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
Pus within the fallopian tube is termed:
pyosalpinx
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
which of the following is the most common malignancy of the ovary?
a. cystic teratoma
b. serous cystadenocarcinoma
c. Krukenberg tumor
d. Sertoli-Leydig cell tumor
b
The short and narrow segment of the fallopian tube distal to the interstitial segment is the:
isthmus
the fingerlike extension of the fallopian tube is called:
fimbria
the longest and most tortuous segment of the fallopian tube is the:
ampulla
Blood within the fallopian tube is termed:
hematosalpinx
Hairlike projections within the fallopian tube are called:
cilia
The inner layer of the wall of the fallopian tube is the:
mucosal layer
The most distal part of the fallopian tube is the:
infunidibulum
The segment of the fallopian tube where fertilization typically occurs is the:
ampulla
What substance does hysterosalpingography utilize for the visualization of the uterine cavity and fallopian tubes?
radiographic contrast
Which of the following is associated with the “whirlpool sign”?
a. ovarian torsion
b. hydrosalpinx
c. ovarian hyperstimulation syndrome
d. ovarian carcinoma
a
markedly elevated levels of HCG, nausea and vomiting, pelvic fullness, pain associated with hemorrhage, rupture, and ovarian torsion
theca lutein cysts
large, bilateral, multiloculated ovarian cystic masses, may contain hemorrhagic components
theca lutein cysts
clinical findings of paraovarian cysts
asymptomatic, if cyst is large, patients may present with pelvic pain and increased lower abdominal girth
simple cyst located adjacent, but not attached to the ovary; if hemorrhage, will appear complex
paraovarian cysts
clinical findings of cystic teratoma
often asymptomatic; if torsion or rupture occurs, the patient may present with acute pelvic pain
complex, partially cystic mass in the ovary that includes one or more echogenic structures that may shadow; “tip of the iceberg sign”, dermoid plug, dermoid mesh
cystic teratoma
may be asymptomatic; postmenopausal vaginal bleeding or abnormal vaginal bleeding secondary to estrogen stimulation; Meigs syndrome
thecoma
hypoechoic solid mass with posterior attenuation, no posterior enhancement, if large, may mimic a pedunculated leiomyoma
thecoma
clinical findings of granulosa cell tumors
adolesence- pseudoprecocious puberty
reproductive age and postmenopausal women- abnormal vaginal bleeding
solid, hypoechoic mass or complex or partially cystic mass
granulosa cell tumor
clinical findings of a fibroma and brenner tumor
may be asymptomatic; Meigs syndrome
hypoechoic, solid mass with posterior attenuation, no posterior enhancement, if large, it may mimic a pedunculated leiomyoma
fibroma
small, solid hypoechoic mass that may contain calcifications
Brenner tumor
patient may be asymptomatic, pelvic pain, infertility, dysmennorhea, menorrhagia, dyspareunia, painful bowel movements
endometriomas
predominantly cystic mass with low-level internal echoes; anechoic or complex, mostly cystic mass with posterior enhancement and may have a fluid-fluid level
endometriomas
clinical findings of a serous cystadenoma
asyptomatic
predominantly, anechoic lesion that contains septations and/or papillary projections
serous cystadenoma
clinical findings of mucinous cystadenoma
pelvic pressure and swelling
large predominantly anechoic lesion that contains septations and/or papillary projections; may contain some recognizable internal, echogenic, layering debris
mucinous cystadenoma
weight loss, pelvic pressure and swelling, abnormal vaginal bleeding, gastrointestinal symptoms, acute abdominal pain associated with torsion or rupture, elevated CA 125
serous and mucinous cystadenocarcinomas
large multilocular cystic masses, papillary projections and septations are often noted within the mass, ascites
serous cystadenocarcinomas
large, multilocular cystic mass; papillary projections are often noted within the mass; echogenic material
clinical findings of Krukenberg Tumor
asymptomatic; history or gastric or colon cancer; possible weight loss; pelvic pain
bilateral, smooth-walled, hypoechoic or hyperechoic ovarian masses; “moth-eaten” appearance; may have ascites
Krukenberg tumor
clinical findings or Sertoli-Leydig Cell Tumors
virilization
abnormal menstruation
hirsutism
solid, hypoechoic ovarian mass; complex or partially cystic mass
Sertoli-Leydig cell tumors
pseudoprecocious puberty; elevated serum lactate dehydrogenase; possible elevated serum hcG
dysgerminoma
ovoid, solid echogenic mass on the ovary; may contain some cystic components
dysgerminoma
clinical findings of a yolk sac tumor
elevation in serum AFP
homogenous hyperechoic or complex mass; varying sonographic appearances
yolk sac tumor
clinical findings or endometroid tumor
history of endometrial cancer or endometriosis
complex mass with solid components; cystic mass with papillary projections
endometroid tumor
Stage I ovarian carcinoma
tumor is confined to the ovary
Stage II ovarian carcinoma
tumor involves one or both ovaries with pelvic extension
Stage III ovarian carcinoma
tumor involves one or both ovaries with confirmed peritoneal metastasis outside the pelvis and/or regional lymph node involvement
Stage IV ovarian carcinoma
distant metastasis beyond the peritoneal cavity
acute unilateral abdominal or pelvic or pain; nausea and vomiting; slight leukocytosis
ovarian torsion
enlarged ovary; enlarged ovary in the presence of multifollicular development; small peripherally located follicles on the enlarged ovary as a result of edema; lack of or diminished flow patterns compared with the nonaffected ovary; “whirlpool sign”; excessive free fluid
ovarian torsion
persistent lower abdominal and back pain after standing for long periods of time; dull, chronic pelvic pain; dyspareunia; dysmenorrhea; abnormal uterine bleeding; chronic fatigue; bowel issues; coexisting vulvar, perineal, and lower extremitiy vanus
pelvic congestion syndrome
multiple tortuous and dilated venous structures adjacent to the uterus and ovaries; dilated veins will measure greater than 4 to 5 mm in diameter and demonstrate a slow flow velocity within spectral imaging; ovarian vein exceeds 6 mm in diameter
pelvic congestion syndrome
history of bilateral salpingo-oophorectomy, chronic pelvic pain, cyclic pelvic pain, possible pelvic mass
ovarian remnant syndrome
Form in upper abdomen and descend into pelvis
ovaries
The ovaries are paired oval shaped ___peritoneal organs
intra
The ovaries have a dual blood supply:
ovarian artery
uterine artery
The ___ ovarian vein drains into the IVC
right
The ____ ovarian vein drains into the left renal vein
left
release estrogen and progesterone in varying amounts throughout the cycle
endocrine glands
The ovaries are located within the ____ pelvis
true
The ovaries may be located anywhere in the true pelvis except the:
anterior cul-de-sac
The ovarian fossa is _____ to the ureter and internal iliac artery.
posterior
The ovarian fossa is _____ to the external iliac artery.
superior
contains ovarian vasculature and lymphatics
medulla
parenchymal element, involves mass of ovary; site of oogenesis
cortex
The ovaries are stimulated by:
FSH
FSH is released by:
anterior pituitary gland
FSH helps develop multiple follicles during first half of the menstrual cycle, the _____ phase
follicular
The cells surrounding the tiny follicles produce _____ that stimulate the endometrium to thicken
estrogen
One follicle will become the ______ before ovulation, all others will undergo atrophy
Graafian follicle
Normal follicles measures __ cm or higher in greatest diameter
3
The ovum is contained within the ______ of the dominant follicle
cumulus oophorus
Ovulation occurs on day ____ of the menstrual cycle
14
describes pain at time of ovulation, typically on side of dominant follicle
Mittelschmerz
Fluid from the ruptured follicle will most often settle in the ______
pouch of Douglas
Most dependent portion of the peritoneal cavity
pouch of Douglas (rectouterine cavity)
After the Graafian follicle has ruptured, its structure is converted into the _____
corpus luteum
Second half of menstrual cycle
luteal phase
If fertilization does not occur, the corpus luteum regresses and becomes the _____
corpus albicans
The ovarian artery has a high-resistive pattern, increased impedance, absent or low-end diastolic velocity during the ____ and ____ phase.
follicular
late luteal
The follicular phase occurs between days __ and __
0
7
The late luteal phase occurs between days ___ and ___.
18
28
The ovarian artery has a low-resistive pattern with low impedance and high levels of diastolic velocity during the ___ and ____ phase.
late follicular
early luteal
The late follicular phase occurs between days ___ and ___
7
17
Ovarian volume equation
length x width x height x 0.5233
mean premenopausal ovarian volume
9.8 mL
Mean postmenopausal ovarian volume
5.8 mL
Graafian follicle fails to rupture and continues to grow and become ____ cyst
follicular
Follicular cysts are between __ and __ cm
3
8
Follicular cysts sonographic appearance
anechoic, thin-walled, unilocular
surgical removal of an ovarian cyst
ovarian cystectomy
Follicular cysts normal resolve within __ weeks
6
follicular cyst that contains blood, fluid-debris level, fishnet, web-like or lacy appearance
hemorrhagic cyst
physiological cyst that develops are ovulation
corpus luteum cysts
Most common pelvic masses seen during the first trimester
corpus luteum of pregnancyt
Corpus luteum of pregnancy usually resolved by __ weeks of gestation
16
largest and least common of follicular cysts
theca lutein cytst
Cysts found in presence of elevated HCG
theca lutein cysts
Theca lutein cysts can grow up to ___ cm
15
small cysts located adjacent to the ovary
paraovarian cysts
Paraovarian cysts most likely arise from _____ or _____
fallopian tubes
broad ligaments
Paraovarian cysts may range from ___ to ___ cm
1.5-19
most common benign ovarian tumor
cystic teratoma
also referred to as a dermoid
cystic teratoma
result from retention of an unfertilized ovum that differentiates into three germ cell layers
cystic teratoma
may contain glandular tissue, thyroid components, bone, hair, sebum, fat, cartilage, and digestive elements
cystic teratoma
complex or partially cystic mass in ovary that includes one or more echogenic structures
cystic teratoma
associated with “tip of the iceberg sign”
cystic teratoma
benign ovarian sex cord-stromal tumor; may be associated with Meigs syndrome
thecoma
condition of having a benign ovarian tumor with ascites and pleural effusion
thecoma
estrogen producing tumor
thecoma
most common estrogenic tumor; sex-cord stromal tumor
granulosa cell tumor
tumor associated with precocious puberty in adolescents
granulosa cell tumor
Granulosa cell tumors can reach sizes up to __ cm.
40
sex cord-stromal tumor that is not associated with estrogen production
fibroma
most often small, hypoechoic unilateral tumors that may contain calcifications; may also be referred to as transitional cell tumors
Brenner tumors
chocolate cyst
endometrioma
benign blood containing tumor associated with endometriosis
endometrioma
form from implantation of functional endometrial tissue
endometrioma
The endometrioma can be found anywhere outside the endometrial cavity, but is most commonly found:
on the ovaryu
dyschezia
painful bowel movements
predominantly cystic mass with low level echoes
endometrioma
__ - __% of cystadenomas are benign serous
50
70
often large and bilateral, predominantly anechoic lesion that contains septations and/or papillary projections
serous cystadenoma
Mucinous cystadenomas can reach sizes up to __ cm
40
Survival rate of ovarian malignancy
15%
most common malignancy of the ovary
serous cystadenocarcinoma
associated with pseudomyxoma peritoneio
mucinous cystadenocarcinoma
intraperitoneal extension of mucin-secreting cells that result from the rupture
mucinous cystadenocarcinoma
malignant ovarian tumor that has most likely metastasized from gastrointestional tract
Krukenberg tumor
The most frequent origin of the Krukenberg tumor is the ____
stomach
has a “moth-eaten” appearance
Krukenberg tumor
sex cord-stromal ovarian neoplasm associated with virilization
Sertoli-Leydig Cell tumors
most common malignant germ cell tumor of the ovary
dysgerminoma
most frequent ovarian malignancy found in childhood
dysgerminoma
second most common malignant germ cell tumor of the ovary
yolk sac tumor
Endometroid tumors usually affect women in the __ and __ decade of life
5
6
most common cancer to originate within an endometrioma
endometroid tumor
Ovarian carcinoma has a ____ diastolic flow velocity because of abnormal vessels created with malignancy
higher
results from adnexal structures twisting on mesenteric connections
ovarian torsion
Ovarian torsion most often occurs on the ____ side
right
Most common cause of ovarian torsion
ovarian cyst or mass
Mean measurement of ovary with ovarian torsion
9.5 cm
round mass with concentric hypoechoic and hyperechoic rings that demonstrate color Doppler signature
“whirlpool sign”
The “whirlpool sign” is associated with:
ovarian torsion
primary purpose of the ____ is to provide an area for fertilization to occur and to provide a means of transportation for the products of conception to reach the uterine cavity
fallopian tubes
3 layers of fallopian tubes
outer serosa
middle muscular
inner mucosal
help transport fertilized ovum; small, hairlike structures
cilia
The fallopian tubes are __ - __ cm long
7
12
The fallopian tubes consist of __ parts
5
The proximal segment of the fallopian tube is located
closest to the uterus
The distal segment of the fallopian tube is located
within adnexa or closer to ovary
part of fallopian tube that is located within the cornu of the uterus
intramural extension
short and narrow segment of the fallopian tube, connects intramural extension to the ampulla section
isthmus
longest and most tortuous segment of the fallopian tube
ampulla
most likely location of fertilization
ampulla
area where most ectopics embed in the fallopian tube
ampulla
distal portion of the fallopian tube; proivdes opening to peritoneal cavity within pelvis
infundibulum
fingerlike projections that extend from the infundibulum
fimbraie
The primary role of the ____ is to draw the unfertilized egg into the fallopian tube
fimbraie
Canner within the fallopian tubes is rare, but typically is
adenocarcinoma
simple serous fluid within fallopian tubes
hydrosalpinx
pus/blood within the fallopian tubes
pyosalpinx
inflammation of the tubes due to infection
salpingitis
Salpingitis is commonly caused by:
PID
obstruction caused by compression of left renal vein at origin of SMA
Nutcracker syndrome
dysfunctional venous valves, estrogenic effects on vasodilation, late pregnancy mechanical injury
Pelvic congestion syndrome
demonstration of multiple tortuous and dilated venous structures adjacent to uterus and ovaries
pelvic congestion syndrome
In pelvic congestion syndrome the ovarian vein typically measures greater than __ mm
6
results from ovarian tissue being left behind, leading to stimulation of tissue by circulating hormones; complication of bilateral salpingo-oophorectomy
ovarian remnant syndrome
Only one follicle will become the dominant follicle, or ______, before ovulation, whereas all other follicles undergo atrophy
Graafian follicle
After the Graafian follicle has ruptured, its structure is converted into the ______
corpus luteum
Typical ovarian flow is said to be high resistant during the _____ and ____ phase and low resistant during the ____ and ____ phase
early follicular
late luteal
late follicular
early luteal
A large mass or cyst on the ovary increases the patient’s risk for _____
ovarian torsion
The sonographic manifestation of a ______ cyst may be described as demonstrating a weblike or lacy appearance
hemmorhagic
______ are large, bilateral, multiloculated ovarian cystic masses that result from high levels of HCG
theca lutein cysts
The most common benign ovarian tumor is the _____, also referred to as a _____
cystic teratoma
dermoid cyst
A _____ produces estrogen and can, therefore, lead to postmenopausal bleeding., It often appears as a hypoechoic mass, which can simulate the appearance of an uterine fibrois
thecoma
In pediatric patients, the granulosa cell tumor is associated with ______
pseudoprecocious puberty
______ are also referred to as “chocolate cysts”
endometriomas
_____ cystadenomas are often larger than _____ cystadenomas, and they tend to contain echogenic material within their cystic components
mucinous
serous
Patients with _____ may complain of weight loss, pelvic pressure and swelling, abnormal vaginal bleeding, and gastrointestinal problems. Although not always specific, they may also have an elevated CA125.
ovarian cancer
______ are metastatic tumors to the ovary, most often from gastrointestinal cancers like stomach cancer
Krukenberg
______ tumors tend to have a “moth-eaten” appearance.
Krukenberg
The _____ is the most common malignant germ cell tumor of the ovary. It is the ovarian equivalent to the testicular seminoma
dysgerminoma
The tumor marker for the yolk sac tumor is
AFP
Ovarian torsion typically occurs on the ____ side
right
The ____ is the longest and most tortuous segment of the fallopian tube. It is a significant portion of the tube because it is the most likely location of fertilization and the area where ectopic pregnancies often embed.
ampulla
