Chapter 17 - The Uterus & Vagina Flashcards
a focal mass of adenomysosis
adenomyoma
the begnign invasion of endometrial tissue into the myometrium of the uterus
adenomysosis
failure of an organ or structure to grow during embryologic development
genesis
the uterine body tilts forward and comes in contact with the cervix, forming an acute angle between the body and the cervix
anteflexion
the typical version of he uterus where the uterine body tilts forward forming a 90 degree angle with the cervix
anteversion
the nonfunctional outer layer of the endometrium
Basal layer (endometrium)
a common uterine anomaly in which the endometrium divides into horns, also referred to as bicornis unicollis
bicornuate uterus
limp
boggy
the rigid lesion of the uterus located between the isthmus and vagina
cervix
physical defects that are present in a person at birth, may also be referred to as congenital anomalies
congenital malformation
areas just inferior to the fundus of the uterus where the fallopian tubes are attached bilaterally
cornea (uterus)
the uterine body
corpus (uterus)
the long axis of the uterus deviating to the right of the midline
dextroverted uterus
a drug administered to pregnant woman from the 1940s to the 1970s to treat threatened abortions and premature labor that has been linked with uterine malformation in the exposed fetus
diethylstilbestrol (DES)
difficult or painful defecation
dyschezia
area that lies between the two layers of the endometrium ; may also be referred to as the uterine cavity
endometrial cavity
the inner mucosal layer of the uterus
endometrium
the inferior portion of the cervix that is in close contact with the vagina
external os
the functional inner layer of the endometrium that is altered by the hormones of the menstrual cycle
functional layer (endometrium)
the most superior and widest portion of the uterus
fundus (uterus)
a benign cyst located within the vagina
Gartner duct cyst
blood accumulation with the vagina
hematocolpos
blood accumulation within the uterine cavity
hematometra
blood accumulation within the uterus and vagina
hematometrocolpos
fluid accumulation within the vagina
hydrocolpos
fluid accumulation with the uterus and vagina
hydrometrcolpos
the surgical removal of the uterus
hysterectomy
a radiographic procedure that uses a dye instilled into the endometrial cavity and fallopian tubes to evaluate for internal abnormalities
hysterosalpingography
the surgical repair of a uterine septum in a spectate uterus using a hysteroscopy
hysteroscopic uterine septoplasty
a vaginal anomaly in which the hymen has no opening therefore resulting in a obstruction of the vagina
imperforate hymen
the superior portion of the cervix closes to the isthmus
internal os
a leiomyoma located within the uterine cavity
intracavitary (fibroid)
location of a leiomyoma within the myometrium of the uterus
intramural (fibroid)
area of the uterus of the uterus between the corpus and cervix
isthmus (uterus)
a benign, smooth muscle tumor of the uterus; may also be referred to as a fibroid or uterine myopia
leiomyoma (uterine)
the malignant manifestation of a leiomyoma
leiomyosarcoma
the long axis of the uterus deviating of the left of the midline
levoverted uterus
the term used for the isthmus of the uterus during pregnancy
lower uterine segment
a fibroid treatment that utilizes focused high frequency high energy ultrasound guided by MRI to heat and destroy fibroid tissue
MRI guided high intensity focused ultrasound
paired embryonic ducts that develop into the female urogenital tract
Mullerain ducts
having birthed more than one child
multiparous
the surgical removal of myoma (fibroid) of the uterus
myomectomy
a muscular layer of the uterus
myometrium
benign cysts located within the cervix
nabothian cysts
the first 4 weeks (28 days) after birth
neonatal
the total number of pregnancies in which the patient has given birth to a fetus at or beyond 20 weeks gestational age or an infant weighing more than 500 g
parity
something that grows off of a stalk
peduncalted
the outer layer of the uterus, may also be referred to as the serial layer
perimetrium
pubertal development before the age of 8 ; the early development of pubic hair ; breast or genitals
precocious puberty
secondary sexual developmenbt induced by sex steroids or from other sources such as ovarian tumors, adrenal tumors or steroid use
psuedoprecocious puberty
the uterine body tilts backwards and comes in contact with the cervix , forming an acute angle between the body and cervix
retroflexion
the uterine body tilts backward , without a bend where the cervix and body meet
retroversion
a sonographic procedure that uses saline instillation into the endometrial cavity and possibly the fallopian tubes to evaluate for internal abnormalities ; also referred to as sonohysterography
saline infusion sonoysterography
common congenital malformation of the uterus that results in a single septum that separates two endometrial cavities
septate uterus
the outermost layer of the uterus may also be referred to as the perimetrium
serosal layer (uterus)
a leiomyoma that distorts the shape of the endometrial
submucosal (fiborid)
congenital malformation of the uterus that results in a normal uterine contour with an endometrium that branches into two horns
subseptate uterus
location of a leiomyoma in which the tumor grows outward and dsitorts the contour of the uterus
subserosal (fibroid)
twisting
torsion
congenital malformation of the uterus that results in a uterus with one horn
unicornuate uterus
procedure used to block the blood supply to a leoimyoma (fibroid)
uterine artery embolization
congenital malformation of the uterus that results in the complete duplication of the uterus, cervix and vagina
uterus didelphys
occlusion or imperforation of the vagina can be congenital or acquired
vagina atresia
the portion of the vagina remaining after a hysterectomy
vaginal cuff
recesses of the vagina
vaginal fornices
What develops from the paired mullerain ducts
uterus
vagina
Fallopian tubes
Mullein ducts or also called
Peimesonephric ducts
What is the primary function of the uterus
provide a place from the products of conception impact and develop
The uterus can be divided into what four major divisions
uterine horns called the cornua
what is the largest part of the uterus
corpus or body
during pregnancy thee isthmus may be referred to as what
lower uterine segment
the cervix is marked superiorly by what and inferiorly by what
superior is the internal os
inferior is the external os
The vagina is a tubular organ which extends from where to where?>
external os of the cervix to the external genitelia
the size and shape of the uterus depends on what
age of patient, parity, presence of pathology or congenital anomalies
in the neonatal period what does the uterus look like
distinct endometrial echoes in the first week of life
following the neonatal period the cervical anterior posterior is equal to or slightly greater than what ?
uterine fundus
the normal pre-pubertal uterus has a cervix to uterus ratio of what
2 to 1
the normal portion of the uterus is considered to be what
anteversion or anteflexion
Congenital malformations of the vagina can lead to what?
Accumulation of fluid within the female genital tract secondary to an obstruction
With congenital malformation of the vagina the obstructions can be the result of what?
Vaginal atresia, vaginal septum, imperforate hymen
The consequence of obstructions for congenital malformation of the vagina could lead to what?
Distention of the vagina, cervix, uterus and Fallopian tubes with blood or fluid
Hydrocolpos is often seen in what age of patient?
Neonatal
What are the clinical findings of vaginal obstructions?
Pelvic pain, enlarged uterus, abdominal pain, urinary retention, amenorrhea
Is the involvement of adenomyosis focal or diffuse?
Both, more often within the posterior portion of the uterus
Adenomysosis is often present in the uterus afflicted with what ?
Fibroid tumors
What are the clinical findings of adenomysosis
uterine enlargement, dysmenorrhea, menometrorrhagia, pelvic pain, dyspareunia , multiparous
What are the sonography findings of adenomyosis?
Diffusely enlarged uterus, hypoechoic or academic areas adjacent to the endometrium, heterogeneous myometrium, myometrial cyst, ill-defined interface between myometrium and endometrium, thickening of the posterior myometrium
What is treatment for adenomyosis?
hysterectomy or hormone therapy
An important differentiation should be made between endometriosis and adenomyosis. Discuss the differences.
Endometriosis tend to be younger and have fertility problems while adenomyosis are often older and multiparous
What is the most common benign gynecologic tumors in the leading cause of hysterectomy and gynecologic surgery?
Leiomyoma
Who are at a greater risk for development of fibroids?
Obese, black, non-smokers, perimenopause
What are the clinical findings of the uterine leiomyoma?
Pelvic pressure, menorrhagia, palpable pelvic Mass, enlarged bulky uterus, urinary frequency, dysuria, constipation, infertility
What are the sonography findings of uterine leiomyoma?
Hypoechoic Mass within the uterus, posterior shadowing from the mass, degenerating fibroids may have calcifications or cystic components, multiple fibroids appear as an enlarged irregular shaped diffusely heterogeneous uterus
What is the most common location for fibroids?
Intramural
Intramural for pedunculated fibroids that tourists what are the clinical findings?
Acute,localized pelvic pain
What fibroids usually lead to abnormal uterine bleeding because of their location in relationship to the endometrium?
Intracavitary
Besides a hysterectomy or myomectomy what is an alternative treatment for fibroids?
Uterine artery embolization
Leiomyosarcoma are more commonly found in what woman?
Perimenopausal or postmenopausal
What are the clinical findings of leiomyosarcoma
Pelvic pressure, menorrhagia, palpable abdominal Mass, enlarged bulky uterus, urinary frequency, dysuria, constipation, infertility
What are the sonography findings of leiomyosarcoma?
Rapidly growing Mass within the uterus, hypoechoic Mass within the uterus, posterior shadowing from the mass, degenerating fibroids may have calcifications or cystic components, multiple fibroids appear has an enlarged irregular shaped diffusely heterogeneous uterus
What are the clinical findings of a nabothian cyst?
Asymptomatic
Asymptomatic what are the sonography findings of a nabothian cyst?
Anechoic Mass within the cervix, maybe multiple, maybe complex
What is the most common female malignancy in women younger than 50?
Cervical carcinoma
How might a Cervical Carcinoma appear sonography?
In homogeneous, enlarged cervix or a focal Mass within the cervix
What are the clinical findings of a Gartner duct cyst?
Asymptomatic
What are the sonography findings of a Gartner duct cyst?
Anechoic mass within the vagina
Pseudoprecocious puberty has been linked with what?
Ovarian, adrenal and liver tumors
Which of the following fibroid locations would most likely result in abnormal uterine bleeding because of its relationship to the endometrium?
a) submucosal
b) intramural
c) subserosal
d) subserosal pedunculated
submucosal
All of the following are sonographic findings consistent with adenomyosis except:
a) diffuse enlarged uterus
b) myometrial cysts
c) hypoechoic areas adjacent to the endometrium
d) complex adnexal mass
d
The largest part of the uterus is the :
a) corpus
b) isthmus
c) cervix
d) fundus
a
Which of the following would be most indicative of a leiomyosarcoma ?
a) vaginal bleeding
b) rapid growth
c) dysuria
d) large hypoechoic mass
b
The inferior portion of the cervix closest to the vagina is the :
a) cornu
b) internal os
c) external os
d) fornix
c
The inner mucosal lining of the uterus is the :
a) myometrium
b) endometrium
c) serosal layer
d) perimetrium
b
Difficult or painful intercourse is referred to as :
a) dysuria
b) dysmenorrhea
c) dyspareunia
d) hydrocolpos
c
What congenital malformation of the uterus is common and has a clear association with an increased risk for spontaneous abortion?
a) anteflexed uterus
b) levoverted uterus
c) dextroverted uterus
d) septate uterus
d
Absence of menstruation is referred to as:
a) adenomyomatosis
b) endometriosis
c) amenorrhea
d) adenomyosis
c
The invasion of endometrial tissue into the myometrium of the uterus is referred to as :
a) amenorrhea
b) endometriosis
c) adenomyomatosis
d) adenomyosis
d
Pseudoprecocious puberty may be associated with all of the following except:
a) ovarian tumor
b) adrenal tumor
c) liver tumor
d) brain tumor
d
The layer of the endometrium that is significantly altered as a result of hormonal stimulation during the menstrual cycle is the :
a) myometrium
b) endometrial cavity
c) functional layer
d) basal layer
c
The most superior and widest portion of the uterus is the :
a) corpus
b) isthmus
c) cervix
d) fundus
d
A 24 YOF present to the us department for pelvic pain. Sono shows an anechoic mass with in the vagina, this is most likely ?
a) nabothian cyst
b) gartner duct cyst
c) dandy walker cyst
d) ovarian cyst
b
What section of the uterus is also referred to as the lower uterine segment ?
a) cervix
b) isthmus
c) fundus
d) cornu
b
The outer layer of the endometrium is the ?
a) myometrium
b) endometrial cavity
c) functional layer
d) basal layer
d
Which of the following would be considered the more common uterine anomaly ?
a) bicornis univernus
b) bicornis bicollis
c) uterus didelphys
d) septate uterus
d
The rigid region of the uterus located between the vagina and the isthmus is the?
a) cornu
b) corpus
c) cervix
d) fundus
c
Upon sono eval a pt complaining of abd distention you visualize a large hypoechoic mass distorting the anterior border of the uterus. What is this most likely location of the mass?
a) intramural
b) subserosal
c) submucosal
d) intracavitary pedunculated
b
A simple fluid collection within the vagina secondary to an imperforate hyme is ?
a) hydrometrocolpos
b) hydrocolpos
c) hematometra
d) hematocolpos
b
The uterine position in which the corpus tilts forward and comes in contact with the cervix decsribes?
a) anteflexion
b) anteversion
c) retroflexion
d) retroversion
a
What leiomyoma location would have an increased risk to undergo torsion?
a) subserosal
b) intracavitary
c) pedunculated
d) submucosal
c
A 13 YOF present to the sono depart. with a hx of cyclic pain, abd swelling, and amenorrhea. You visualize an enlarges uterus and a distended vagina that contains anechoic fluid with debris. This is most likely what?
a) cervical stenosis
b) adenomyosis
c) endometriosis
d) hematocolpos
d
All of the following are clinical findings associated with leiomyoma except:
a) myometrial cysts
b) infertility
c) palpable pelvic mass
d) menorrhagia
a
The surgical removal of a fibroid is termed:
a) hysterosonogram
b) total abdominal hysterectomy
c) myomectomy
d) uterine artey embolization
c
Which of the following is typically not a clinical complaint of women who are suffering from adenomyosis?
a) amenorrhea
b) dysmenorrhea
c) dyspareunia
d) menometrohragia
a
The paired embryonic ducts that develop into the female urogenital tract are the:
a) fallopian ducts
b) wolfiian ducts
c) gartner duct
d) mullerian duct
d
Precocious puberty is defined as the development of pubic hair, breasts, and the genitals before the age of
a) 13
b) 8
c) 5
d) 10
b
Abnormally heavy and prolonged menstrual flow between periods is termed?
a) menometrorrhagia
b) menarche
c) menorrhagia
d) dysmenorrhea
a
Leiomyomas that project from a stalk are termed:
a) submucosal
b) intramural
c) subserosal
d) pedunculated
d
Congenital malformation of the uterus that results in complete duplication of the genital tract is :
a) unicornuate uterus
b) bicornis bicolli
c) uterus didelphys
d) subseptate uterus
c
A 38 YOF presents to the us depart. w/ pelvic pain. Us shows anechoic area within cervix, this is most likely a :
a) nabothian cyst
b) benign follicular cyst
c) dermoid cyst
d) gartner duct cyst
a
Leiomyosarcoma of the uterus denotes:
a) the benign invasion of endometrial tissue into the myometrium
b) the ectopic location of endometrial tissue in the adnexa
c) the malignant counter part of a fibroid
d) an anechoic simple cyst located within the cervix
c
The location of a fibroid within the myometrium?
a) submucosal
b) intracavitary
c) subserosal
d) intramural
d
The superior portion pf the cervix is the ;
a) cornu
b) corpus
c) internal os
d) external os
c
Anechoic fluid distending the uterus and vagina within a pediatric patient is termed;
a) hydrocolpos
b) hydrometrocolpos
c) hydrometra
d) menatometrocolpos
b
The normal position of the uterus is:
a) retroverted
b) retroflexed
c) anteverted
d) dysverted
c
The area of attachment of the fallopian tubes to the uterus is the:
a) fundus
b) corpus
c) isthmus
d) cornua
d
The recesses of the vagina are called:
a) cornu
b) isthmi
c) fornices
d) parity
c