DOCSLIB.ORG

6Lr4so6trfs5rvh1oiu5zwxsk

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
6Lr4so6trfs5rvh1oiu5zwxsk Investigation methods of gynecological patients. General clinical symptoms of gynecological diseases 1. Rationale Professional motivation: The investigation methods in gynecology has a great value for studying subject. The basic and auxiliary methods of gynecological examination can enables to understand of gynecological diseases. These methods are used for verification of the diagnosis. 2. Objectives: 1. To analyze the main clinical symptoms of the gynecological diseases and gynecological anamnesis. -To explain The basic (objective) and auxiliary methods of gynecological examination and methods of functional diagnostics -To suggest tactics of management of patients in different diseases of reproductive system. -To classify the diseases of the cervix, endometrium, vulva according to current morphological and clinical classifications and ICD. -To interpret data of laboratory and instrumental examinations of the cervix, endometrium, vulva and endoscopic methods of examination gynecological patients -To draw a diagram of “patient route” and “plan of examination” in the background and precancerous pathology; indications of localization and PID To make the analysis of degrees of vagina cleanness. Cytology types. -To make up the models of clinical cases with various pathology in women of reproductive and premenopausal age. 3. The basic level of expertise, skills, abilities, required for learning the topic (interdisciplinary integration ) The name of the previous Acquired skills disciplines Normal Anatomy Structure of female genital organs. Topography of abdominal organs and pelvic organs. Histology Histological structure of the cervix, vulva and endometrium in normal and in pathological conditions. Notmal Physiology Physiological changes occurring in the hypothalamic- pituitary-ovarian system of women and target organs of the sex hormones action at different ages. Possession of the methodology for conducting functional diagnostics tests. Microbiology, Immunology Specific and nonspecific protective factors, antiviral immunity Pathological Anatomy Morphological structure of all types of benign tumors of the female genital organs. Pathological Physiology Hormonal changes in the body during the menstrual cycle and disorders of the microbiota of the female reproductive system. Operative Surgery The main types of surgery on the female genital organs. Mechanisms of therapeutic action of physical factors (electric current, refrigerants, laser radiation, phototherapy). Pharmacology Groups of medications that affect the function of the hypothalamus, pituitary gland, ovaries, adrenal glands; mechanism of pharmacological action of hormonal, hemostatic, anti-inflammatory, antiviral drugs. 4. Tasks for independent work in preparation for the lesson and in class. 4.1. The list of the major terms, parameters, characteristics to be acquired by a student to be prepared for the lesson The term Definition Gynecological pelvic Inspection of the external genitalia examination Inspection of the cervix and vagina using a speculum Bimanual examination Rectal, rectovaginal Clinical breast exam complaints A specific gynecological Меnstrual anamnesis, function: Sextual function Reproductive function: Gynecological diseases cytological (PAP-test) bacterioscopic laboratory tests in bacteriological gynecology virological (HPV-test) histological from the vagina, cervix, cervical canal and urethra and uterus functional diagnostics tests basal temperature Colposcopy Hysteroscopy Endoscopic Laparascopy research methods in gynecology Interpretation of the data of transabdominal and transvaginal ultrasound examination of Ultrasound examination of the the pelvic organs pelvic organs curettage of the cervical canal and uterine cavity Instrumental methods of examination gynecological patient. 4.2 Theoretical questions for the lesson: 1. General and specific methods of examination of gynecological patients. 2. Bimanual, vaginal and rectal examinations. Speculum examination. 3. Methods of diagnosing the functional state of the ovaries. 4. History taking, estimation of the laboratory investigations ( general and biochemical blood tests, urine blood coagulation, etc.) 5. Taking material from the vagina, urethra and cervical canal. 6. Evaluate the results of colpocytological study. 7. Evaluate the results of colposcopy. 8. Evaluate the diagnostic tests of the ovaries function. 9. Evaluate the results of the cytological, histological and bacteriological investigation. 10. Evaluate results of X-ray of female genitalia. 11.Estimate results of pelvic sonography. 12. Plan the investigations of patiens with various gynecological diseases. 4.3 Practical activities (tasks) to be performed on the lesson: To perform gynecological examination (bivalve vaginal speculum, bimanual, rectal, rectovaginal). To collect a specific gynecological anamnesis, to evaluate the findings of laboratory tests. To collect material from the vagina, cervix, cervical canal and urethra for cytological, and bacterioscopic studies. To evaluate the findings of cytological, histological, virological and bacteriological studies. To evaluate the findings of the ultrasonography of organs of the small pelvis. To estimate the protocol of the colposcopy of the cervix and vulva. To make a plan of examination of a patient in various nosological forms of background and precancerous pathology. 4.4 Topic content Investigation methods of gynecological patients. General clinical symptoms of gynecological diseases Examination of the patient, who had been admitted to the gynecological department, consists of anamnesis, objective (general and special) examination, and auxiliary methods. 1.1. Gynecological Anamnesis First, the doctor makes inquiries about the patient’s complaints, then about the development of the given disease (case history, anamnesis morbi), special gynecological history (certificates of the menstrual, sexual, reproductive, and secretory functions, antifertility agent application) (gynecological history, anamnesis gynaecology), and after that about living conditions, the history of diseases, allergic reactions (anamnesis vitae). The questioning is conducted according to a certain plan. 1. Passport data: the surname, name, patronymic name, age of the woman. 2. The patient’s complaints. Most often patients appeal to the doctor with complaints of pain, leucorrhoea, menstrual irregularities, bleeding, and also dysfunction of the adjacent organs (urinary incontinence, frequent urination, constipations, pain in defecating). 3. Case history. The doctor should find out how the disease began – acutely or gradually, what might have promoted disease development, whether there have been any examinations or treatment. 4. Gynecological history includes information about the menstrual, sexual, reproductive, and secretory functions of the woman. Menstrual function: the age of the first menstruation (menarche), the presence or absence of pain, menstruation duration, its regularity, menstrual cycle change after deliveries and abortions, the presence and duration of menopause, the date of the last menstruation. Sexual function: at what age the woman began sexual life, if there were any signs of the disease when she began sexual life or changed partner, how many sexual partners the woman has at the same time, what contraception method is preferred. Reproductive function: in what time interval after beginning sexual life without contraception the woman became pregnant for the first time, how many pregnancies the woman has had (deliveries, abortions), if there have been any complications after deliveries or abortions. Secretory function: the information about the quantity, smell, appearance, and periodicity of the vaginal discharge. Correctly collected gynecological anamnesis allows giving a provisional diagnosis with satisfactory accuracy. However, the doctor can draw the final conclusion about the disease only after an objective examination of the patient. 5. Life history: under what conditions the woman used to live and develop, what diseases she has had, allergic anamnesis, the presence of any pernicious habits (smoking, alcoholism, drug addiction). 6. Objective examination methods. 1.2. The basic methods of gynecological examination Gynecological examination is carried out on a gynecological chair. The woman is lying on her back with her legs half-bent in the knee and hip joints. Before examination the woman must necessarily evacuate the urinary bladder; if it is necessary, a cleansing enema is given. The doctor examines the woman in sterile gloves. Examination of the external genitals: pubis (its form, the state of the hypoderm, the pattern of hair distribution – adult woman, adult male, or mixed), perineum, large and small lips of pudendum (size, presence of edemas, ulcers, tumors, condylomatous excrescences, the degree of pudendal fissure closure); examination of the external urethral orifice, clitoris, internal surface of the large and small lips of pudendum (color, the state of the mucous tunic, pigmentation, ulcers), detecting the size of the Bartholin’s glands (location of their excretory ducts, the character of the secret, the presence of swelling and reddening around the orifice), posterior labial commissure (ruptures, scars), detecting falling and prolapse of the vaginal walls and uterus. The doctor obligatorily assesses the state of the hymen (intact, ruptured, acute ruptures). Simultaneously the doctor finds signs of infantilism (a narrow pudendal fissure, the large lips of pudendum
Load more

Recommended publications
  • The First Answer (A) Is Correct! 1
    The first answer (A) is correct! 1. 2. A 32 y.o. woman consulted a gynecologist about having abundant long menses within 3 months. Bimanual investigation: the body of the uterus is enlarged according to about 12 weeks of pregnancy, distorted, tuberous, of dense consistence. Appendages are not palpated. Histological test of the uterus body mucosa: adenocystous hyperplasia of endometrium. Optimal medical tactics: A. Surgical treatment B. Hormonetherapy C. Phytotherapy D. Radial therapy E. Phase by phase vitamin therapy 2. 3. A woman was hospitalised with fullterm pregnancy. In survey: the uterus is morbid, the abdomen is tense, heart sounds of the fetus are not auscultated. What is the most probable complication of pregnancy? A. Premature detachment of the normally posed placenta B. Preterm labour C. Back occipital presentation D. Acute hypoxia of a fetus E. Hydramnion 3. 4. By the end of the 1st period of physiological labour the clear amniotic waters were given vent. Contractions lasted 35-40 sec every 4-5 min. Palpitation of the fetus is 100 bpm. The AP is 140/90 mm Hg. Diagnosis: A. Acute hypoxia of the fetus B. Labors before term C. Premature detachment of normally posed placenta D. Back occipital presentation E. Hydramnion 4. 6. Which gestational age gives the most accurate estimation of weeks of pregnancy by uterine size? A. Less that 12 weeks B. Between 12 and 20 weeks C. Between 21 and 30 weeks D. Between 31 and 40 weeks E. Over 40 weeks 5. 7. A number of viable fetuses per 1000 women at the age between 15 and 44 is determined by: A.
    [Show full text]
  • Test Items for Licensing Examination Krok 2 MEDICINE
    MINISTRY OF PUBLIC HEALTH OF UKRAINE Department of human resources policy, education and science Testing Board Student ID Last name Variant ___________________ Test items for licensing examination Krok 2 MEDICINE General Instruction Every one of these numbered questions or unfinished statements in this chapter corresponds to answers or statements endings. Choose the answer (finished statements) that fits best and fill in the circle with the corresponding Latin letter on the answer sheet. Authors of items: Andrusiak O.V., Andrusha A.B., Artyshchenko V.A., Baburіna O.A., Babyn Yu.F., Badogіna L.P., Balabuieva S.V., Berezov V.M., Boiko M.І., Bondarenko V.V., Borovkova S.O., Borzova O.Yu., Bukhtieieva E.R., Buriak V.M., Burka O.A., Butvyn І.M., Bіlenko O.A., Bіlonko O.F., Bіlyk O.V., Bіlyk V.D., Chekanov S.L., Chonka І.І., Chuiko A.P., Demchenko T.V., Derkach V.G., Desiatska Yu.V., Detsyk O.Z., Dobrovolska L.M., Dziuba G.A., Dzіs N.P., Emіralіieva Z.R., Galagan S.І., Genyk N.І., Gerasymenko O.І., Golubovska N.M., Goriachev V.V., Grygorova І.A., Gryshchenko V.I., Gutsalenko O.O., Іvaniuta S.O., Kabeliuzhenko S.B., Karlіichuk O.O., Kelmanska S.І., Kolesnyk O.M., Kolesnіkova O.V., Koltsova N.І., Kondratiev V.O., Konopkіna L.І., Korobko O.A., Koval І.І., Kovaliova O.M., Kovtunenko R.V., Kozhushko M.Yu., Kravchenko T.Yu., Kriachkova L.V., Krut Yu.Ya., Krylova V.Yu., Kudrevych O.M., Kudria V.I., Kudіievskyi A.V., Kutuzov І.M., Kuzmenko S.A., Kvasnytska O.B., Kyrylenko V.A., Lakusta N.M., Lazar A.P., Lotysh N.G., Lymar L.Ye., Lysenko D.A., Maliovanyi
    [Show full text]
  • Clinical, Pathologic and Pharmacologic Correlations 2004
    HUMAN REPRODUCTION: CLINICAL, PATHOLOGIC AND PHARMACOLOGIC CORRELATIONS 2004 Course Co-Director Kirtly Parker Jones, M.D. Professor Vice Chair for Educational Affairs Department of Obstetrics and Gynecology Course Co-Director C. Matthew Peterson, M.D. Professor and Chief Division of Reproductive Endocrinology and Infertility Department of Obstetrics and Gynecology 1 Welcome to the course on Human Reproduction. This syllabus has been recently revised to incorporate the most recent information available and to insure success on national qualifying examinations. This course is designed to be used in conjunction with our website which has interactive materials, visual displays and practice tests to assist your endeavors to master the material. Group discussions are provided to allow in-depth coverage. We encourage you to attend these sessions. For those of you who are web learners, please visit our web site that has case studies, clinical/pathological correlations, and test questions. http://medstat.med.utah.edu/kw/human_reprod 2 TABLE OF CONTENTS Page Lectures/Examination................................................................................................................................... 4 Schedule........................................................................................................................................................ 5 Faculty .......................................................................................................................................................... 8 Groups .........................................................................................................................................................
    [Show full text]
  • Gender Confirmation Surgery Reference Number: PA.CP.MP.95 Effective Date: 01/18 Coding Implications Last Review Date: 09/17 Revision Log
    Clinical Policy: Gender Confirmation Surgery Reference Number: PA.CP.MP.95 Effective Date: 01/18 Coding Implications Last Review Date: 09/17 Revision Log Description Services for gender confirmation most often include hormone treatment, counseling, psychotherapy, complete hysterectomy, bilateral mastectomy, chest reconstruction or augmentation as appropriate, genital reconstruction, facial hair removal, and certain facial plastic reconstruction. Not every individual will require each intervention so necessity needs to be considered on an individualized basis. This criteria outlines medical necessity criteria for gender confirmation surgery when such services are included under the members’ benefit plan contract provisions. Policy/Criteria It is the policy of Pennsylvania Health and Wellness® (PHW) that the gender confirmation surgeries listed in section III are considered medically necessary for members when diagnosed with gender dysphoria per criteria in section I and when meeting eligibility criteria in section II. I. Gender Dysphoria Criteria, meets A and B A. Marked incongruence between the member’s experienced/expressed gender and assigned gender, of at least 6 month’s duration, as indicated by two or more of the following: 1. Marked incongruence between the member’s experienced/expressed gender and primary and/or secondary sex characteristics; 2. A strong desire to be rid of one’s primary and/or secondary sex characteristics because of a marked incongruence with one’s experienced/expressed gender; 3. A strong desire for the primary and/or secondary sex characteristics of the other gender; 4. A strong desire to be of the other gender (or some alternative gender different from one’s assigned gender); 5. A strong desire to be treated as the other gender (or some alternative gender different from one’s assigned gender); 6.
    [Show full text]
  • Once in a Lifetime Procedures Code List 2019 Effective: 11/14/2010
    Policy Name: Once in a Lifetime Procedures Once in a Lifetime Procedures Code List 2019 Effective: 11/14/2010 Family Rhinectomy Code Description 30160 Rhinectomy; total Family Laryngectomy Code Description 31360 Laryngectomy; total, without radical neck dissection 31365 Laryngectomy; total, with radical neck dissection Family Pneumonectomy Code Description 32440 Removal of lung, pneumonectomy; Removal of lung, pneumonectomy; with resection of segment of trachea followed by 32442 broncho-tracheal anastomosis (sleeve pneumonectomy) 32445 Removal of lung, pneumonectomy; extrapleural Family Splenectomy Code Description 38100 Splenectomy; total (separate procedure) Splenectomy; total, en bloc for extensive disease, in conjunction with other procedure (List 38102 in addition to code for primary procedure) Family Glossectomy Code Description Glossectomy; complete or total, with or without tracheostomy, without radical neck 41140 dissection Glossectomy; complete or total, with or without tracheostomy, with unilateral radical neck 41145 dissection Family Uvulectomy Code Description 42140 Uvulectomy, excision of uvula Family Gastrectomy Code Description 43620 Gastrectomy, total; with esophagoenterostomy 43621 Gastrectomy, total; with Roux-en-Y reconstruction 43622 Gastrectomy, total; with formation of intestinal pouch, any type Family Colectomy Code Description 44150 Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy 44151 Colectomy, total, abdominal, without proctectomy; with continent ileostomy 44155 Colectomy,
    [Show full text]
  • Clinical Pelvic Anatomy
    SECTION ONE • Fundamentals 1 Clinical pelvic anatomy Introduction 1 Anatomical points for obstetric analgesia 3 Obstetric anatomy 1 Gynaecological anatomy 5 The pelvic organs during pregnancy 1 Anatomy of the lower urinary tract 13 the necks of the femora tends to compress the pelvis Introduction from the sides, reducing the transverse diameters of this part of the pelvis (Fig. 1.1). At an intermediate level, opposite A thorough understanding of pelvic anatomy is essential for the third segment of the sacrum, the canal retains a circular clinical practice. Not only does it facilitate an understanding cross-section. With this picture in mind, the ‘average’ of the process of labour, it also allows an appreciation of diameters of the pelvis at brim, cavity, and outlet levels can the mechanisms of sexual function and reproduction, and be readily understood (Table 1.1). establishes a background to the understanding of gynae- The distortions from a circular cross-section, however, cological pathology. Congenital abnormalities are discussed are very modest. If, in circumstances of malnutrition or in Chapter 3. metabolic bone disease, the consolidation of bone is impaired, more gross distortion of the pelvic shape is liable to occur, and labour is likely to involve mechanical difficulty. Obstetric anatomy This is termed cephalopelvic disproportion. The changing cross-sectional shape of the true pelvis at different levels The bony pelvis – transverse oval at the brim and anteroposterior oval at the outlet – usually determines a fundamental feature of The girdle of bones formed by the sacrum and the two labour, i.e. that the ovoid fetal head enters the brim with its innominate bones has several important functions (Fig.
    [Show full text]
  • CASE of DOUBLE UTERUS, Tion of the Peritoneum, Appendages And
    A DESCRIPTION OF THE APPEARANCES OBSERVED IN A CASE OF DOUBLE UTERUS, IN WHICH IMPREGNATION HAD TAKEN PLACE, WITH REMARKS ON THE STRUCTURE AND FORMATION OF THE MEMBRANES OF THE HUMAN OVUM. BY ROBERT LEE, M.D. F.R.S. SECRETARY. PHYSICIAN TO THE BRITISH LYING-IN HOSPITAL. READ MAY 22, 1832. ON the 2d of August, 1831, I was present with Dr. Sims and Mr. Morley of Leicester Square, at the examination of the body of a woman who had died eight days subsequent to parturition, from inflamma- tion of the peritoneum, appendages and veins of the uterus. She had previously borne several living children, but nothing unusual occurred during labour Downloaded from jrs.sagepub.com at MCMASTER UNIV LIBRARY on June 8, 2016 474 DR. LEE ON DOUBLE UTERUS, AND on any of these occasions. The uterine organs were found on dissection to be malf'ormed, and several re- markable appearances were observed in their struc- ture, of which the following is a short history. The accompanying preparation of the parts, with a draw- ing and model in wax, will enable the members of the Society to verify the accuracy of the descrip- tion *. The body of the uterus was cleft as it were down the middle, from the fundus to the cervix, so as to form two lateral halves which opened into the cervix, like the uterine cornua of most mammiferous animals. The cervix, os uteri, and vagina presented the or- din~ary appearances observable at the same period after delivery. The right cornu had contained the foetus, and it did not differ perceptibly in its form and size from the uterus in common cases a week after delivery.
    [Show full text]
  • Vaginal Hysterectomy: Carl W
    OBGM_0306_Zimmerman.finalREV 2/22/06 2:51 PM Page 21 SURGICALTECHNIQUES Vaginal hysterectomy: Carl W. Zimmerman, MD Professor of Obstetrics and Gynecology, Vanderbilt University Is skill the limiting factor? School of Medicine, Nashville, Tenn For the expert surgeon, there is no absolute uterine size limit CASE Bleeding, a large uterus, aginal hysterectomy is not only fea- and no response to hormones sible, it is preferred. Although V laparoscopic surgeons are fond of “M.G.,” a 42-year-old nullipara, complains using the phrase “minimally invasive sur- of menstrual periods that last 10 days and gery” to describe their procedures, when it occur on a 28-day cycle. She says the ® comesDowden to hysterectomy, Health only Media the vaginal bleeding is extremely heavy, with frequent, route qualifies for this superlative descrip- copious clotting. She routinely avoids tion. And although uterine size does some- planning social activities aroundCopyright the timeFor timespersonal limit use ofuse the vaginal only route, it need of her period and occasionally cancels do so in only a minority of cases. nonessential engagements because of it. This article describes surgical tech- Over the past year, this professional niques for vaginal removal of the large woman has missed 6 days of work uterus, using morcellation, coring, cervi- IN THIS ARTICLE because of the problem with her menses. cectomy, and other strategies. When you ask about her history, she ❙ How to choose reports that another gynecologist first Is the vaginal approach always best? a hysterectomy palpated an enlarged and irregular uterus Guidelines addressing this question were route 5 years earlier, and an ultrasound at that developed by the Society of Pelvic Page 22 time revealed a multinodular fundus of Reconstructive Surgeons and evaluated by approximately 12 weeks’ size.
    [Show full text]
  • Accuracy of Colposcopy-Directed Biopsy in Detecting Early Cervical
    Archives of Gynecology and Obstetrics (2019) 299:525–532 https://doi.org/10.1007/s00404-018-4953-8 GYNECOLOGIC ONCOLOGY Accuracy of colposcopy‑directed biopsy in detecting early cervical neoplasia: a retrospective study Frederik A. Stuebs1 · Carla E. Schulmeyer1 · Grit Mehlhorn1 · Paul Gass1 · Sven Kehl1 · Simone K. Renner1,2 · Stefan P. Renner1,2 · Carol Geppert3 · Werner Adler4 · Arndt Hartmann3 · Matthias W. Beckmann1 · Martin C. Koch1 Received: 1 September 2018 / Accepted: 20 October 2018 / Published online: 27 October 2018 © Springer-Verlag GmbH Germany, part of Springer Nature 2018 Abstract Purpose Colposcopy-directed biopsy is a cornerstone method for diagnosing cervical intraepithelial neoplasia. The aim of this study was to evaluate the accuracy of colposcopy-directed biopsy in comparison with defnitive surgery. Methods The accuracy of colposcopy-directed biopsy was compared with the fnal histology in relation to diferent types of transformation zone (TZ), the patient’s age, and the examiner’s level of training. Results The overall accuracy of biopsy in comparison with defnitive surgery was 71.9% for all entities—benign lesions, low- grade squamous intraepithelial lesions, high-grade squamous intraepithelial lesions (HSILs), and cervical carcinoma—with an underdiagnosis rate of 11.8% and an overdiagnosis rate of 16.5%. The accuracy for detecting HSIL was 88% (401/455), with an underdiagnosis rate of 10.5% and overdiagnosis rate of 1.3%. The accuracy rates for detecting HSIL in women with TZ 1, TZ 2, or TZ 3 were 92.2, 90.5, and 76.5%, respectively. The accuracy rates for detecting HSIL in the diferent age groups were 93.1% (age 0–34), 83.6% (age 34–55), and 80% (age 55 or older).
    [Show full text]
  • Cervix Uteri Surgery Codes
    SEER Program Coding and Staging Manual 2015 Cervix Uteri C530–C539 (Except for M9727, 9733, 9741-9742, 9764-9809, 9832, 9840-9931, 9945-9946, 9950-9967, 9975-9992) [SEER Note: Do not code dilation and curettage (D&C) as Surgery of Primary Site for invasive cancers] Codes 00 None; no surgery of primary site; autopsy ONLY 10 Local tumor destruction, NOS 11 Photodynamic therapy (PDT) 12 Electrocautery; fulguration (includes use of hot forceps for tumor destruction) 13 Cryosurgery 14 Laser 15 Loop Electrocautery Excision Procedure (LEEP) 16 Laser ablation 17 Thermal ablation No specimen sent to pathology from surgical events 10–17 20 Local tumor excision, NOS [SEER Note: Margins of resection may have microscopic involvement. Procedures in code 20 include but are not limited to: cryosurgery, electrocautery, excisional biopsy, laser ablation, or thermal ablation.] 26 Excisional biopsy, NOS 27 Cone biopsy 24 Cone biopsy WITH gross excision of lesion 29 Trachelectomy; removal of cervical stump; cervicectomy Any combination of 20, 24, 26, 27 or 29 WITH 21 Electrocautery 22 Cryosurgery 23 Laser ablation or excision 25 Dilatation and curettage; endocervical curettage (for in situ only) 28 Loop electrocautery excision procedure (LEEP) 30 Total hysterectomy (simple, pan-) WITHOUT removal of tubes and ovaries Total hysterectomy removes both the corpus and the cervix uteri and may also include a portion of vaginal cuff 40 Total hysterectomy (simple, pan-) WITH removal of tubes and/or ovary Total hysterectomy removes both the corpus and the cervix uteri
    [Show full text]
  • OBGYN Outpatient Surgery Coding
    OBGYN Outpatient Surgery Coding Anatomy Anatomy • Hyster/o – uterus, womb • Uter/o – uterus, womb • Metr/o – uterus, womb • Salping/o – tube, usually fallopian tube • Oophor/o – ovary • Ovari/o - ovary Terminology • Colpo – vagina • Cervic/o – cervix, lower part of the uterus, the “neck” • Episi/o – vulva • Vulv/o – vulva • Perine/o – the space between the anus and vulva Hysterectomy • A hysterectomy is an operation to remove a woman's uterus. • A woman may have a hysterectomy for different reasons, including: • Uterine fibroids that cause pain • bleeding, or other problems. • Uterine prolapse, which is a sliding of the uterus from its normal position into the vaginal canal. Hysterectomy • There are around 30 hysterectomy CPT codes. • To find the correct code you have to first check: • the surgical approach and • extent of the procedure. Surgical Approaches • Abdominal – the uterus is removed via an incision in the lower abdomen • Vaginal – the uterus is removed via an incision in the vagina • Laparoscopic – the procedure is performed using a laparoscope , inserted via several small incisions in the body. • Their are also CPT codes for laparoscopic-assisted vaginal approach. In this procedure ,the scope is inserted via a small incisions in the vagina. Extent of Procedure • Total hysterectomy: It includes laparoscopically detaching the entire uterine cervix and body from the surrounding supporting structures and suturing the vaginal cuff. It includes bivalving, coring, or morcellating the excised tissues, as required. The uterus is then removed through the vagina or abdomen. • Subtotal, partial or supracervical hysterectomy: It is the removal of the fundus or op portion of the uterus only, leaving the cervix in place.
    [Show full text]
  • Gross Anatomy Mcqs Database Contents 1
    Gross Anatomy MCQs Database Contents 1. The abdomino-pelvic boundary is level with: 8. The superficial boundary between abdomen and a. the ischiadic spine & pelvic diaphragm thorax does NOT include: b. the arcuate lines of coxal bones & promontorium a. xiphoid process c. the pubic symphysis & iliac crests b. inferior margin of costal cartilages 7-10 d. the iliac crests & promontorium c. inferior margin of ribs 10-12 e. none of the above d. tip of spinous process T12 e. tendinous center of diaphragm 2. The inferior limit of the abdominal walls includes: a. the anterior inferior iliac spines 9. Insertions of external oblique muscle: b. the posterior inferior iliac spines a. iliac crest, external lip c. the inguinal ligament b. pubis d. the arcuate ligament c. inguinal ligament e. all the above d. rectus sheath e. all of the above 3. The thoraco-abdominal boundary is: a. the diaphragma muscle 10. The actions of the rectus abdominis muscle: b. the subcostal line a. increase of abdominal pressure c. the T12 horizontal plane b. decrease of thoracic volume d. the inferior costal rim c. hardening of the anterior abdominal wall e. the subchondral line d. flexion of the trunk e. all of the above 4. Organ that passes through the pelvic inlet occasionally: 11. The common action of the abdominal wall muscles: a. sigmoid colon a. lateral bending of the trunk b. ureters b. increase of abdominal pressure c. common iliac vessels c. flexion of the trunk d. hypogastric nerves d. rotation of the trunk e. uterus e. all the above 5.
    [Show full text]