Ch. 17 The Uterus and Vagina Flashcards
1
Q
During the ____, the uterus and kidneys develop at essentially the same time, hence the reason why they are included together as parts of the urogenital (genitourinary) system
A
embryonic period
2
Q
Patients who present with uterine anomalies may also require a ____sonogram
A
urinary tract
3
Q
Most common renal anomalies being that of a ___ or ____
A
duplicated or duplex renal collecting system
4
Q
The uterus, vagina, and fallopian tubes develop from the paired ____
A
Mullerian ducts (paramesonephric ducts)
5
Q
Paired embryonic ducts that develop into the female urogenital tract
A
Mullerian ducts (paramesonephric ducts)
6
Q
Incomplete fusion, partial fusion, or agenesis of the Mullerian ducts will result in an anatomic varian of the ____, ____, and/or ____ that may be recognized sonographically.
A
uterus, cervix, vagina
7
Q
Sound Off:
Congenital anomalies of the kidney and ____ often coexist
A
uterus
8
Q
The ____ is a pear-shaped, retroperitoneal organ that lies anterior to the rectum and posterior to the urinary bladder and is bounded laterally by the ____
A
uterus, broad ligament
9
Q
Pelvic ligament that extends from the lateral aspect of the uterus to the side walls of the pelvis
A
broad ligaments
10
Q
Female development does not require estrogen but rather the absence of ___.
A
testosterone
11
Q
Its the presence of the ___ that supplies testis determining factor resulting in gender development.
A
Y chromosome
12
Q
The primary function of the uterus?
A
provide a place for the products of conception to implant and develop
13
Q
Each fallopian tube attaches to the uterus at the level of the uterine horns called
A
cornua
14
Q
Largest part of the uterus, inferior to fundus
A
corpus (body)
15
Q
A tubular organ that extends from the external os of the cervix to external genetalia
A
vagina
16
Q
Recesses of the vagina
A
vaginal fornices
17
Q
Term used for isthmus of uterus during pregnancy
A
lower uterine segment
18
Q
Area of the uterus between the corpus and the cervix
A
isthmus
19
Q
Superior portion of the cervix closest to the isthmus
A
internal os
20
Q
Most superior and widest portion of the uterus
A
fundus
21
Q
Functional inner layer of the endometrium thats, thickness is altered by hormones of the menstrual cycle
A
functional layer
22
Q
Inferior portion of the cervix that is in close contact with the vagina
A
external os
23
Q
Inner mucosal layer of the uterus
A
endometrium (further divided in basal and functional layer)
24
Q
Area that lies between the two functional layers of the endometrium, also called uterine cavity
A
endometrial cavity
25
The rigid region of the uterus located between the vagina and the isthmus is the
cervix
26
Just inferior to the fundus of the uterus where the fallopian tubes attach bilaterally
cornua (uterus)
27
The outer layer of the endometrium
basal layer/deep
28
Size and shape of the uterus depend on
age, parity and presence of pathology
29
In the first week of life a normal neonatal uterus is prominent and exhibits endometrial echoes due to
maternal hormone stimulation
30
Normal uterus in nulliparous individual measures
6-8.5 in length, 2-4 cm in AP
31
Normal uterus in multiparous individual measures
8-10.5 cm in length, 3-5 cm in AP
32
Postmenopausal uterus measures
3.5-7.5 cm in length, 1.7-3.3 in AP
33
Following the neonatal period, the cervical anteroposterior (AP) diameter is equal to or slightly greater than that of the uterine fundus. The normal prepubertal uterus has a cervix-to-uterus ratio of ___. The uterus grows minimally during prepubertal years, whereas after puberty, the uterine fundus becomes much larger than the cervix, consequently providing the pear-shaped appearance of the normal adult uterus.
2:1
34
The normal position of the uterus is considered to be
anteversion or anteflexion
35
The word part " colli " refers to the
neck or cervix of the uterus
36
The word part "cornu" refers to the
horn of the uterus
37
Congenital malformations have been linked to
menstrual disorders, infertility, and OB complications
38
___ uterus has an explicit connection with spontaneous abortion
septate uterus
39
The ___ uterus is said to be one of the most common mullerian duct anomalies.
septate uterus
40
Congenital malformation of the uterus that results in complete duplication of the uterus, cervix, and vagina
uterus didelphys
41
Congenital malformation of the uterus that results in a uterus with one horn
unicornuate uterus
42
Common congenital malformation of the uterus that results in a single septum that separates two endometrial cavities
septate uterus
43
The uterine body tilts backward and comes in contact with the cervix, forming acute angle between body and cervix
retroflexion
44
The uterine body tilts backwards without a bend where the cervix and body meet
retroversion
45
Outer layer of the uterus also called serosal layer, continuous with fascia of the pelvis
perimetrium
46
The first 4 weeks (28 days) after birth
neonatal
47
The long axis of the uterus deviating to the left of the midline
levoverted uterus
48
A long axis of the uterus deviating to the right of the midline
dextroverted uterus
49
Difficult or painful defacation
dyschezia
50
A common uterine anomaly in which the endometrium divide into 2 horns, one cervix, with prominent concavity noted in the fundus;also called bicornis unicollis
bicornuate uterus
51
A typical version of the uterus where the uterine body tilts forward forming a 90 degree angle with the cervix
anteversion
52
The uterine body tilts forward and comes in contact with the cervix, forming an acute angle between the body and the cervix
anteflexion
53
_______ uterus, which is characterized by an incomplete septum, has a normal uterine contour with an endometrium that branches into two horns.
subseptate
54
______DES was a drug administered to pregnant woman from the 1940s to the 1970s to treat threatened abortions and premature labor. The female fetus exposed to DES in utero had an increased likelihood of developing a congenital uterine malformation. (*this anomaly shows a T-shaped uterus)
diethylstilbestrol (DES)
55
________,which is a radiographic study that utilizes contrast to evaluate the uterine cavity and fallopian tubes, was often performed on women with suggested congenital uterine malformations or who are suffering from infertility
hysterosalpingography,
56
The _____ uterus is a subtle variant in which the endometrium has a concave contour at the uterine fundus.
arcuate
57
For patients with a septate uterus, sonography can also aid in the resection of the septum during a _______.
hysteroscopic uterine septoplasty
58
The obstruction of the ____can be the result of vaginal atresia, a vaginal septum, or an imperforate hymen. The consequence of this obstruction could lead to the distension of the vagina, cervix, uterus, and fallopian tubes with fluid or blood.
vagina
59
occlusion or imperforation of the vagina; can be congenital or acquired
vaginal atresia
60
a vaginal anomaly in which the hymen has no opening, therefore resulting in an obstruction of the vagina
imperforate hymen
61
Clinically, neonatal patients with vaginal obstructions present with a ____ or ___ as a result of an excessive buildup of vaginal secretions in utero
palpable pelvic or abdominal mass
62
They may also have hematometrocolpos, a condition when both the uterine cavity and the vagina are filled with blood. This obstruction is frequently associated with the presence of an ______ in young girls. Clinically, these patients will present with amenorrhea, cyclic abdominal pain, an abdominal mass, enlarged uterus, and, possibly, urinary retention.
imperforate hymen
63
fluid accumulation within the vagina
Hydrocolpos
64
fluid accumulation within the uterus and vagina
hydrometrocolpos
65
blood accumulation within the uterine cavity
hematometra
66
blood accumulation within the vagina
hematocolpos
67
blood accumulation within the uterus and vagina
hematometrocolpos
68
Clinical Findings of ______:
1.Cyclic pelvic pain (often at the time of menses in adolescent girls)
2.Enlarged uterus
3.Abdominal pain
4.Urinary retention
5.Amenorrhea (adolescent girls)
Vaginal Obstructions
69
Sonographic Findings of _______:
1.Distension of the uterus or vagina or both with anechoic or complex fluid
Vaginal Obstructions
70
is the invasion of endometrial tissue into the myometrium and is a common cause of abnormal uterine bleeding. For unknown reasons, endometrial tissue is allowed to invade the myometrium. The basal layer of the endometrium can often extend into the myometrium at depths of at least 2.5 mm.
Adenomyosis
71
The involvement of adenomyosis may be either focal or diffuse and is typically found more often within the fundus and posterior portion of the uterus. Focal adenomyosis in the form of a mass is termed an ____
adenomyoma
72
a focal mass of adenomyosis
adenomyoma
73
Adenomyosis is often present in the uterus afflicted with ______ tumors. Up to 20% of patients with adenomyosis suffer from endometriosis as well.
fibroid
74
Treatment for adenomyosis is ______ or ________, with the latter often producing limited, if any, relief from symptoms.
hysterectomy,hormone therapy
75
Patients with endometriosis tend to be ______ and have fertility troubles, whereas those with adenomyosis are often _____(average age is older than 40) and multiparous. Other risk factors include increased early menarche and shorter menstrual cycles.
younger, older
76
Clinical Findings of ______:
1.Uterine enlargement
2.Boggy(limp), tender uterus
3.Dysmenorrhea
4.Menometrorrhagia
5.Pelvic pain
6.Dyschezia(difficult or painful defecation)
7.Dyspareunia
8.Multiparous
Adenomyosis
77
Sonographic Findings of ______:
1.Diffusely enlarged uterus
2.Hypoechoic or echogenic areas adjacent to endometrium
3.Heterogeneous myometrium
4.Myometrial cysts
5.Ill-defined interface between myometrium and endometrium
6.Thickening of the fundus or posterior myometrium
Adenomyosis
78
is a benign, smooth muscle tumor of the uterus that may also be referred to as a fibroid or uterine myoma.
leiomyoma
79
______are the most common benign gynecologic tumors and the leading cause of hysterectomy and gynecologic surgery.
leiomyoma
80
Symptoms up to 2 weeks before the onset of menstrual flow, have a boggy enlarged and tender uterus refers to
adenomyosis
81
Obese, black, nonsmokers, and perimenopausal women are at a greater risk for developing.There also appears to be a familial link, with first-degree relatives of women with fibroids having a 2.5 times greater risk of having fibroid themselves
leiomyoma
82
_______fibroids may have calcifications or cystic components, whereas multiple fibroids may cause diffuse uterine enlargement and heterogeneity. Fibroid ________occurs because as the fibroid enlarges, it outgrows its blood supply, possibly leading to pain.
Degenerating; degenerating
83
A uterus that is distorted by multiple leiomyomas may be referred to as a _____ uterus. A ______ uterus will be enlarged and have an irregular shape.
fibroid
84
Because fibroids are made up of smooth muscles fibers surrounded by a vascular pseudocapsule, ______Doppler may be helpful to identify the borders of these tumors, thus aiding in measuring them appropriately.
color
85
Clinical Findings of a Uterine ______:
Pelvic pressure
Menorrhagia
Palpable pelvic mass
Enlarged, bulky uterus (if multiple)
Urinary frequency
Dysuria
Constipation
Infertility
Leiomyoma
86
Sonographic Findings of a Uterine______:
1.Hypoechoic mass within the uterus
2.Posterior shadowing from the mass
3.Degenerating fibroids may have calcifications or cystic components
4.Multiple fibroids appear as an enlarged, irregularly shaped, diffusely heterogeneous uterus
Leiomyoma
87
Most common location for fibroid's
intramural, or within the myometrium
88
Pedunculated fibroids may undergo ______as well, thus cutting off the blood supply to the mass. This lack of blood supply results in necrosis, and clinically, the patient will present with acute, localized pelvic pain.
torsion
89
location of a leiomyoma in which the tumor grows outward and distorts the contour of the uterus
subserosal fibroid
90
a leiomyoma that distorts the shape of the endometrium
Submucosal fibroid
91
______fibroids, the fibroids located within the uterine cavity, and submucosal fibroids usually lead to abnormal uterine bleeding because of their location in relationship to the endometrium. Some fibroids may also extend into the cervix when pedunculated and may prolapse into the vagina as well.
Intracavitary
92
Fibroid growth has been associated with ______stimulation, and consequently, their size may increase during _____ and reduce after menopause. A decrease in estrogen exposure secondary to smoking, exercise, and increased parity reduces the likelihood of developing fibroids.
estrogen; pregnancy
93
Fibroids may impact fertility if they are _____ or ______, because the location of these fibroids may result in a higher incidence of spontaneous abortion.
intracavitary; submucosal
94
The medical treatment for fibroids is hormone therapy and targeted drugs, which typically results in a reduction in tumor size. Surgical treatment may be either ______or______
hysterectomy,myomectomy
95
the surgical removal of a myoma(fibroid) of the uterus
myomectomy
96
procedure used to block the blood supply to a leiomyoma(fibroid)
uterine artery embolization
97
____________offers an additional noninvasive management of fibroids that uses focused high-frequency, high-energy ultrasound guided by MRI to heat and destroy fibroid tissue.
Magnetic resonance imaging–guided high-intensity–focused ultrasound
98
the malignant manifestation of a leiomyoma. Rare,African American women have a higher incidence of ________. The median age of ________ is 54.
Leiomyosarcoma
99
Clinical Findings of _______: (*same as leiomyoma)
Pelvic pressure and pain
Menorrhagia
Palpable abdominal mass
Enlarged, bulky uterus
Urinary frequency
Dysuria
Constipation
Leiomyosarcoma
100
Sonographic Findings of _______:(*similar to leiomyoma)
1.Rapidly growing mass within the uterus
2.Hypoechoic mass within the uterus
3.Posterior shadowing from the mass
4.Degenerating fibroids may have calcifications or cystic components
5.Multiple fibroids appear as an enlarged, irregularly shaped, diffusely heterogeneous uterus
Leiomyosarcoma
101
Leiomyosarcomas are more commonly found in
postmenopausal & perimenopausal women
102
Treatment for ____ is typically in the form of a total hysterectomy, with postmenopausal women undergoing a bilateral salpingo-oophorectomy as well.
leiomyosarcoma
103
___these benign retention cysts are located within the cervix and may cause cervical enlargement on physical examination. ______ are classically simple but may have some internal debris or septations, which may represent hemorrhage or infection
Nabothian cyst
104
Clinical findings of_____:
Asymptomatic
Nabothian cyst
105
Sonographic findings of____:
1.Anechoic mass within the cervix
2.May be multiple
3.May be complex
Nabothian cyst
106
Most common female malignancy in women younger than 50 years old
Cervical carcinoma
107
The greatest risk for cervical cancer is the ____.
human papillomavirus
108
The cervical width should not exceed __ cm
4cm
109
Although not typically diagnosed with US________it may present as an inhomogeneous, bulky, enlarged cervix or as a focal mass within the cervix. Loss of the normal cervical canal may occur as well. The cervical width should not exceed 4 cm, and color Doppler typically demonstrated increased vascularity
Cervical carcinoma
110
Patients who have had a hysterectomy, cervical remnant should not exceed ___ in AP and ___ in length
4.4cm, 4.3cm
111
After hysterectomy a vaginal cuff should not exceed
2cm
112
_______which is the narrowing of the endocervical canal, often leads to an abnormal quantity of fluid in the endocervical or endometrial canals. It can be the result of a tumor in the cervix, cervical fibroid, cervical polyp, cervical infection, cervical atrophy, or scarring of the cervix following radiation treatment for cancer
cervical stenosis
113
an overgrowth of epithelial cells within the cervix resulting in a broad based or pedunculated mass of tissue; Pts may be asymptomatic; however, some may suffer from chronic inflammation, bleeding, or, possibly, infection.
cervical polyp
114
women with _______may be asymptomatic, whereas those who are still menstruating may present with absent menstrual flow when expected. In some women, an enlarged uterus may be noted during a physical examination as well.
cervical stenosis
115
a benign cyst located within the vagina. Are though to be remnants of the mesonephric or Wolffian duct
Gartner duct cyst
116
they are typically small and located along the wall of the vagina
Gartner duct cyst
117
Clinical Findings of a _________:
Asymptomatic
Gartner Duct Cyst
118
Sonographic Findings of a _______:
Anechoic or complex mass within the vagina
Gartner Duct Cyst
119
_______is a benign cyst that is located in one of the Bartholin glands in the region of the vulva. There are two Bartholin ducts, which are essentially mucus-secreting glands, located on the posterolateral aspect of the vaginal orifice.
Bartholin duct cyst
120
collective term for the mons pubis, labia majora and labia minora, vestibule, Bartholin gland, and clitoris
vulva
121
It is obstruction of these glands that lead to a Bartholin duct cyst and possibly to a Bartholin duct abscess.
Bartholin glands
122
A ______ transducer should be employed, and possible a standoff pad, secondary to the superficial nature of the mass.
linear
123
Clinical Findings of a _______:
Painful swelling and enlargement in the area of the vulva
Fever(concern of abscess)
Dysuria
Dyspareunia
Bartholin Duct Cyst or Abscess
124
Sonographic Findings of a _______:
1.Simple cyst (if not infected-will appear anechoic_
2.Abscess may contain echogenic debris and, possibly, septations and produce dirty shadowing
3.Color Doppler may provide evidence of hyperemia due to infection
Bartholin Duct Cyst or Abscess
125
pubertal development before the age of 7
Precocious puberty
126
________, also referred to as central precocious puberty, may be associated with intracranial tumors, infection, congenital abnormality, or traumatic injury to the hypothalamus or may simply be idiopathic.
True precocious puberty
127
The brain tumor most likely associated with central precocious puberty is the ________.
hypothalamic hamartoma
128
______, also referred to as peripheral pseudosexual precocity or gonadotropin-independent precocious puberty, has been linked with ovarian, adrenal, and liver tumors. Adrenal tumors may also lead to congenital adrenal hyperplasia.
Pseudoprecocious puberty
129
Pts with ______The uterus may appear enlarged with a postpubertal shape and contain a prominent endometrial stripe. The ovary or ovaries may be enlarged, and a functional ovarian cyst or ovarian mass may be seen.
precocious puberty
130
______puberty may be associated with intracranial tumors or may simply be idiopathic. ______ puberty has been linked with ovarian, adrenal, and liver tumors.
True precocious ;Pseudoprecocious
131
is described as absent or incomplete breast development after the age of 12.
Delayed puberty
132
_______, also referred to as monosomy X or gonadal dysgenesis, is the most common cause of delayed puberty in the presence of an elevation in follicle-stimulating hormone
Turner syndrome
133
Patients with _______typically suffer several conditions, including small stature, webbed neck, poor breast development, rudimentary ovaries, and primary amenorrhea
Turner syndrome
134
Gender is not typically apparent until about ___ weeks.
12
135
Early development of secondary sexual characteristics with menses, ovulation, and elevated gonadotropin levels
Isosexual precocity
136
Characterized by isolated pubic hair development and increased levels of adrenal androgens
Premature adrenarche
137
Characterized by isolated breast development with normal prepubertal hormones
Premature thelarche
138
Body changes typically occurring at puberty, such as enlargement of breasts and growth of pubic hair
Secondary sexual characteristics
139
A condition in which a female develops physical changes that are associated with male hormones (androgens), such as hair growth
Virilization
