1. Define the following terms: 1.

1 Gynecological examination

-Investigation and assessment of the female urogenital system for the purposes of diagnosis and to rule out the presence of disease or injury.

1.2 Gynecology - a branch of medicine that deals with the diseases and routine physical care of the reproductive system of women -The word "gynecology" comes from the Greek gyno, gynaikos meaning woman + logia meaning study, so gynecology literally is the study of women. 1.3 Gyne -is short for gynecology or for a gynecologist, a physician who specializes in treating diseases of the female reproductive organs. 1.4 Adenofibrinoma -a tumor of the connective tissue which contain glandular elements 1.5 Duct Ectasia -an abnormal dilation of a duct by lipids and cellular debris. In a mammary duct the condition, which tends mainly to affect postmenopausal women, may be accompanied by inflammation and infiltration by plasma cells. 1.6 Gynecomastia

-excessive development of the breast in the male

1.7 Mastitis

-inflammation of the mammary gland or udder usually caused by infection

1.8 Amenorrhea -abnormal absence or suppression of menstruation 1.9 Menorrhagia -abnormally profuse menstrual flow 1.10 Cyst

-a closed sac having a distinct membrane and developing abnormally in a body cavity or structure

1.11 Cystocele

-is a bulging in the anterior vaginal wall caused by thickening of the pelvic musculature. As a result, the bladder, covered by vaginal mucosa, prolapses into the vagina.

1.12 Dyspareunia -difficult or painful sexual intercourse 1.13 Endometrioses

-the presence and growth of functioning endometrial tissue in places other than the uterus that often results in severe pain and infertility

1.14 Herpes

-any of several inflammatory diseases of the skin caused by herpesviruses and characterized by clusters of vesicles

1.15 Fistula

-an abnormal passage that leads from an abscess or hollow organ or part to the body surface or from one hollow organ or part to another and that may be surgically created to permit passage of fluids or secretions

1.16 Hernia

-a protrusion of an organ or part through connective tissue or through a wall of the cavity in which it is normally enclosed

1.17 Leiomyomas

-a benign tumor (as a fibroid) consisting of smooth muscle fibers

1.18 Myomas

-a tumor consisting of muscle tissue

1.19 Polyp

-a projecting mass of swollen and hypertrophied or tumorous membrane (as in the nasal cavity or the intestine)

1.20 Rectocele

-is a bulging in the posterior vaginal wall caused by weakening of the pelvic musculature. Part of the rectum covered by the vaginal mucosa protrudes into the vagina.

1.21 Vaginitis

-inflammation (as from bacterial or fungal infection, allergic reaction, or hormone deficiency) of the vagina that may be marked by irritation and vaginal discharge

1.22 Vulvitis

-inflammation of the vulva

1.23 Salphingitis

-inflammation of a fallopian

1.24 Menopause -is a normal physiologic process that occurs in women between the ages of 40 to 58 years, with a mean age of 50 1.25 Wart

-a horny projection on the skin usually of the extremities produced by proliferation of the skin papillae and caused by any of numerous genotypes of the human papillomavirus

2. Review the anatomy and physiology of female reproductive system 1. Internal organs a.) Uterus The uterus is a hollow organ about the size and shape of a pear. It serves two important functions: it is the organ of menstruation and during pregnancy it receives the fertilized ovum, retains and nourishes it until it expels the fetus during labor. Divisions of the uterus. The uterus consists of the body or corpus, fundus, cervix, and the isthmus. The major portion of the uterus is called the body or corpus. The fundus is the superior, rounded region above the entrance of the fallopian tubes. The cervix is the narrow, inferior outlet that protrudes into the vagina. The isthmus is the slightly constricted portion that joins the corpus to the cervix. b.) Vagina The vagina is a thin-walled tube 8 to 10 cm (3-4 inches) long. It lies between the bladder and rectum and extends from the cervix to the body exterior. The vagina provides a passageway for the delivery of an infant and for the menstrual flow to leave the body. Because it receives the penis (and semen) during sexual intercourse, it is the female organ of copulation. c.) Fallopian Tubes (Two) Each tube is about 4 inches long and extends medially from each ovary to empty into the superior region of the uterus. The fallopian tubes transport ovum from the ovaries to the uterus. There is no contact of fallopian tubes with the ovaries. d.) Ovaries The ovaries are for oogenesis-the production of eggs (female sex cells) and for hormone production (estrogen and progesterone).

 The ovaries are about the size and shape of almonds. They lie against the lateral walls of the pelvis, one on each side.

Process of egg production-----oogenesis Primary oocytes remain in the state of suspended animation through childhood until the female reaches puberty (ages 10 to 14 years). At puberty, the anterior pituitary gland secretes follicle-stimulating hormone (FSH), which stimulates a small number of primary follicles to mature each month. As a primary oocyte begins dividing, two different cells are produced, each containing 23 unpaired chromosomes. One of the cells is called a secondary oocyte and the other is called the first polar body. The secondary oocyte is the larger cell and is capable of being fertilized. The first polar body is very small, is nonfunctional, and incapable of being fertilized. By the time follicles have matured to the graafian follicle stage, they contain secondary oocytes and can be seen bulging from the surface of the ovary. Follicle development to this stage takes about 14 days. Ovulation (ejection of the mature egg from the ovary) occurs at this 14-day point in response to the luteinizing hormone (LH), which is released by the anterior pituitary gland. The follicle at the proper stage of maturity when the LH is secreted will rupture and release its oocyte into the peritoneal cavity. The motion of the fimbriae draws the oocyte into the fallopian tube. The luteinizing hormone also causes the ruptured follicle to change into a granular structure called corpus luteum, which secretes estrogen and progesterone. If the secondary oocyte is penetrated by a sperm, a secondary division occurs that produces another polar body and an ovum, which combines its 23 chromosomes with those of the sperm to form the fertilized egg, which contains 46 chromosomes. Process of hormone production by the ovaries Estrogen is produced by the follicle cells, which are responsible secondary sex characteristics and for the maintenance of these traits. These secondary sex characteristics include the enlargement of fallopian tubes, uterus, vagina, and external genitals; breast development; increased deposits of fat in hips and breasts; widening of the pelvis; and onset of menses or menstrual cycle.

 Progesterone is produced by the corpus luteum in presence of in the blood. It works with estrogen to produce a normal menstrual cycle. Progesterone is important during pregnancy and in preparing the breasts for milk production. 2. External Female Organs a.) Mons Pubis This is the fatty rounded area overlying the symphysis pubis and covered with thick coarse hair. b.) Labia Majora The labia majora run posteriorly from the mons pubis. They are the 2 elongated hair covered skin folds. They enclose and protect other external reproductive organs. c.) Labia Minora The labia minora are 2 smaller folds enclosed by the labia majora. They protect the opening of the vagina and urethra. d.) Vestibule The vestibule consists of the clitoris, urethral meatus, and the vaginal introitus. The clitoris is a short erectile organ at the top of the vaginal vestibule whose function is sexual excitation. The urethral meatus is the mouth or opening of the urethra. The urethra is a small tubular structure that drains urine from the bladder. e.) Perineum This is the skin covered muscular area between the vaginal opening (introitus) and the anus. It aids in constricting the urinary, vaginal, and anal opening. It also helps support the pelvic contents. d.) Bartholins glands (Vulvovaginal or Vestibular Glands)

 The Bartholins glands lie on either side of the vaginal opening. They produce a mucoid substance, which provides lubrication for intercourse.

3. Mammary Glands Internally, each mammary gland consists of 15 to 25 lobes that radiate around the nipple. The lobes are padded and separated from one another by connective tissue and fat. Within each lobe are smaller chambers called lobules, which contains cluster of alveolar glands that produce the milk when a woman is lactating. The alveolar glands of each lobule pass the milk into the lactiferous ducts, which open to the outside of the nipple. Because the biological role of the mammary glands is to produce milk to nourish a newborn baby, they are actually important when reproduction has already been accomplished. Each mammary gland is contained within a rounded skin-covered breast anterior to the pectoral muscles. Slightly below the center of each breast is a pigmented area, the areola, which surrounds a central protruding nipple.