Anatomy and Physiology

Female external structures○ Vulva○ Labia majora and labia minora○ Clitoris○ Vestibule and vestibular glands○ Hymen○ Vaginal orifice

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Anatomy and Physiology

Female internal structuresOvariesFallopian tubesUterusCervixVagina

Hormones: estrogen and progesterone

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Anatomy and Physiology

Male external organsScrotum and penis

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Anatomy and Physiology

Male internal organsTestesEpididymisVas deferensUrethraSeminal vesiclesBulbouretheral and prostate glands

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Common Signs and Symptoms Female

Abdominal and pelvic painFever and malaiseAbnormal vaginal dischargeBurning and/or itching of the genitals

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Common Signs and Symptoms Female

Pain during sexual intercourseAny change in breast tissueAbnormal discharge from the nipple

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Common Signs and Symptoms Male

Urinary disorders including frequency, dysuria, nocturia, and incontinence

Pain in the pelvis, groin, or reproductive organs

Lesions on external genitals

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Common Signs and Symptoms Male

Swelling or abnormal enlargement of the reproductive organs

Abnormal penile dischargeBurning and/or itching of the genitals

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Diagnostic Tests

Female Bimanual examinationHysterosalpingogramPapanicolaou smear of cervixCervical biopsyCone biopsy

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Diagnostic Tests

Female Dilatation and CurettageLaparoscopyMammographyBlood tests

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Diagnostic Tests

MaleDigital rectal examinationCystoscopyBiopsyLaboratory tests including PSA

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Premenstrual Syndrome

Symotoms prior to menses Symptoms begin mid-cycle

Headache and nauseaBack and joint painEdema and bloatingWeight gain

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Premenstrual Syndrome

Symptoms begin mid-cycleBreast tendernessSleep disturbancesIrritabilityMood swingsDepression

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Premenstrual Syndrome

TreatmentIndividualized Dietary changesAvoid caffeine, chocolate, nicotine, salt,

sugar, and alcohol

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Menstrual Abnormalities

Amenorrhea Dysmenorrhea Menorrhagia Metrorrhagia

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Endometriosis

Abnormal growth of endometrial tissue outside of the uterus

Common sites of implantation include ovaries, fallopian tubes, abdominal wall, and intestines

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Endometriosis

SymptomsDysmenorrheaLow back, vaginal, and pelvic crampingHeavy menses and dyspareunia

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Endometriosis

TreatmentHormonesRemission with pregnancy, nursing, and

menopausePanhysterectomy

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Pelvic Inflammatory Disease Inflammation of some or all of the pelvic

reproductive organs May include cervicitis, salpingitis,

endometritis, oophoritis Most commonly caused by STDs

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Pelvic Inflammatory Disease Symptoms

FeverChillsPain in pelvic areaLeukorrhea

Treatment: antibiotics, analgesics, and rest

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Ovarian Cyst

Commonly benign fluid-filled sacs on or near the ovary

Two typesPhysiologicNeoplastic

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Ovarian Cyst Symptoms

Low back painPelvic painDyspareuniaNausea and vomiting

Treatment depends on type and size May resolve by itself or require

laparoscopy

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Fibroid Tumor

Also known as leiomyomas Benign tumors of smooth uterine muscle Symptoms

Abnormal uterine bleedingExcessive menstrual bleeding and pain

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Fibroid Tumor

Treatment depends on woman’s age and desire for children

Surgical removal of fibroids or hysterectomy

Uterine embolization Hormone therapy

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Vaginitis

Inflammation of vagina Symptoms

Burning and itchingSwelling of vagina and external genitalia

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Vaginitis

Common type of vaginitisCandida: fungus or yeastTrichomonas: parasiteAtrophic: post-menopausal

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Toxic Shock Syndrome

Found almost exclusively in menstruating women using tampons

Organism: staphylococcus aureus Symptoms: high fever, vomiting,

diarrhea, and dropping blood pressure Treatment: IV fluids, antibiotics

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Toxic Shock Syndrome

SymptomsHigh feverVomitingDiarrheaDecreasing blood pressure

Treatment: IV fluids, antibiotics

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Menopause

Natural halting of menstruation Occurs between ages 45 and 55

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Menopause

Common symptomsHot flashes and night sweatsVaginal drynessDepressionSleep disorders Decreased libido

Treatment: hormone therapy, exercise

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Uterine Prolapse

Uterus protrudes into vagina Symptoms

Heaviness in pelvisUrinary stress DysuriaLow back pain

Treatment: hysterectomy

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Cystocele

Herniation of urinary bladder through anterior vaginal wall

Symptoms: pelvic pressure, urinary urgency, frequency, and incontinence

Treatment: depends on degree of herniation

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Rectocele

Herniation of rectum through posterior vaginal wall

Symptoms: discomfort, constipation, fecal incontinence

Treatment: surgical repair

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Cervical Cancer

Fifth leading cause of cancer-related death in females

Symptoms: abnormal cervical bleeding Treatment: surgical removal of tumor

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Uterine Cancer

Develops in endometrium and spreads to uterine wall

Symptoms: abnormal bleeding in menopausal women

Treatment: surgical removal of uterus and ovaries with radiation

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Ovarian Cancer

Quite common and often fatal Symptoms: pressure on the bladder,

abdominal or pelvic pain, general feeling of ill health

Treatment: complete hysterectomy, radiation, and chemotherapy

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Fibrocystic Disease

Most common breast disorder of premenopausal females between the ages of 30 and 55

Cysts are linked to estrogen levels

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Fibrocystic Disease

To decrease breast pain:Reduce caffeine and saltUse of mild diureticsUse of mild analgesics the week prior to

menstruation is recommended

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Mastitis

Inflammation of breast tissue Symptoms

RednessHeatSwellingPain and often bloody nipple discharge

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Mastitis

TreatmentAntibioticsApplication of heatAnalgesicsFirm supporting bra to decrease discomfort

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Breast Cancer

Adenocarcinoma of the breast ducts Most common breast neoplasm (affects

one out of nine females) Risk factors

Age 40 and overFamily member affected with breast cancer

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Breast Cancer

Risk factorsOnset of menses before age 13Menses continuing after age 50NulliparaFirst child after age 30ObesityChronic breast disease

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Breast Cancer

SymptomsNon-tender lump of varying size Occurs most often in upper outer quadrant

of breast often with dimpling

TreatmentMastectomy, chemotherapy, and/or

radiation

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Ectopic Pregnancy

Fertilized ovum attaches to tissue outside the uterus, usually in fallopian tubes

SymptomsAcute pelvic painVaginal bleedingPositive pregnancy test

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Ectopic Pregnancy

TreatmentPrompt surgery to terminate pregnancyEvery effort is taken to preserve ovary and

tube if future pregnancy is desired

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Spontaneous Abortion

“Miscarriage” Natural termination of pregnancy before

fetus is viable Symptoms

Vaginal bleedingCramping and pelvic pain

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Spontaneous Abortion

Once it starts, progression is difficult to stop

D & C may be necessary to remove any tissue remaining in the uterus

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Morning Sickness

Associated with first trimester of pregnancy

Symptoms: nausea and vomiting Treatment

Not necessary unless vomiting Light meals several times a day

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Morning Sickness

Treatment Dry food before drinkingAvoid fatty foodsRest after meals

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Hyperemesis Gravidarum Excessive vomiting during pregnancy Treatment includes IV fluids and

withholding all foods and oral fluids Usually subsides by second pregnancy

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Toxemia

Usually appears during 3rd trimester Symptoms

HypertensionSudden weight gainProteinuriaEdema in face, hands, and feet

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Toxemia

TreatmentFrequent monitoring of blood pressureWeight and urine protein

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Abruptio Placentae

Separation of placenta from uterus Degrees of symptoms

Partial separation may be asymptomaticComplete separation may cause severe

abdominal pain and vaginal bleedingShock and decrease in fetal heart tones

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Abruptio Placentae

TreatmentPrompt delivery either vaginally or by c-

sectionBlood replacement may also be necessary

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Placenta Previa

Abnormal positioning of placenta in lower uterus near or over cervical os

Symptoms: painless, bright red vaginal bleeding during third trimester

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Placenta Previa

Treatment-vaginal delivery is asymptomatic or if bleeding is not severe; emergency c-section if maternal bleeding or fetal anoxia

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Placenta Previa

Treatment Vaginal delivery is asymptomatic if bleeding

is not severeEmergency c-section if maternal bleeding or

fetal anoxia

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Prostatitis

Inflammation of prostate gland Symptoms

DysuriaPyuriaFever and low back pain

Treatment: antibiotics, warm sitz baths, increased fluid intake, analgesics

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Benign Prostatic Hyperplasia Enlargement of prostate gland due to

normal cells overgrowing and enlarging Common in men over age 60

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Benign Prostatic Hyperplasia Symptoms

NocturiaInability to start urinationWeak urinary streamInability to empty stream

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Benign Prostatic Hyperplasia Treatment

Prostatic massageSitz bathCatheterizationsRegular sexual intercourseSurgery

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Prostatic Carcinoma

Neoplasm of prostate gland affecting men over 50

Second most common cause of cancer-related deaths in men

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Prostatic Carcinoma

Symptoms are similar to BPH Treatment

Depends on age and physical condition of individual

Degree of metastasis

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Epididymitis

Inflammation of epididymis Symptoms

Swollen, hard, and painful epididymis Often accompanied by severe scrotal pain

and swelling

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Epididymitis

TreatmentRestAnalgesicsUse of a scrotal supportAvoidance of alcohol, spicy foods, and

sexual stimulation

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Orchitis

Inflammation of one or both testes due to viral or bacterial infection

Symptoms: swelling, pain, tenderness of one or both testes, fever, malaise

Treatment: dependent on cause

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Testicular Tumor

Commonly affect young men age 20-35 Most common type of cancer in this

group Symptoms: painless mass felt in testicle Treatment: orchiectomy, chemotherapy,

and radiation

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Cryptorchidism

Undescended testicle Premature birth is common cause Treatment: surgery

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Genital Herpes

Viral infection 1 in 6 individuals in United States is

infected Not curable Periods of remission and exacerbation

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Genital Herpes

SymptomsBlister-like lesions causing dysuriaSevere itching

Treatment is symptomaticAntiviral medicationsSitz bathsIce therapy and analgesics

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Gonorrhea

“Clap” Symptoms

Purulent discharge from penis and vagina DysuriaUrinary frequency in males and femalesFemale - cervicitis Genital itching and burning pain

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Gonorrhea

TreatmentAntibiotics including PenicillinTetracyclineCeftiaxone

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Syphilis

Treatment: Penicillin or Tetracycline is very effective

Three stagesPrimary - appearance of painless chancreSecondary - chancre healsPeriod of rest lasting 6 weeks to 1 year

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Syphilis

Secondary - rash appears Tertiary

Bacteria invade organs throughout body causing gumma

Curable with antibiotics during this stage but effects of lesions are irreversible

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Chlamydia

Known as “silent” STD - Bacterial Symptoms

Drainage with burning and itching Urination due to urethritis and epididymitis

Treatment: antibiotics

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Trichomoniasis

Caused by protozoan Symptoms

Male - urethritis, epididymitis, and prostatitisFemale - green frothy vaginal discharge,

itching and burning of genital area

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Trichomoniasis

TreatmentAntiparasitic medications such as Flagyl

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Genital Warts

Viral infection Symptoms

Possible tenderness in affected area

TreatmentChemical or surgical removal

Cervical cancer related to genital warts

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Dyspareunia

Pain or discomfort with sexual intercourse

May affect men and women Treatment is dependent on cause

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Premature Ejaculation

Expulsion of seminal fluid during foreplay, prior to complete erection, or immediately after sexual intercourse

Common in young males Treatment is based on cause

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Infertility

Inability of couple to achieve pregnancy after one year of unprotected sex

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Infertility

CausesPresence of STDHormonal disordersAbnormality of reproductive organsEndometriosisScarring or blockage of fallopian tubesVaginal antibodies that kill sperm

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Infertility

TreatmentBased on causeSurgeryMedication therapyHormone imbalance

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Hydiatidiform Mole

Grape-like cysts in uterus that mimic pregnancy

Treatment: D & C At higher risk to develop

choriocarcinoma requiring frequent follow-up examinations

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