2. Acquired

Question 1

Answer 1

Salpingitis Isthmica Nodosa (SIN)

This is a nodular scarring o f the fallopian tubes
involves the proximal 2/3 of the tube

Question 2

Salpingitis Istiimica Nodosa (SIN) is strongly associated with =

Answer 2

infertility and ectopic pregnancy

Question 3

Answer 3

Uterine AVM

Congenital or acquired (more common)

“serpiginous and/or tubular anechoic structures within the myometrium with high velocity color Doppler flow”

Question 4

Causes of Uterine AVM

Answer 4

previous dilation and curettage
therapeutic abortion
caesarean section
just multiple pregnancies.

Question 5

This is scarring in the uterus, that occurs secondary to injury: prior dilation and curettage Tmost commonI surgery, or pregnancy.

Answer 5

Intrauterine Adhesion (Ashermans)

Question 6

Answer 6

Intrauterine Adhesion (Ashermans)

(a) non filling of the uterus, or
(b) multiple irregular linear filling defects (lacunar pattern), with inability to appropriately distend the endometrial canal.

Question 7

Answer 7

MRI would show a bunch of T2 dark bands.

Question 8

Intrauterine Adhesion (Ashermans) clinically can result to =

Answer 8

Infertility

Question 9

This is in the spectrum o f PID. You often see it 2-5 days after delivery, especially in women with prolonged labor or premature rupture.

Answer 9

Endometritis

fluid + thickend endoemtrial cavity
Gas in the cavity (not specifitc in a postpartu woman)

Question 10

Endometritis can progress to =

Answer 10

pyometrium

Expansion + pus

Question 11

3 functional compartments of the pelvic floor

Answer 11

Anterior
Middle
Posterior

Question 12

The anterior pelvic compartment

Answer 12

Bladder
Urethra

Question 13

Middle pelvic comparment

Answer 13

Vagina
Cervix
Uterus
Adnexa

Question 14

Posterior pelvic compartment

Answer 14

Anus
Rectum

Question 15

Supports the Anterior and middle comparments

Answer 15

Endopelvic fascia (buncha ligaments)

Question 16

Main muscular component of the pelvic floor

Answer 16

Levator ani

Question 17

The levator ani is composed of:

Answer 17

Puborectalis
pubococcygeus
ileococcygeus

Question 18

This muscle groups constant contraction maintains the pelvic floor height.

Answer 18

Levator ani

Question 19

This is the most caudal or superficial musculofascial structure.

Answer 19

Uroganital diaphragm

Question 20

Anatomic landmark used in the classification of urethral injury

Answer 20

Urogenital diaphragm

Question 21

Pelvic floor relaxation has two components

Answer 21

1. Pelvic floor descent
2. Widening

Question 22

rawn from inferior margin of the symphysis pubis to the junction between the first and second coccygeal elements.

Answer 22

Pubococcygeal line

Question 23

drawn from the inferior margin of the symphysis pubis to the posterior aspect of the puborectalis muscle sling.

Answer 23

H line

Question 24

shortest distance between the posterior aspect of the puborectalis muscle sling and the PCL

Answer 24

M line

Question 25

Hiatal enlargement (H line) =

Answer 25

> 6 cm

Question 26

Pelvic floor descent (M line) =

Answer 26

> 2 cm

Question 27

Bladder Descent > 1 cm below the pubococcygeal line.

Answer 27

Cystocele

Question 28

Horizontally rotated urethra

Answer 28

Urethral hvpermobility

Question 29

Answer 29

Anal fistula

loss of the normal “H shaped” vagina or direct defects / asymmetric thinning in the muscular sling

Axial image through the Ischioanal space (Triangle of fat lateral and caudal to the levator ani

Question 30

Descent of the cervix or posterior vaginal fornix > 1 cm below the pubococcygeal line.

Answer 30

Uterine prolapse

A big turd can prop up the uterus - so it is best to measure them with an empty rectum (post defecation phase

Axial images could show the vagina lose its normal “H” shape - hanging low like the sleeve of a wizard (or the tongue of a tired dog).

Question 31

RIsk factore of uterine prolapse

Answer 31

Hysterectomy

Question 32

Abnormal rectal bulging (typically anteriorly).

Due to weakening of the rectovaginal fascia

Answer 32

Rectocele

Question 33

Rectocele risk factors

Answer 33

Vaginal Surgery
Hysterectomy
Chronic constipation
Being old as dirt