Chapter 18 - The ovaries & fallopian Tubes Flashcards
the longest and most tortuous segment of the fallopian tube
ampulla
small benign ovarian tumors
Brenners tumors
another name for endometriomas
chocolate cysts
hairlike projections within the fallopian tube
cilia
the remaining structure of the corpus luteum after its deterioation
corpus albicans
temporary endocrine gland that results from rupture of the Graafian follicle after ovulation
Corpus luteum
physiologic cyst that develops after ovulation has occured
corpus luteum cyst
the corpus luteum that is maintained during an early preganncy for the purpose of producing estrogen and primarily progesterone
corpus luteum of pregnancy
structure that contains teh developing oocyte
cumulus oophorus
benign ovarian mass that is composed of 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 examination
dermoid plug
the outer germ cell layer of the embryo that develops into the skin hair and nails and other structures
ectoderm
a typically malignant ovarian tumor that is often associated with a history of endometrial cancer, endometriosis and endometrial hyperplasia
endomertroid 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 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 hormone
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 prior to ovulation
Graafian follicle
blood within the fallopian tube
hematosalpinx
a cyst that contains blood
hemorrhagic cyst
hormone produced by the trophoblastic cells of the early placenta ; may also be used a tumor marker in nongravid patients and males
human chorionic gonadotropin
the abnormal accumulation of fluid within the fallopian tube
hydrosalpinx
excessive vomitting
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 (cornua)
interstitial
tube: 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
Krukenburg tumor
destruction or breaking down (ex : hemolysis the breaking down of blood components)
lysis
developing into cancer
malignant degeneration
the germ cell layer of the embryo that develops into the circulatory system, muscles, reproductive system and other structures
Mesoderm
pelvic pain at the time of ovulation
mittelschmerz
the creation of an ovum
oogenesis
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
the release of the mature egg from the ovary
ovulation
small protrusion of tissues
papillary projections
leiomyoma (fibroid) that extends dfrom uterus on a stalk
pedunculated uterine leiomyoma
contraction that move in a wavelike patter to propel a substance
peristalsis
inflammation of the peritoneal lining
peritonitis
secondary sexual development induced by sex steroids or from other sources like ovarian tumors, adrenal tumors or steroid use
pseudoprecocious puberty
the presence of pus within the fallopian tube
pyosalpinx
inflammation of the fallopian tubes
salpingitis
an oily substance secreted by the sebaceous glands
sebum
a partition seperating two or more cavities
septations
malignant sex cord stromal ovarian neoplasm that is associated with virilization
Sertoli-Leydig cell tumor
tumor marker that is elevated in the presence of an ovarian dysgerminoma and other abdominal abnormaliities
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 fallopain 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 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” sign
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
(ovary) malignant germ cell tumor of the ovary
yolk sac tumor
In utero, the ovaries form in the
upper abdomen & descend into the pelvis in utero
the ovaries have dual blood supply from the …
ovarian and uterine arteries
the ovaries release whic hhormones
- estrogen
- progesterone
The ovary consists of an outer __ and inner __
Cortex
medulla
The medulla contains _
the ovarian vasculature and lymphatics s
The cortex involves the mass of the ovary and is the site of __
oogenesis
The ovaries are stimulated by ___
follicle-stimulating hormone
FSH is produced by ___
the anterior pituitary gland
The first half of the menstrual cycle is called
the follicular phase
The dominant follicle is also known as the
The graafian follicle
All follicles except the dominant follicle will become
Atrophy
the cumulus oophorus can be seen sonographically as a
daughter cyst
Ovulation occurs approximately on day
14
The fluid from the ruptured follicle most often will settle in the
Rectouterine pouch (pouch of douglas)
After the graafian follicle has ruptured its structure is converted into the ___
corpus luteum
The second half of the menstrual cycle is called
the luteal phase
If fertilization occurs, the corpus luteum is maintained and become
the corpus luteum of pregnancy
if fertilization does not occur, the corpus luteum regresses and becomes
the corpus albicans
typical ovarian flow is said to be ______ during the menstrual and proliferative phases
high-resistant
typical ovarian flow is said to be at ______mid cycle
low-resistant
Ovarian volume can be determined with the formula
volume = length x width x height x 0.52332
Postmenopausal ovaries…
Atrophy
Should the graffian follicle fail to ovulate, it could continue to enlarge and result in a
follicular cyst
Follicular cysts range in size from ____ to ____ cm
3
8
The most common masses seen during a first-trimester sonographic examination
Corpus luteum of pregnancy
Corpus luteum of pregnancy often resolve by ___ weeks gestation and do not exceed —- cm
16
3
The largest and least common of functional cysts
Theca lutein cysts
The most common benign ovarian tumor
Cystic teratoma or dermoid cyst
____ Results from the retention of an unfertilized ovum that differntiates into three germ cell layers
dermoids
Germ cell tumors are composed of ____ and
ectoderm
mesoderm
endoderm
Dermoids are most often found in___
reproductive age group but may also be found in post-menopausal patients
The sonographic sign shows only the anterior element of the mass while the greater part of the mass is obscured by shadowing
“tip of the iceberg”
Various tissues that is the source of posterior shadowing
Dermoid plug
The visualization of hair within a mass
dermoid mesh
Most often found in postmenopausal women and may be associated with Meigs Syndrome
thecoma
The most common estrogenic tumor
granulosa cell tumor
Unlike thecomas _____ are not associated with hormone (estrogen) production
FIbromas
Ectopic endometrial tissue is
Functional
The hormones of menstruation act on the ectopic tissue just as if it were located within the uterus, causing it to..
Hemorrhage
Hemorrhage from endometriosis forms into focal areas of blood tumors known as
endometriomas
The lesions have been termed “chocolate cyst” because of their blood content
Endometriomas
Endmetriomas are most commonly found ___
on the ovary
Serous cystadenomas are small/large and are often unilateral/bilateral
large,bilateral
Serous cystadenomas appear sonographically as
predominately anechoic lesion that contains septations and or papillary projections
Which of the two are typically the largest
Serous or Mucinous
Mucinous
Mucinous cystadenomas are not often unilateral/bilateral
bilateral
What is the most common malignnacy of the ovary
serious cystadenocarcinoma
A serous cystadenocarcinoma looks similar to its benign counterpart with an exception
there appears to be more prominent papillary projections and thicker septations
In a serous cystadenocarcinoma cast, pt may have an elevated
Ca-125 level
The mucinous cystadenocarcinoma is associated with a condition known as
Psudeomyxoma peritonei
A malignant tumor that metastzised from the GI tract, most freqquently the stomach
Krukenberg tumor
A sertoli-Leydig cell tumor is also known as
Androblastoma
a sex cord stromal ovarian neoplasm that is associated with virilization abnormal menstruation and hirsutism
Sertoli-Leydig cell tumor
The most common malignant germ cell tumor
Dysgerminoma
Dysgerminoms arise more often in patients …
younger then 30 years of age
Children with ovarian dysgerminomas may present with …. and have an elevation in
precocious puberty
serum HCG levels
The tumor marker used for dysgerminoma is an elevation in
Serum lactate dehydrogenase
The testicular equilvanet of an ovarian dysgerminoma
seminoma
The second most common malignant germ cell tumor
yolk sac tumor
The yolk tumor is also known occurs in females..
younger than 20 years
Yolk sac tumors are highly and carries a —–
malignant, poor prognosis
patients with yolk sac tumors present with an elevation
serum-apla-fetoprotein (AFP)
The doppler analysis of a malignant ovarian masses often reveal ____
higher diastolic flow
vessels found in ovarian carcinoma often lack _______ and thus produce a less resitive waveform pattern
Smooth muscle
tumor is confined to the ovary
Stage 1
tumor involves one or both of the ovaries with pelvic extension
Stage 2
tumor involbes one or both ovaries with confirmed peritoneal metastatis outside of the pelvis/ and or regional lymph node involvemnet
Stage 3
distant metastasis beyond the peritoneal caivty
Stage 4
Ovarian torsion occurs most often on the ____ side
right
The most common cause of ovarian torsion is ____
cyst or mass
Also referred to as oviducts, uterine tubes, or salpinges
Fallopain tubes
An endometrioma most likely appears as a :
a) simple, anechoic mass with through transmission
b) complex mass with internal shadowing components
c) mostly cystic mass with low level echoes
d) solid, hyperechoic shadowing mass
C
With what ovarian tumor is Meigs syndrome most likely associated?
a) dysgerminoma
b) cystic teratoma
c) fibroma
d) yolk sac tumor
C - fibroma
Sonographically which of the following would most likely be confused for a pedunculated fibroid tumor because of its solid appearing structure?
a) serous cystadenoma
b) mucinous cystadenoma
c) fibroma
d) theca lutein cyst
C
During the pelvic US you visualize a small cyst located adjacent to the ovary. What is the most likely etiology of this cyst?
a) dermoid cyst
b) ovarian cystadenoma
c) endometrioma
d) paraovarian cyst
D
The most common benign ovarian tumor is the:
a) cystic teratoma
b) mucinous cystadenoma
c) fibroma
d) sertoli-leydig cell tumor
Cystic teratoma
The ovarian mass that contains fat, sebum, and teeth?
a) dermoid
b) fibroma
c) mucinous cystadenoma
d) yolk sac tumor
A
The ovarian cysts that are most often bilateral and are associated with markedly elevated levels of HCG are the:
a) corpus luteum cyst
b) paraovarian cysts
c) granulosa cell cyst
d) theca lutein cyst
D
The cystic mass commonly noted with a pregnancy is the:
a) corpus luteum
b) dermoid cyst
c) dysgerminoma
d) serous cystadenoma
A
The sonographic appearance of an ovarian dermoid tumor in which only the anterior elements of the mass can be seen, while the greater part of the mass is obscured by shadowing is consistent with:
a) whirlpool sign
b) tip of the iceburg
c) dermoid mesh sign
d) dermoid plug sign
B
The dominant follicle prior to ovulation is termed the:
a) graafian follicle
b) corpus albicans
c) corpus luteum
d) medulla
A
After the graffian follicle ruptures the remaining structure is termed the
a) graafian remnant
b) corpus albicans
c) corpus luteum
d) theca lutein cyst
C
Which of the following is the correct formula for evaluating ovarian volume?
length x width x heigjt x 0.5233
Which of the following sono finds would not increase the likelihood of an ovarian malignancy?
a) septation measuring > 3 mm in thickness
b) irregular borders
c) solid wall nodule
d) anechoic components with acoustic enhancement
d
Normal ovarian flow is said to be :
a) low resistant during the 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) hirtutism
b) excessive exercise
c) ovarian mass
d) sonohisterography
c
The malignant ovarian tumor with gastrointestinal origin is the:
a) brenner tumor
b) krukenburg tumor
c) yolk sac tumor
d) granulosa cell tumor
b
The malignant ovarian mass that is associated with pseudomyxoma peritonei is the;
a) dysgerminoma
b) sertoli leydig cell tumor
c) serous cystadenocarcinoma
d) mucinous cystadenocarcinoma
d
All of the following adenxal 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 :
a) dysgerminoma
b) sertoli leydig tumor
c) androblastoma
d) ucinous cystadenocarcinoma
a
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?
a) krukenburg tumor
b) cystic teratoma
c) serous cystadenoma
d) sertoli leydig tumor
d
A 24 YOF presents with severe rlq pain, nausea, vomiting,. The us shows an enlarged ovary with no doppler signal. What is this most likely to be?
a) ovarian cystadenocarcinoma
b) cystic teratoma
c) ovarian torsion
d) endometriosis
c
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 ave a moth eaten appearance on sono?
a) cystic teratoma
b) serous cystadenocarcinoma
c) krukenburg tumor
d) sertoli leydig tumor
c
A 55 YOF presents with pelvic pressure, abd swelling, and abnormal bleeding. Us reveals a large multiloculated cystic mass with papillary projections. What is the most likely diagnosis?
a) serous cystadenocarcinoma
b) cystic teratoma
c) anroblastoma
d) dysgerminoma
a
A patient with an ovarian mass presents with elevated ms-afp. Which would be most likely?
a) ovarian fibroma
b) ovarian thecoma
c) dermoid cyst
d) yolk sac tumor
d
The ovarian cyst associated with gestational trophoblastic disease is the:
a) corpus luteum cyst
b) theca lutein cyst
c) dermoid cyst
d) paraovarian cyst
b
Pus within the fallopian tube is termed:
a) hematosalpinx
b) pyosalpinx
c) hydrosalpinx
d) hemosalpinx
b
Which of the following is the most common malignancy of the ovary ?
a) cystic teratoma
b) serous cystadeoncarcinoma
c) krukenburg tumor
d) sertoli leydig tumor
b
The short and narrow segment of the fallopian tube distal to the interstitial segment is the:
a) ampulla
b) fimbria
c) infundibulum
d) isthmus
d
The fingerlike extensions of the fallopian tube are called:
a) fimbria
b) infundibulum
c) cilia
d) ampulla
a
The longest and most tortuous segment of the fallopian tube:
a) frimbria
b) ampulla
c) isthmus
d) interstitial
b
Blood within the fallopian tube is termed:
a) hydrosalpinx
b) hematosalpinx
c) pyosalpinx
d) hemosalpinx
b
Hairlike projections within the the fallopian tube are called:
a) fimbria
b) interstitial
c) cilia
d) peristalsis
c
The inner wall layer of the fallopian tube is the :
a) muscular layer
b) mucosal layer
c) myometrial layer
d) serosal layer
b
The most distal part of the fallopian tube is the :
a) cornu
b) ampulla
c) interstitial
d) infundibulum
d
The segment of the fallopian tube where fertilization occurs typically is the :
a) cornu
b) fimbria
c) interstitial
d) ampulla
d
What substance does hysterosalpingography utilize for visualization of the uterine cavity and fallopian tubes ?
a) saline
b) radiographic contrast
c) water
d) betadine
a
Which of the following is associated with the whirlpool sign?
a) ovarian torsion
b) hydrosalpinx
c) ovarian hyperstimulation syndrome
d) ovarian carcinoma
a
