Paramedic Care- Principles & Practice, V5, 5e Bledsoe Lesson Plan, Test Bank, Quiz, Chapter Review, And Answer Key. Chapter 1-16. 468 Pages. Detailed Lesson Plan Gynecology 85–110 Minutes Cha pter 1 objectives can be fou
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Paramedic Care- Principles & Practice, V5, 5e Bledsoe Lesson Plan, Test Bank, Quiz, Chapter Review, And Answer Key. Chapter 1-16. 468 Pages. Detailed Lesson Plan Gynecology 85–110 Minutes Cha pter 1 objectives can be found on the opening chapter page. These objectives, which form the basis of each chapter, were developed from the new Education Standards and Instructional Guidelines. Minutes Content Outline Master Teaching Notes 5 I. Case Study Teaching Tips Have a student read the scenario. Tell students that the case will be reviewed after the lecture. 5 II. Introduction A. The term gynecology is derived from Greek gynaik, meaning woman. B. Branch of medicine that deals with health and diseases of women and their reproductive organs C. Obstetrics is the branch that deals with care of women throughout pregnancy. D. Most patients experience abdominal pain or vaginal bleeding. 15 III. Anatomy and Physiology A. Understanding of anatomy and physiology of the female reproductive system will allow better understanding, recognition, and treatment of emergencies as they arise B. Female Reproductive Organs 1. External genitalia have accessory functions and include the perineum, mons pubis, labia majora and minora, clitoris, and urethra. a. Perineum – skin-covered tissue that separates the vagina and anus; term may include entire vulvar area; may be torn during childbirth or sexual assault b. Mons pubis – fatty layer over the symphysis pubis that protects symphysis pubis during intercourse c. Labia majora – structure that is located laterally and protects Teaching Tips Use an anatomic model, picture, etc. to show students the female reproductive system, which will allow them a visual of how close all organs are to each other and why internal bleeding can be hidden. MASTER TEACHING NOTES Teaching Tips Discussion Topics Class Activities Points to Emphasize Knowledge Application©2017 Pearson Education, Inc. Paramedic Care: Principles & Practice, Volume 5, 5th Ed. 2 Chapter 1 objectives can be found on the opening chapter page. These objectives, which form the basis of each chapter, were developed from the new Education Standards and Instructional Guidelines. Minutes Content Outline Master Teaching Notes vagina and urethra d. Labia minora – structure that is located medial and protects vagina and urethra e. Clitoris – highly innervated, major site of sexual stimulation f. Urethra – located superior and anterior to vagina; drains the urinary bladder; owing to decreased length, females are more susceptible to bladder infections 2. Internal organs are located within pelvic cavity and include ovaries, fallopian tubes, uterus, and vagina. a. Vagina – three functions: female organ of copulation, final passageway during childbirth, and outlet for menstrual blood and tissue b. Uterus – primary function: to provide site for fetal development; muscle of pregnancy that has a body (fundus) and neck (cervix); innermost layer called endometrium, middle layer called myometrium, and outer layer called perimetrium c. Ovaries – primary female sex glands that are situated laterally on either side of uterus; two functions: secretion of estrogen and progesterone and development and release of eggs for reproduction d. Fallopian tubes – flexible tubes that extend from uterus to each ovary; function of tubes: to conduct egg from ovary into uterine cavity using peristalsis 15 IV. The Menstrual Cycle A. Hormonal cycle generally occurring every 28 days B. Prepares uterus to receive fertilized egg C. Onset of menstrual cycle, menarche, usually begins between 10 and 14 years of age. D. A normal menstrual cycle varies for each woman, so it is important to inquire as to the normal length for the woman in question. E. Female sex hormones estrogen and progesterone control the ovarian menstrual cycle, pregnancy, and lactation (estrogen and progesterone Teaching Tips Cover with students the various hormones related to the female cycle, explaining which hormones are secreted by the ovaries and which by the pituitary.©2017 Pearson Education, Inc. Paramedic Care: Principles & Practice, Volume 5, 5th Ed. 3 Chapter 1 objectives can be found on the opening chapter page. These objectives, which form the basis of each chapter, were developed from the new Education Standards and Instructional Guidelines. Minutes Content Outline Master Teaching Notes secretion controlled by follicle-stimulating hormone [FSH] and luteinizing hormone [LH] secretion). F. Proliferative Phase 1. First two weeks of menstrual cycle 2. Dominated by estrogen, which causes lining of uterus to thicken 3. Ovulation takes place due to surge of LH at day 14. a. Immature ovarian follicles, graafian follicles, are present in female at birth and gradually used up during lifetime. b. Follicle reaches maturity due to FSH and increased estrogen. c. Follicle ruptures and discharges egg through ovary. d. Ruptured follicle develops the corpus luteum (body of cells). e. If not fertilized, corpus luteum will atrophy within 3 days. f. If fertilized, corpus luteum produces progesterone until placenta takes over. G. Secretory Phase 1. Stage immediately surrounding ovulation 2. If egg is not fertilized, estrogen levels drop while progesterone dominates. 3. Uterine vascularity increases in anticipation of fertilized egg. H. Ischemic Phase 1. If fertilization does not occur, estrogen and progesterone levels drop 2. Endometrium undergoes vascular changes that cause small blood vessel rupture. I. Menstrual Phase 1. Ischemic endometrium is shed. 2. Menstrual flow usually lasts 3–5 days. 3. Average blood loss is 50 mL. 4. Premenstrual syndrome can be experienced, and includes physical changes related to changing hormone levels. 5. Absence of a menstrual cycle in a sexually active woman of childbearing years should raise suspicion of pregnancy. J. Premenstrual Dysphoric Disorder (PMDD) 1. Condition similar to premenstrual syndrome, but symptoms more©2017 Pearson Education, Inc. Paramedic Care: Principles & Practice, Volume 5, 5th Ed. 4 Chapter 1 objectives can be found on the opening chapter page. These objectives, which form the basis of each chapter, were developed from the new Education Standards and Instructional Guidelines. Minutes Content Outline Master Teaching Notes severe 2. Includes a wide range of physical and/or emotional symptoms K. Menopause 1. Cessation of menses, marks cessation of ovarian function 2. Menses declines around 45–55 years old, until menses stops 3. End of reproductive life 4. Sexual hormones decline 15 V. Assessment of the Gynecologic Patient A. Most common complaints are abdominal pain and vaginal bleeding 1. Dysmenorrhea – severe discomfort during menstrual periods 2. Dyspareunia – painful sexual intercourse B. Complete primary and secondary assessments; specific questions must be asked regarding reproductive function and dysfunction C. History D. OPQRST for chief complaint E. SAMPLE for past medical history F. Any associated symptoms? G. Obstetrical history H. Last menstrual period I. Sexually activity J. Possibility of pregnancy K. Contraceptive use L. Physical exam M. Exam limited in the field N. Patient comfort guide’s exam O. Always have a chaperone if an examination is necessary. and explain to the patient what you will be doing. P. Indicators during the
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