EVOLVE ELSEVIER HESI MED SURG ACTUAL
STUDY GUIDE WITH REAL EXAM QUESTIONS
AND CORRECT ANSWERS WITH WELL-
ELABORATED RATIONALES/ EVOLVE HESI
MEDICAL SURGICAL LATEST EXAM 2025-2026
(BRAND NEW!!)
Normal Anatomy of the Female Reproductive Tract-ANSWER-–
Vulva: external opening
–Vestibule: area between the vulva and vagina
––proximal to the urethral tubercle
–Vagina: between the vestibule and the cervix
Congenital Abnormalities of the Vulva-ANSWER-–Vulvar
Stenosis
–Anovulvar or vulvovestibular clefts
1|Page
,Vulvar Stenosis-ANSWER-–Small vulvar opening
–Congenital abnormality of the vulva
–Results in difficulty breeding
––common in collies and shelties
–Animal may have recurrent UTIs
––urine is trapped in the vestibule, causes irritation and
infection
Vulvar Stenosis Treatment-ANSWER-–Episiotomy
–Enlarge the vulvar opening, opens the vestibule and the
vagina
–Incision from the vulvar opening towards the anus
–Suture the vestibular mucosa to the skin
Vulvar Clefts-ANSWER-–Vulvar opening is too large
–Congenital abnormality of the vulva
–Generally extends dorsally towards the anus more than it
should
–Excise the edges of the defect and close in three layers
––mucosa, submucosa, and skin closures
2|Page
,Acquired abnormalities of the Vulva-ANSWER-–Vulvar
hypertrophy
–Recessed vulva
Vulvar Hypertrophy-ANSWER-–Acquired abnormality of the
vulva
–Hypertrophy of the vulva is normal during estrus
–If persistent, indicates ovarian cyst or tumor
––Luteal phase and XXX exposure should shrink the vulva
Recessed Vulva-ANSWER-–Acquired abnormality of the vulva
–Excessive skin folds cover the vulva
––overweight dogs
–Moist environment in the peri–vulvar folds allow
accumulation of urine, feces, and debris
–Predisposes skin to dermatitis, vaginitis, cystitis, and UTIs
Peri–vulvar dermatitis-ANSWER-–Irritation of skin around
vulva
–Can be due to a recessed vulva in overweight dogs
3|Page
, –Treat by clipping hair, washing and drying frequently, topical
treatments, and encouraging the dog to lose weight
–If mild, can treat topically
Vulvar fold excision-ANSWER-–Surgical treatment for recessed
vulva
–Episioplasty or vulvoplasty
–Definitive treatment involves excision of folds
–Estimate the amount of skin to be removed, make half–
moon incision
––Remove skin and fat, suture skin back together
Vulvar fold excision results-ANSWER-–Dermatitis is usually
resolved
–UTI issues are usually resolved
–Effective procedure with low morbidity
Dog Vagina Anatomy-ANSWER-–Area from the vestibule to the
cervix
–Proximal to the urethral tubercle
–majority of the vagina lies dorsal to the pubis
4|Page
STUDY GUIDE WITH REAL EXAM QUESTIONS
AND CORRECT ANSWERS WITH WELL-
ELABORATED RATIONALES/ EVOLVE HESI
MEDICAL SURGICAL LATEST EXAM 2025-2026
(BRAND NEW!!)
Normal Anatomy of the Female Reproductive Tract-ANSWER-–
Vulva: external opening
–Vestibule: area between the vulva and vagina
––proximal to the urethral tubercle
–Vagina: between the vestibule and the cervix
Congenital Abnormalities of the Vulva-ANSWER-–Vulvar
Stenosis
–Anovulvar or vulvovestibular clefts
1|Page
,Vulvar Stenosis-ANSWER-–Small vulvar opening
–Congenital abnormality of the vulva
–Results in difficulty breeding
––common in collies and shelties
–Animal may have recurrent UTIs
––urine is trapped in the vestibule, causes irritation and
infection
Vulvar Stenosis Treatment-ANSWER-–Episiotomy
–Enlarge the vulvar opening, opens the vestibule and the
vagina
–Incision from the vulvar opening towards the anus
–Suture the vestibular mucosa to the skin
Vulvar Clefts-ANSWER-–Vulvar opening is too large
–Congenital abnormality of the vulva
–Generally extends dorsally towards the anus more than it
should
–Excise the edges of the defect and close in three layers
––mucosa, submucosa, and skin closures
2|Page
,Acquired abnormalities of the Vulva-ANSWER-–Vulvar
hypertrophy
–Recessed vulva
Vulvar Hypertrophy-ANSWER-–Acquired abnormality of the
vulva
–Hypertrophy of the vulva is normal during estrus
–If persistent, indicates ovarian cyst or tumor
––Luteal phase and XXX exposure should shrink the vulva
Recessed Vulva-ANSWER-–Acquired abnormality of the vulva
–Excessive skin folds cover the vulva
––overweight dogs
–Moist environment in the peri–vulvar folds allow
accumulation of urine, feces, and debris
–Predisposes skin to dermatitis, vaginitis, cystitis, and UTIs
Peri–vulvar dermatitis-ANSWER-–Irritation of skin around
vulva
–Can be due to a recessed vulva in overweight dogs
3|Page
, –Treat by clipping hair, washing and drying frequently, topical
treatments, and encouraging the dog to lose weight
–If mild, can treat topically
Vulvar fold excision-ANSWER-–Surgical treatment for recessed
vulva
–Episioplasty or vulvoplasty
–Definitive treatment involves excision of folds
–Estimate the amount of skin to be removed, make half–
moon incision
––Remove skin and fat, suture skin back together
Vulvar fold excision results-ANSWER-–Dermatitis is usually
resolved
–UTI issues are usually resolved
–Effective procedure with low morbidity
Dog Vagina Anatomy-ANSWER-–Area from the vestibule to the
cervix
–Proximal to the urethral tubercle
–majority of the vagina lies dorsal to the pubis
4|Page
