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OBGYN > GYN registry review > Flashcards

GYN registry review Flashcards

1
Q

Boney boundaries of female pelvis

A

Sacrum, Coccyx, Ilium, Ischium, Pubic Symphysis

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2
Q

TRUE pelvis

A

Deep and below linea terminalis, structures only seen in transvaginal imaging

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3
Q

Organs of the TRUE pelvis

A

Bladder
Small bowel
Ascending/Descending colon
Rectum
Uterus
Ovaries
Fallopian Tubes
Internal Iliac
4 muscles

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4
Q

4 muscles of the TRUE pelvis

A

Levator ani
Coccygeus
Obturator internus
Piriformis

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5
Q

Hammock shaped muscles that support pelvic organs

A

Levator ani and coccygeus

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6
Q

Result of weakened levator ani and coccygeous muscles

A

Uterine prolapse

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7
Q

Muscles found in the adnexas

A

Obturator internus (lateral to bladder)
Piriformis (posterolateral)
Iliopsoas (anterolateral)

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8
Q

Broad ligaments

A

A double fold of the peritoneum, laterally attached to the walls of the pelvis, supports pelvic organs

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9
Q

Round ligaments

A

Found BETWEEN the folds of the broad ligament, superiorly supports the fundus of the uterus

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10
Q

Cardinal ligaments

A

Contains vasculature of uterus

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11
Q

Space of Retzius (retropubic space)

A

Space anterior to the bladder

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12
Q

Adnexa

A

Lower quadrants of abdomen, lateral spaces of uterus. Contains ovaries (illiacs are landmarks)

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13
Q

Anterior Cul De Sac (vesicouterine pouch)

A

Space between anterior uterus and bladder

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14
Q

Pouch of Douglas (rectouterine pouch/posterior cul de sac)

A

Space between posterior uterus and rectum

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15
Q

Uterine arteries

A

branches of internal iliac arteries

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16
Q

Arcuate arteries

A

Periphery of myometrium

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17
Q

Radial arteries

A

Deeper into myometrium

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18
Q

Straight arteries

A

Feeds basal layer of endometrium

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19
Q

Spiral arteries

A

Feeds functional layer of endometrium

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20
Q

Ovarian (gonadal) arteries

A

Originate at aorta

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21
Q

Ovarian blood supply

A

Receive blood from ovarian artery and uterine artery

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22
Q

Uterine vein

A

Drains into internal iliac veins

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23
Q

Right ovarian vein

A

Drains into IVC

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24
Q

Left ovarian vein

A

Drains into left renal vein
*longest pelvic vessel

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25
Q

Uterus

A

A retroperitoneal organ, developed from fusion of paired Mullerian ducts. Sits between rectum and bladder with broad ligaments bound bilaterally

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26
Q

Uterine fundus

A

Most superior and widest part of uterus, fallopian tubes attach at uterine cornu

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27
Q

Uterine corpus

A

Body of uterus, largest area

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28
Q

Uterine Isthmus

A

Lower uterine segment during pregnancy

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29
Q

Cervix

A

Internal and external os

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30
Q

External os

A

Opens into most inferior part of vaginal canal, surrounded by vaginal fornix

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31
Q

Perimetrium (serosa layer)

A

Outermost layer of uterus (organ fascia)

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32
Q

Myometrium

A

Muscular layer of uterus

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33
Q

Endometrium

A

Mucosal layer of uterus– consists of basal layer and functional layer

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34
Q

Basal layer

A

Deep endometrial layer

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35
Q

Functional layer

A

Superficial endometrial layer that SHEDS during menses

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36
Q

Neonatal uterus size and shape

A

Prominent uterus due to maternal hormone stimulation.
Enlarged cervix (double size of body)

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37
Q

Prepubertal uterus size and shape

A

Tubular shape.
Body size=cervix size

38
Q

Puberty uterus size and shape

A

Increased fundal diameter (pear shape)
6-8cm during reproductive years

39
Q

Menopausal uterus size and shape

A

Decreased size, 4-6cm

40
Q

Anteverted

A

Body of uterus TILTS forward at 90 degree angle with cervix

41
Q

Anteflexed

A

Body of uterus FOLDS forward coming in contact with the cervix

42
Q

Retroflexed

A

Body of uterus FOLDS back coming in contact with the cervix

43
Q

Retroverted

A

Body of uterus TILTS back without a bend, no contact with uterus

44
Q

Detroflexed

A

Flexed to the right

45
Q

Levoflexed

A

Flexed to the left

46
Q

Fallopian tubes (salpinges)

A

7-12cm tubes extending from cornu of uterus within the broad ligaments to the adnexa.
Means for fertilization and transportation to uterus

47
Q
A
48
Q

Fallopian tube cilia

A

Tiny, hair like structures inside tubes that move back and forth to aid the movement of the fertilized ovum

49
Q

Interstitial segment

A

Most proximal segment of fallopian tube, where tube attaches to uterus cornu

50
Q

Isthmus segment

A

“Bridge” that connects the interstitial segment to the ampulla segment of the fallopian tube

51
Q

Ampulla segment

A

Longest and most tortuous segment of the fallopian tube
most common location of fertilization and ectopics

52
Q

Infundibulum segment

A

Distal and widest portion of fallopian tube with fimbria at the end

53
Q

Fimbria

A

Fingerlike extensions of infundibulum that draw unfertilized egg into tube

54
Q

Ovaries

A

Paired, intraperitoneal ENDOcrine organs
Supported laterally of uterus by ovarian ligaments and laterally of pelvic walls by suspensory ligaments

55
Q

Hormones produced by ovaries

A

Estrogen and Progesterone as response to FSH (follicle stimulating hormone) and LH (luteinizing hormone)

56
Q

Outer cortex of ovaries

A

Site of oogenesis/follicles

57
Q

Medulla of ovaries

A

Site of vasculature and lymphatics

58
Q

Ovarian response to FSH

A

Follicles develop–> Graafian follicle matures–> thecal cells of follicle produce estrogen–> ovum found inside cumulus oophorus of dominant follicle–> ovulation in 36 hours

59
Q

Ovarian response to LH

A

Graafian ruptured and replaced by corpus luteum–> corpus luteum releases progesterone–> corpus luteum regresses and replaced with corpus albicans

60
Q

Hormone release order during menstrual cycle

A

Gonadotropin releasing hormone (via hypothalamus) stimulates anterior pituitary gland –> anterior pituitary gland releases FSH –> FSH (via pituitary) stimulates ovaries to develop and mature dominant follicle –> follicles produce estrogen –> dominant follicles mature leading to peak in estrogen –> LH surge released (via pituitary) –> stimulates rupture of dominant follicle (AKA ovulation) –> ruptured follicle = corpus luteum and releases PROGESTERONE and some estrogen

61
Q

Estrogen affect on endometrium

A

Thickens endometrium

62
Q

Progesterone affect on endometrium

A

Maintains and prepares endometrium for implantation

63
Q

NO pregnancy affects on endometrium

A

Endometrium slough off and menses begin due to drop in progesterone levels

64
Q

Follicular phase days 1-14

A

-FSH stimulates follicle development
-Dominant follicle matures to ~2.5-2.7cm until ovulation
-Follicles release estrogen

65
Q

Menstrual phase days 1-5

A

Menses and shredding of endometrium

66
Q

Early proliferative phase days ~6-10

A

-Immediately following menses
-Thin, echogenic endometrium
-Endo no more than 4mm

67
Q

Late proliferative phase days
~10-14

A

-Endo will reach 6-10mm
-“Three line sign” (echogenic basal layer surrounding hypoechoic functional layer)

68
Q

Ovulation day 14

A

-LH surge ruptures dominant follicle releasing ovum
-FF possibly seen in post CDS
occurs 14 days prior to start of next menstrual cycle

69
Q

Luteal phase days 15-28

A

-Graafian follicle becomes corpus luteum producing progesterone to maintain endo thickness
NO fertilization by day 28 = regression of CL cyst

70
Q

Secretory phase

A

-Progesterone maintains thickness for implantation
-Endo thick and echogenic 7-16mm
-Progesterone drop = begin menses

71
Q

Gravida

A

Total number of pregnancies

72
Q

Para

A

Total number of pregnancies carried to term

73
Q

Mittelschmertz

A

Middle pain, pain in the middle of cycle near ovulation

74
Q

Primary amenorrhea

A

Failure to have menses by age 16; never reached menarche

75
Q

Secondary amenorrhea

A

Menses stopped

76
Q

C-section scar/defect

A

Fluid or separation of c-section scar

77
Q

C-section dehiscence

A

Myometrial walls are separating

78
Q

Dehiscence

A

A partial or total separation of previously approximated wound edges, due to a failure of proper wound healing

79
Q

Intrauterine device (IUD)

A

-Device that prevents implantation of fertilized ovum
-Echogenic linear echo with posterior shadowing or reverberation within endometrial cavity

80
Q

Postmenopausal asymptomatic endometrium measures

A

NO bleeding
< or equal to 8mm

81
Q

Postmenopausal symptomatic endometrium measures

A

YES bleeding
< equal to 5mm

82
Q

Postmenopausal HRT endometrium measures

A

Variable/premenopausal appearance

83
Q

Early proliferative endometrium measures

A

4-6mm

84
Q

Late proliferative endometrium measures

A

6-10mm

85
Q

Secretory endometrium measures

A

< equal to 16mm

86
Q

Amenorrhea

A

Without menses

87
Q

Hypomenorrhea

A

Decreased menses

88
Q

High resistance doppler

A

Less diastole, less volume flow

89
Q

Lower resistance doppler

A

More diastole, more volume flow

90
Q

Ovarian doppler during menstrual and early proliferative phase

A

High resistive, demands for blood are low
*most accurate time especially in presence of mass

91
Q

Ovarian doppler during mid cycle and luteal

A

Lower resistance

92
Q

Non-gravida uterus doppler

A

Normally high resistance
*decreased resistance can be found in cancer and traumatic AVM

OBGYN (17 decks)

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