OBGYN Flashcards
What are the 3 signs seen on the cervix during pregnancy
? ligament assists w/ holding fallopian tubes and ovaries?
Chadwick: early inc vascularity
Goodell: cervical softening due to edema
Hegar: isthmus/uterus softening
Broad ligament- contains arteries, veins and nerves
What part of the broad ligament are the fallopian tubes in?
What are the 4 parts of the fallopain tubes?
Mesosalpinx
Infundibulum
Ampulla
Isthmus
Interstitial/intramural
What arteries feed blood to the ovaries
Where do these arteries drain to?
Ovarian/Uterine arteries through medulla
L ovary- L renal vein
R ovary- IVC
What are the two parts of the pelvis
What is the term of the head position desired for delivery
True: immobile/constraining
False: above linea terminalis; supports pregnant uterus
Occiput anterior- back of baby head facing mother anterior
What are the 3 baby head presentation positions possible for birth
What are the 3 pelvic landmarks
Vertex- occiput anterior?
Sinciput
Brow
Interspinous diameter
Transverse inlet
Obstetrical conjugate- needs to be 11cm for delivery
What are the two hip categories favorable for vaginal delivery?
What two categories are not favorable?
Gynecoid, Arthropoid
Android, Platypelloid
What mother position may help increase pelvic outlet diameter?
Linea terminalis is AKA and includes ? structures
McRoberts maneuver: hyperflexion of legs in dorsal lithotomy, inc by 1.5-2cm
AKA Innominate line, separates false/true pelvis Pubic crest Pectineal line Arcuate line Sacral ala Sacral promontory
What makes the bony pelvis
What part contains all of the abdominal organs?
Innominate bones
Sacrum
True/lesser pelvis
The false/greater pelvis is bound in what 3 locations
Where are the superficial vascular structures in the abdomen supplied w/ blood from and travel in ? direction
Lumbar vertebrae- post
Iliac fossae- laterally
Abdominal wall- ant
Femoral artery
Diagonal towards umbilicus
What vascular structures provide blood to the muscles and fascia of the anterior abdominal wall
What is the name of the c-section incision and what strucutres may be unintentionally hit?
External iliac vessels
Maylard
Inferior epigastric artery on lateral side of rectus belly
When entering through a Pfannenstiel incision, what is the risk?
Hypothalamus releases ?
Ant Pit releases ? to take affect on ?
Severing Iliohypogastric nerve, loss of sensation over lateral gluteal/hypogastric regions
GnRH
LH/FSH on ovaries
Ovaries release ? two hormones that conduct ? two functions
What is the only female organ not changed during pregnancy?
Estrogen: proliferative; helps endometrium grow
Progresterone: secretory; helps w/ glandular processes
Ovary
What are the 3 sources of gonad tissues
Mesothelium: lines posterior abdominal wall
Mesenchyme: embryonic CT
Primordial germ cell: earliest undiff sex cells
What is the sequence of differentiation of gonad development into ovaries
When does ovary/testis differentiation begin?
Mesothelium Gonad ridge Gonad cord Indifferent gonads Ovary
Begins: 5w of gestation
Committed: 7w of gestation
? ducts develop into testes
? ducts develop into ovaries
Testes only develop from the ducts if ? is avail, otherwise ovaries develop
T: mesonephric/wolffian by 7wks
O: paramesonephric/mullerian by 12wks
TDF
How is the male phenotype made?
What hormone has no role in the gonad differentiation process?
Undifferentiated gonad + Y chromosome= TDF
Testes= MIF, T, DHT:
testes development, testosterone, mullerian inhibiting factor, fusion of labial folds, growth of phallus/prostate
Estrogen
What processes occur prior to gonadal differentiation?
Ovary can be histologically identified by ? wk but isn’t truly developed until ? wk
?wk does the cortical cords break down and into ?
Germ cells migrate to ridges/cords
10 and 12
16wk into premordial follicles
Primordial germ cells contain ? which derive from ? tissue
While still in a fetus, what replication process are the oogoniums doing?
Oogonium
Mesoderm, surface epithelium
Mitosis- diploid 46xx
By 20th wk of development, oogonium are committed and stop/rest at ? step of replication?
8-12wks of gestation, Hcg peaks and stimulates production of ? signaling the start of ?
Prophase I
Testosterone
Anti-mullerian hormone
Gonadal differentiation
What male/female organs are present at 9wks of development
11wks?
12wks?
Penis Clitoris Minora
Majora Scrotum
External urethra
M: Prepuce, scrotal raphe
F: Clitoris, mons, vaginal orifice
Define Didelphys
Define Bicornuate uterus
Define Bicornuate w/ rudimentary horn
Define Septate
Define Unicornuate
Inferior duct fails to fuse, single or double vagina
Duplicated upper uterus body
Slowed growth of one duct, no fusion
Failure of resorption, septum
One duct fails to develop; PT fertile but risk of preterm delivery/loss
Define Ovotesticular DSD
What is an example of this
What can cause this example
Chromatin +
Most 46XX w/ ovotestis
M or F w/ ambiguous genital
46XX:
+ ovary, ambiguous externals
Excess androgens= virilization (fusion, hypertrophy, sinus)
+ Wolf and Muller cells
Causes:
Impair Fetal Steroidgenesis- CAH (no 21 hydroxylase)
Mother took androgens
Luteoma: masculinizing tumor
46XY DSD
D/o of testicular development= dec production of T/MIS, causes low virilization
Chromatin -
Define Androgen Insensitivity Syndrome
Kallmann Syndrome
Genotype: male
Phenotype: female
Female genital Abdominal/inguinal testis
No masculinization, menses
Partial: point mutation on androgen receptor gene
Kallman: Hypo Hypo; anosmia
Dec FSH LH and E
SECONDARY Hypogonadism