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Lecture Notes Classroom Activity to Accompany Medical Terminology Systems, Sixth Edition Barbara A. Gylys ∙ Mary Ellen Wedding 12 Female Reproductive System 12 FEMALE REPRODUCTIVE SYSTEM Structure • Ovaries • Fallopian tubes • Uterus • Vagina • Clitoris • Vulva 2 12 FEMALE REPRODUCTIVE SYSTEM Function • Organs and glands that produce and unite female sex cells (ova or egg cells) • Transport ova to site of fertilization • Perpetuate the species • Pass genetic material from generation to generation 3 12 FEMALE REPRODUCTIVE SYSTEM Structure and Function Exercise Q: Where are the ovaries located? A: Pelvic cavity, one on each side of the uterus. Q: What is the biological role of mammary glands? A: Secrete milk for nourishment of the newborn. Q: What do the terms gestation and parturition mean? A: Gestation is the period from the fertilization of the ovum until birth; parturition refers to the process of giving birth. 4 12 FEMALE REPRODUCTIVE SYSTEM Ectopic Pregnancy Signs and Symptoms • Fertilized ovum implants and grows in places other than the uterine cavity. 5 12 FEMALE REPRODUCTIVE SYSTEM Ectopic Pregnancy Signs and Symptoms (continued) • Common site is interior of the fallopian tube. • Other sites include the ovary, wall of the uterus, or anywhere in the pelvic cavity. • Signs of early pregnancy may be present. • Abdominal pain and tenderness, as well as slight vaginal bleeding. • Rupture of a fallopian tube is life threatening and may cause severe abdominal pain and intra-abdominal bleeding. 6 12 FEMALE REPRODUCTIVE SYSTEM Ectopic Pregnancy Treatment • Laparotomy. • Ruptured fallopian tube may require removal. • All attempts are made to save the ovary. • Blood transfusion may be necessary in severe intra-abdominal bleeding or hypovolemic shock. 7 12 FEMALE REPRODUCTIVE SYSTEM Clinically Related Exercise Q: Ellen presents to ED complaining of abdominal pain. CT of the abdomen reveals an ovum has implanted in her fallopian tube. A pregnancy for an implanted ovum outside of the uterine cavity is known as an ___________________. A: ectopic pregnancy Q: The doctor diagnoses Heather with ectopic pregnancy. She asks her to explain what causes this condition. A: She states it is caused by a blockage or scarring of the tubes which prevents the fertilized egg from being transported to the uterus. Q: The nurse explains that a common cause of scarring or blockage of the fallopian tubes is due to infections such as PID. This abbreviation is defined as _____________________. A: pelvic inflammatory disease Q: Jean is diagnosed with ectopic pregnancy in the fallopian tube. The obstetrician informs her of the risks involved with this type of pregnancy. What are some of these risks? A: The fallopian tube may rupture, which is life threatening. It may also cause severe abdominal pain and intra-abdominal bleeding. 8 12 FEMALE REPRODUCTIVE SYSTEM Breast Cancer Signs and Symptoms • Early symptoms include swelling, lump, dimpling, retraction of nipple, discharge from nipple, tenderness. • Most common site for a lump is in the upper outer quadrant of the breast. • Advanced symptoms include nodularity, redness, edema, ulceration of skin, enlargement or shrinkage of breast. 9 12 FEMALE REPRODUCTIVE SYSTEM Breast Cancer Signs and Symptoms (continued) • Most common malignancy of women in the United States. • Appears to be associated with ovarian hormonal function. • High-fat diet appears to increase the incidence of breast cancer. 10 12 FEMALE REPRODUCTIVE SYSTEM Breast Cancer Signs and Symptoms (continued) • Family history of breast cancer. • Possibly use of hormone replacement therapy (HRT), especially for prolonged periods of time. 11 12 FEMALE REPRODUCTIVE SYSTEM Breast Cancer Treatment • Lumpectomy • Primary tumor in red and surrounding tissue removed during lumpectomy in pink. 12 12 FEMALE REPRODUCTIVE SYSTEM Breast Cancer Treatment (continued) • Modified radical mastectomy. 13 12 FEMALE REPRODUCTIVE SYSTEM Breast Cancer Treatment (continued) • Adjuvant chemotherapy may be indicated after surgery if malignant cells are found in the lymph nodes. • Any combination of surgery, radiation, chemotherapy, and hormonal therapy. 14 12 FEMALE REPRODUCTIVE SYSTEM Clinically Related Exercise Q: Mrs. S had a mastectomy because of breast cancer and the doctor explains the postsurgical, adjuvant chemotherapy he is recommending. Can you explain the purpose of adjuvant chemotherapy? A: It is chemotherapy that is used to enhance or extend the effects of surgery and to eliminate any possible metastasis. Q: Lisa finds a lump in her breast while performing breast self- examination. After mammography shows a small tumor, an excision of the breast tumor is performed. This is known as a ________________. A: lumpectomy Q: Sasha is diagnosed with breast cancer and asks the doctor the types of treatments prescribed for breast cancer besides surgery. A: He states that radiation, chemotherapy, and hormonal therapy are the treatments other than surgery. Q: Mary is scheduled for a modified radical mastectomy to treat her breast cancer. This surgical procedure involves removal of the entire breast and excision of the underarm lymph nodes. The medical term for removal of the lymph node is _____________. A: lymphadenectomy 15 12 FEMALE REPRODUCTIVE SYSTEM Endometriosis Signs and Symptoms • Growth of endometrial tissue in areas outside the uterus. 16 12 FEMALE REPRODUCTIVE SYSTEM Endometriosis Signs and Symptoms (continued) • Dysmenorrhea with pain in lower back and vagina. • Severity of pain does not necessarily indicate extent of the disease. • Dyspareunia, dysuria, and, sometimes, painful defecation. 17 12 FEMALE REPRODUCTIVE SYSTEM Clinically Related Exercise Q: Joan, a 22-year-old, presents to the office with severe pain with menstruation. Her complaint is documented as _________________________. A: dysmenorrhea Q: During laparoscopy, ectopic deposits of endometrial tissue are noted within the pelvis. The doctor charts this condition of endometrial tissue outside of the uterus as (endometritis, histometrial, endometriosis). A: endometriosis Q: A 15-year-old arrives at the clinic for birth control counseling. After weighing her options, she decides that birth control pills are her best option because they are highly reliable and easy to use. The abbreviation for the oral contraceptives is __________. A: OCPs Q: June comes into the clinic complaining of pain during sexual intercourse. The MA documents this complaint as (dysmenorrhea, dyspareunia, dysuria). A: dyspareunia 18 12 FEMALE REPRODUCTIVE SYSTEM Medical Vocabulary • amniocentesis • Transabdominal puncture of the amniotic sac under ultrasound guidance to remove amniotic fluid. 19 12 FEMALE REPRODUCTIVE SYSTEM Medical Vocabulary (continued) • • • • • • • • candidiasis cerclage cervicitis chlamydia eclampsia endometritis gynecologist menarche 20 12 FEMALE REPRODUCTIVE SYSTEM Medical Vocabulary (continued) • • • • • • • • menorrhagia neonatal neonate obstetrician postpartum primigravida pseudocyesis retroversion 21 12 FEMALE REPRODUCTIVE SYSTEM Diagnostic Procedures • Laparoscopy • Visual examination of abdominal cavity with a laparascope through one or more small incisions in the abdominal wall, usually at the umbilicus. 22 12 FEMALE REPRODUCTIVE SYSTEM Diagnostic Procedures (continued) • Colposcopy • Hysterosalpingography • Mammography • Pap test 23 12 FEMALE REPRODUCTIVE SYSTEM Word Building Exercise Q: Visual examination of the vagina: A: colposcopy Q: Process of recording (radiography) the uterus and fallopian tubes: A: hysterosalpingography Q: Instrument to examine the abdomen: A: laparoscope Q: Incision of the vulva: A: episiotomy Q: Surgical repair of the breast: A: mammoplasty, mastoplasty Q: Visual examination of the abdomen: A: laparoscopy Q: Excision or removal of the breast: A: mastectomy 24 12 FEMALE REPRODUCTIVE SYSTEM Medical and Surgical Procedures • Cerclage • Dilation and curettage (D&C) • Hysterosalpingo-oophorectomy 25 12 FEMALE REPRODUCTIVE SYSTEM Medical and Surgical Procedures (continued) • Hysterectomy with structure shaded purple. • Subtotal hysterectomy (cervix not removed). • Total hysterectomy (cervix removed) • Total hysterectomy plus bilateral salpingooophorectomy 26 12 FEMALE REPRODUCTIVE SYSTEM Medical and Surgical Procedures (continued) • Reconstructive breast surgery. • Tissue (skin) expansion. 27 12 FEMALE REPRODUCTIVE SYSTEM Medical and Surgical Procedures (continued) • Transverse rectus abdominis muscle (TRAM) flap. • Surgical creation of a skin flap (using skin and fat from lower half of abdomen), which is passed under the skin to the breast area, shaped into a naturallooking breast, and sutured in place 28 12 FEMALE REPRODUCTIVE SYSTEM Clinically Related Exercise Q: Mary presents to the OB clinic in her early third trimester with symptoms of premature labor. The physician recommends a procedure to suture the cervix to prevent premature labor and decrease the chance of spontaneous abortion. This procedure is called _________. A: cerclage Q: The patient is scheduled for removal of her uterus and both fallopian tubes. The physician charts this surgical procedure as a total hysterectomy plus bilateral ___________________________. A: salpingo-oophorectomy Q: Mary presents with heavy bleeding over the last 6 months and is scheduled to have a a scraping of uterine endometrium with a curette after dilation of the cervix. The abbreviation for this procedure is __________. A: D&C Q: Susan is considering reconstructive breast surgery following her mastectomy and is considering the TRAM flap procedure. What is the meaning of the abbreviation TRAM? A: transverse rectus abdominis muscle 29 12 FEMALE REPRODUCTIVE SYSTEM Pharmacology • Antifungals • Estrogens • Hormone replacement therapy (HRT) • Oral contraceptives (OCPs) 30 12 FEMALE REPRODUCTIVE SYSTEM Clinically Related Exercise Q: The patient presents with a vaginal yeast infection. The physician prescribes a suppository (antifungal, estrogen, HRT). A: antifungal Q: Mrs. A is menopausal and has symptoms of vaginal dryness and hot flashes. The physician writes her a prescription for an agent known as a/an (antifungal, estrogen, OCP). A: estrogen Q: Lauren, a 22-year-old, is sexually active with her husband but wants to wait a couple of years before having children. The NP explains the most effective option to prevent conception is to use an agent known as a/an (antifungal, estrogen, OCP). A: OCP 31