Volume 3 Chapter 13

Gynecology

Branch of medicine dealing with health maintenance and disease of women, primarily repoductive organs

Obstetrics

Branch of medicine dealing with care of women throughout pregnancy

External Genitalia (Vulva)

Perineum: Muscular tissue/skin that seperates vagina and anus. -Episiotomy-surgical tearing to facilitate birth.Mons Pubis: Fatty layer of tissue over the pubic symphysis.Labia: Structures that protect the vagina and the urethra. -Labia Majora: Located laterally-Labia Minora: Located mediallyClitoris: Highly innervated and vasular erectile tissue. For sexual stimulation.Urethra: Drains urinary bladder.

Internal Genitalia

Vagina: Passage of smooth muscle connecting external genitalia to uterus.Uterus: Hollor musclar organ used to house fetus during pregnancy.-Endometrium: Inner layer of the uterine wall where fertilized egg implants-Myometrium: Thick middle layer of uterine wall made up of smooth muscle fibers.-Perimetrium: The serosal peritoneal membrane that forms the outermost layer of uterine wall.Fallopian Tubes: Conduct egg from ovaries to uterus.Ovaries: Female sex glands. Secrete hormones estrogen and progesterone in respones to Follicle Stimulating Hormone (FSH) and Lutenizing Hormone (LH). Development and release of eggs.

Menarche

Onset of menses. Usually between 10-14 years of age.

Ovulation

Release of an egg from the ovary

Menstrual Cycle

28 days long. Prepares uterus to receive egg.Proliferative Phase: First 2 weeks. Uterine lining becomes engorged with blood. After 14 days release of an egg takes place in reponse to LHSecretory Phase: Stage immediately surrounding ovulation.Ischemic Phase: If fertilization does not occur estrogen and progesterone levels fall. Vascular changes cause endometrium to become pale and small blood vessels rupture.Menstrual Phase: Sloughing of inner lining of uterus occurs. Usual blood loss of 50 mL.

Menstruation

Sloughing of endometrium if fertilized egg is not implanted. Controlled by hormones.

Menopause

Cessation of menses and ovarian function due to decreased secretion of estrogen.

Most Common Emergency GYN Complaints

Abdominal PainVaginal Bleeding

Dysmenorrhea

Painful menstruation

Dyspareunia

Painful Sexual Intercourse

Pelvic Inflammatory Disease (PID)

An acute infection of the reproductive organs.

Cystitis

Infection of the urinary bladder.

Dysuria

Painful urination often associated with cystitis

Mittelschmerz

Abdominal pain associated with ovulation

Endometritis

Infection of the endometrium

Endometriosis

Endometrial tissue grows outside uterus.

Ectopic Pregnancy

Implantation of a developing fetus outside the uterus

Treatment for Abdominal Pain

ComfortTransport

Menorrhagia

Excessive menstrual flow

Treatment for Vaginal Bleeding

Absorb blood flowTransportOxygen and IV access

Pregnancy Terms

Antepartum: Time prior to fetus deliveryPostpartum: Time after fetus deliveryPrenatal: Prior to birthNatal: Relating to birthGravidity: Number of times a woman has been pregnantParity: Number of pregnancies carried to full termPrimigravida: Women pregnant for first timePrimipara: Woman given birth to first childMultigravida: Been pregnant more than onceNulligravida: Never been pregnantMultipara: Delivered more than one babyNullipara: Never delivered a babyGrand Multiparity: More than 7 babies deliveredGestation: Period of time for intrauterine fetal development