Clin Med GUT women's health anatomy and radiology part 2

Question 1

What type of imaging is done for fertility studies?

Answer 1

Hysterosalpingogram- Injection of radiographic dye into the uterine cavity. This is to see if the fallopian tubes are open. The dye should travel to them and be seen in the peritoneal cavity. Open tubes are normal tubes

Question 2

What is a primary VUR?

Answer 2

Primary VUR- immaturity with a short ureteral tunnel through bladder wall or a congenital anomaly with no tunnel at all

Question 3

What is a secondary VUR?

Answer 3

Secondary VUR- caused by Posterior urethral valves or neurogenic dysfunctional bladder

Question 4

If prenatal fetal hydronephosis occurs or patient has documented pyelonephritis what work up should you do?

Answer 4

1. VCUG

2. Radionuclide cystogram

Question 5

At what beta-HCG level should an intrauterine gestational sac be seen with a transvaginal ultrasound?

Answer 5

> 1500 IU/mL def if >2000IU/mL

Question 6

When should embryonic cardiac activity be present on a Transvaginal sonogram?

Answer 6

By 5+ weeks, when the sac is at least 16mm long or embryonic crown rump length is at least 5mm

Question 7

What does hematosalpinx mean?

Answer 7

Blood in the fallopian tubes

Question 8

What is the adnexa?

Answer 8

adnexa are the pelvic structures around the uterus, i.e Ovary, fallopian tubes, pouch of Douglas

Question 9

What are additional criteria to suspect an ectopic pregnancy?

Answer 9

Additional criteria are:–

1. If no intrauterine gestational sac is seen at all
2. If a live, extrauterine embryo is identified
3. There is free fluid in the pelvis or peritoneum–
4. There is an adnexal mass
5. There is a hematosalpinx – blood in Fallopian tube

Question 10

What type of cell in the ovary can develop into any organ?

Answer 10

Plenipotential cells

This can form a dermoid cyst (benign) that can have

Question 11

What does a sister mary joseph sign mean?

Answer 11

Pancreatic cancer

Question 12

True or flase: carcinoma of the ovary is malignant?

Answer 12

True

Question 13

What supports the bladder in women?

Answer 13

Pubocervical fascia

Question 14

A weakness in the pubocervical fascia can allow what to happen?

Answer 14

A cystocele- on exam you can feel a bulge in the anterior vaginal wall accentuated when the patient coughs

Question 15

When the rectal supports structures weaken what can happen?

Answer 15

a Rectocele- when the rectum prolapses

Question 16

What is the Urachus?

Answer 16

A hollow canal connecting the fetal urinary bladder to the umbilical cord

Question 17

When the Urachus obliterates during development what does it become?

Answer 17

Median umbilical ligament or fold

Question 18

the obliteration of the Umbilical Artery that during development is connected to the internal iliac artery forms what?

Answer 18

The MediaL umbilical ligament- Not to be confused with the median*

Question 19

True or false: Newborn infants can have urine come out of their umbilicus if the lumen remains open?

Answer 19

True

A Urachal cyst can also form

Question 20

What are the pelvic floor muscles?

Answer 20

1. Coccygeus
2. iliococcygeus
3. Pubococcygeus
4. Puborectalis

Question 21

Supporting structures of the Uterus are?

Answer 21

1. Pelvic diaphragm (pelvic floor)
2. Urogenital diaphragm/perineal membrane
3. Perineal body

Question 22

Which ligaments are not considered true supporting ligaments?

Answer 22

1. Broad ligament
2. Round ligament
3. suspensory ligament of the ovary
4. Peritoneal folds associated with the uterus

Question 23

What are the major supporting ligaments of the uterus?

Answer 23

1. Cardinal (transverse cervical/ Mackenrodt)
2. Uterosacral ligaments
3. Anterior pubocervical ligament

Question 24

Match the following:

1. Fibromuscular fascia from either side of cervix to the pelvic walls
2. From posterior cervix to the sacrum- comprised of the recto-uterine folds-comprised of fibrous tissue and muscular fibers attached to front of scarum
3. From uterus to the pubic symphysis

A. Uterosacral ligaments
B. Anterior Pubocervical ligament
C. Cardinal ligament

Answer 24

1 with C

2 with A

3 with B

Question 25

What are all the names for the pouch of douglas?

Answer 25

1. Rectouterine

2. Rectovaginal

Question 26

Describe the location of the pouch of douglas?

Answer 26

Deep pouch that is posterior to the uterus and anterior to the rectum

Question 27

What are the supporting structures of the ovary?

Answer 27

1. Mesovarium
2. Suspensory ligament of ovary
3. Ligament of ovary

Question 28

Match the following

A. Mesovarium
B. Suspensory ligament of ovary
C. Ligament of ovary

1. A fold of peritoneum from superiolateral pelvic wall and contains arteries, veins, lymphatics
2. A fold of peritoneum off the broad ligament
3. Continuous with Round ligament of uterus. Attached to lower pole of ovary to uterus

Answer 28

A with 2

B with 1

C with 3

Question 29

There are basically three levels of pelvic support structures. What is in level 1?

Answer 29

Level 1 has the cardinal, uterosacral, and anterior pubocervical ligaments

Question 30

There are basically three levels of pelvic support structures. What is in level 2?

Answer 30

Level 2 has: Levator ani and Arcus tendinous fasciae pelvis

Question 31

There are basically three levels of pelvic support structures. What is in level 3?

Answer 31

Level 3 has: Urogenital diaphragm

Question 32

What lies laterally to the obturator internus muscle and medially to the peritoneum?

Answer 32

Arcus tendineus fascia