The document provides information on assessing the female reproductive system, including:
1. An overview of the objectives, introduction, external and internal structures, equipment used, and general examination procedures.
2. Descriptions of inspecting and palpating the external genitalia, speculum examination of the internal genitalia, and collecting specimens.
3. Details on performing a bimanual examination to assess the vagina, cervix, uterus and adnexa. The document outlines the normal findings and abnormalities to look for during the physical examination.
This document discusses incontinence of urine, including the physiology of micturition, definitions of different types of incontinence, and methods for diagnosing and treating stress incontinence. It defines stress incontinence as the involuntary escape of urine with increased intra-abdominal pressure, such as during coughing or sneezing. Diagnostic tests include stress tests, cystourethrography, and urodynamics to differentiate between urethral hypermobility and intrinsic sphincter dysfunction as causes. Treatment options include pelvic floor exercises, pessaries, bladder neck slings or colposuspension surgery.
This document discusses urinary incontinence. It covers the epidemiology, types, causes, risk factors, evaluation, and treatment of urinary incontinence. Regarding treatment, it describes behavioral techniques like toileting assistance and pelvic muscle exercises. It also discusses pharmacological options for urge incontinence like anticholinergic agents and stress incontinence like alpha-adrenergic agonists. Surgical treatment is also an option but requires thorough evaluation first.
Urinary incontinence affects approximately 30% of women and 15% of men, with the most common causes being overactive bladder, weakness of the pelvic floor after childbirth, and bladder outlet obstruction in middle-aged men. Assessment of incontinence considers symptoms and disorders through urine analysis, urodynamic testing like cystometry, and physical examinations. Treatment options include lifestyle changes like fluid management and pelvic floor exercises, as well as drugs like anticholinergics and antimuscarinics.
Urinary incontinence simply means involuntary leaking of urine.
Incontinence can range from leaking just a few drops of urine to complete emptying of the bladder.
Social and hygienic problem.
This document provides an overview of obstetric fistula, including:
1. Obstetric fistula is an abnormal connection between the bladder and vagina or rectum and vagina, usually caused by prolonged obstructed labor without access to emergency cesarean section.
2. The condition is most common in developing countries, especially in sub-Saharan Africa where child marriage and lack of access to medical care contribute to high rates of obstructed labor. An estimated over 2 million women in developing countries currently live with untreated obstetric fistula.
3. In addition to incontinence, obstetric fistula can cause serious physical, psychological, and social problems for women including infection,
Urinary incontinence is a common condition in older adults that is not a normal part of aging. It can be caused by age-related changes, medical conditions, medications, and environmental factors. There are different types of urinary incontinence including stress, urge, overflow, functional, and mixed incontinence. Evaluation involves taking a history, physical exam, urinalysis, post-void residual measurement, and sometimes urodynamic testing. Management uses a stepped approach starting with conservative treatments like lifestyle changes, pelvic floor exercises, and behavioral therapy. If conservative treatments are ineffective, pharmacologic therapy and sometimes surgical options may be used.
This document discusses various menstrual disorders including amenorrhea, dysmenorrhea, dysfunctional bleeding, premenstrual syndrome, pelvic inflammatory disease, endometriosis, pelvic relaxation disorders, cystitis, urinary incontinence, and perimenopause. It defines each condition, discusses etiology and pathophysiology, assessment findings, diagnosis, and treatment. Nursing considerations are provided for educating women on prevention and management of these common gynecological issues.
This document discusses incontinence of urine, including the physiology of micturition, definitions of different types of incontinence, and methods for diagnosing and treating stress incontinence. It defines stress incontinence as the involuntary escape of urine with increased intra-abdominal pressure, such as during coughing or sneezing. Diagnostic tests include stress tests, cystourethrography, and urodynamics to differentiate between urethral hypermobility and intrinsic sphincter dysfunction as causes. Treatment options include pelvic floor exercises, pessaries, bladder neck slings or colposuspension surgery.
This document discusses urinary incontinence. It covers the epidemiology, types, causes, risk factors, evaluation, and treatment of urinary incontinence. Regarding treatment, it describes behavioral techniques like toileting assistance and pelvic muscle exercises. It also discusses pharmacological options for urge incontinence like anticholinergic agents and stress incontinence like alpha-adrenergic agonists. Surgical treatment is also an option but requires thorough evaluation first.
Urinary incontinence affects approximately 30% of women and 15% of men, with the most common causes being overactive bladder, weakness of the pelvic floor after childbirth, and bladder outlet obstruction in middle-aged men. Assessment of incontinence considers symptoms and disorders through urine analysis, urodynamic testing like cystometry, and physical examinations. Treatment options include lifestyle changes like fluid management and pelvic floor exercises, as well as drugs like anticholinergics and antimuscarinics.
Urinary incontinence simply means involuntary leaking of urine.
Incontinence can range from leaking just a few drops of urine to complete emptying of the bladder.
Social and hygienic problem.
This document provides an overview of obstetric fistula, including:
1. Obstetric fistula is an abnormal connection between the bladder and vagina or rectum and vagina, usually caused by prolonged obstructed labor without access to emergency cesarean section.
2. The condition is most common in developing countries, especially in sub-Saharan Africa where child marriage and lack of access to medical care contribute to high rates of obstructed labor. An estimated over 2 million women in developing countries currently live with untreated obstetric fistula.
3. In addition to incontinence, obstetric fistula can cause serious physical, psychological, and social problems for women including infection,
Urinary incontinence is a common condition in older adults that is not a normal part of aging. It can be caused by age-related changes, medical conditions, medications, and environmental factors. There are different types of urinary incontinence including stress, urge, overflow, functional, and mixed incontinence. Evaluation involves taking a history, physical exam, urinalysis, post-void residual measurement, and sometimes urodynamic testing. Management uses a stepped approach starting with conservative treatments like lifestyle changes, pelvic floor exercises, and behavioral therapy. If conservative treatments are ineffective, pharmacologic therapy and sometimes surgical options may be used.
This document discusses various menstrual disorders including amenorrhea, dysmenorrhea, dysfunctional bleeding, premenstrual syndrome, pelvic inflammatory disease, endometriosis, pelvic relaxation disorders, cystitis, urinary incontinence, and perimenopause. It defines each condition, discusses etiology and pathophysiology, assessment findings, diagnosis, and treatment. Nursing considerations are provided for educating women on prevention and management of these common gynecological issues.
This is a slide share on the topic Metorrhagia and menorrhagia . This topic was very hard to find on internet with full information. I faced lot of problems in finding topic, eventually i consult different books and gathered all information that i required. Now um uploading this topic cause i don't want anybody face the problems that i faced.
Jazakh Allahu Khyran
This document provides an overview of urinary incontinence. It defines urinary incontinence as the involuntary loss of urine that is objectively demonstrable and a social or hygienic problem. The document then discusses the epidemiology of urinary incontinence, risk factors, types of incontinence, diagnosis, and management. For management, it describes non-pharmacological therapies like lifestyle changes, pharmacological therapies for urgency and stress incontinence, and surgical options like sacral nerve stimulation, transurethral bulking agents, perineal slings, and artificial urinary sphincters. The overall document provides a comprehensive review of urinary incontinence.
Congenital abnormalities of reproductive systemVahitha Vahitha
The document discusses congenital abnormalities of the female reproductive system. It begins by describing the normal anatomy and functions of the uterus, ovaries, fallopian tubes, vagina, and cervix. It then discusses various types of developmental anomalies that can occur, including defects in fusion of the müllerian ducts that can result in septate or bicornuate uteri. Other abnormalities include cervical duplication, vaginal atresia or septa, and unicornuate or didelphys uteri. Many anomalies are associated with complications in pregnancy like miscarriage or preterm delivery. Surgical treatments like metroplasty or cerclage may help in some cases.
This document discusses shoulder dystocia, which occurs when a baby's head is delivered but the shoulders become stuck and cannot be delivered. It defines shoulder dystocia and lists its main causes as a large baby or failure of the shoulders to rotate after delivery of the head. The document then outlines some management techniques for shoulder dystocia, including avoiding excessive pushing, pulling, or pivoting. It provides details on two management types: forceps delivery and ventouse (vacuum) delivery.
Vaginal prolapse is a condition in which structures such as the uterus, rectum, bladder, urethra, small bowel, or the vagina itself may begin to prolapse, or fall out of their normal positions.
1. Neurogenic bladder is caused by damage to the nervous system that controls bladder function, resulting in the bladder being unable to empty completely or contract properly.
2. It is diagnosed through medical history, exams, bladder function tests and imaging to evaluate the bladder and kidneys.
3. Treatment includes physical therapy like timed voiding, electrical stimulation implants, catheterization, and sometimes surgery to address the bladder sphincter or install an artificial sphincter. Follow-up care monitors bladder and kidney health.
The document discusses examination of the urogenital system in various animal species. It describes the location and palpation of kidneys and bladder. For males, it covers visual inspection and palpation of testes, prepuce, and penis. For females, it discusses visual inspection, palpation of vaginal region, and use of a speculum to examine inside the vagina. It also addresses collection and analysis of urine samples to examine for abnormalities. Rectal palpation is described as a method to examine kidneys in some large animals.
The document discusses the physiological changes that occur during pregnancy across multiple body systems. Key changes include enlargement and elevation of the uterus throughout pregnancy. Cardiovascular changes include increased stroke volume, pulse rate, cardiac output and blood volume. Respiratory changes include increased respiratory rate and tidal volume. The urinary system experiences increased bladder capacity and renal blood flow. Total maternal weight gain during pregnancy is 12-14kg, including gains in fat, placenta, fetus, amniotic fluid and blood volume.
This document provides information on urinary incontinence, including its definition, epidemiology, risk factors, types, diagnosis, and treatment options. It defines urinary incontinence as the involuntary leakage of urine. Some key points include:
- Prevalence is 25-55% in Western societies, but only 25% seek treatment due to embarrassment.
- Stress urinary incontinence accounts for 29-75% of cases, while urge accounts for 33%.
- Risk factors include age, pregnancy/childbirth, menopause, hysterectomy, obesity, chronic coughing.
- Types include stress, urge, mixed, functional, and extraurethral incontinence.
- Diagnosis
Vaginitis is an inflammation of the vagina that affects about 1 in 3 women during their reproductive years. It is often caused by infections like bacterial vaginosis, trichomoniasis, or a yeast infection. Symptoms include burning and itching outside the vagina along with a white, lumpy discharge. Doctors diagnose vaginitis by examining a sample of vaginal discharge under a microscope. Treatment depends on the specific type but generally involves oral or topical medications.
Postpartum psychosis is a severe mental illness which develops acutely in the early postnatal period. It is a psychiatric emergency. Identifying women at risk allows development of care plans to allow early detection and treatment. Management requires specialist care. Health professionals must take into account the needs of the family and new baby, as well as the risks of medication whilst breast-feeding.
here give the knowledge that you should possess to manage acute and chronic urine retention. the lecture is more concerned about practical patient care and ward setting management. you should minimally be aware about following facts regarding urine retention. the multiple causes of retention will be discussed later in detailed manner. Direction of the lecture seems more toward BPH and acute retention management. beware there are many aspects of a patient present with an AUR. do no harm and always try to keep patient satisfaction. Let me know about your comments an Ideas. try to improve the quality. good luck.
The involuntary loss of urine, which is objectively demonstrable, with such a degree of severity that it becomes a social or hygienic problem is a common scene in older women. These slides focus on role of physiotherapy in treatment of urinary incontinence in older women
1. Vesicovaginal fistula is an abnormal connection between the bladder and vagina that causes continuous urinary incontinence.
2. It is most commonly caused by prolonged obstructed labor in developing countries, while medical/surgical procedures are more common causes in developed nations.
3. Clinical features include continuous urinary leakage from the vagina. Examination involves identifying the fistula location, size, and involvement of surrounding structures.
This document defines premenstrual syndrome and discusses its prevalence, etiology, diagnosis, and management. Some key points include:
- PMS involves physical, psychological, and behavioral symptoms that occur during the luteal phase of the menstrual cycle and go away during menstruation.
- About 15% of women have no PMS symptoms, 50% have mild symptoms, 30% have moderate symptoms, and 5-10% have severe symptoms.
- Management includes lifestyle changes, dietary supplements, exercise, stress reduction, hormonal treatments, antidepressants, and in severe cases, surgery. Cognitive behavioral therapy provides long-term benefits.
PMS is a psychoneuroendocrine disorder that causes a variety of physical and behavioral symptoms in the week before a woman's period begins, due to alterations in estrogen and progesterone levels. Common symptoms include mood swings, breast tenderness, bloating, headaches, and fatigue. While the exact cause is unknown, potential contributing factors include neurotransmitter levels, psychological factors, and hormones. Treatment focuses on lifestyle changes like diet, exercise and stress reduction, as well as hormonal birth control, antidepressants, vitamins, and herbal supplements to manage symptoms.
This document discusses benign prostatic hyperplasia (BPH). It defines BPH as a noncancerous enlargement of the prostate gland caused by an increase in size of the prostate stromal and glandular cells. BPH typically occurs in men over 40 and causes compression of the urethra leading to urinary symptoms. Treatment options include medications that shrink the prostate, minimally invasive procedures such as transurethral resection of the prostate (TURP), and open prostatectomy for large enlargements. Holmium laser enucleation of the prostate (HoLEP) has emerged as a new gold standard procedure for BPH.
Well explained and illustrated gynaecology notes, yet simply explained for easy understanding.
Includes overview of female reproductive system, assessment, various conditions, their management and nursing process.
This document discusses subfertility, which is defined as the failure to conceive within 1 year of unprotected regular sexual intercourse. It describes various factors that can affect fertility in both men and women, including ovulation disorders, tubal damage, age, sexually transmitted diseases, endometriosis, and male factors like varicocele and low semen quality. The management of subfertility involves taking a history, examination, and investigations to determine the cause, followed by treatments tailored to the specific diagnosis, such as clomiphene citrate for ovulation disorders or surgery for tubal disease.
This is a slide share on the topic Metorrhagia and menorrhagia . This topic was very hard to find on internet with full information. I faced lot of problems in finding topic, eventually i consult different books and gathered all information that i required. Now um uploading this topic cause i don't want anybody face the problems that i faced.
Jazakh Allahu Khyran
This document provides an overview of urinary incontinence. It defines urinary incontinence as the involuntary loss of urine that is objectively demonstrable and a social or hygienic problem. The document then discusses the epidemiology of urinary incontinence, risk factors, types of incontinence, diagnosis, and management. For management, it describes non-pharmacological therapies like lifestyle changes, pharmacological therapies for urgency and stress incontinence, and surgical options like sacral nerve stimulation, transurethral bulking agents, perineal slings, and artificial urinary sphincters. The overall document provides a comprehensive review of urinary incontinence.
Congenital abnormalities of reproductive systemVahitha Vahitha
The document discusses congenital abnormalities of the female reproductive system. It begins by describing the normal anatomy and functions of the uterus, ovaries, fallopian tubes, vagina, and cervix. It then discusses various types of developmental anomalies that can occur, including defects in fusion of the müllerian ducts that can result in septate or bicornuate uteri. Other abnormalities include cervical duplication, vaginal atresia or septa, and unicornuate or didelphys uteri. Many anomalies are associated with complications in pregnancy like miscarriage or preterm delivery. Surgical treatments like metroplasty or cerclage may help in some cases.
This document discusses shoulder dystocia, which occurs when a baby's head is delivered but the shoulders become stuck and cannot be delivered. It defines shoulder dystocia and lists its main causes as a large baby or failure of the shoulders to rotate after delivery of the head. The document then outlines some management techniques for shoulder dystocia, including avoiding excessive pushing, pulling, or pivoting. It provides details on two management types: forceps delivery and ventouse (vacuum) delivery.
Vaginal prolapse is a condition in which structures such as the uterus, rectum, bladder, urethra, small bowel, or the vagina itself may begin to prolapse, or fall out of their normal positions.
1. Neurogenic bladder is caused by damage to the nervous system that controls bladder function, resulting in the bladder being unable to empty completely or contract properly.
2. It is diagnosed through medical history, exams, bladder function tests and imaging to evaluate the bladder and kidneys.
3. Treatment includes physical therapy like timed voiding, electrical stimulation implants, catheterization, and sometimes surgery to address the bladder sphincter or install an artificial sphincter. Follow-up care monitors bladder and kidney health.
The document discusses examination of the urogenital system in various animal species. It describes the location and palpation of kidneys and bladder. For males, it covers visual inspection and palpation of testes, prepuce, and penis. For females, it discusses visual inspection, palpation of vaginal region, and use of a speculum to examine inside the vagina. It also addresses collection and analysis of urine samples to examine for abnormalities. Rectal palpation is described as a method to examine kidneys in some large animals.
The document discusses the physiological changes that occur during pregnancy across multiple body systems. Key changes include enlargement and elevation of the uterus throughout pregnancy. Cardiovascular changes include increased stroke volume, pulse rate, cardiac output and blood volume. Respiratory changes include increased respiratory rate and tidal volume. The urinary system experiences increased bladder capacity and renal blood flow. Total maternal weight gain during pregnancy is 12-14kg, including gains in fat, placenta, fetus, amniotic fluid and blood volume.
This document provides information on urinary incontinence, including its definition, epidemiology, risk factors, types, diagnosis, and treatment options. It defines urinary incontinence as the involuntary leakage of urine. Some key points include:
- Prevalence is 25-55% in Western societies, but only 25% seek treatment due to embarrassment.
- Stress urinary incontinence accounts for 29-75% of cases, while urge accounts for 33%.
- Risk factors include age, pregnancy/childbirth, menopause, hysterectomy, obesity, chronic coughing.
- Types include stress, urge, mixed, functional, and extraurethral incontinence.
- Diagnosis
Vaginitis is an inflammation of the vagina that affects about 1 in 3 women during their reproductive years. It is often caused by infections like bacterial vaginosis, trichomoniasis, or a yeast infection. Symptoms include burning and itching outside the vagina along with a white, lumpy discharge. Doctors diagnose vaginitis by examining a sample of vaginal discharge under a microscope. Treatment depends on the specific type but generally involves oral or topical medications.
Postpartum psychosis is a severe mental illness which develops acutely in the early postnatal period. It is a psychiatric emergency. Identifying women at risk allows development of care plans to allow early detection and treatment. Management requires specialist care. Health professionals must take into account the needs of the family and new baby, as well as the risks of medication whilst breast-feeding.
here give the knowledge that you should possess to manage acute and chronic urine retention. the lecture is more concerned about practical patient care and ward setting management. you should minimally be aware about following facts regarding urine retention. the multiple causes of retention will be discussed later in detailed manner. Direction of the lecture seems more toward BPH and acute retention management. beware there are many aspects of a patient present with an AUR. do no harm and always try to keep patient satisfaction. Let me know about your comments an Ideas. try to improve the quality. good luck.
The involuntary loss of urine, which is objectively demonstrable, with such a degree of severity that it becomes a social or hygienic problem is a common scene in older women. These slides focus on role of physiotherapy in treatment of urinary incontinence in older women
1. Vesicovaginal fistula is an abnormal connection between the bladder and vagina that causes continuous urinary incontinence.
2. It is most commonly caused by prolonged obstructed labor in developing countries, while medical/surgical procedures are more common causes in developed nations.
3. Clinical features include continuous urinary leakage from the vagina. Examination involves identifying the fistula location, size, and involvement of surrounding structures.
This document defines premenstrual syndrome and discusses its prevalence, etiology, diagnosis, and management. Some key points include:
- PMS involves physical, psychological, and behavioral symptoms that occur during the luteal phase of the menstrual cycle and go away during menstruation.
- About 15% of women have no PMS symptoms, 50% have mild symptoms, 30% have moderate symptoms, and 5-10% have severe symptoms.
- Management includes lifestyle changes, dietary supplements, exercise, stress reduction, hormonal treatments, antidepressants, and in severe cases, surgery. Cognitive behavioral therapy provides long-term benefits.
PMS is a psychoneuroendocrine disorder that causes a variety of physical and behavioral symptoms in the week before a woman's period begins, due to alterations in estrogen and progesterone levels. Common symptoms include mood swings, breast tenderness, bloating, headaches, and fatigue. While the exact cause is unknown, potential contributing factors include neurotransmitter levels, psychological factors, and hormones. Treatment focuses on lifestyle changes like diet, exercise and stress reduction, as well as hormonal birth control, antidepressants, vitamins, and herbal supplements to manage symptoms.
This document discusses benign prostatic hyperplasia (BPH). It defines BPH as a noncancerous enlargement of the prostate gland caused by an increase in size of the prostate stromal and glandular cells. BPH typically occurs in men over 40 and causes compression of the urethra leading to urinary symptoms. Treatment options include medications that shrink the prostate, minimally invasive procedures such as transurethral resection of the prostate (TURP), and open prostatectomy for large enlargements. Holmium laser enucleation of the prostate (HoLEP) has emerged as a new gold standard procedure for BPH.
Well explained and illustrated gynaecology notes, yet simply explained for easy understanding.
Includes overview of female reproductive system, assessment, various conditions, their management and nursing process.
This document discusses subfertility, which is defined as the failure to conceive within 1 year of unprotected regular sexual intercourse. It describes various factors that can affect fertility in both men and women, including ovulation disorders, tubal damage, age, sexually transmitted diseases, endometriosis, and male factors like varicocele and low semen quality. The management of subfertility involves taking a history, examination, and investigations to determine the cause, followed by treatments tailored to the specific diagnosis, such as clomiphene citrate for ovulation disorders or surgery for tubal disease.
Infertility is “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.”
By World Health Organization
The uterine cycle, also known as the menstrual cycle, is a complex series of events that occurs in the female reproductive system, primarily involving the uterus and ovaries. The cycle is divided into three main phases: the menstrual phase, the proliferative phase, and the secretory phase. The uterine cycle is tightly regulated by hormonal changes, primarily those involving estrogen and progesterone. The uterine cycle is a dynamic and intricately regulated process essential for reproductive health. It plays a central role in the preparation of the uterus for potential pregnancy and is influenced by hormonal fluctuations throughout the menstrual cycle.
EVALUATION OF INFERTILITY AND MEDICAL ASPECTS.pdfBhavyaRaval3
The document provides an overview of infertility, its causes, diagnosis, and treatment options. It discusses infertility in males and females separately. For males, common causes include low sperm count, motility issues, or abnormalities. For females, common causes are ovulation disorders, issues with the fallopian tubes or uterus, poor egg quality, or cervical/uterine problems. Diagnosis involves medical histories, physical exams, and tests like semen analysis, blood tests, and ultrasounds. Treatment may include lifestyle changes, ovulation drugs, surgery, artificial insemination, in vitro fertilization, or donor gametes if needed.
This document provides an overview of topics covered in gynecology for the 5th stage, including a detailed guide to taking a gynecological patient history and performing a gynecological examination. The gynecological history section outlines the various components to cover, such as menstrual history, sexual/contraceptive history, past medical/surgical history, and family history. The gynecological examination section describes examining the breasts, abdomen, and pelvic organs and specifies how to conduct an abdominal exam, pelvic exam using a speculum and digitally, and a rectal exam if needed.
This document discusses various women's health issues and disorders and how yoga can help address them. It covers:
1) Common health disorders women face such as PMS, dysmenorrhea, amenorrhea, and issues related to pregnancy, menopause, and infertility.
2) How stress physically and psychologically impacts the body.
3) Yoga practices like Surya Namaskar and meditation that aim to relax the body, slow the breath, and calm the mind for stress management.
The document provides information on yoga techniques for treating various women's health disorders and menstrual issues. It outlines integrated yoga modules involving breathing practices, yoga poses, relaxation techniques, and meditation/pranayama that can help with conditions like heavy or painful periods, irregular cycles, PMS, infertility, menopause, and incontinence. The modules are designed to stimulate, relax, and balance the body and mind.
GYNAECOLOGICAL DISORDERS. Nursing detailed approach to gynaecological disordersAtamboMathewMandela
The document provides information on caring for patients with gynecological conditions. It outlines the objectives of understanding key terms, recognizing disorders, describing common disorders, and demonstrating care abilities. It defines important gynecological terms and describes investigations including medical history, physical exam, urine and blood tests, cervical smears, biopsies, and radiological exams to diagnose gynecological issues.
This document provides information about infertility, including definitions, causes, tests, and treatments. It notes that infertility is defined as failure to conceive within one year of unprotected sex. The most common causes are issues with ovulation (30% of cases), male factor infertility (30%), and tubal damage or blockages (30-50% of female cases). Diagnostic testing involves assessing hormone levels, semen analysis, hysterosalpingography, and laparoscopy. Treatment depends on the underlying cause but may include fertility drugs, artificial insemination, in vitro fertilization (IVF), or surgery. Success rates vary based in the cause but range from 20-60% for treatments and 15-43% for IV
This document discusses infertility and provides guidance on evaluating and managing cases of infertility. It defines primary and secondary infertility according to the WHO. For males, it describes evaluating infertility through a comprehensive history, physical exam, and semen analysis. It outlines initial workup and management based on risk factors and test results. The document then presents a case study of a male patient, Ali, who presents with infertility. It describes evaluating Ali through history, exam, lifestyle counseling, anxiety management, and semen analysis. Based on Ali's mildly abnormal analysis, the document recommends further follow up and investigation.
Infertility is defined as the failure to conceive after 12 months of unprotected sex. It can be caused by issues with either the man or woman's reproductive systems. Common causes include fallopian tube damage, ovulation disorders, low sperm count/quality, and age-related decline in fertility. Diagnosis involves medical history, physical exams, and tests like semen analysis and ultrasound. Treatment may include lifestyle changes, fertility drugs, artificial insemination, in vitro fertilization, and surrogacy. Preventing infertility requires a healthy diet, exercise, stress management, avoiding drugs/excessive alcohol, and considering age-related fertility decline.
Infertility affects approximately 15% of couples globally and can be caused by female or male factors. Evaluating both partners is important to determine the cause, which may include issues with ovulation, fallopian tubes, sperm, or other uterine or hormonal problems. Treatment options range from ovulation-inducing drugs, surgery to repair issues, and assisted reproductive technologies like IVF, IUI, or ICSI depending on the underlying cause.
This document provides information on assessing the female genitourinary system, including:
- The structures that make up the system and their functions
- How to take a history, examine patients, and identify normal vs abnormal findings
- Cultural and developmental variations
- A case study of a patient complaining of scant midcycle bleeding, and the relevant history, exam findings, and potential nursing diagnoses for this patient
1. INFERTLITY and Menopouse for PG.pptxMesfinShifara
Infertility is defined as the inability to conceive after 12 months of regular unprotected intercourse. It can be caused by problems with sperm, eggs, fertilization, or implantation. Common causes include ovulatory disorders, tubal damage, male factor issues, and unexplained infertility. Diagnosis involves medical history, physical exam, semen analysis, and tests of hormone levels and fallopian tube patency. Treatment may include lifestyle changes, ovulation induction, intrauterine insemination, in vitro fertilization, or assisted reproductive technologies.
N544- Physical Assessment of the Male GU System, Anus, Rectum and Prostate- u...MulugetaAbeneh1
This document provides information on performing a physical assessment of the male genitourinary system. It begins with an anatomy review of the penis, scrotum, testes, and prostate gland. It emphasizes minimizing the patient's anxiety during the exam and taking a thorough history regarding present and past issues. The physical exam process is outlined, including inspection and palpation of the genitalia, scrotum, hernias, and lymph nodes. Common abnormalities like STDs, masses, and hernias are described. The document also covers the exam of the anus, rectum and prostate, including inspection, palpation techniques and common disorders.
The document discusses infertility, its causes and treatments. It defines infertility as the inability to conceive after one year of regular unprotected sex. Approximately 10-15% of couples experience infertility, with female factors accounting for 60% of cases, male factors 30% and both male and female factors in 10% of cases. Common female causes include problems with ovulation, fallopian tubes or cervical factors. Common male causes include abnormal sperm production or function. Treatments aim to address the specific cause, and may include ovulation induction medications, surgery, assisted reproduction technologies like IUI or IVF.
This document discusses fertility and infertility, including chances of conception, factors that affect fertility, evaluating fertility, and treatment options. It provides information on:
1. The chances of conception within 1 year of unprotected intercourse is 80% and within 1.5 years is 90%. Investigations should be waited after 1 year of trying.
2. Factors that can affect fertility include lifestyle factors like smoking, alcohol, obesity, occupational heat exposure, and recreational drug use. Medical conditions and medications can also impact fertility.
3. Evaluating fertility involves testing for issues like abnormal semen analysis, ovulation disorders, tubal damage, uterine anomalies, and assessing ovarian reserve. Treatment depends on identified causes and may include lifestyle
This document provides guidance on performing genitourinary assessments as a nurse. It outlines that nurses typically assess external genitalia and lymph nodes, while more in-depth exams are done by nurse practitioners, physicians, and specialty nurses. Even novice nurses may assist or witness exams. The genitourinary system includes reproductive and urinary organs. Exams can be embarrassing, so competence and professionalism are important. Comprehensive male exams include hernia checks, genital inspection and palpation, while female exams may include internal exams with speculums or digital exams for sexually active or symptomatic women. Rectal exams are also described.
Similar to 8.Assessment of Female Reproductive.pptx (20)
This document discusses nutrition for critically ill patients. It outlines nutritional risk assessment tools, energy and protein needs, and enteral feeding protocols. For the case, it recommends starting enteral nutrition as soon as hemodynamically stable, with a calorie target of 25-30 kcal/kg ideal body weight per day, or 1250-1500 kcal for a 50kg man. Locally available formulas like Plumpy'Nut and Mumbai formula are options for enteral feeding in the ICU.
This document provides an overview of sedation, analgesia, and delirium management in the intensive care unit (ICU). It discusses pain in critically ill patients, common painful procedures, and tools for pain assessment. It covers pharmacological and non-pharmacological approaches to pain management, including regional analgesia, opioid analgesics like fentanyl and morphine, and non-opioid options. The document also addresses goals of sedation in the ICU, scales for sedation monitoring, benzodiazepines, dexmedetomidine, propofol and their properties and adverse effects. Finally, it briefly discusses delirium and its management.
This document discusses vasoactive agents used to treat shock. It outlines different types of shock including septic, cardiogenic, and hypovolemic shock. It describes the autonomic nervous system and types of adrenergic receptors. Various vasopressors and inotropes are presented including norepinephrine, dopamine, epinephrine, vasopressin, and phenylephrine. Their mechanisms, dosages, and indications for treating shock are provided. Maintaining adequate perfusion and tissue oxygen delivery is critical for treatment.
This document provides an overview of fluid management for a patient admitted to the ICU. It discusses fluid types, their components and uses. It describes how to assess a patient's fluid status and calculate fluid requirements. The document outlines fluid monitoring, electrolyte disorders like hyponatremia and hypernatremia, and their management. It emphasizes the importance of maintaining fluid balance and addressing imbalances to support organ function.
A 29-year old male with no previous medical history was admitted to the ICU after a car crash with multiple trauma requiring laparotomy. He is intubated, sedated and on noradrenaline with low blood pressure and heart rate. A feeding tube was inserted into his jejunum. The discussion points are about when to start nutrition, what the energy target should be, and how to manage hypoglycemia. The document discusses the risks and benefits of early enteral nutrition in the ICU, optimal routes, timing and formulations of feeding as well as monitoring for complications. It also covers indications for parenteral nutrition and management of hypoglycemia.
Electrolytes like sodium, potassium, calcium, and magnesium are important minerals in the body that regulate functions like nerve impulses, muscle contraction, and fluid balance. Sodium is the main cation in extracellular fluid and helps maintain fluid balance and nerve transmission. Potassium is mainly intracellular and regulates muscle contraction and acid-base balance. Common electrolyte imbalances include hyponatremia (low sodium), hypernatremia (high sodium), hypokalemia (low potassium), and hyperkalemia (high potassium). Their causes, clinical effects, and management strategies are discussed.
Critically ill patients are susceptible to short- and long-term complications. Implementing proven best practices through checklists, bundles, and interdisciplinary rounds can help prevent these complications. A bundle is a set of evidence-based interventions that improve patient outcomes more than any single intervention alone, such as the ABCDEF bundle which is shown to reduce ICU length of stay, delirium, and mortality.
This document discusses various clinical syndromes related to COVID-19 including:
- Mild to severe pneumonia characterized by cough and respiratory symptoms. Severe pneumonia can progress to ARDS.
- ARDS is identified by acute hypoxemic respiratory failure, bilateral lung opacities, and onset within one week of a known clinical insult or infection.
- Sepsis is defined as a dysregulated immune response to infection leading to life-threatening organ dysfunction. Septic shock involves circulatory and metabolic abnormalities requiring vasopressors.
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Many 0 to 1 startup founders often overlook market research, but this critical step can make or break a venture, especially in health tech.
But Why do they skip it?
Limited resources—time, money, and manpower—are common culprits.
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Example of Market Research working
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Competitive Analysis: Analyzed competitors offering similar solutions in healthcare analytics and interoperability. Identified gaps in comprehensive data aggregation, real-time analytics, and actionable insights.
Regulatory Compliance: Ensured their platform complied with HIPAA and other healthcare data privacy regulations. This compliance was crucial to gaining trust from healthcare providers wary of data security issues.
Customer Validation: Conducted pilot programs with several healthcare organizations to validate the platform's effectiveness in improving care outcomes and operational efficiency. Gathered feedback to refine features and user interface.
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8.Assessment of Female Reproductive.pptx
1. SALALE UNIVERSITY COLLEGE OF
HEALTH SCIENCES
DEPARTMENT OF ADULT HEALTH
NURSING
Assessment of Female Reproductive System
Presented by : Merga Wekwaya
Presented to: Mr Bikila T. (BSc, MSc, Ass’t Prof.)
Jun 2023
Fitche
2:10:24 PM 1
Female Reproductive System
2. Objective
After studying this chapter you will be able to:
Describe anatomy and physiology.
Identify equipment, positioning, techniques.
Explain process of performing assessment of
female reproductive systems.
Differentiate between normal and abnormal
assessment data.
2:10:24 PM 2
Female Reproductive System
3. Introduction
The female reproductive system is responsible
for producing gametes, sex hormones, and
keeping fertilized eggs alive until they mature
into fetuses and are prepared for birth.
History, a comprehensive physical examination,
and an assessment of the external and internal
genitalia are all part of the physical exam's
section on the female reproductive system.
2:10:24 PM 3
Female Reproductive System
4. Female Reproductive System
External Structures
Mons Pubis, Clitoris
Labia Majora
Labia Minora
Skene’s Glands
Hymen
Bartholin’s Glands
2:10:24 PM 4
Female Reproductive System
5. Female Reproductive System
Internal Structures
Vagina: Muscular tube from cervix to vulva.
Cervix: lower, narrow portion of uterus
Uterus: pear-shaped organ containing growing
fetus
Fallopian Tubes: pathway for egg travel during
ovulation
Ovaries: egg-producing organs
2:10:24 PM 5
Female Reproductive System
7. Equipment For Examination Female
Reproductive System
Gloves
Drape
Vaginal Speculum
Cotton-tipped
applicator
Examination table
Screen
Ayre Spatula
(endocervical brush)
Specimen container
Small bottle(3)
Warm water
Lubricating jelly
Flexible light source
2:10:24 PM Female Reproductive System 7
8. General Consideration
Begin with woman in sitting position
Explain each step in the exam before you do it.
The patient must have an empty bladder.
Place woman in lithotomy position
Appropriately drape, covering the stomach, and
legs, exposing only the vulva to your view.
Ask if she would like a friend, family member
present.
2:10:24 PM 8
Female Reproductive System
9. Health history:
Present complaint
Menstrual history: Age of Menarche? LMP?
Any changes or pain related to menstruation?
Past Gynecological history: Age at which
puberty began? How old was the patient when
the first sexual encounter occurred and how
many sexual partners has the patient had?
2:10:24 PM 9
Female Reproductive System
10. Cont’d
Obstetrics History:
Past Medical, Surgical, and Social histories.
Family history
Medication and Drug history.
Nutritional history
Personal History
Breast History:
2:10:24 PM 10
Female Reproductive System
11. Head-to-Toe Physical Assessment
General Health Survey: Personality changes and
mental deterioration can accompany late-stage
syphilis, Depression can affect sexual functioning,
Loss of height seen in postmenopausal women
with osteoporosis, Wt. loss resulting from
anorexia can cause amenorrhea, Wt. gain is
associated with pregnancy, Unexplained weight
loss may be associated with malignancy.
2:10:24 PM Female Reproductive System 11
12. Cont’d
Integumentary : Skin & Hair
Rashes and skin lesions are associated with
many STDs.
Systemic rash: Secondary syphilis.
Vesicles: Herpes simplex types 1 and 2.
Increased skin pigmentation: Increased
hormones during pregnancy.
Alopecia: Secondary syphilis.
Abnormal increase in body hair (hirsutism):
Decrease in female hormones.
2:10:24 PM Female Reproductive System 12
13. Cont’d
HEENT:
Palpable lymph nodes: May indicate systemic infection
or malignancy.
Enlarged thyroid (hypo- or hyperthyroidism): May affect
reproductive and sexual functioning.
Conjunctivitis: Can be caused by gonorrhea.
Oral lesions: Associated with STDs.
Respiratory :
Chronic lung disease may impair sexual functioning.
2:10:24 PM Female Reproductive System 13
14. Cont’d
Cardiovascular
Anemia can cause tachycardia and a systolic
flow murmur.
Oral contraceptives associated with increased
risk of thrombus formation
Breasts
Cyclic hormonal changes may cause breast
fullness and tenderness
2:10:24 PM Female Reproductive System 14
15. Cont’d
Abdomen
Palpable abdominal masses: May be a fetus or fibroid
tumor.
Enlarged liver and ascites: Associated with metastasis
of gynecological cancers.
Musculoskeletal
Weakness may limit sexual functioning, Neurosyphilis.
Charcot joints: Late syphilis.
Unexplained fractures or spinal changes (dowager’s
bump): Osteoporosis in postmenopausal women.
2:10:24 PM Female Reproductive System 15
16. Cont’d
Neurological
Weakness and paralysis: Neurosyphilis.
Changes in mental status/psychosis: Late syphilis.
Depression may affect sexual functioning.
Lymphatic/Hematologic
Palpable lymph nodes: May indicate infection.
Inguinal lymph nodes: Associated with metastatic
disease
2:10:24 PM Female Reproductive System 16
17. Physical Examination Female Organ
1. Inspection & Palpation of the External Genitalia
2. Speculum assessment of Internal Genitalia
3. Collection of Specimens for Laboratory
4. Bimanual Examination
5. Rectovaginal Assessment
2:10:24 PM 17
Female Reproductive System
18. Mons Pubis & Pubic Hair Inspection
Normal Findings
Skin over Mons Pubis clear with normal hair
distribution, inverse triangle
There may be some growth on abdomen and
upper inner thigh, no nits or lice
Geriatric: Gray and sparse
2:10:24 PM 18
Female Reproductive System
19. Vulva: Inspection & Palpation
Inspection
Skin coloration and condition
of the mons pubis and vulva
Inspecting the Vulva With gloved hands,
separate the labia majora
Observe the labia majora and the labia minora
for discoloration, symmetric, lesions, trauma.
2:10:24 PM 19
Female Reproductive System
20. Cont’d
Normal Findings Labia majora and minora
• Symmetrical, Smooth to somewhat wrinkled,
unbroken, slightly pigmented skin surface
• No ecchymosis, excoriation, nodules, swelling,
rash, lesions.
• Occasional sebaceous cyst is within normal
limits, nontender, yellow nodules, < 1 cm.
2:10:24 PM 20
Female Reproductive System
21. Cont’d
Geriatric: atrophied- appears flatter and smaller
Nulliparous woman, labia meet in midline;
following vaginal delivery, labia are gaping and
slightly shriveled.
Multiparrous women: majora are separated and
minora more prominent
2:10:24 PM 21
Female Reproductive System
22. Cont’d
Palpating the Labia
Palpate each labium, vaginal introitus (Bartholin
glands) between the thumb and the index finger
of your dominant hand.
Feel soft and uniform in structure, no swelling,
pain, induration, or purulent discharge.
If discharge is present, obtain a specimen and
change the gloves into clean ones.
2:10:24 PM 22
Female Reproductive System
23. Clitoris: Inspection
Using the dominant hand and index finger,
separate the labia minora laterally to expose the
prepuce of the clitoris
~ 2 cm in length and 0.5 cm in diameter
Without lesions
Abnormal Findings: Hypertrophy
(clitoromegaly), Chancre, FGM
2:10:24 PM 23
Female Reproductive System
24. Urethral Meatus: Inspect and Palpate
Inspection by separate the labia minora to
expose the urethral meatus.
Observe for shape, color, and size of urethra
Urethral opening appears stellate or slit like
Midline
Free from discharge, swelling, or redness
About the size of a pea
2:10:24 PM 24
Female Reproductive System
25. Cont’d
Palpation
Milking the urethra and paraurethral glands
Insert your dominant index finger into the vagina
Apply pressure to the anterior aspect of the
vaginal wall and milk the urethra
Observe for discharge and client discomfort
2:10:24 PM 25
Female Reproductive System
26. Vaginal Introitus: Inspect and Palpate
Inspection
To inspect keep labia minora retracted laterally
Vaginal opening may appear narrow, vertical slit
Ask the patient to bear down.
Observe for patency and bleeding.
Normal Findings: pink and moist, patent, Without
bulging, normal vaginal discharge
2:10:24 PM 26
Female Reproductive System
27. Cont’d
Palpation
Insert your dominant finger in the vagina, ask the
client to squeeze the vaginal muscles around
your finger, evaluate muscle strength and tone
Normal Findings Vaginal muscle tone
In nulliparous woman: tight and strong
In a parrous woman: it is diminished
2:10:24 PM 27
Female Reproductive System
28. Cont’d
Abnormal Findings
Pale color and dryness (atrophy, aging)
Discharge: Foul-smelling, irritating discharge
Tear, fissure, Bulging
Pelvic Organ Prolapse: Cystocele, Rectocele,
Cystourethrocele, Uterine Prolapse
2:10:24 PM 28
Female Reproductive System
29. Perineum:
Inspection the Perineum
Observe texture, and color of the perineum and
shape of the anus
Palpating the Perineum
Place the index finger posterior to the perineum
and the thumb anterior to the perineum
Assess perineum between the thumb and index
finger for muscular tone and texture
2:10:24 PM 29
Female Reproductive System
30. Cont’d
Normal Findings of Perineum
Smooth and Firm,Homogenous in nulliparous
Thinner in parous women, Slightly darkened
Well-healed episiotomy.
Abnormal Findings
Atrophy, Perianal cyst or lump, swelling,
Tear,Tenderness
2:10:24 PM 30
Female Reproductive System
31. Abnormal Findings of External Genitalia
Nits (eggs) adherent to pubic hair
Swelling, discharge
Bartholin’s Cyst ,
Carcinoma
Painless mass indicates malignancy
Painful mass indicates hernia
Prolapse of urethral mucosa
2:10:24 PM Female Reproductive System 31
32. Common long-term complications of FGM
Constant pain.
Pain and difficulty having sex.
Repeated infections, which can lead to infertility.
Bleeding, cysts and abscesses.
Problems peeing or holding pee in (incontinence)
Depression, flashbacks and self-harm
2:10:24 PM Female Reproductive System 32
34. Abnormal Findings of External Genitalia
2:10:24 PM Female Reproductive System 34
Syphilitic Chancre
Herpes Simplex Virus- Type 2
excoriations, erythematous areas.
Genital Human Papillomavirus
35. 2. Speculum Examination: Inspection
Cervical Examination
Select the appropriate sized speculum
Lubricate and warm the speculum by rinsing it with
warm water
Do not use lubricant jel
Hold the speculum with the closed blades between
the index and middle fingers .
2:10:24 PM 35
Female Reproductive System
36. Cont’d
Insert your nondominant index and middle fingers,
ventral sides down, just inside the vagina and
apply pressure to the posterior vaginal wall
Encourage client to bear down; this will help to
relax the perineal muscles opens introitus
Encourage client to relax by taking deep breaths.
2:10:24 PM 36
Female Reproductive System
37. Cont’d
Oblique insertion of the speculum
Withdraw your nondominant hand from the
vagina
Gently rotate the speculum to a horizontal angle
Advance the speculum at a 45-degree angle
against the posterior vaginal wall. until it reaches
the end of the vagina.
2:10:24 PM 37
Female Reproductive System
38. Cont’d
Final Adjustment of the Speculum
Opening of the speculum blades, by depressing
the lever With your dominant thumb,
Once the cervix is fully visualized, lock the
speculum blades into place.
Adjust your light source so that it shines through
the speculum.
2:10:24 PM 38
Female Reproductive System
39. Cont’d
Normal Findings of cervix
Glistening pink color, pale after menopause
Blue (Chadwick’s sign) during pregnancy
Midline in to the vaginal, 2.5 cm to 3 cm size in
young woman, Smaller in elderly
Shape of cervical os: In nulliparous is small and
either round, In a parrous is a horizontal slit
2:10:24 PM 39
Female Reproductive System
40. Cont’d
Abnormal Findings
Redness, Pallor wit anemia, cyanotic
Lateral position- adhesion or tumor, Projection
>3 cm may be prolapse.
Hypertrophy > 4 cm- inflammation or tumor.
Venereal warts, Candidiasis, Endocervical
Gonorrhea
Strawberry spots (trichomonal infection)
Cervical lacerations, Cyst Ectropion, carcinoma
2:10:24 PM 40
Female Reproductive System
41. Cont’d
Inspection of the Vaginal Wall
Inspection disengage the locking device of the
speculum
Slowly withdraw the speculum but do not close
the blades
Rotate the speculum into oblique, inspect the
vaginal walls for color and texture, Pink, Moist,
Deeply ruggated, Without lesions or redness.
2:10:24 PM 41
Female Reproductive System
43. 3. Collecting Specimens For Culture
That are obtained from 3 sites- Cervix, Vaginal
pool, Posterior fornix of the vagina
Smears and Cultures Smear
1. Pap test
2. Gonococcal Smear
3. Vaginal wet Mount (Wet Prep)
4. KOH Prep
5. 5% Acetic Acid Wash
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45. Cont’d
Bimanual Examination Vaginal walls
Palpate the walls of the vagina for any
irregularities or masses
Lubricate the gloved index and middle fingers of
your dominant hand.
Carefully separate the labia using the thumb and
index finger of your non-dominant hand.
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46. Cont’d
Gently insert the gloved index and middle finger
of your dominant hand into the vagina.
Enter the vagina with your palm facing laterally
and then rotate 90 degrees so that your palm is
facing upwards.
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47. Cont’d
Cervix; Examine the cervix to assess:
Position (e.g. anterior or posterior)
Consistency (e.g. irregular, smooth)
Cervical motion tenderness: involves severe
pain on palpation of the cervix and may suggest
PID or ectopic pregnancy.
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48. Cont’d
Fornices
The fornices are the superior portions of
the vagina, extending into the recesses created
by the vaginal portion of the cervix.
Gently palpate lateral fornices for any masses.
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49. Cont’d
Bimanually palpate the uterus:
1. Place your non-dominant hand 4cm above the pubis
symphysis.
2. Place two of your dominant hand’s fingers into
the posterior fornix.
3. Push upwards with the internal fingers whilst
simultaneously palpating the lower abdomen with
your non-dominant hand. You should be able to feel
the uterus between your hands.
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50. Cont’d
Assess the uterus:
Size: approximately orange-sized in an average
female.
Shape: may be distorted by masses
Position: the uterus may be anteverted or
retroverted.
Surface characteristics: note if the uterus feels
smooth or nodular.
Tenderness: may suggest inflammation (e.g. PID,
ectopic pregnancy).
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51. Cont’d
Bimanually palpate the adnexa:
1. Position your internal fingers in the left lateral
fornix.
2. Position your external hand onto the left iliac
fossa.
3. Perform deep palpation of the left iliac
fossa whilst moving your internal fingers
upwards and laterally (towards the left).
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52. Cont’d
4. Feel for any palpable masses, size and shape
(e.g. ovarian cyst, ovarian tumour, fibroid).
5. Repeat adnexal assessment on the right.
6. Withdraw your fingers and inspect the glove for
blood or abnormal discharge.
Provide paper towels for the patient to clean
themselves.
Dispose of the used equipment into a clinical
waste bin.
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53. Cont’d
Abnormal Findings
Enlargement and lateral displacement
(asymmetric uterus), Immobile
Nodules or irregular surface (leiomyomas)
Non palpable uterus (hysterectomy)
Extreme pain on palpation with inflammation or
ectopic pregnancy.
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Female Reproductive System
54. 5. Retrovaginal Examination
Performed to assess
Pelvic pain,
Rectal symptoms,
Pelvic mass.
It can also provide a
sample for fecal
occult blood testing.
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Female Reproductive System
55. Retrovaginal Examination
1. Assessing rectovaginal septum, post. Uterine wall,
cul-de-sac, and rectum.
2. Change gloves- avoids spreading poss. Infection.
3. Lubricate first two fingers.
4. Instruct pt. poss. Feeling of discomfort.
5. Ask pt. to bear down as fingers are inserted into
vagina, middle finger is gently inserted into rectum,
while pushing with abdominal hand.
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56. Cont’d
6. Note: Rectovaginal spetum-smooth, thin, firm,
pliable.
7. Rectovaginal pouch, or cul-de-sac- not palpated.
8. Uterine wall and fundus feel firm, smooth.
9. Rotate intrarectal finger to check rectal wall and
anal sphincter tone.
10.Give pt. tissue to wipe area, help her up.
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57. Abnormal Findings
Stool test positive for occult blood: Warrants
further investigation.
Masses or lesions: Consider malignancy or
internal hemorrhoids.
Lax sphincter tone: Perineal trauma from
childbirth, anal intercourse, or neurological
disorders.
2:10:24 PM Female Reproductive System 57
58. Summery
The female reproductive system is an area
where you can have a major impact on your
patient’s health through routine screening and
education.
The assessment also requires sensitivity in
responding to the woman’s need for privacy and
in respecting her personal boundaries.
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Ecchymosis; form when blood pools under your skin. caused by a blood vessel break. Bruises look like a mark on your skin that's black and blue or red to purple
Palpating around the vaginal introitus (Bartholin glands) Assess posterior of labia majora with index finger inside and thumb outside.
Should feel soft and homogeneous.
Skene’s glands and Bartholin’s glands are not normally seen by naked eye Normal Deviations
If discharge is present , obtain a specimen and change the gloves into clean ones
Do not touch the urethral meatus- may cause pain and urethral spasm
Bulging -indicates cystocele, rectocele, or uterine prolapses.
Normal Vaginal Discharge – white and free of foul odor (some white clumps may be seen—mass clamps of epithelia cells)
the feel, appearance, or consistency of a surface
Oblique insertion of the speculum When you feel the muscles relax, until the speculum reaches the end of the fingers that are in the vagina
Surface characteristics:
Covered by glistening pink squamous epithelium, which is similar to vaginal epithelium
Discharge: Note characteristics of any discharge
Position:
Located midline in the vagina with an anterior or posterior position relative to the vaginal vault, Projects 1-3 cm into vagina.
Hypertrophy > 4 cm occurs with inflammation or tumor. (Cervicitis, Cervical Cancer)
Cauliflower overgrowth (carcinoma)
Cervical lacerations- Unilateral transverse, bilateral transvere, stellate
Atrophic vaginitis External genitalia Note loss of labial and vulvar fullness, pallor of urethral and vaginal epithelium, and decreased vaginal moisture
- Pap test; A speculum is inserted into the vagina to widen it. Then, a brush is inserted into the vagina to collect cells from the cervix. The cells are checked under a microscope for signs of disease.
-Gonococcal Culture Specimen; Rotate swab against the wall of the endocervical canal several times for 20-30 seconds and withdraw without touching the vaginal surface.
-A vaginal wet mount (or vaginal smear or wet prep) is a gynecologic test wherein a sample of vaginal discharge is observed by wet mount microscopy by placing the specimen on a glass slide and mixing with a salt solution. It is used to find the cause of vaginitis and vulvitis.
- KOH prep test, also called a potassium hydroxide preparation test, is done when a fungal infection is suspected.
5% acetic acid is prepared by adding 5 ml of glacial acetic acid into 95 ml of distilled water- on visual screening for cervical neoplasia
Bimanual Examination (per )
The term adnexa refers to the area that includes the ovaries and fallopian tubes.