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OBGYN Clerkship- Amboss Study Plan > Basics > Flashcards

Basics Flashcards

1
Q

Female Upper Genital Tract

A

uterus, fallopian tubes, ovaries, and cervix

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2
Q

Cervix Histology

A
  1. Endocervix: proximal to the uterine external os
    • simple columnar epithelium with mucous-producing cells
  2. Cervical transformation zone
    • squamocolumnar junction
    • Cervical cancer most commonly occurs in this zone.
  3. Ectocervix: distal to the uterine external os
    • stratified squamous epithelium (nonkeratinized)
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3
Q

Female Lower Genital Tract

A

vagina and vulva

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4
Q

Function of the Uterus

A
  1. Site of implantation of the fertilized ovum
  2. Protects and supports the growth of the fetus
  3. Site of menstruation
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5
Q

Function of the cervix

A
  1. Promotes entry of sperm into the uterus for fertilization
  2. Allows menstrual blood to flow from the uterus into the vagina
  3. The endocervix secretes a clear, alkaline fluid to facilitate the passage of sperm.
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6
Q

Location and position of the uterus

A
  • located posterior to the bladder and anterior to the rectum
  • commonly anteverted by 90° and anteflexed by 120
    • retroflexion may impair conception
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7
Q

Anteverted vs Anteflexed

A
  • Flexion: angle between the axis of the uterine body and the axis of the cervix
  • Version: angle between the axis of the cervix and the axis of the vagina.
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8
Q

Location of the cervix

A
  • most distal aspect of the uterus and protrudes into the fundus of the vagina
    *
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9
Q

Pouch of Douglas

Recto[uterine/vesicle] space

A
  • Intraperitoneal space that lies between the uterus and the rectum (bladder and rectum in males)
  • lowest point of the peritoneal cavity
  • common site of fluid collection and/or intraperitoneal metastases.
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10
Q

Uterine Vein:

Location/ Function

A
  • Venous plexus in the uterine wall (broad ligament) → uterine veins
    • → internal iliac veins
  • Crosses the ureter anteriorly in the broad ligament

Function

  • Drains the uterus
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11
Q

Uterine Artery:

Location/ Function

A
  • Branch of the internal iliac artery
  • Crosses the ureter anteriorly in the broad ligament
  • Ligation of the uterine arteries (e.g., during hysterectomy) → risk of ureter injury!

Function

  • Supplies the distal portion of the uterus and the cervix
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12
Q

Uterus Histology

A
  1. Endometrium: mucosal layer
    • Simple columnar epithelium with tubular glands
    • Connective tissue (stroma)
  2. Myometrium: smooth muscle layer
  3. Serosa/adventitia:
    • Uterine body: peritoneal serosa
    • Anterior cervix and lateral uterine body: adventitia (not covered by peritoneum)
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13
Q

Paramesonephric Duct ( Mullarian duct)

A
  1. uterus,
  2. cervix,
  3. fallopian tubes
  4. proximal part of the vagina
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14
Q

Location and Structure of Fallopian Tubes

A

Contained in the proximal part of the broad ligaments

  • Fimbria: Ciliated end of the fallopian tube
  • Infundibulum: funnel-shaped opening with attached fimbriae
  • Ampulla: widest part; most common site of fertilization
  • Isthmus: narrowest part
  • Intramural: located in the myometrium of the uterus
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15
Q

Fallopian tube vasculature

A

Lateral 2/3

  • Ovarian artery and vein

Medial 1/3

  • Uterin artery and vein
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16
Q

Fallopian Tubes Histology

A
  1. Mucosa:
    • simple ciliated columnar epithelium and secretory Peg cells
  2. Muscular layer:
    • smooth muscle(Inner circular and outer longitudinal layer)
  3. Serosa: highly vascular layer
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17
Q

Location of Ovaraies

A
  • Lateral to the uterus
  • close to the lateral pelvic wall
  • Suspended in the mesovarium
    • (attached to the posterior part of the broad ligament)
18
Q

Ovarian Vein:

Location/ Function

A
  • Pampiniform plexus → ovarian veins →
    • renal vein (left) and inferior vena cava (right)
  • Located in the mesovarium and infundibulopelvic ligament

Function

  • Drains the ovaries and lateral two-thirds of the fallopian tubes
19
Q

Ovarian Artery:

Location/ Function

A
  • Located in the infundibulopelvic ligament
  • Anastomosis with ovarian branches from the uterine artery

Function

  • Supplies the ovaries and lateral two-thirds of the fallopian tubes
  • Supplies the proximal portion of the uterine body
20
Q

Lymphatic Drainage of the Vulva

A
  • The superficial inguinal nodes
    • → deep inguinal → pelvic and external iliac lymph nodes → paraaortic lymph nodes
21
Q

Lymphatic Drainage of the Vagina

A
  • Upper third: external iliac nodes
  • Middle third: common and internal iliac nodes
  • Distal third: superficial inguinal nodes
22
Q

Sensory Inervation of the Vagina

A

Pudendal Nerve (S2-4)

Pudendal nerve block is often used for anesthesia prior to vaginal procedures, childbirth, or episiotomy.

23
Q

Vagina Histology

A

Inner mucosal layer

  • Nonkeratinized stratified squamous epithelium rich in glycogen.

External muscular layer

  • Outer longitudinal and Inner circular smooth muscle layer

Hymen:

  • nonkeratinized stratified squamous epithelium
24
Q

Vulva Histology

A
  1. Labia minora
    • Nonkeratinized stratified squamous epithelium (sebaceous glands)
  2. Labia majora
    • Keratinized stratified squamous epithelium
    • Eccrine, apocrine, and sebaceous glands
  3. Vestibule:
    • nonkeratinized squamous epithelium (vestibular glands)
  4. Urethra:
    • columnar epithelium (vestibular glands)
25
Q

Vagina and Vulva Embryology

A
  1. Paramesonephric ducts (Müllerian ducts) → upper third of the vagina
  2. Urogenital sinus → lower two-thirds of the vagina, vaginal vestibule, vestibular glands
  3. Urogenital folds → labia minora
  4. Labioscrotal swelling → labia majora
  5. Genital tubercle → clitoris
26
Q

Broad Ligament and Ureter relation

A

the ureter is located directly posterior to the infundibulopelvic ligament, close to the medial leaf of the broad ligament.

27
Q

Speculum Examination

A
  • Insertion of a speculum device facilitates the inspection of the vaginal wall and ectocervix
  • Evaluate the quality of vaginal discharge to determine whether a smear should be acquired
28
Q

Signs and Symptoms of pathologic discharge

A
  • Malodorous
  • consistency (e.g., frothy, curd-like)
  • Pruritic and/or erythematous vagina
  • Cervical tenderness
29
Q

Physiologic leukorrhea (normal discharge)

A
  • Profuse white or yellow and non-malodorous vaginal discharge can be physiological if none of the features mentioned above are present.
  • In newborns, vaginal discharge may occur due to in-utero exposure to maternal estrogen (no treatment is necessary).
30
Q

Colposcopy

A
  • a type of microscope used to acquire a magnified view of the ectocervix or vaginal wall
  • Application of acetic acid or iodine facilitates the colposcopic detection of precancerous and cancerous lesions
  • Colposcopy-directed cervical smears and biopsies
31
Q

Cervical Ectopy

A
  • squamous cell epithelium of the ectocervix is replaced by columnar cell epithelium of the endocervix
  • physiological influence of estrogen (e.g., pregnancy, certain oral contraceptives).
  • Cervical ectopy is seen on colposcopy as a sharply demarcated bright red area with papillarystructures.
  • Malignant transformation may occur in cases of HPV-16 and/or HPV-18 infections
32
Q

Abnormal findings in Colposcopy

A
  1. White lesions under acetic acid application: condylomata acuminata
  2. White membrane that cannot be scraped off: cervical leukoplakia
  3. Punctate lesions or coarse mosaic pattern: cervical intraepithelial neoplasia
  4. Atypical vessels: cervical cancer
33
Q

Normal Vaginal Smear

A

cylindrical Lactobacilli (Doderlein’s bacilli)

34
Q

Trichomoniasis Vagnial Smear

A

Motile flagellated protozoa

35
Q

Gonorrhea Vagnial Smear

A

Gram staining when gonorrhea is suspected → gram-negative, intracellular diplococci

36
Q

Bacterial Vaginosis Vagnial Smear

A

Clue cells and whiff test (adding KOH to vaginal smear elicits a fishy odor)

pH > 4.5

37
Q

Vaginal Candidiasis Vagnial Smear

A

Pseudomycelia and/or yeast cells

pH <4

38
Q
A
39
Q

M

A
40
Q

Pulmonary contusion

A

Lung penchymal

41
Q
A
42
Q

promotional content!!!

A

I cannot believe this works! C and if it works

OBGYN Clerkship- Amboss Study Plan (9 decks)

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