Quiz 5: Reproduction & Airway alterations

Medroxyprogesterone

An injectable progestin that prevents ovulation for $12\,\text{weeks}$, is $99.7\,\%$ effective, and has a return to fertility of $6$ to $12\,\text{months}$.

Estradiol (monthly injection)

A monthly injectable contraceptive similar to oral contraceptives that provides immediate contraception within $5\,\text{days}$ of the last normal menstrual period (LNMP).

Intrauterine device (IUD)

A contraceptive device inserted by a health care provider that causes degeneration of the fertilized egg or renders the uterine wall impervious to implantation; it is nearly $100\,\%$ effective.

IUD String

A component of an Intrauterine device that the client must check for routinely, especially after each menstrual period, to ensure the device is still in place.

Male condom

A rubber sheath applied over the erect penis that prevents sperm from entering the vagina and helps prevent sexually transmitted disease; only water-based lubricants should be used.

Female (vaginal) condom

A polyurethane pouch with flexible rings inserted into the vagina that provides protection without relying on a male condom, though it has failure rates of about $21\,\%$.

Diaphragm

A flexible rubber ring with a latex-covered dome fitted by a health care provider that is released to cover the cervix and prevent sperm entry.

Toxic shock syndrome (TSS)

A potential risk associated with diaphragm use; to decrease this risk, the device should be removed at least once in $24\,\text{hours}$.

Vaginal spermicides

Over-the-counter creams, foams, or jellies that interfere with the viability of sperm and prevent their entry into the cervix.

Natural family planning

A method involving periodic abstinence from intercourse during the fertile period based on the regularity of ovulation.

Ovulatory cervical mucus

Mucus that becomes abundant, clear, thin, stretchy, and slippery, indicating the fertile period during the cervical mucus method.

Coitus interruptus

A contraceptive method where the man withdraws his penis before ejaculation to avoid depositing sperm into the vagina.

Vasectomy

A permanent male sterilization procedure that terminates the passage of sperm through the vas deferens; sterility is not complete until the proximal vas deferens is free of sperm, which takes about $3\,\text{months}$.

Tubal ligation

A female sterilization procedure where fallopian tubes are tied and/or cauterized through an abdominal incision, laparoscopy, or minilaparotomy.

Oral contraceptives

Contraceptive pills that inhibit the release of FSH, resulting in anovulatory menstrual cycles; they are close to $100\,\%$ effective but contraindicated in those with hypertension or thromboembolic disease.

Mons veneris

A fat pad covered with pubic hair, located over the symphysis pubis.

Labia majora

Crescent-shaped fatty tissue containing folds of skin that extends down from the mons veneris to the perineum.

Labia minora

Narrow folds of hairless skin located between the labia majora and the vagina.

Clitoris

A short, sensitive, erectile tissue located at the anterior junction of the vulva.

Perineum

The area between the vaginal opening and the anus composed of muscles and fascia that support pelvic structures.

Ovaries

Small oval organs located on each side of the uterus in the upper part of the pelvis that function in the development and expulsion of ova.

Fallopian tubes (oviduct)

Two tubes, each closely adjoining an ovary, that conduct the released ovum from the ovary to the uterus.

Myometrium

Involuntary muscle fibers of the uterus that provide for expansion and support during pregnancy, expulsion of the fetus, and control of hemorrhage during labor.

Endometrium

The highly vascular lining of the uterus that provides for implantation of a fertilized ovum and is shed during menstruation.

Gynecoid pelvis

The classic female pelvis inlet, which is well-rounded (oval) and ideal for delivery.

Android pelvis

A pelvis resembling a male pelvis, narrow and heart-shaped, that usually requires a cesarean section or difficult forceps delivery.

Platypelloid pelvis

A flat, broad pelvis that is usually not adequate for vaginal delivery.

Anthropoid pelvis

A pelvis similar to that of an anthropoid ape, being long, deep, and narrow; usually adequate for vaginal delivery.

Montgomery’s glands

Glands located in the areola of the breasts that lubricate the nipples.

Alveoli

Internal breast structures that produce colostrum (premilk) and breast milk.

Menstrual phase

The phase occurring during days $1$–$5$ of a $28$-d cycle, involving the degeneration and discharge of most of the endometrium if conception does not occur.

Proliferative phase

The phase occurring during days $6$–$14$ where the graafian follicle approaches maximum development and estrogen causes thickening of the endometrium.

Secretory/luteal phase

The phase occurring during days $14$–$28$ where the corpus luteum secretes progesterone to prepare the uterine lining for implantation.

Ischemic phase

The phase that occurs if fertilization does not happen; the corpus luteum degenerates, estrogen and progesterone levels decrease, and menstrual flow begins.

Amenorrhea

The absence of menstrual flow when normally expected; often caused by pregnancy.

Oligomenorrhea

Scanty menstrual flow.

Menorrhagia

Excessive menstrual flow.

Dysmenorrhea

Painful menstruation.

Menopause

The cessation of menses and fertility, occurring at an average age of $50$ years old.

Black cohosh

A complementary therapy that relieves hot flashes but may increase the hypotensive effect of antihypertensives; should not be taken for more than $6$ months.

Scrotum

An external pouch containing the testes, epididymis, and vas deferens at a lower temperature than normal body temperature.

Testes

The site of testosterone and sperm production in the male.

Seminiferous tubules

The specific site within the testes where sperm production occurs.

Interstitual cells

Cells in the male reproductive system that secrete testosterone.

Oral contraceptives (“the pill”)

A method that inhibits the release of FSH to result in anovulatory cycles; it is close to $100\%$ effective.

Medroxyprogesterone estradiol

An injectable progestin hormone that prevents ovulation for $12$ weeks; the injection site should not be massaged.

Intrauterine device (IUD)

A device inserted by a health care provider that renders the uterine wall impervious to implantation; nearly $100\%$ effective.

Diaphragm

A flexible rubber ring with a latex-covered dome that prevents sperm from entering the cervix; carries risks of UTI and toxic shock syndrome (TSS).

Vasectomy

A permanent male sterilization procedure that terminates the passage of sperm through the vas deferens.

Culdoscopy

The insertion of a lighted tube through the vagina to examine ovaries, fallopian tubes, uterus, and small intestines; used to rule out ectopic pregnancy.

Colposcopy

An examination where a magnifying scope is inserted into the vagina to observe tissues for color, shape, vasculature, and lesions.

Laparoscopy

The insertion of a lighted scope through an incision beneath the umbilicus to view pelvic cavity structures under general anesthesia.

Mammography

A radiographic examination used to detect breast tumors before clinical symptoms appear; no deodorant or powder should be used before the test.

Thermography

A test that detects changes in circulation in breast tissue where increased heat indicates a tumor process.

Simple vaginitis

An infection characterized by yellow discharge, itching, burning, and edema.

Candida albicans

An overgrowth of vaginal yeast characterized by odorless, cheesy white discharge and an inflamed perineum.

Trichomonas vaginalis

A protozoan infection causing profuse green/yellow/white, malodorous, frothy discharge and a “strawberry” cervix.

Toxic shock syndrome (TSS)

A condition usually caused by Staphylococcus aureus, characterized by high fever, vomiting, diarrhea, and a sunburn-like rash on palms and soles.

Pelvic inflammatory disease (PID)

A local infection (usually gonorrhea or chlamydia) that spreads to the fallopian tubes and ovaries, potentially causing adhesions and sterility.

Mastitis

An infection of the breast, often occurring during lactation, characterized by reddened, inflamed tissue and exudate from the nipple.

Fibrocystic changes

Development of multiple soft, tender, freely moving cysts that enlarge during the menstrual period.

Uterine fibroids (myomas)

Benign tumors of the myometrium that can cause menorrhagia and backache.

Kegel exercises

Isometric exercises of the pubococcygeus (PC) muscle used to improve pelvic musculature support and control urinary flow.

Pessary

A device inserted into the vagina to give support to the uterus in cases of retroversion or prolapse.

Endometriosis

The proliferation of aberrant endometrial tissue outside the uterus, causing dysmenorrhea, backache, and infertility.

Subtotal hysterectomy

Surgical removal of the fundus of the uterus only.

Total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH-BSO)

Surgical removal of the uterus, fallopian tubes, and ovaries.

Benign prostatic hyperplasia (BPH)

Enlargement of prostate tissue resulting in compression of the urethra and urinary retention, common in men over $50$ years old.

Phimosis

Stenosis of the distal foreskin of the penis, resulting in an inability to retract the foreskin.

Inguinal hernia

Protrusion of a bowel loop through the inguinal ring; requires immediate attention if it fails to reduce.

Varicocele

Abnormal dilation and tortuosity of the veins along the spermatic cord; a common cause of male infertility.

Testicular cancer

The most common malignancy in men aged $20$–$34$; a painless mass is the primary assessment finding.

Cystocele

Protrusion of the bladder through the vaginal wall, resulting in stress incontinence.

Rectocele

Protrusion of the rectum through the vaginal wall, characterized by rectal pressure and hemorrhoids.

Prostate-specific antigen (PSA)

A blood test used to detect prostatic cancer.

Syphilis

An STI that progresses through three stages, starting with a painless chancre, followed by a copper-colored rash, and eventually cardiac/CNS dysfunction.

Gonorrhea

An STI characterized by thick discharge and dysuria; it coexists with chlamydia in $45\%$ of cases.

Condylomata acuminata

Genital warts caused by the human papilloma virus (HPV), appearing as cauliflower-like clusters.

Abdominal respirations

Breathing accomplished by abdominal muscles and diaphragm; normal in infants and toddlers.

Apnea

Temporary cessation of breathing; may be seen in older adults.

Cheyne-Stokes respirations

Breathing followed by slow, heavier breathing and seconds of normal breathing; seen with brain injury and death in older adults.

Dyspnea

Difficult, labored, or painful breathing.

Hyperpnea

Abnormally deep breathing seen with fever or metabolic acidosis; rate may be normal, slow, or increased.

Hyperventilation

Abnormally rapid, deep, and prolonged breathing that produces respiratory alkalosis due to reduction in $CO_2$ tension.

Hypoventilation

Reduced ventilatory efficiency that produces respiratory acidosis due to elevation in $CO_2$ tension; caused by emphysema, pneumonia, or pulmonary edema.

Kussmaul respirations (air hunger)

Marked increase in depth and rate of breathing; caused by diabetic ketoacidosis or metabolic acidosis.

Orthopnea

Inability to breathe except when the trunk is in an upright position; caused by severe lung or heart disease.

Paradoxical respirations

Breathing pattern where a lung or portion of a lung deflates during inspiration; caused by severe lung disease or flail chest.

Periodic breathing

Rate, depth, or tidal volume changes markedly from one interval to the next in a reproducible pattern.

Agonal respirations

Gasping breath patterns seen in cardiac arrest and at the end of life; the last pattern prior to terminal apnea.

Fine crackles

Popping sounds heard mostly on late inspiration, originating in the alveoli and sounding like rubbing hair.

Coarse crackles

Discontinuous popping sounds heard early in inspiration, originating in the large bronchus; described as harsh and moist.

Sibilant wheeze

High-pitched, musical sounds similar to a squeak, commonly heard on expiration over small airways; associated with asthma or bronchospasm.

Sonorous wheeze

Low-pitched, coarse, loud, moaning/snoring sounds arising from large airways; may clear with coughing.

Stridor

Harsh, high-pitched sounds heard over the trachea associated with upper airway inflammation and partial obstruction.

Pleural friction rub

A superficial, low-pitched, coarse rubbing or grating sound heard throughout inspiration and expiration in individuals with pleurisy.

Five-and-five

Emergency management for choking involving alternating between 5 back blows and 5 abdominal thrusts (Heimlich maneuver) until the blockage is dislodged.

Tracheostomy

Surgical incision made into the trachea via the throat where a tube is inserted to facilitate mechanical ventilation or prevent aspiration.

Suctioning wall pressure

The setting for wall suction during catheter withdrawal, which should be between $80-120\,mm\,Hg$.

Nasal cannula

Oxygen delivery method providing $23-42\%$ oxygen at a flow rate of $1-6\,L/min$.