Anatomy and Physiology

Female external structures
○ Vulva
○ Labia majora and labia minora
○ Clitoris
○ Vestibule and vestibular glands
○ Hymen
○ Vaginal orifice
2
Anatomy and Physiology

Female internal structures
 Ovaries
 Fallopian tubes
 Uterus
 Cervix
 Vagina

Hormones: estrogen and progesterone
3
Anatomy and Physiology

Male external organs
 Scrotum and penis
4
Anatomy and Physiology

Male internal organs
 Testes
 Epididymis
 Vas deferens
 Urethra
 Seminal vesicles
 Bulbouretheral and prostate glands
5
Common Signs and Symptoms

Female
 Abdominal and pelvic pain
 Fever and malaise
 Abnormal vaginal discharge
 Burning and/or itching of the genitals
6
Common Signs and Symptoms

Female
 Pain during sexual intercourse
 Any change in breast tissue
 Abnormal discharge from the nipple
7
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
8
Common Signs and Symptoms

Male
 Swelling or abnormal enlargement of the
reproductive organs
 Abnormal penile discharge
 Burning and/or itching of the genitals
9
Diagnostic Tests

Female
 Bimanual examination
 Hysterosalpingogram
 Papanicolaou smear of cervix
 Cervical biopsy
 Cone biopsy
10
Diagnostic Tests

Female
 Dilatation and Curettage
 Laparoscopy
 Mammography
 Blood tests
11
Diagnostic Tests

Male
 Digital rectal examination
 Cystoscopy
 Biopsy
 Laboratory tests including PSA
12
Premenstrual Syndrome
Symotoms prior to menses
 Symptoms begin mid-cycle

 Headache and nausea
 Back and joint pain
 Edema and bloating
 Weight gain
13
Premenstrual Syndrome

Symptoms begin mid-cycle
 Breast tenderness
 Sleep disturbances
 Irritability
 Mood swings
 Depression
14
Premenstrual Syndrome

Treatment
 Individualized
 Dietary changes
 Avoid caffeine, chocolate, nicotine, salt,
sugar, and alcohol
15
Menstrual Abnormalities
Amenorrhea
 Dysmenorrhea
 Menorrhagia
 Metrorrhagia

16
Endometriosis
Abnormal growth of endometrial tissue
outside of the uterus
 Common sites of implantation include
ovaries, fallopian tubes, abdominal wall,
and intestines

17
Endometriosis

Symptoms
 Dysmenorrhea
 Low back, vaginal, and pelvic cramping
 Heavy menses and dyspareunia
18
Endometriosis

Treatment
 Hormones
 Remission with pregnancy, nursing, and
menopause
 Panhysterectomy
19
Pelvic Inflammatory Disease
Inflammation of some or all of the pelvic
reproductive organs
 May include cervicitis, salpingitis,
endometritis, oophoritis
 Most commonly caused by STDs

20
Pelvic Inflammatory Disease

Symptoms
 Fever
 Chills
 Pain in pelvic area
 Leukorrhea

Treatment: antibiotics, analgesics, and
rest
21
Ovarian Cyst
Commonly benign fluid-filled sacs on or
near the ovary
 Two types

 Physiologic
 Neoplastic
22
Ovarian Cyst

Symptoms




Low back pain
Pelvic pain
Dyspareunia
Nausea and vomiting
Treatment depends on type and size
 May resolve by itself or require
laparoscopy

23
Fibroid Tumor
Also known as leiomyomas
 Benign tumors of smooth uterine muscle
 Symptoms

 Abnormal uterine bleeding
 Excessive menstrual bleeding and pain
24
Fibroid Tumor
Treatment depends on woman’s age
and desire for children
 Surgical removal of fibroids or
hysterectomy
 Uterine embolization
 Hormone therapy

25
Vaginitis
Inflammation of vagina
 Symptoms

 Burning and itching
 Swelling of vagina and external genitalia
26
Vaginitis

Common type of vaginitis
 Candida: fungus or yeast
 Trichomonas: parasite
 Atrophic: post-menopausal
27
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

28
Toxic Shock Syndrome

Symptoms
 High fever
 Vomiting
 Diarrhea
 Decreasing blood pressure

Treatment: IV fluids, antibiotics
29
Menopause
Natural halting of menstruation
 Occurs between ages 45 and 55

30
Menopause

Common symptoms
 Hot flashes and night sweats
 Vaginal dryness
 Depression
 Sleep disorders
 Decreased libido

Treatment: hormone therapy, exercise
31
Uterine Prolapse
Uterus protrudes into vagina
 Symptoms

 Heaviness in pelvis
 Urinary stress
 Dysuria
 Low back pain

Treatment: hysterectomy
32
Cystocele
Herniation of urinary bladder through
anterior vaginal wall
 Symptoms: pelvic pressure, urinary
urgency, frequency, and incontinence
 Treatment: depends on degree of
herniation

33
Rectocele
Herniation of rectum through posterior
vaginal wall
 Symptoms: discomfort, constipation,
fecal incontinence
 Treatment: surgical repair

34
Cervical Cancer
Fifth leading cause of cancer-related
death in females
 Symptoms: abnormal cervical bleeding
 Treatment: surgical removal of tumor

35
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

36
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

37
Fibrocystic Disease
Most common breast disorder of
premenopausal females between the
ages of 30 and 55
 Cysts are linked to estrogen levels

38
Fibrocystic Disease

To decrease breast pain:
 Reduce caffeine and salt
 Use of mild diuretics
 Use of mild analgesics the week prior to
menstruation is recommended
39
Mastitis
Inflammation of breast tissue
 Symptoms

 Redness
 Heat
 Swelling
 Pain and often bloody nipple discharge
40
Mastitis

Treatment
 Antibiotics
 Application of heat
 Analgesics
 Firm supporting bra to decrease discomfort
41
Breast Cancer
Adenocarcinoma of the breast ducts
 Most common breast neoplasm (affects
one out of nine females)
 Risk factors

 Age 40 and over
 Family member affected with breast cancer
42
Breast Cancer

Risk factors
 Onset of menses before age 13
 Menses continuing after age 50
 Nullipara
 First child after age 30
 Obesity
 Chronic breast disease
43
Breast Cancer

Symptoms
 Non-tender lump of varying size
 Occurs most often in upper outer quadrant
of breast often with dimpling

Treatment
 Mastectomy, chemotherapy, and/or radiation
44
Ectopic Pregnancy
Fertilized ovum attaches to tissue
outside the uterus, usually in fallopian
tubes
 Symptoms

 Acute pelvic pain
 Vaginal bleeding
 Positive pregnancy test
45
Ectopic Pregnancy

Treatment
 Prompt surgery to terminate pregnancy
 Every effort is taken to preserve ovary and
tube if future pregnancy is desired
46
Spontaneous Abortion
“Miscarriage”
 Natural termination of pregnancy before
fetus is viable
 Symptoms

 Vaginal bleeding
 Cramping and pelvic pain
47
Spontaneous Abortion
Once it starts, progression is difficult to
stop
 D & C may be necessary to remove any
tissue remaining in the uterus

48
Morning Sickness
Associated with first trimester of
pregnancy
 Symptoms: nausea and vomiting
 Treatment

 Not necessary unless vomiting
 Light meals several times a day
49
Morning Sickness

Treatment
 Dry food before drinking
 Avoid fatty foods
 Rest after meals
50
Hyperemesis Gravidarum
Excessive vomiting during pregnancy
 Treatment includes IV fluids and
withholding all foods and oral fluids
 Usually subsides by second pregnancy

51
Toxemia
Usually appears during 3rd trimester
 Symptoms

 Hypertension
 Sudden weight gain
 Proteinuria
 Edema in face, hands, and feet
52
Toxemia

Treatment
 Frequent monitoring of blood pressure
 Weight and urine protein
53
Abruptio Placentae
Separation of placenta from uterus
 Degrees of symptoms

 Partial separation may be asymptomatic
 Complete separation may cause severe
abdominal pain and vaginal bleeding
 Shock and decrease in fetal heart tones
54
Abruptio Placentae

Treatment
 Prompt delivery either vaginally or by c-
section
 Blood replacement may also be necessary
55
Placenta Previa
Abnormal positioning of placenta in
lower uterus near or over cervical os
 Symptoms: painless, bright red vaginal
bleeding during third trimester

56
Placenta Previa

Treatment-vaginal delivery is
asymptomatic or if bleeding is not
severe; emergency c-section if maternal
bleeding or fetal anoxia
57
Placenta Previa

Treatment
 Vaginal delivery is asymptomatic if bleeding
is not severe
 Emergency c-section if maternal bleeding or
fetal anoxia
58
Prostatitis
Inflammation of prostate gland
 Symptoms

 Dysuria
 Pyuria
 Fever and low back pain

Treatment: antibiotics, warm sitz baths,
increased fluid intake, analgesics
59
Benign Prostatic Hyperplasia
Enlargement of prostate gland due to
normal cells overgrowing and enlarging
 Common in men over age 60

60
Benign Prostatic Hyperplasia

Symptoms
 Nocturia
 Inability to start urination
 Weak urinary stream
 Inability to empty stream
61
Benign Prostatic Hyperplasia

Treatment
 Prostatic massage
 Sitz bath
 Catheterizations
 Regular sexual intercourse
 Surgery
62
Prostatic Carcinoma
Neoplasm of prostate gland affecting
men over 50
 Second most common cause of cancerrelated deaths in men

63
Prostatic Carcinoma
Symptoms are similar to BPH
 Treatment

 Depends on age and physical condition of
individual
 Degree of metastasis
64
Epididymitis
Inflammation of epididymis
 Symptoms

 Swollen, hard, and painful epididymis
 Often accompanied by severe scrotal pain
and swelling
65
Epididymitis

Treatment
 Rest
 Analgesics
 Use of a scrotal support
 Avoidance of alcohol, spicy foods, and
sexual stimulation
66
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

67
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

68
Cryptorchidism
Undescended testicle
 Premature birth is common cause
 Treatment: surgery

69
Genital Herpes
Viral infection
 1 in 6 individuals in United States is
infected
 Not curable
 Periods of remission and exacerbation

70
Genital Herpes

Symptoms
 Blister-like lesions causing dysuria
 Severe itching

Treatment is symptomatic
 Antiviral medications
 Sitz baths
 Ice therapy and analgesics
71
Gonorrhea
“Clap”
 Symptoms

 Purulent discharge from penis and vagina
 Dysuria
 Urinary frequency in males and females
 Female - cervicitis
 Genital itching and burning pain
72
Gonorrhea

Treatment
 Antibiotics including Penicillin
 Tetracycline
 Ceftiaxone
73
Syphilis
Treatment: Penicillin or Tetracycline is
very effective
 Three stages

 Primary - appearance of painless chancre
 Secondary - chancre heals
 Period of rest lasting 6 weeks to 1 year
74
Syphilis
Secondary - rash appears
 Tertiary

 Bacteria invade organs throughout body
causing gumma
 Curable with antibiotics during this stage but
effects of lesions are irreversible
75
Chlamydia
Known as “silent” STD - Bacterial
 Symptoms

 Drainage with burning and itching
 Urination due to urethritis and epididymitis

Treatment: antibiotics
76
Trichomoniasis
Caused by protozoan
 Symptoms

 Male - urethritis, epididymitis, and prostatitis
 Female - green frothy vaginal discharge,
itching and burning of genital area
77
Trichomoniasis

Treatment
 Antiparasitic medications such as Flagyl
78
Genital Warts
Viral infection
 Symptoms

 Possible tenderness in affected area

Treatment
 Chemical or surgical removal

Cervical cancer related to genital warts
79
Dyspareunia
Pain or discomfort with sexual
intercourse
 May affect men and women
 Treatment is dependent on cause

80
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

81
Infertility

Inability of couple to achieve pregnancy
after one year of unprotected sex
82
Infertility

Causes
 Presence of STD
 Hormonal disorders
 Abnormality of reproductive organs
 Endometriosis
 Scarring or blockage of fallopian tubes
 Vaginal antibodies that kill sperm
83
Infertility

Treatment
 Based on cause
 Surgery
 Medication therapy
 Hormone imbalance
84
Hydiatidiform Mole
Grape-like cysts in uterus that mimic
pregnancy
 Treatment: D & C
 At higher risk to develop
choriocarcinoma requiring frequent
follow-up examinations

85