External Genitalia - Answer- -(vulva) mons pubis, clitoris, external urinary meatus, urethra, bartholin's glands, vagina, labia minora, labia majora, hymen What is the mons pubis? - Answer- -round, firm pad of adipose tissue covering the symphysis pubis Vestibular Glands (Bartholin) - Answer- -secrete clear lubricating fluid Internal Genitalia - Answer- -ovaries, uterus, vagina, rugae, cervix, Fallopian tubes What is the uterus? - Answer- -pear shaped, thick walled muscular organ The Aging Woman - Answer- -menopause cessation of the menses, occurs around 48-50 -the preceding is 1-2 years of decline in ovarian function shows irregular menses that gradually become farther apart and produce lighter flow -ovaries stop producing estrogen and progesterone More Aging Woman - Answer- -uterus shrinks -ovaries atrophy to 1-2 cm not palpable after menopause -sacral ligaments relax, and pelvic musculature weakens; thus uterus drops -cervix shrinks and looks paler with a thick, glistening epithelium -vaginal epithelium atrophies —> thinner, drier, itchy —> fragile mucosal surface at risk for bleeding and vaginitis HPV vaccine - Answer- -linked to steep decline in the presence of the virus in teenage girl and young women -recommended for boys and girls age 11 and 12 -HPV causes almost all cervical cancers as well as vulvar, vaginal, anal, and oropharyngeal cancers in female Female Genital Mutilation - Answer- -is a ice coercive procedure performed on girls before puberty -social custom, illegal in US -involves the removal of partial or total of clitoris, believed to inhibit sexual pleasure -can case, severe bleeding, death, sterility, infection, psychological trauma, and severe consequences during childbirth Subjective Data - Answer- -menstrual history -obstetric history menopause -patient centered care -acute pelvic pain -urinary symptoms -vaginal discharge -past history -sexual activity -contraceptives use -STI contact Menstrual History - Answer- -usually nonthreatening, good place to start What is LMP? - Answer- -last menstrual period What is menarche? - Answer- -first period -usually 12-13 yo, delayed onset suggests endocrine or underweight problem Period Cycle - Answer- -normally every 28 days; varies from 18-45 days Amenorrhea - Answer- -absent period Duration of Period - Answer- -average 3-7 days Menorrhagia - Answer- -heavy period What is dysmenorrhea? - Answer- -painful period, responds to ibuprofen because it works on uterine smoothie muscles Menopause - Answer- -when they have actually stopped getting period for over a year Premenopausal - Answer- -ranges from 40-55 and has hormone shifts resulting in vasomotor instability PAP tests - Answer- -dont start until 21 -once every 3 years for women 21-30 -HPV and pap "co-testing" every 3 years for women 30-65 Delaying PAP test - Answer- -delaying until 21 allows HPV infections to regress spontaneously in adolescents, avoiding overtreatment Acute Pelvic Pain - Answer- -less than 3 months -consider urgent conditions: pelvic inflammatory disease (PID), appendicitis, ruptured ovarian cyst, ovarian torsion Urinary Symptosm - Answer- -urgency dysuria, nocturia, hematuria (blood in urine, occurs with UTI and kidney disease), bile in urine or UTI Vaginal Discharge - Answer- -normal is small, clear, or cloudy, always nonirritating Postmenapausal Bleeding - Answer- -warrants pelvic exam, transvaginal ultrasonography Position for Inspecting Vagina - Answer- -lithotomy position