Genitourinary - Exam 2 (Gynecological def, Pregnancy + RQ)

Amenorrhea

absence of menses

Hypermenorrhea

excessive bleeding during menstrual period of usual duration

Hypomenorrhea

decreased amount of menstrual flow

Menorrhagia

excessive bleeding during a menstrual period that is longer in duration

Polymenorrhea

increase frequency of menstruation not consistently associated with ovulation

Dyspareunia

pain during intercourse

Chandelier sign

pain upon movement of cervix

Adnexal

tissue near the uterus

Friable cervix

cervix that is more sensitive to bleeding and irritation

Signs of Pregnancy - Goodell

softening of cervix (4-6wks)

Signs of Pregnancy - Chadwick

bluish/purplish color of cervix, vagina, vulva (8-12wks)

Signs of Pregnancy - Hegar

softening of uterine isthmus (6-8wks) due to hormones

Signs of Pregnancy - McDonald

fundus flexes easily on cervix (7-8wks)

Signs of Pregnancy - Braun von Fernwald

fullness/softening of fundus at site of implantation (7-8wks)

What is the hallmark symptom of an ovarian cyst over other gynecological conditions

GI distress

The transitional phase leading up to menopause when hormone levels begin to fluctuate around late 30s to 40s

perimenopause

How long does perimenopause last

few months to several years (4-8yrs) before menopause

The point at which a woman has gone 12 consecutive months without a menstrual period (end of reproductive years)

menopause (avg age 51)

The stage of life after menopause has been reached around mid-50s and continues for the rest of a woman’s life

postmenopause

Hydrocolpos

distention of vagina caused by accumulation of fluid due to congenital vaginal obstruction

• imperforate hymen

• transverse vaginal septum

Naegele rule (gestational age)

add 7 days to the first day of the last normal menstrual period and count back 3 months

Average duration of a pregnancy

40 weeks (280days)

Measuring fundal height (cm)

upper part of pubis symphysis to superior fundus (over midline)

Fundal height is the most accurate between ____ weeks (fundal height = gestational age in wks)

20-30wks

What is the abdominal palpation for fetal position known as

Leopold’s

Vertex presentation of fetus

head down in pelvis

Breech presentation of fetus

head is up in uterine fundus and buttock in pelvis

Denominator

letter that represents that presenting fetal part

• Occiput (O)

• Sacrum (S)

• Mentum (M)

• Frontal (F)

• Acromion (AC)

Leopold’s Maneuver (determine position of baby and expected presentation during L&D)

1) What part is in the fundus (hand near rib cage)

2) Determine position of the back (hands either side of abdomen)

3) Determine what part is lying above the inlet (cup shaped hand above symphysis pubis)

4) Flexed/Deflexed/Extended (hands diagonal towards symphysis pubis)

1st trimester expected physical changes

fatigue

mild abdominal tenderness (implantation)

breast tenderness

slight increase in HR

2nd trimester expected physical changes

fetal flutters (feel kicks around 16-20wks)

mild production leakage

linea nigra

melasma

striae gravidarum

spider veins

3rd trimester expected physical changes

braxton hicks

fetal drop (more pressure on bladder, accentuation of lordosis)

swelling (LE) and waddling

corneal thickening and thicker tears

hoarseness

thyroid may enlarge

dyspnea

The diaphragm may sit ___ higher during pregnancy

4cm

Cardiovascular changes during pregnancy

apical pulse moves up 1.5cm

HR 10-15bpm higher

left ventricle hypertrophy

aorta + pulmonary artery increase in size and thickness

Pregnant women’s blood increases by

40-50%

Hair and nails changes during pregnancy

grow faster…then increased hair loss postpartum

GI changes in pregnancy

1st tri - nausea ranges from mild to hyperemesis

2nd tri - appetite and caloric need increases

3rd - crowding of stomach = heartburn

constipation

hemorrhoids

Diastasis recti

separation btw the 2 sides of the rectus abdominus muscle (split down the middle)