Female Genital Tract Flashcards
1
Q
Used to stage and follow up pelvic malignancies to supplement US by providing additional characterization of lesion
A
MR and CT
2
Q
Has the potential to aid in the discrimination between benign peritoneal metastases and tumor recurrence
A
Diffusion weigted MR
3
Q
In sonohysterography, what is used as a contrast agent
A
Isotonic saline
4
Q
Emerging MDCT technique that offers the potential of high-resolution images depicting both the internal and external surfaces of the uterus and fallopian tubes
A
Virtual HSG
5
Q
Pear-shaped organ located between the bladder and rectum
A
Uterus
6
Q
Anterior and posterior surfaces of the uterus are covered by peritoneum, the folds of which extend laterally to the pelvic sidewalls forming the
A
Broad ligament
7
Q
A “bare area” of extraperitoneal space is present between the ______ which is an important area for the direct spread of tumor from one organ to the other
A
Lower uterus and bladder
8
Q
Uterus, cervix and upper one-third of vagina are derived from
A
Mullerian ducts
9
Q
Lower two-thirds of vagina arise from the
A
Urogenital sinus
10
Q
Refers to connective tissue adjacent to the vagina
A
Parametrium
11
Q
Parametrium allows passage of
A
Uterine vessels and lymphatics
12
Q
Well outlined when fluid is present in the pelvic peritoneal cavity
A
Broad ligament
13
Q
Part of uterus that extends cephalad from the origin of the fallopian tubes
A
Fundus
14
Q
A slight constriction that marks the location of the internal cervical Os
A
Isthmus
15
Q
Length of cervix
A
3-4 cm
16
Q
Ureters pass __ cm lateral to the supravaginal portion of cervix
A
2 cm
17
Q
Ovarian size varies on
A
Woman’s age, hormonal status and stage of menstrual cycle
18
Q
Adult ovary is oval with a maximal dimension of
A
5 x 3 x 2 cm
19
Q
Abnormalities of ovarian size are best determined by calculating
A
Ovarian volume
20
Q
Maximum ovarian volume is ____ cc before menarch, ____ cc mentruating women, ____ cc in postmenopausal women
A
9cc
22cc
6 cc
21
Q
Typical location of ovaries
A
Lateral, superior or posterior to the uterine fundus or in cul-de-sac
22
Q
Landmark for pelvic masses
A
Pelvic ureters
23
Q
Ovaries are located ______ to the ureters, so an ovarian mass will displace the ureter posteriorly or posterolaterally
A
Anteriorly
24
Q
Adenopathy will displace the ureters
A
Medially or anteromedially
25
Appearance of endometrium in T2WI
High signal intensity
26
The junctional zone of myometrium appears what on T2
Low signal intensity
27
Normal thickness of endometrium in women of menstrual age
14mm
28
Bulk of myometrium appears what in T2
Intermediate signal intensity
29
On T1, uterus is
Low in signal
30
Cervix is largely composed of collagenous tissues, which appears ____ in signal in both T1 and T2
Low in signal
31
Cervical carcinomas appearance on T1 and T2
Homogeneous high signal
32
In high resolution MR using surface or intravaginal coils shows two zones in the cervical fibromuscular stroma, a darker ______ zone contiguous with the uterine junctional zone and intermediate signal ______ zone
Inner
| Outer
33
May be inserted for MR scanning to distend the vagina and optimize evaluation of vagina and cervix
Aqueous vaginal gel
34
Ovarian follicles of fertile woman appear _____ on T2
Bright
35
Follicles are _____ in signal on T1
Low or intermediate
36
Cortex of ovary in premenopausal women is ____ in signal than the medulla in T2
Darker
37
Imaging that is sensitive to physiological changes that affect the uterus and ovary during menstrual cycle
MR
38
Signal intensity of myometrium is highest during what menstrual stage
Late proliferative and early secretary phases
39
MR Signal intensity is lowest in what menstrual stage
Menstruation and early proliferative phase
40
Low intensity myometrial lesions such as leiomyomas and adenomyas are best demonstrated when the myometrium has the highest signal intensity in what phase
Mid-menstrual cycle
41
Ovaries are largest with a dominant follicle at what phase of menstrual cycle
Just prior to ovulation
42
Outline of uterus often appears _____ because of position
Lobulated or bulbous
43
Endocervical canal width
1 to 3 cm
44
Normal fallopian tubes are ____ cm in length, extending from cornua or uterus
10 to 12 cm
45
Lumen of fallopian tube is
Thread like (1-2 mm)
46
The ampulla of fallopian tube has width of
5-10 mm
47
most congenital anomalies of the female genital tract result from
arrested mullerian duct development
48
this finding is found in 5-10% of patients with female genital tract anomalies
ipsilateral renal agenesis
49
two uteri, two cervices and two vaginas
uterus didelphys
50
two uterine horns, one or two cervices and one vagina
bicornuate uterus
51
midline septum dividing uterus into two cavities
arcuate (septate) uterus
52
most common uterine tumor affecting 50% of women of reproductive age
leiomyomas
53
myomas that has scant fibrous tissue enhance
brightly
54
myomas that has abundant fibrous tissue enhance
poorly
55
most myomas are intramural? subserosal or submucosal?
intramural
56
type of myoma that is prone to ulcerate resulting in severe menorrhagia
submucosal
57
type of myoma that may be pedunculated and on long stalks
subserosal or submucosal
58
imaging that provides best characterization of size, number and location of myomas
MRI
59
appearance of myomas in MRI
low signal compared to myometrium on both T1 and T2, visualization is best on T2
60
benign disease of the uterus characterized by the presence of ectopic endometrial glands and stroma within the myometrium eliciting surrounding myometrial hypertrophy
adenomyosis
61
diffuse adenomyosis is characterized by regular or irregular thickening of the myometrium of ___mm
>12 mm
62
Difference in the borders of leiomyoma versus adenomyosis
Leiomyomas are well circumscribe, whereas adenomyosis are poorly defined with vague margination
63
Retention cysts of the mucous-secreting glands of the cervical epithelium
Nabothian cysts
64
Multicystic form of cervical adenocarcinoma
Adenoma malignum
65
Differentiates adenoma malignum with nabothian cysts
Nabothian cysts has small size and sharp margins
66
Size of physiologic ovarian follicle
<3cm
67
Normal physiologic ovarian structure that develops at the site of dominant follicle following ovulation
Corpus luteum
68
Size of normal corpus luteum
Smaller than 3 cm
69
Ovarian follicle that has diffusely thick wall and prominent peripheral blood flow
Corpus luteum
70
presence of endometrial tissue in locations outside of the uterus
endometriosis
71
hallmarks of this disease include numerous tiny implantations of endometrial tissue on peritoneal surfaces, development of endometriomas (endometrial cysts filled with hemorrhage and formation of adhesions between surrounding tissues
endometriosis
72
most common sites of endometriosis
ovaries, cul-de-sac and peritoneal refelctions over the uterus, fallopian tubes, bladder and rectosigmoid colon
73
cause of severe pelvic pain with tiny deposits of endometrium on peritoneal surfaces in recesses, pelvic organs and other extraperitoneal sites
deep pelvic endometriosis
74
contain blood products of various ages reflecting recurrent episodes of bleeding corresponding to the menstrual cycle. they are characteristically multiple, bilateral and located in the cul-de-sac
endometriomas
75
common associated finding in endometriomas
hydrosalpinx
76
endometriosis may involve what areas
bowel, urinary tract or occur outside the pelvis and in surgical scars
77
common adnexal mass that may occur as an isolated lesion or as a component of a complex adnexal mass
hydrosalpinx
78
most common cause of hydrosalpinx
pelvic infection
79
increasingly common and difficult to treat cause of chronic pelvic pain. adhesions from previous surgery or inflammatory process entrap the ovary within a fluid collection that extends into peritoneal recesses
peritoneal inclusion cyst
80
most common germ cell neoplasm of the ovary. lesions contain ectoderm, mesoderm or endoderm resulting in a broad range of appearance
benign cystic teratoma
81
mean patient at discovery of benign cystic teratoma is
30 years
82
solid ovarian masses that are commonly associated with ascites which mimic ovarian cancers
fibrotic ovarian tumors
83
fibrotic ovarian tumor tissue types
fibromas, thecomas, and fibrothecomas
84
defined as association of ascites and pleural effusion with an ovarian fibroma
Meigs syndrome
85
a gynecologic emergency resulting from twisting of the ovary, fallopian tube or most commonly both structures restricting blood supply
adnexal torsion
86
key findings in adnexal torsion include
smooth-walled adnexal mass, which serves as a nidus for twisting. the torsed mass demonstrates concentric wall thickening. involved fallopian tube appears as an amorphous mass or as a tube with thickened walls. uterus is deviated toward the torsed adnexa
87
most common histologic type of ovarian cancer
epithelial
88
peak age of ovarian cancer
55 to 59 y.o
89
serologic marker for ovarian cancer
CA 125
90
evidence of ovarial malignancy
wall thickness greater than 3 mm, nodularity, vegetations, solid components, evidence of invasion of adjacent structures, ascites, contrast enhancement of peritoneym and adenopathy
91
ovarian carcinoma spreads primarily by
peritoneal seeding wiuth small tumor nodules implanting on the peritoneum, mesentery, omentum and malignant ascites
92
properly applied only to mucinous tumors metasttic to the ovary from a mucinous gastric carcinoma
Krukenberg tumor
93
produces large bilateral solid ovarian masses that show minimal enhancement
ovarian lymphoma
94
most common gynecologic malignancy
cervical cancer
95
95% of cervical cancer are what histologic type
adenocarcinoma
96
peak age of cervical cancer
45- 55 y.o
97
second most common gynecologic malignancy in women aged 15 to 34 y.o
cervical cancer
98
moder of cervical cancer spread
predominantly direct extension to involve the vagina, paracervical and parametrial tissues, bladder and rectum
99
sign of pelvic side wall invasion from cervical ca include
tumor abutting or extending to within 3 mm of pelvic musculature
100
most common invasive gynecologic malignancy
endometrial carcinoma
101
peak age of endometrial cancer
55 to 62 years old
102
key symptom of endometrial cancer
postmenopausal bleeding
103
true or false: lymph node metastasis are unlikely in endometrial cancer if myometrial invasion is less than 50%
true
104
most aggressive of uterine tumors
uterine sarcomas
105
fallopian tube carcinoma histologic types
adenocarcinoma, endometroid carcinoma and transitional cell carcinoma
106
most fallopian tube carcinoma arise in what part of the fallopian tube
ampulla
107
most of the vaginal malignancies are of what histologic type
squamous cell carcinoma
