Female Genitalia Health Assessment Lecture

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  • Topic: Uterus, Vagina, Vulva
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  • Published : December 13, 2012
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Female Genitalia
Health Assessment Lecture

Objectives:
* Describe the structure and function of the female genitalia * Describe particular developmental and transcultural considerations. * Collective subjective and objective data.
* Record the findings.
* Identify the appropriate nursing diagnoses for problem areas identified.

Female Genitalia
Structure & Function
* Consists of external and internal structures
External:
* vulva or pudendum (extends from mons pubis to anal opening) * mons pubis (fat pad over pubic symphysis)
* labia majora and minora (hairless, usually darker pink) * Clitoris: 3 parts – glans, corpus, crura
* Analogous to the penis

* Vestibule (boat-shaped area/fossa)
* Urethral meatus
* Skene’s glands (either side of the urethral openings) * lesser vestibular glands, secretes mucus
* Vaginal orifice
* Bartholin’s glands (b/w vaginal orifice and labia minora) * Greater vestibular glands

Internal
* Vagina (10 cm long)
* 3 functions: passage of menses; receives penis; lower portion of birth canal * 4 layers:
* Outer layer – pink squamous epithelium; rugae
* Second layer – submucosal layer (blood vessels, nerves and lymphatic channels * Third layer – smooth muscle
* Fourth layer – connectiv tissue and vascular network. Acidic pH (3.8 to 4.2) – Doderlien’s bacilli
* Cervix
* Internal os: junction of isthmus & cervix
* External os: junction of cervix and vagina
* 2 epithelium: (squamocolumnar junction)
* Pink squamous epithelium (ectocervix)
* Red, rough looking columnar epithelium (endocervix) * Uterus
* 2 components:
* corpus – fundus, body and isthmus
* Cervix
* 45-degree angle to the vagina (anteverted and anteflexed) * 7.5cm long, 5cm wide and 2.5 cm thick
* 3 layers: endometrium, myometrium, and perimetrium
* Peritoneum covers uterus and separates from abdominal cavity

* Ovaries – 3cm long, 2 cm wide and 1 cm deep

* Fallopian tubes – 8- to 12-cm long

* Fimbrae

* Adnexae (Latin for appendages): term used to describe ovaries, fallopian tubes, and supporting ovarian ligaments

Assessment of the Female Genitalia
Collecting Subjective Data
* Interview approach (COLDSPA) for Nursing Assessment
* Self-esteem and body-image
* Anxiety, embarrassment and fear
* Collecting Subjective Data
* History of Present Health Concern
* LMP, regular schedule; length; amount
* Any clotting?
* Normal: 18 – 45 day cycle; 3 – 7 days in duration
* Symptoms before and after menses
* PMS
* Menarche: ave. 12.5 years; 48kg (106lbs)
* Irregularities or amenorrhea (menopause, pregnancy, depression, ovarian tumors or cysts, hormonal imbalances, autoimmune

History of Present Health Concern
* Menopause
* Ages 40 to 58 years
* Perimenopausal period: hormones fluctuates
* Symptoms?
* HRT?
* Vaginal discharge, pain and masses
* Pain, itching
* Vaginal discharge
* Lumps, swelling or masses in genital area
* Urination
* Dysuria
* Blood, change in odor, color, burning or pain with urination * Urinary incontinence (urgency or stress incontinence) – common in older women * Sexual Dysfunction
* Libido; infertility
Past Health History
* Gynecologic problems
* Last pelvic examinations
* Pap smear: sexually active at 18 years; 3 normal consecutive tests may have test every 2-3 years * Previously diagnosed with STD? Treated?
* Pregnancy: Gravida and Para
* Diabetes (yeast infections)

Family History
* History of genital cancer
* Collecting Subjective Data
* Lifestyle and Health Practices
* Smoking and OCP
* How many sexual partners?
* Sexual preference?
* Ever tested for HIV?
* Douching?

Collecting Objective Data
*...
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