OBGYN test Flashcards
true pelvis
lower portion
false pelvis
upper portion- part that lies above the pelvic inlet
*ilium/iliac crest
the pelvic floor
give support to the pelvic organs, maintenance of normal strength of the pelvic floor
levator ani muscles
control of the bladder, rectum and vaginal childbirth
shape of uterus
upside down pear
function of uterus
carries fetus and contracts to expel fetus
parts of the uterus
fundus
body
cervix
fundus
top, rounded portion
body
middle
cervix
bottom, has external and internal openings called the os
outer layer of the uterus
peritoneal layer
overlies the pelvic surface
myometrium
middle
muscle, vascular (placenta attaches here)
endometrium
inner basilar (doesn't slough) and functional (sloughs)
broad ligament
contains fallopian tube, ovarian ligament, round ligament, blood vessels and nerves
round ligament
passes through the inguinal ring forward and laterally through the broad ligaments
cardinal ligament
strong connective tissue
uterosacral ligament
continuation of the peritoneal tissue
fallopian tubes location
bilateral
upper margin of the broad ligament
fallopian tubes function
accept and hold the egg for fertilization, periostalsis propels the egg to the uterus
fimbriae/infundibulum
finger like projections, catch the egg and guide it into the tube
ampulla
main body of the tube
isthmus
muscle, acts as a sphinctor, opens into the uterus, helps to prevent endometeriosis
intramural
within the wall of the uterus
cornu
the opening of the tube into the uterus
ovary functions
endocrine-produce estrogen and prog.
exocrine-produce eggs and expulsion of them to fallopian tubes
cortex ovary
outer, contaisn the ovarian follicles
medulla ovary
vascular structures, nerves, lymphatic system
suspensory ligaments
fold of peritoneum from overlying fimbra
ovarain ligament
lies in the broad ligament, main support for the ovaries
vagina
collapsed tube
birth canal, products of menstruation, copulation, lined with mucosal tissue
rugae
folds of tissue that run the length of the vagina
vaginal fluid
acidic, kills most sperm
bartholin glands
at lower end of bagin, produce fluid for lubrication
mons pubis
fatty tissue over the anterior symphysis pubis
labia majora
prominent folds of skin extending from the mons pubis to the perineum
labia minor
flat delicate folds lying within the labia
vestibule
contains the urethral and vaginal openings
skene glands
secrete alkaline fluid to increase the life of spem
clitoris
erectile tissue, lies directly above the urethral orifice and below the mons pubis
hymen
vascular fold of thin tissue, broekn with intercourse
dysmenorrhea
painful menstruation
metorrhagia
uterine bleeding other than that caused by menstruation
menorrhagia
excessively heavy menstruation
fibroids/leiomyoma
benign tumor of the uterus, made up of fibrous tissue, symp: abornal bleeding
diag: bimanual exam, US, lap
endometriosis
ectopic endometrial cells found on the outside of the uterus
symp: dysmenorrhea
diag: lap
dysplasia
abornal tissue of the uterus
symp: menorrhagia
diag: D&C
puncture or rupture
P: during surgical procedure
R: during preg. and require emergent C section
ante/retroverted
entire uterus tipped forward or backward
ante/retroflexed
uterus bent forward or backward at the junction of the cervix and the body
malpositioned uterus
symp: infertility
diag: manual exam
incompetent cervis
dilation of the cervix before term without labor or contractions
symp: premarture birth
diag: history of premature births
bifurcation
separation of the uterus into two segments by a septum
symp: contractions
diag: hysteroscopy
PID
inflamm. condition of the female pelvic organs caused by bacterial infection
symp: fever, vag. discharge
diag: history and symptom
tx: antibiotics
chlamydia
most common STD and cause of infertility
cysts
fluid filled sac on the ovary
symp: abd pain
diag: manual exam
follicular cysts
normal, the fluid carries the egg to the fimbria
chocolate cyst
ovarian endometrial cysts containing menstrum
dermoid cyst
derived from embroyonal tissue, contain hair, teeth, bone, fatty tissue, cartilage
cancer
malignant neoplastic disease of the ovary
symp: abd sweeling
diag: US and CT
cystocele
protrusion of the bladder through the wall of the vagina
symp: stress incontinence
diag: complaint
rectocele
protrusion of rectal wall into the vagina
symp: difficulty pooping
diag: complaint
enterocele
herniation of a loop of intestine into the cul de sac of the douglas
symp: pressure and cramping
diag: complaint
vesicovaginal fistula
open tract between the bladder and the vagina
urethrovaginal fistula
open tract between the urethra and the vagina
vag. fistulas
allow urine to flow out of the vagina
diag: complaint
rectovaginal fistula
open tract between the rectum and the vagina, stool enters the vagina
diag: complaint
bartholins cyst
inflamm. of the bartholins gland which has become fluid filled
symp: pain with movement
diag: complaint
ectopic preg.
abnormal preg. in which the conceptus implants outside the uterine cavity
symp: abd pain
diag: serum preg. test
infertility due to occlusion
lumen of the fallopian tube is blocked due to adhesions, inflamm,
symp: infertility
diag: hystersalpingogram
infertility due to sperm factos
lack of sufficient number of sperm or lack of motility
diag: sperm counts
tx: in vitro fertilization
undesired fertility
individual no longer wishes to have the ability to conceive child
uterine prolapse
weakening or stretching of the uterine ligaments
symp: uterine prolapses
diag: complaint
vulvar cancer
malginant cells which occur on the vulva
symp: itching
diag: application of toluidine blue
lugols solution
stain the cervix for detection of cancer cells, apply with stick sponge
lugols cells
healthy turn brown
cancer white
methylene blue
used in chromotubation of the fallopain tubes during lap
toluidine blue
stain cancer cells of vulvar tissue
indigo carmine
IV, check patency of the ureters
salpix and sinografin
fluro, check patency of the fallopian tubes
pitocin
stimulates the uterus to tighten, induce labor
ergotrate
given after delivery if the uterus is really boggy or soft and bleeding is significant
methergine
for boggy or soft uterus and when bleeding is significant
estrogen
produced by the ovaries, stops with menopause
prostaglandin gel
applied to cervix to ripen it, or encourage to dilate in prep for birth
rhogam
given to rh neg. women who has rh positive babies, protective measure so mom doesn’t develop antibodies
legs during gyn surgery
legs need to go up and down together to avoid back strain, lower slowly at the end of case to avoid HTN
D&C
dilation of the cervix and curettage of the uterus
suction curettage
vacuum aspiration of the uterus, incomplete spontaneous abortion or term of early pregnancy
cervical bx
diagnostic tool, done for ppl with sign. findings on pap smear confirm malignancy
cervical polyp removal
stop the bleeding they cause and reduce tissue irritation
cervial conization
when dysplasia is more progressed, removal of a piece of the cervix
LEEP
stain cervix, check for margins, tag it
uterine radiation seeding
treat cervial and endometrial malignancy, seeds placed in pateitns room not in OR, more controlled
colposcope
evaluate the cervix on women with suspected abnormal changed detected by pap smear
condylomata
wart like lesions caused by HPV, sexually transmitted, ablated
shirodkar procedure, cervical cerclage
treat incompetent cervix, prevent dilation in women who have repeated 2nd timester abortions
what is done in shirodkar procedure?
ligature of heavy suture is placed around the internal os to keep it closed
what wouldn’t be used on shirodkar procedure?
sounds, dilators, curettes!! you don’t want to open it up!
marsupialization of bartholins cyst
removal or incision of cyst and drainage of surround area
when is marsupialization of bartholins cyst done?
cyst is resting
how does the bartholins cyst heal after marsupialization?
granulation
vulvectomy
excision of a portion of the vulva
when is a vulvectomy done?
when cancerous lesions that cant be successfully removed by laser ablation
labioplasty
repair trauma, remove growths or cosmetic, easy to access since on outside
perineal laceration
repair of traumatic laceration called episiotomy
hysteroscopy
visculation of the uterine cavity and tubal orifices, diag and tx of pathologies
endometrial ablation
treat abnormal bleeding
endometrial thermal balloon ablation
balloon inserted into the uterus and the endometrium is ablated
vag hyst count
periotenum between the vagina and rectum is closed with continuous stitch and first count is done
LAVH
easier removal, has 2 different set ups
anterior/posterior repairs
specimen is cystocele/rectocele or vaginal tissue
enterocele repair
tissue distal to the purse string is excised and transverse suture closure is used to give support to the tissue and prevent recurrence
fistula reapirs
abnormal opeings between 2 structures
bladder suspensions
done to treat stress incontinence
what is used during bladder suspensions?
anchoring devices, tapes, sutures
goal of bladder suspensions
restore fascial support and assist the weakened pubococcygeal muscle
what is done at the end of the bladder suspension surgery>
surgeon will check repair at end with cystoscope and may palce a suprapubic catheter
name of the 4 uterine ligaments
broad, round, cardinal, uterosacral
which layer of the uterus would the palcenta attach to in pregnancy?
endometrium
portions of the fallpian tubes
fimbriae, ampulla, isthmus, intramural, cornu
what muscles give support to the pelvic floor?
coccylgeal
where are the bartholin glands located?
lower end of vagina
another name for the external genitalia
vulva
where is chromotubation performed?
OR
where is hystersalpingogram performed?
xray
what type of dy is used for chromotubation?
meth. blue
what type of dye is used for hystersalpingogram?
salpix
how is chromotubation viewed?
video camera
how is hystersalpingogram viewed?
fluoro
why is chromotubation/hystersalpingogram?
tubal patency
when would a surgeon choose to do a chromotubation instead of a hystersalpingogram?
infertility
why is ectopic pregnancy possible?
fimbriae is floating, not attached to egg
lack of connection between between tube and ovary
what two structures are involved in cystocele and rectoccele?
c-bladder
r-rectum
how is indigo carmine administered, and why would it be given?
IV
assess ureters for damage
fistula between the bladder and vagina
vesicovagina
fistula between the rectum and vagina
rectovagina
between the urethra and vagina
uretrovagina
for hysteroscopy, the scope is inserted into the _____. prior to insertion of the scope, you would hand ___, ____, and _____.
cervix, tenaculum, dilators, speculum
PID is possible in females, but not in males because
goes into abd.
what is needed for final diagnosis of ovarian cancer?
laparotomy
gold standard suture
0 or 2-0 vicryl on CT-1
used on uterine ligaments, fascia, peritoneum, uterus
TAH
total abd hysterectomy
TAH/BSO
total abd hysterectomy, bilateral salpingo-oophorectomy
abd hysterectomy incision
lower midline or pfannenstiel
lap hysterectomy
need uterine manipulator with balloon to maintain pneurmoperitoneum
morcellator in lap hyster
remove uterine tissue when the uterus is large
robotic assisted hyster
uterine manipulator with vag balloon occulder into the vagina to maintain pneumo.
robotic assisted hyster specimen
uterus and cervix dilivered vaginally
uterine myomectomy
excsion of one or more fibroids from the uterus
why is a uterine myomectomy done?
preserve the uterus in women who still desire fertility, or when the fibroid is affecting fertility
radical hysterectomy
cervical or endometrial cancer
peritoneal washings
check for free floating cancer cells
pelvic exenteration
en bloc removal of rectum, distal sigmoid colon, bladder, distal ureters, internal iliac vessels and branches, reproductive organs and lymph nodes and entire pelvic floor
why is pelvic exenteration done?
tx for recurrent or persistent cancers of the uterus, cervix or vagina
oophorectomy
excision of ovary
salpingo-oophorectomy
removal of tube and all or part of the corresponding ovary
why is salpingo-oophorectomy done?
chronic inflammation in pateints with repeated tubal pregnancies
salpingo-oophorectomy instruments
allis, babcock to grasp tube, infundibulopelvic ligament is clamped with hemostats
salpingectomy/ excsion of ectopic pregnancy
excsion of all or part of the fallopian tube, rupture can be life threatening due to hemorrhage
lap/pelviscopy
look into the abdominal cavity
KTP/YAG
flexible fiber made of single strand of fiberglass used to deliver the beam to the tissue
tubal ligation
interruption of the continuity of the fallopian tube for sterilization
tuboplasty microtubal reanastomosis
reconstruction of fallopian tubes after tubal ligation or pathology that is affecting the aptency of the tube
goal of tuboplasty microtubal reanastomosis
restore fertility
tuboplasty microtubal reanastomosis liquids
lactated ringers or hep lactated ringers to keep delicate tissue from drying out
in vitro fertilization
done to treat infertility, eggs are stimulated with drugs
intracytoplasmic sperm injection
one sperm is injected into the egg in the lab
GIFT procedure
gamete intrafallopian transfer
ovum and sperm are placed in the fallopian tubes lap.
ZIFT procedure
zygote intrafallopian transfer
fertilized eggs are placed into the falloppian tubes
GIFT and ZIFT
anesthesia time is minimized to reduce egg exposure to anesthesia
c section
delivery of the fetus through abd lap
emergent c section
cord prolapse, abruptio placentae
non emergent c section
mal position, CPD, diabetic
c section emergency supplies
drape mayo, kinfe with blade, clamps, sponges
what is used to close uterus in c section?
0 vicrly CT 1
foley for emergent c section
yes
scissors for uterus c section
bandage
what is necessary for invitro
1 functioning ovary, tried for 1 year, functioning uterus
