Assisting in Gynecologic Examinations Objectives: After 2 hours of varied teaching learning activities the level 3 students will be able to: 1. define the following terms: 1.1 bartholinitis 1.2 chancre 1.3 Cystocele 1.4 Cystourethrocele 1.5 DUB 1.6 Dysmenorrhea 1.7 Dypareunia 1.8 Endometrial ablation 1.9 Endometriosis 1.10Estradiol 1.11Fibroids 1.12Functional hypothalamic amenorrhea 1.13Gynecologic examination 1.14Hernia 1.15Herpes 1.16HPV 1.17Hysterectomy 1.18Luteal phase deficiency 1.19Myomas 1.20Oophorocystestomy 1.21Pap smear 1.22Perinoplasty 1.23Rectocele 1.24Salpingitis 1.25Syphilis 1.26Vaginal speculum 1.27Vaginismus 1.28Vaginitis 1.29Von willebrand factor 2. discuss the anatomy and physiology of the female reproductive system 3. Enumerate the purpose of gynecologic as to its indications, contraindications and how the procedure is done. 4.1 mammography 4.2 ultrasound 4.3 pap smear 4.4 pelvic examination 5. give the guidelines in each gynecologic exam
Female Reproductive system The human female reproductive system contains two main parts: the vagina & uterus, which act as the receptacle pf the male’s sperm, and the ovaries, which produce the female ova. All of these parts are always internal; the vagina meets the outside at the vulva, which also includes the labia, clitoris, urethra. The vagina is attached to the uterus through the cervix, while the uterus is attached to the ovaries via the Fallopian tubes. At certain intervals, the ovaries release an ovum passes through the fallopian tube into the uterus. If, in this transit, it means with sperm, the sperm penetrate and merge with the egg, fertilizing it. The fertilization usually occurs in the oviducts, but can happen in the uterus itself. The zygote then implants itself in the wall of the uterus, where it begins the processes of embryogenesis and morphogenesis. When developed enough to survive outside the womb, the cervix dilates and contractions of the uterus propel the fetus through the birth canal, which is the vagina. The ova are larger than the sperm and are generally all created by birth. Approximately every month, a process of oogenesis matures one ovum to be sent down the Fallopian tube attached to its ovary in anticipation of fertilization. If not fertilized, this eggs is flushed out of the system through menstruation. The vagina is the tubular tract leading from the uterus to the exterior of the body in female mammals, or to the cloaca in female birds and some reptiles. Female insects and other invertebrates also have vagina, which is terminal part of the oviduct. The vagina is the place where the semen from the man is deposited into the woman’s body during sexual intercourse.
Cervix The cervix is the lower, narrow portion of the uterus where it joins with the top end of the vagina. It is cylindrical or conical shape and protrudes through the upper anterior vagina wall. Approximately half its length is visible, the remainder lies above the vagina beyond view.
Uterus The uterus is the major female reproductive organ of humans. One end, the cervix, opens into the vagina, the other is connected on both sides to the fallopian tubes. The uterus mostly consists of muscle, known as myometrium, and derives nourishment from blood vessels which develop exclusively for this purpose. The fertilized ovum becomes an embryo, develops into a fetus and gestates until childbirth.
Oviducts The fallopian tubes or oviducts are two very fine tubes leading from the ovaries of female mammals into the uterus. On maturity of an ovum, the follicle and the ovary’s wall rupture, allowing the ovum to escape and enter the Fallopian tube. There it travels toward the uterus, pushed along by movements of cilia on the inner lining of the tubes. This trip takes hours or days. If the ovum is fertilized while in the Fallopian tube, then it normally implants in the endometrium when it reaches the uterus, which signals the beginning of pregnancy.
Ovaries The ovaries are the place inside the female body where ova or eggs are produced. The process by which the ovum is released is called ovulation. The speed of ovulation is periodic and impacts directly to the length of menstrual cycle. After ovulation, the ovum is captured by the oviduct, where it traveled down the oviduct to the uterus, occasionally being fertilized on its way by an incoming sperm, leading to pregnancy. The Fallopian tubes are often called the oviducts and they have small hairs to help the egg cell travel.
Female reproductive system Ovaries: Germinal epithelium-Tunica albugunea-cortex (Cumulus oophorus. Stroma of ovary)-Medulla of ovary Follicles: Corpus luteum-Corpus albicans-Granulosa cells-Membrana granulosa-Corona radiate-Theca of follicle-Follicular antrum-Follicular fluid-Zona pellucidaFolliculogenesis/Oogenesis Ligaments: Proper-Suspensory-Round-Broad (Mesovarium, Mesosalpinx, Mesometrium)-Cardinal Fallopian tubes: Isthmus-Ampulla-Infundibulum-Fimbria Uterus: cervix/neck (External orifice. Canal of the cervix, Internal orifice)corpus/body(Cavity of the body, Fundus)layers(Endometrium,Myometrium,Perimetrium) Vulva: Mons pubis-Labium (Labial commissures, Frenulum labiorum pudenda, Labia majora, Cleft of venus, Labia munora, Vulval vestibute, interlabial sulci)-Clitoris
(Clitoral hood, Clitoral glans, Frenulum clitoridis, Clitoral crura, Corpus cavernosa, Vestibular bulbs)-Vagina(Bartholin’s glands, Bartholin’s ducts, Skene’s glands, Skene’s ducts, Fossa of vestibute of vagina. Fornix vaginae, Hymen) Breast: Mammary glands, Nipple, Areola, Lactiferous duct G-spot-Urethral sponge
Purpose of Gynecologic Examinations • • • • •
Promotes sexual health For early detection of infection or cancer formation Obtain information that provides a picture of a woman’s sexuality and sexual practices Aids un the management of adult female reproductive function Allows opportunities for health teaching