cervix to the uterus, uterine tubes, and ovaries; often caused by a sexually transmitted disease

Uterine prolapse

Downward movement of the uterus due to ligament stretching or pelvic floor muscle weakness; associated with childbirth and age

Follicle-stimulating hormone (FSH)

follicle enlargement and ovum maturation

Luteinizing hormone (LH)

causes the follicle to rupture and release the ovum

Estradiol

type of estrogen that produces the female secondary sexual \n characteristics that occur during puberty

Amenorrhea

The absence of menstrual periods due to hormone imbalance, disease, or stress

Dysmenorrhea

Painful menstruation due to excess prostaglandin, endometriosis, pelvic inflammatory disease (PID), or uterine fibroids

Menopause

Normal cessation of menstrual periods in middle \n age; ovulation stops and the menstrual period ceases

Menorrhagia

Menstrual period with excessively heavy flow or a menstrual period lasting more than 7 days; caused by hormone imbalance, fibroids, or endometriosis

Oligomenorrhea

Very light menstrual flow or infrequent menstrual periods in a woman who previously had normal periods; caused by hormone imbalance

Premenstrual syndrome (PMS)

Breast tenderness, fluid retention, bloating, and mild mood change in the days before menstruation; caused by high hormone levels

Cervical cancer

Cancerous tumor of the cervix that involves dysplasia, ulceration, and bleeding. \n • HPV infection is a predisposing factor. \n • When localized to one site, it is considered carcinoma in situ (CIS)

Cervical dysplasia

Abnormal growth of squamous cells in the surface layer of the cervix; precancerous condition that can be caused by HPV infection

Bacterial vaginosis

Bacterial infection caused by Gardnerella vaginalis; there is a white or gray discharge with a fishy odor

Candidiasis

Yeast infection caused by Candida albicans, often during an antibiotic regimen; there is itching and leukorrhea

Cystocele

Herniation of the bladder into the vagina due to weakness of the vaginal wall

Dyspareunia

Difficult or painful intercourse or pain after intercourse; caused by infection, pelvic inflammatory disease (PID), endometriosis, or structural issues

Rectocele

Hernia of the rectum into the vagina due to weakness in the vaginal wall; can interfere with bowel movements

Vaginitis

Vaginal inflammation or infection. \n • Inflammation is due to irritation from chemicals in spermicides or douches. \n • Infection is due to yeast infection or bacterial or viral STD infection

Failure of lactation

Lack of milk production from the breasts after childbirth; caused by hyposecretion of prolactin from the anterior pituitary gland

Galactorrhea

Discharge of milk from the breast when a woman is not pregnant or breast feeding

Breast cancer

Cancerous adenocarcinoma of the lactiferous lobules; may be swelling, enlarged lymph nodes, nipple discharge, and peau d’orange

Abruptio placentae

Partial or complete separation of the placenta from the uterine wall prior to the third stage of labor; disrupts blood flow and oxygen to the fetus

Abnormal presentation

Birth position in which the head is not the presenting part. \n • Breech (feet first) \n • Transverse lie

Ectopic pregnancy

Pregnancy in which a fertilized ovum implants outside of the uterus, often in the uterine tube

Gestational diabetes mellitus

Temporary disorder of glucose metabolism during pregnancy; increased estradiol and progesterone block the action of insulin from the pancreas

Incompetent cervix

Premature dilation of the cervix during the second trimester of pregnancy; can result in miscarriage of the fetus

Mastitis

Inflammation or infection of the breast; caused by milk engorgement or Staphylococcus aureus

Morning sickness

Temporary nausea and vomiting in the first trimester of pregnancy due to elevated estradiol and progesterone

placenta previa

Incorrect position of the placenta in which it partially or completely covers the cervical canal; cervical dilation disrupts the connection between the placenta and uterus

Preeclampsia

Hypertensive disorder with increased blood pressure, edema, weight gain, and proteinuria; can progress to eclampsia with seizures

Postpartum hemorrhage

Continual bleeding after delivery from the site \n of placental separation; caused by \n hyposecretion of oxytocin

Premature labor

Regular uterine contractions of labor that begin before the fetus is mature enough to be born; the cervix dilates and blood and amniotic fluid leak

meconium

first stool- thick, greenish-black, and tar like

Apnea

Temporary or permanent cessation of breathing after birth; the immature nervous system fails to maintain a constant respiratory rate

Fetal distress

Decreased blood flow through the placenta or umbilical cord causes lack of oxygen to the fetus; fetal heart rate (FHR) decreases and meconium passes

Growth abnormalities

Growth problems associated with maternal illness, malnutrition, or smoking. \n • Small for gestational age (SGA) \n • Large for gestational age (LGA) \n • Appropriate for gestational age (AGA)

Jaundice

Yellow discoloration of the skin; due to inability of the newborn liver to conjugate bilirubin from red blood cells

Meconium aspiration

Inhalation of meconium that has been passed in the amniotic fluid; it can block the airway and cause respiratory distress or death

Nuchal cord

Umbilical cord wrapped around the neck of the fetus; a tight cord can impair blood flow to the brain, causing brain damage or death

Infant respiratory distress syndrome (IRDS)

Difficulty inflating the lungs to breathe due to a lack of the substance surfactant; occurs most often in premature infants who cannot yet make surfactant

BRCA1 and BRCA2

Blood test that shows whether a patient has inherited the BRCA1 or BRCA2 gene mutation; these mutations increase the risk for breast and ovarian cancers

Estrogen receptor (ER) assay

Cytology test that examines malignant breast cells for estrogen receptors; presence of receptors indicates that the tumor requires estradiol and progesterone to grow

Papanicolaou (Pap) test or smear

Cytology test to detect dysplasia or carcinoma in situ (CIS) of the cervix; cells are scraped from the cervix and placed on slides or in vials for microscopic examination

Antisperm antibody test

Laboratory test that detects antibodies against sperm in a woman’s cervical mucus. \n • Some antibodies attack the tail of the sperm and prevent swimming. \n • Others prevent penetration of the ovum by the sperm

Hormone testing

Blood test that determines the levels of FSH and LH released by the anterior pituitary and the levels of estradiol and progesterone released by the ovaries

Amniocentesis

Test of the amniotic fluid; ultrasound guidance is used to collect the fluid sample. \n • Chromosome studies indicate genetic abnormalities. \n • Include tests to indicate neural tube defect. \n • Also, tests to indicate fetal lung maturity

Pregnancy test

Blood test to detect human chorionic gonadotropin (hCG) secreted into the blood by a fertilized ovum; positive result is diagnostic of pregnancy, but ectopic pregnancy and hydatidiform mole give a false positive. \n Urine dip stick tests (over the counter pregnancy test) is looking for the presence of hCG as well

Ultrasonography

High-frequency sound waves that produce images of a developing fetus or structural abnormality of the pelvic organs

Colposcopy

Visual examination of the vagina and cervix using a lighted instrument with magnification

Gynecologic examination

Physical examination of the external and internal genital; patient is in the dorsal lithotomy position. \n • External genitalia are examined for lesions, rashes, and discharge. \n • Internal genitalia are bimanually examined for tenderness or masses. \n • Internal genitalia are visually examined using a speculum. \n • Pap test is performed

Breast self-examination (BSE)

Systematic palpation of all areas of the breast and underarm to detect lumps, masses, and enlarged lymph nodes; used to detect early signs of cancer

Tanner staging

System of five stages used to describe the development of the female breasts from childhood through puberty; also used to describe development of female genitalia

Mammography

X-ray procedure that creates an image of the breast; compresses and flattens the breast. \n • Xeromammography uses a photon beam and dry chemical developer. \n • MRI is used to create clearer images when there are multiple cysts

Amniotomy

Rupture of the amniotic sac with a hooked tool

Apgar score

Newborn assessment at 1 and 5 minutes following birth; low score indicates the need for special care

Assisted delivery

Facilitation of delivery using a vacuum extractor

Assisted reproductive technology (ART)

Procedures to assist in the process of conception

Epidural anesthesia

Local anesthesia of the abdomen, perineum, and legs during labor and delivery (L&D); anesthetic drug is injected into the epidural space

Obstetrical history

Documentation of past pregnancies and deliveries; uses the G/TPAL (gravida/term, premature, abortion, living) system. \n • Nulligravida \n • Primigravida \n • Multigravida

GTPAL

Antiyeast drugs

Topical treatment for Candida albicans infection

Drugs for amenorrhea

Correct a lack of hormones that contribute to amenorrhea and abnormal uterine bleeding

Drugs for contraception

Suppress the release of FSH and LH from the anterior pituitary to prevent pregnancy

Drugs for endometriosis

Suppress the menstrual cycle to cause atrophy of endometrial implants in the pelvic cavity

Drugs to dilate the cervix

Topical medications to dilate and efface the cervix during labor

Drugs to induce labor

Stimulate the uterus to increase the strength and frequency of uterine wall contractions

Hormone replacement therapy (HRT)

Treat the symptoms of menopause associated with a decreasing level of estradiol.

Nonsteroidal anti-inflammatories (NSAIDs)

Treat pain associated with dysmenorrhea.

Ovulation- stimulating drugs

Treat infertility by stimulating the anterior pituitary gland to secrete FSH and LH

Tocolytic drugs

Suppress uterine contractions to prevent premature labor and delivery

Biopsy (Bx)

Removal of a uterine tissue specimen to diagnose uterine bleeding and cancer; small specimens are collected through the vagina via catheter

Cryosurgery

Destruction of small areas of abnormal tissue in the cervix using a cryoprobe and extremely cold liquid nitrogen

Dilation and curettage (D&C)

Removal of abnormal tissue from inside the uterus using a curet that scrapes the endometrium

Endometrial ablation

Destruction of the endometrium using heat (laser, hot fluid, or electrode) or cold (cryoprobe) to treat dysfunctional bleeding

Hysterectomy

Removal of the uterus through the abdomen or the vagina

Oophorectomy

Removal of an ovary because of large ovarian cysts or cancer; bilateral oophorectomy removes both ovaries

Laparoscopy

Visualization of the abdominopelvic cavity, uterus, uterine tubes, and ovaries; tools can be used along with the scope to perform procedures

Salpingectomy

Reconstructive breast surgery

Rebuilds the breast after mastectomy; may use an implant, TRAM flap, or DIEP flap

Cerclage

Purse-string suture around the cervix to prevent premature dilation; removed prior to delivery

Cesarean section (C-section)

Surgical procedure to remove a fetus through an abdominal incision; done because of CPD, failure to progress, past due delivery, or medical problems