Chapter 18: The Ovaries and Fallopian Tubes Flashcards
the area located posterior to the broad ligaments and adjacent to the uterus, which contains the ovaries and fallopian tubes
adnexa
the longest and most tortuous segment of the fallopian tube
ampulla
Serdoli-Leydig cell tumor is also known as:
androblastoma
peritoneal outpouching located between the bladder and the uterus; also referred to as the vesicouterine pouch
anterior cul-de-sac
excessive fluid in the peritoneal cavity
ascited
small benign ovarian tumors
Brenner tumors
a protein that may be increased in the blood of women with ovarian cancer and other abnormalities
CA 125
another name for endometriomas
chocolate cysts
hairlike projections within the fallopian tube
cilia
the remaining structure of the corpus luteum after its deterioration
corpus albicans
temporary endocrine gland that results from the rupture of the Graafian follicle after ovulation
corpus luteum
physiologic cyst that develops after ovulation has occurred
corpus luteum cyst
the corpus luteum that is maintained during an early pregnancy for the purpose of producing estrogen and primarily progesterone
corpus luteum of pregnanc
structure that contains the developing oocyte
cumulus oophorus
benign ovarian mass that is composed of the three germ cell layers; also referred to as a dermoid cyst
cystic teratoma
a small cyst within a large cyst
daughter cyst
another name for a cystic teratoma
dermoid cyst
mass of hair within a cystic teratoma
dermoid mesh
part of a dermoid tumor that contains various tissues and may produce posterior shadowing during a sonographic exam
dermoid plug
painful sexual intercourse
dyspareunia
the outer germ cell layer of the embryo that develops into the skin, hair, and nails, and other structures
ectoderm
the germ cell layer of the embryo that develops into the gastrointestinal and respiratory tracts
endoderm
a typically malignant ovarian tumor that is often associated with a history of endometrial cancer, endometriosis, and endometrial hyperplasia
endometroid tumor
benign, blood containing tumor that forms from the implantation of ectopic endometrial tissue; tumor associated with endometriosis
endometrioma
functional ectopic endometrial tissue located outside of the uterus
endometriosis
an ovarian sex-cord stromal tumor found in middle aged women
fibroma
the fingerlike extension of the fallopian tube located on the infundibulum
fimbria
hormone of the anterior pituitary gland that causes the development of multiple follicles on the ovaries
follicle-stimulating hormona
ovarian cyst that forms as a result of the failure of the Graafian follicle to ovulate
follicular cyst
a type of neoplasm derived from germ cells of the gonads; may also be found outside the reproductive tract
germ cell tumor
a disease associated with an abnormal proliferation of the trophoblastic cells during pregnancy; may also be referred to as a molar pregnancy
gestational trophoblastic disease
the name for the dominant follicle before ovulation
Graafian follicle
blood within the fallopian tube
hematosalpinx
a cyst that contains blood
hemorrhagic cyst
excessive hair growth in women in areas where hair growth is normal negligable
hirsutism
Which of the following would be least likely associated with PCS?
a. right renal vein entrapment
b. dysfunctional venous valves
c. abnormal uterine bleeding
d. chronic fatigue
a
Which of the following would be least likely associated with an increase for developing ovarian cancer?
a. Nulliparity
b. late menarche
c. delayed childbearing
d. age of over 50
b
What mass would least likely appear as a solid adnexal mass?
a. thecoma
b. fibroma
c. dermoid
d. Brenner tumor
c
What is another name for the androblastoma?
Sertoli-Leydig cell tumor
What is the most common cancer to originate within an endometrioma?
endometroid tumor
Intraperitoneal extension of mucin-secreting cells that results from the rupture of a mucinous tumor may be associated with ovarian carcinoma or cancer of the:
appendix
Inflammation of the uterine tube is termed:
salpingitis
Which of the following would be associated with an elevated CA 125?\
a. Fibroma
b. thecoma
c. dysgerminoma
d. PCS
c
Which of the following is not true concerning ovarian cancer?
a. patients tend to have ovarian cancer familial incidence
b. patients tend to have a history of familial breast cancer
c. Patients tend to present early in the disease
d. Sonography does not serve as the best screening mechanism for ovarian cancer
c
What germ cell tumor contains elements of the ectoderm, mesoderm, and endoderm?
cystic teratoma
An endometriom most likely appears:
mostly cystic mass with low-level echoes
With what ovarian tumor is Meigs sydrome most likely associated?
fibroma
sonographically, which of the following would most likely be confused for a pendunculated fibroid tumor because of its solid-appearing structure?
a. serous cystadenoma
b. mucinous cystadenoma
c. fibroma
d. theca lutein cyst
c
During a pelvic sonogram, you visualized a small cyst located adjacent to the ovary. what is the most likely etiology of this cyst?
paraovarian cyst
The most common benign ovarian tumor is the:
cystic teratoma
The ovarian mass that contains fat, sebum, and teeth is the:
dermoid
The ovarian cysts that are most often bilateral and are associated with makedly elevated levels of hCG are the:
theca lutein cysts
The cystic mass noted most commonly with a pregnancy is the:
corpus luteum
The sonographic appearance of an ovarian dermoid tumor in which only the anterior elements of the mass can be seen, wile the greater part of the mass is obsured by shadowing is consistent with:
tip of the icerberg sign
The dominnt follicle before ovulaion is termed the:
Graafian follicle
Which of the following is the correting formula for calculating ovarian volume?
a. length x width x height x 0.6243
b. length x width x height x 0.3899
c. length x width x height x 0.5233
d. ovarian cannot be calculated
c
Which of the following sonographic findings would not increase the likelihood of an ovarian malignancy?
a. septation measuring greater than 3mm in thickness
b. irregular borders
c. solid wall nodule
d. anechoic components with acoustic enhancement
d
hormone produced by the trophoblastic cells of the early placenta; may also be used as a tumor marker in nongravid patients and males
human chorionic gonadotropin
the abnormal accumulation of fluid within the fallopian tube
hydrosalpinx
excessive vomiting
hyperemesis
a radiographic procedure that uses a dye instilled into the endometrial cavity and fallopian tubes to evaluate for internal abnormalities
hysterosalpingography
the distal segment of the fallopian tube
infundibulum
the segment of the fallopian tube that lies within the uterine horn (cornu)
interstitial
the segment of the fallopian tube that is located between the interstitial and ampulla; uterus: area of the uterus between the corpus and cervix
isthmus
malignant ovarian tumor that metastasizes from most likely the gastrointestinal tract
Krukenberg tumor
destruction or breaking down
lysis
developing into cancer
malignant degeneration
ascites and pleural effusion in the presence of a benign ovarian tumor
Meigs syndrome
abnormally heavy and prolonged menstruation
menorrhagia
the germ cell layer of the embryo that develops into the circulatory system, muscles, reproductive system, and other structures
mesoderm
pelvic pain at time of ovulation
mittelschmerz
having more than one internal cavity
multiloculated
an anomaly where left renal vein entrapment occurs between the SMA and abdominal aorta
nutcracker syndrome
the creation of an ovum
oogenesis
surgical removal of the ovary
oophorectomy
the surgical removal of an ovarian cyst
ovarian cystectomy
a syndrome resulting from hyperstimulation of the ovaries by fertility drugs; results in the development of multiple, enlarged follicular ovarian cysts
ovarian hyperstimulation syndrome
an abnormality that results from the ovary twisting on its mesenteric connection, consequently cutting off the blood supply to the ovary
ovarian torsion
the release of the mature egg from the ovary
ovulation
a small protrusion of tissue
papillary projections
leiomyoma (fibroid) that extends from the uterus on a stalk
pedunculated uterine leiomyoma
a condition that is thought to result from the compression of the left renal vein at the origin of the SMA, a condition termed nutcracker syndrome
pelvic congestion syndrome
infection of the female genital tract that may involve the ovaries, uterus, and/or fallopian tubes
pelvic inflammatory disease
contractions that move in a wavelike pattern to propel a substance
peristalsis
inflammation of the peritoneal lining
peritonitis
intraperitoneal extension of mucin-secreting cells that results from the rupture of a malignant mucinous ovarian tumor or, possibly, a malignant tumor of the appendix
pseudomyxoma peritonei
secondary sexual development induced by sex steroids or from other sources like ovarian tumors, adrenal tumors, or steroid use
pseudoprecocious puberty
presence of pus within the fallopian tubes
pyosalpinx
inflammation of the fallopian tubes
salpingitis
an oily substance secreted by the sebaceous glands
sebum
a partition separating two or more cavities
septation
malignant sex cord-stromal ovarian neoplasm that is associated with virilization; also referred to as an androblastoma
Sertoli-Leydig cell tumor
tumor marker that is elevated in the presence of an ovarian dysgerminoma and other abdominal abnormalities
serum lactate dehydrogenase
ovarian tumors that arise from the gonadal ridges
sex cord-stromal tumors
a sonographic procedure that uses saline instillation into the endometrial cavity and fallopian tubes to evaluate for internal abnormalities
sonohysterography
functional ovarian cysts that are found in the presence of elevated levels of human chorionic gonadotropin, also referred to as a theca luteal cyst
theca lutein cysts
benign ovarian sex cord-stromal tumor that produces estrogen in older women
thecoma
denotes the sonographic appearance of a cystic teratoma (dermoid) when only the anterior element of the mass is seen, while the greater part of the mass is obscured by shadowing
“tip of the iceberg” isgn
inferior portion of the pelvis that contains the uterus, ovaries, fallopian tubes, urinary bladder, small bowel, sigmoid colon, and rectum
true pelvis
having only one internal cavity
unilocular
examination of the veins of the legs and pelvis that includes the use of contrast media; can be performed using radiography (flouroscopy), computed tomography, and MRI
venography
changes within the female that are typically associated with males; caused by increased androgens and may lead to deepening of the voice and hirsutism
virilization
an indicator of the torsed ovarian pedicle adjacent to the ovary, appearing as a round mass with concentric hypoechoic and hyperechoic rings that demonstrates a swirling color Doppler signature
“whirlpool” sign
malignant germ cell tumor of the ovary
yolk sac tumor of the ovary
Ovarian arterial flow in the early follicular phase
high impedance with absent or low end-diastolic velocity
ovarian arterial flow late follicular phase
low impedance with increased end-diastolic flow
ovarian arterial flow early luteal phase
low impedance with increased end-diastolic flow
ovarian arterial flow late luteal phase
high impedance with absent or low end-diastolic velocity
clinical findings of follicular cysts
asymptomatic
pain associated with hemorrhage and enlargement of cyst
anechoic, thin walled, unilocular round posterior enhancement within ovary
simple cyst
variable appearances including complex components or entirely echogenic, depending on the amount of blood and stage of lysis; may have a fluid-debris level, fishnet, weblike or lacy appearance as well
hemorrhagic cyst
clinical findings of corpus luteum cysts
asymptomatic
pain associated with hemorrhage and enlargement of the cyst
may look like a simple cyst, have a thick wall, be completely echogenic, and may be difficult to differentiate from other masses, may appear hemorrhagic, “ring of fire”
corpus luteum cysts
Normal ovarian flow is said to be:
a. low resistant during menstruation and high resistant during the proliferative phase
b. high resistant during menstruation and low resistant at the time of ovulation
c. low resistant
d. high resistant
b
What would be a predisposing condition that would increase the risk for suffering from ovarian torsion?
a. hirsutism
b. excessive exercise
c. ovarian mass
d. sonohysterography
c
The malignant ovarian tumor with gastrointestinal origin is the:
Kurkenberg tumor
The malignant ovarian mass that is associated with pseudomyxoma peritonei is the:
mucinous cystadenocarcinoma
All of the following adnexal masses may appear sonographically similar to a uterine leiomyoma except:
a. thecoma
b. paraovarian cyst
c. fibroma
d. granulosa cell tumor
b
Which of the following is also referred to as a chocolate cyst?
a. endometrioma
b. endometroid
c. cystic teratoma
d. androblastoma
a
The ovarian tumor associated with an elevated serum lactate dehydrogenase is the:
dysgerminoma
Which of the following is a tumor of ectopic endometrial tissue?
a. Brenner tumor
b. cystic teratoma
c. yolk sac tumor
d. endometrioma
d
What ovarian mass is associated with virilization?
Sertoli-Leydig cell tumor
A 24 year old female patient presents to the emergency department with severe right lower quadrant pain, nausea, and vomiting. The sonographic examination reveals an enlarged ovary with no detectable doppler signal. What is the most likely diagnosis?
ovarian torsion
Which of the following is an estrogen producing ovarian tumor?
a. cystic teratoma
b. fibroma
c. thecoma
d. endometrioma
c
What ovarian tumor will most likely have a moth-eaten appearance on sonography?
Krukenberg tumor
A 55 year old patient presents to the sonography department with a history of pelvic pressure, abdominal swelling, and abnormal uterine bleeding. A pelvic sonogram reveals a large, multiloculated cystic mass with papillary projections. What is the most likely diagnosis?
serous cystadenocarcinoma
A patient with an ovarian mass presents with an elevated serum AFP. Which of the following would be the most likely diagnosis?
a. ovarian fibroma
b. ovarian thecoma
c. cystic teratoma
d. yolk sac tumor
d
The ovarian cyst associated with gestational trophoblastic disease is the:
theca lutein cyst
