1. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley CHAPTER Medical Language Second Edition Gynecology and Obstetrics 13

2. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Gynecology -The medical specialty that studies the anatomy and physiology of the female genital system and uses diagnostic tests, medical and surgical procedures, and drugs to treat female genital diseases.

3. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Obstetrics -The medical specialty that studies the anatomy and physiology of the female reproductive system and uses diagnostic tests, medical and surgical procedures, and drugs to monitor normal pregnancy and childbirth and treat diseases.

4. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Anatomy and Physiology Internal Genitalia: ovaries uterine tubes uterus vagina External Genitalia: Area of the vulva: mons pubis labia majora labia minora clitoris vaginal introitus The function of the female genital and reproductive system is to display the female secondary sexual characteristics, produce ova (eggs), and, when appropriate, conceive and bear children.

5. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-2 Abdominopelvic cavity.

6. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Anatomy of the Female Genital and Reproductive System 1. Ovaries: -Small egg-shaped glands about 2 inches in length that are near the end of a uterine tube. -Gonads or sex glands in a female. -Function as part of the female genital and reproductive system and the endocrine system. -Contain follicles that rupture and release ova (eggs) during the menstrual cycle. -Secrete hormones estradiol, progesterone, and testosterone that affect puberty, thickening of the endometrium, and female sex drive.

7. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-3 Ovaries, fallopian tubes, and uterus

8. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley 2. Uterine Tubes: -Function is to transport an ovum from the ovary to the uterus. -Also known as oviducts or fallopian tubes. Anatomy of the Female Genital and Reproductive System

9. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-4 Uterus

10. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley 3. Uterus -Fundus is the rounded top of the uterus. -The corpus, or body, of the uterus is its widest part. -The body narrows and becomes the cervix (neck of the uterus). -Within the uterus is the hollow intrauterine cavity, which narrows into the cervical canal. -The wall of the uterus is composed of three layers: perimetrium, myometrium, and endometrium. Anatomy of the Female Genital and Reproductive System

11. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley 4. Vagina -The fornix is the area of the vaginal canal that is behind and around the cervix. -Covering the inferior end of the vaginal canal is the hymen, although it is sometimes absent. -The vaginal introitus is the opening to the outside of the body. -During menstruation, it transports the shed endometrium to the outside of the body. -It holds the penis during sexual intercourse. -It is the part of the birth canal that takes the baby to the outside of the mother’s body. Anatomy of the Female Genital and Reproductive System

12. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley External Genitalia: -Labia majora -Labia minora -Clitoris -Vaginal introitus (entrance) -Glands that produce lubricating secretions The vulva includes all of these structures as well as the urethral meatus and the mons pubis. Anatomy of the Female Genital and Reproductive System

13. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-5 External female genitalia

14. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Breasts: -composed of adipose (fatty) tissue and glands, the breasts (or mammary glands) are a part of the integumentary & reproductive systems. -develop at puberty. -contain lactiferous lobules that produce milk to nourish the newborn after birth. Anatomy of the Female Genital and Reproductive System

15. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-6 Breast

16. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Physiology of Sexual Maturity, Oogenesis, Menstruation, and Conception: Anterior Pituitary Gland (brain): -secretesfollicle-stimulating hormone (FSH) luteinizing hormone (LH) Functions:-produce a mature ovum -release a mature ovum from the ovary

17. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Physiology of Sexual Maturity, Oogenesis, Menstruation, and Conception: FSH stimulates a follicle in the ovary to enlarge and produce a mature ovum and secrete estradiol, which causes the development of female sexual characteristics. LH stimulates a single follicle each month to rupture and release its mature ovum. LH stimulates the ruptured follicle (corpus luteum) to secrete estradiol and progesterone.

18. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-7 Hormones secreted by the ovaries

19. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Physiology of Sexual Maturity, Oogenesis, Menstruation, and Conception The Menstrual Cycle -At the onset of puberty, the female begins to ovulate and menstruate. -Menarche is the beginning of menstruation, which occurs with the first menstrual period, or menses. -lasts approx. 28 days.

20. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Physiology of Sexual Maturity, Oogenesis, Menstruation, and Conception The Menstrual Cycle: -Menstrual phaseDays 1-6 -Proliferative phaseDays 7-13 -OvulationDay 14 -Secretory phaseDays 15-26 -Ischemic phaseDays 27-28

21. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-8 The menstrual cycle

22. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Physiology of Sexual Maturity, Oogenesis, Menstruation, and Conception Conception: -Spermatozoa reach the ovum 24 to 48 hours after sexual intercourse. -Chemicals secreted by the ovum attract the spermatozoa. -Only one spermatozoa penetrates the ovum; this is the moment of fertilization, or conception. -23 chromosomes (sperm) + 23 chromosomes (egg) = 46 chromosome zygote…pregnancy! -Mitosis begins immediately…after 4 days it a embryo…after 8 weeks, it is a fetus. -Gestation refers to the entire period of pregnancy time. (38-42 weeks)

23. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-9 An ovum and spermatozoa D. Philips / Photo Researchers, Inc.

24. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-10 A fetus at 9 weeks’ gestation Photo Lennart Nilsson/Albert Bonniers Forlag

25. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Physiology of Labor and Delivery The process of labor and childbirth is known as parturition; it is divided into three stages. -First stage of labor: Cervical dilation, effacement, rupture of membranes. -Second stage of labor: Crowning occurs, the baby is delivered, and the umbilical cord is clamped and cut. -Third stage of labor: Delivery of placenta, suturing of the episiotomy if one was performed.

26. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-12 Labor and Delivery

27. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-13 Crowning of the fetal head

28. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-14 Cutting the umbilical cord

29. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley The Newborn -A newborn who is between 38 and 42 weeks’ gestation is a term neonate. -A newborn between 28 and 37 weeks’ gestation is preterm, or premature. -The skin of the newborn is covered with vernix caseosa, a thick, white, cheesy substance that protects the skin from amniotic fluid in the uterus.

30. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-15 Term neonate

31. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley The Newborn -On the top of the head, the anterior fontanel, or soft spot, is a soft area that bulges when the newborn cries. -There is also a smaller posterior fontanel at the back of the head that allows the brain to grow before the bones fuse together. -The first stool is meconium, a thick, greenish- black, sticky substance.

32. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Diseases and Conditions Ovaries and Uterine Tubes -Anovulation -Ovarian cancer -Polycystic ovary syndrome -Salpingitis

33. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-17 Endometriosis Z. Binor/Custom Medical Stock Photo, Inc.

34. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Uterus: -Endometrial cancer -Endometriosis -Leiomyoma -Leiomyosarcoma -Myometritis -Pelvic inflammatory disease (PID) -Retroflexion of the uterus -Uterine fibroids -Uterine prolapse

35. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-18 Leiomyoma CNRI/Photo Researchers, Inc.

36. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Menstrual Disorders: -Amenorrhea -Dysfunctional uterine bleeding (DUB) -Dysmenorrhea -Menopause -Menorrhagia -Oligomenorrhea -Premenstrual syndrome (PMS) -Premenstrual dysphoric disorder (PMDD)

37. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Cervix: -Cervical cancer -Cervical dysplasia -Incompetent cervix Vagina and Perineum: -Bacterial vaginosis -Candidiasis -Cystocele -Dyspareunia -Rectocele -Vaginitis

38. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-19 Cervical dysplasia SPL/Photo Researchers, Inc.

39. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Breasts: -Breast cancer -Failure of lactation -Fibrocystic disease -Galactorrhea

40. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Pregnancy and Labor and Delivery: -Abnormal presentation -Abruptio placentae -Cephalopelvic disproportion (CPD) -Dystocia -Ectopic pregnancy -Gestational diabetes mellitus -Hydatidiform mole -Mastitis -Morning sickness -Oligohydramnios -Placenta previa -Polyhydramnios -Postpartum hemorrhage -Preeclampsia -Premature labor -Premature rupture of membranes (PROM) -Prolapsed cord -Spontaneous abortion (SAB) -Uterine inertia

41. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-20 Breast with cancer and cysts

42. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-22 Breech position Vince Michaels/Getty Images Inc. – Stone Allstock

43. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-23 Malpresentation of fraternal twins

44. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-24 Placenta previa

45. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Fetus and Neonate: -Apnea -Fetal distress -Growth abnormalities -Jaundice -Meconium aspiration -Nuchal cord -Respiratory distress syndrome (RDS)

46. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Laboratory and Diagnostic Procedures Gynecologic Diagnostic Procedures: -Acid phosphatase -BRCA1 or BRCA2 gene -Biopsy -Estrogen receptor assay -Pap smear -Wet mount

47. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-25 Taking a Pap smear

48. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Infertility Diagnostic Tests: -Antisperm antibody test -Hormone testing Pregnancy and Neonatal Diagnostic Tests: -Amniocentesis -Chorionic villus sampling (CVS) -Pregnancy test

49. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-27 Amniocentesis Yoav Levy / Phototake NYC

50. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Radiologic Procedures: -Hysterosalpingography -Mammography -Ultrasonography Medical Procedures of the Internal Genitalia: -Colposcopy -Cryosurgery -Gynecologic examination

51. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-29 Three-dimensional ultrasonography GE Medical Systems / Photo Researchers, Inc.

52. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-30 Bimanual examination

53. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-31 Speculum Simon Fraser/Science Photo Library/Photo Researchers, Inc.

54. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Medical Procedures of the Breast: -Breast self-examination (BSE) -Tanner staging

55. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Medical Procedures for Obstetrics: -Amniotomy -Apgar score -Assisted delivery -Epidural anesthesia -Fundal height -Induction of labor -Nägele’s rule -Nonstress test (NST) -Obstetrical history -Therapeutic abortion -Version

56. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Medical Procedures for Obstetrics: - Assisted Reproductive Technology (ART)  In vitro fertilization (IVF)  Zygote intrafallopian transfer (ZIFT)  Gamete intrafallopian transfer (GIFT)  Intracytoplasmic sperm injection (ICSI)

57. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-33 Intracytoplasmic sperm injection (ICSI) Zephyr/Photo Researchers, Inc.

58. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Surgical Procedures of the Uterus, Uterine Tubes, and Ovaries: -Dilation and curettage (D&C) -Endometrial ablation -Hysterectomy -Laparoscopy -Myomectomy -Oophorectomy -Salpingectomy -Tubal ligation -Uterine artery embolization -Uterine suspension

59. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-34 Laparoscopic surgery (b) David M. Grossman / Phototake NYC

60. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Surgical Procedures of the Cervix and Vagina: -Colporrhaphy -Conization -Culdoscopy Surgical Procedures of the Breast: -Lumpectomy -Mammaplasty -Mastectomy -Reconstructive breast surgery Surgical Procedures in Obstetrics: -Cerclage -Cesarean section -Episiotomy

61. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Medical and Surgical Procedures (cont’d) Surgical Procedures of the Breast –Lumpectomy –Mammaplasty –Mastectomy –Reconstructive breast surgery Surgical Procedures in Obstetrics –Cerclage –Cesarean section –Episiotomy

62. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-35 Breast implant Getty Images – Photodisc-Royalty Free

63. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 13-39 TRAM flap reconstruction

64. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Abbreviations

65. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Abbreviations

66. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Abbreviations