Week 8
Chapters 18-19.
Female Genitalia;male Genitalia.
Midsagittal view of the female pelvic organs.
Summarize the ovulation cycle and identify the functions of the hormones produced
.
An older woman who has stopped regular menstruation asks whether she can still become pregnant. What is the best response you can give this patient?
What is the name of the tissue that separates the anterior wall of the vagina from the bladder and urethra?
Name the four bones that form the pelvis
why it is important to teach mothers correct perineal care for their newborn infant daughters.
What possibility must you consider if in a child you observe vaginal swelling of the vulvar tissues accompanied by bruising or foul-smelling discharge?
Describe premenstrual syndrome (PMS).
Identify and explain positions other than the lithotomy in which a pelvic examination can be performed.
You are about to conduct a pelvic examination on an adolescent girl. What should you take time to do before carrying out the examination?
A 12-year-old girl is experiencing a vaginal mucus discharge. What can you tell this girl to decrease her anxiety?
A new mother is frightened by the appearance of blood-tinged mucus at her newborn daughter’s vaginal entrance. What response can alleviate this woman’s anxiety?
MC is a 28-year-old patient who presents to the urgent care for complaints of abdominal pain and cramping. Today she has noticed a yellow vaginal discharge.
Her past medical history is noncontributory. She admits to having multiple sexual partners with unprotected intercourse
1-What additional questions regarding her vaginal discharge could you ask at this point?
2- Describe the stages of salpingitis.
3- What physical assessment findings on the vaginal examination and bimanual would you expect to see if the patient has salpingitis?
Male pelvic organs
A 60-year-old man asks you whether it is still possible for him to become a father. How would you respond to this patient? What effect does aging have on male fertility?
Which part of the male genitalia is a soft, comma-shaped structure located on the posterolateral and upper aspect of the testis in 90% of males and provides for storage, maturation, and transit of sperm?
Differentiate between the external genitalia for a male and female fetus at both 8 weeks and 12 weeks of gestation.
Summarize the pros and cons of newborn circumcision.
The mother of a newborn you are examining voices concern that one of her son’s testicles has not yet “appeared.” What can you tell this mother to reassure her?
What is the expected time for final descent of the testes into the scrotal sac?
Assignment help – Discuss how do you could effectively work with a child to evaluate the testicles.
You are performing a genital examination on a 12-year-old boy who seems noticeably embarrassed and nervous. What communication measures can be included to decrease anxiety and facilitate the examination?
A patient has an erection while you are performing a genital examination. What is the best response to decrease anxiety and embarrassment?
Describe the cremasteric reflex.
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Ovulation Cycle Summary:
The ovulation cycle, also known as the menstrual cycle, is a roughly 28-day process in which a woman’s body prepares for potential pregnancy. It consists of four phases: menstrual, follicular, ovulation, and luteal. Hormones such as follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrogen, and progesterone play crucial roles in regulating the cycle.
Menstrual phase: Shedding of the uterine lining occurs.
Follicular phase: FSH stimulates the growth of ovarian follicles, and estrogen levels rise.
Ovulation phase: A surge in LH triggers the release of a mature egg from the ovary.
Luteal phase: The corpus luteum forms and secretes progesterone, preparing the uterus for potential implantation.
Older Woman and Pregnancy:
An older woman who has stopped regular menstruation is likely experiencing menopause, which marks the end of her reproductive years. While the chances of becoming pregnant are significantly reduced, it is still possible, albeit rare, for a woman to conceive during perimenopause. It is important to discuss contraception and fertility options with a healthcare professional.
Tissue Separating Vagina from Bladder and Urethra:
The tissue that separates the anterior wall of the vagina from the bladder and urethra is called the vesicovaginal septum.
Four Bones Forming the Pelvis:
The pelvis is formed by the ilium, ischium, pubis, and sacrum.
Importance of Teaching Perineal Care:
Teaching mothers correct perineal care for their newborn infant daughters is important to prevent infection, maintain hygiene, and promote overall health.
Vulvar Swelling, Bruising, or Foul-Smelling Discharge in a Child:
In a child with these symptoms, it is important to consider the possibility of sexual abuse or an infection.
Premenstrual Syndrome (PMS):
PMS is a group of physical, emotional, and behavioral symptoms that occur in the days leading up to menstruation. Symptoms may include bloating, mood swings, fatigue, and irritability.
Pelvic Examination Positions:
In addition to the lithotomy position, pelvic examinations can be performed in the Sims’ position (lateral recumbent) or the knee-chest position.
Before Examining an Adolescent Girl:
Take time to explain the procedure, address any concerns, and ensure the patient feels comfortable and informed.
Reassuring a 12-Year-Old with Vaginal Mucus Discharge:
Explain that vaginal mucus discharge is a normal part of puberty and the body’s way of keeping the vagina clean and healthy.
Alleviating Anxiety About Newborn Daughter’s Blood-Tinged Mucus:
Explain that this is a normal occurrence due to maternal hormones and should resolve on its own within a few days.
Additional Questions for MC:
Ask about the color, consistency, and odor of the discharge, as well as any associated itching, pain, or fever.
Stages of Salpingitis:
Salpingitis is an inflammation of the fallopian tubes, often caused by a bacterial infection. It can be acute (sudden onset, severe symptoms) or chronic (long-lasting, milder symptoms).
Physical Assessment Findings for Salpingitis:
Findings may include cervical motion tenderness, adnexal tenderness, and possibly a palpable adnexal mass.
Male Fertility and Aging:
While men can father children at an older age, fertility does decline with age. Sperm quality and quantity may decrease, and the risk of genetic abnormalities increases.
Structure for Sperm Storage and Maturation:
The epididymis is the structure responsible for sperm storage, maturation, and transit.
External Genitalia at 8 and 12 Weeks Gestation:
At 8 weeks, male and female genitalia are indistinguishable. By 12 weeks, male genitalia begin to differentiate, with the development of the penis and scrotum.
Pros and Cons of Newborn Circumcision:
Pros: Reduced risk of urinary tract infections, decreased risk of sexually transmitted infections, and easier hygiene. Cons: Pain, risk of complications, and ethical considerations.
Reassuring Mother About Undescended Testicle:
Explain that it is common for testicles to descend later in infancy and that most cases resolve on their own by 6 months of age.
Expected Time for Testes Descent:
The testes typically descend into the scrotal sac by the time of birth or within the first few months of life.
Evaluating Testicles in a Child:
Use a gentle, reassuring approach, explain the procedure, and involve the child in the process to help them feel more comfortable.
Decreasing Anxiety in a 12-Year-Old Boy:
Use age-appropriate language, explain the procedure, and maintain a professional and nonjudgmental demeanor.
Addressing an Erection During Examination:
Normalize the situation by explaining that erections can be an involuntary response and continue the examination in a professional manner.
Cremasteric Reflex:
The cremasteric reflex is a contraction of the cremaster muscle, which pulls the testicles upward in response to stroking the inner thigh. This reflex helps protect the testicles from injury.
