Female repro anatomy + pelvic mass

Question 1

Suspensory ligament of ovary

Answer 1

peritoneal fold
attaches to lateral wall of pelvis
contains ovarian vessels

Question 2

Ligament of the ovary

Answer 2

band of CT and SM extending from ovary to lateral margin fo uterus, below uterotubal jxn
remnant of gubernaculum

Question 3

Infundibulum of Fallopian tube

Answer 3

each uterine tube has an expanded trumpet-shaped end
curves around superolateral pole of related ovary
lumen opens into peritoneal cavity at narrowed end of infundibulum

Question 4

Fimbriae

Answer 4

Fingerlike projections rimming margins of infundibulum

Question 5

Ampulla of oviduct

Answer 5

expansion medial to infundibulum

usually the site of fertilization

Question 6

Isthmus of oviduct

Answer 6

narrow part btw ampulla and intramural part

Question 7

Intramural part of oviduct

Answer 7

passes through wall of uterus and opens into uterine cavity

Question 8

Fundus of uterus

Answer 8

upper rounded part above entrance of uterine tubes

Question 9

Body of uterus

Answer 9

tapering intermediate part

normally the site of implantation of blastocyst

Question 10

Uterus-cervix angle

Answer 10

Flexion

Question 11

Uterus-vagina angle

Answer 11

Version

Question 12

Normal positions of uterus

Answer 12

Anteflexed

Anteverted

Question 13

Other positions of uterus

Answer 13

Retroflexed
Retroverted
Prolapsed

Question 14

Douglas pouch

Answer 14

aka recto-uterine pouch

Question 15

Pelvic mass DDx

Answer 15

ovarian
Fallopian tube
GI
Paratubal - embryologic remnants
Uterine
Urologic

Question 16

Pelvic mass in reproductive age group

Answer 16

Physiologic cysts: up to 8 cm, cycle-dependent
Repeat exam in follicular phase
Should not develop on OCP or during pregnancy
>90% in this age group benign
>90% in pregnancy benign

Question 17

Adnexal mass potential for malignancy

Answer 17

age most important factor
Pre-menarchal/postmenopausal masses are abnormal, investigate in a timely fashion
Postmenopausal ovaries should not be palpable

Question 18

Symptomatic pelvic mass SSx

Answer 18

Torsion
bleeding
enlargement
compression of acjacent structures - bowel, bladder, ureter

Question 19

Post menopausal pelvic mass investigations

Answer 19

US pelvis
Tumour markers: any suspicion
CT scan: suspicious of advanced stage
Chest X-ray: preop ? effusion
Colonoscopy/gastroscopy if GI suspicions

Question 20

alpha FP

Answer 20

tumour marker for germ cell, liver

Question 21

LDH

Answer 21

marker of hemolysis and tissue breakdown, lymphoma

Question 22

betaHCG marker

Answer 22

seminoma
choriocarcinoma
germ cell
hydratidiform mole

Question 23

Ca-125

Answer 23

ovarian ca marker

Question 24

CEA

Answer 24

colorectal cancer marker

Question 25

Ca-19.9

Answer 25

pancreatic ca marker

Question 26

Ca-15.3

Answer 26

breast ca marker