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SONOCAN OB Review > Pohysiology Of The Female Pelvis Notes > Flashcards

Pohysiology Of The Female Pelvis Notes Flashcards

1
Q

What is amenorrhea?

A

Absence of menstruation.

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2
Q

What is the corpus albicans?

A

Scar from previous corpus luteum.

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3
Q

What is the corpus luteum? What does it produce?

A

A fluid structure formed from the graafian follicle after ovulation; produces progesterone.

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4
Q

What is the cumulus oophorus?

A

Protrusion within the graafian follicle containing the oocyte.

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5
Q

What is dysmenorrhea?

A

Painful menses.

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6
Q

What is dyspareunia? What is it associate with?

A

Abnormal pain during sexual intercourse due to a spasm.

Associated with endometriosis and hormonal changes in post menopause and lactating women.

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7
Q

What is estrogen?

A

Hormone secreted by the follicle, promoting growth of the endometrium.

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8
Q

What is a follicle?

A

Functional or physiological ovulatory cyst consisting of an ovum surrounded by a layer of cells.

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9
Q

What is follicle-stimulating hormone (FSH)?

A

Hormone that stimulates growth and maturation of the graafian follicle(s).

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10
Q

What is a graafian follicle?

A

Mature follicle containing a cumulus mass with a single oocyte.

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11
Q

What is luteinizing hormone (LH)?

A

Hormone that stimulates ovulation.

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12
Q

What is menopause?

A

The last menstrual cycle.

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13
Q

What is menorrhagia?

A

Abnormally heavy or long menses.

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14
Q

What is the menstrual cycle?

A

Monthly cyclic changes in the female reproductive system typically 28 days in length.

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15
Q

What is mittelschmerz?

A

Term used to describe pelvic pain preceding ovulation.

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16
Q

What is oligomenorrhea?

A

Time between monthly menstrual cycles that exceeds 35 days.

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17
Q

What is ovulation?

A

Explosive release of an ovum from a ruptured graafian follicle.

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18
Q

What is perimenopausal?

A

Transition period occurring several years before menopause.

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19
Q

What is polymenorrhea?

A

Time between monthly menstrual cycles that is fewer than 21 days.

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20
Q

What is precocious puberty?

A

An unusually early onset of puberty.

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21
Q

What is progesterone?

A

Hormone that helps to prepare and maintain the endometrium.

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22
Q

What is the normal onset age of menstruation?

A

Generally occurs between 11 and 13 years of age.

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23
Q

What is the typical age of cessation of menstruation?

A

Usually occurs around 50 years of age.

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24
Q

What is the average length of a menstrual cycle?

A

Ranges between 21 and 35 days (average 28 days).

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25
Q

What is required for menstruation?

A

Depends on the functional integrity of the hypothalamus, pituitary gland, and ovarian axis.

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26
Q

What are normal estradiol levels during the follicular phase?

A

30 to 100 pg/mL.

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27
Q

What are normal estradiol levels during the ovulatory phase?

A

200 to 400 pg/mL.

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28
Q

What are normal estradiol levels during the luteal phase?

A

50 to 140 pg/mL.

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29
Q

What does estradiol primarily reflect?

A

The activity of the ovaries.

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30
Q

What are normal estrogen levels?

A

5 to 100 μg/24 h (urine).

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31
Q

What are the primary female sex hormones? 2

A
  1. Progesterone
  2. Estrogen
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32
Q

What stimulates the production of estrogen in the ovaries?

A

Follicle-stimulating hormone (FSH) and luteinizing hormone (LH).

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33
Q

What is the function of estrogen?

A

Promotes formation of female secondary sex characteristics, accelerates growth in height and metabolism, reduces muscle mass, stimulates endometrial growth and proliferation, and increases uterine growth.

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34
Q

What are normal FSH levels premenopause?

A

4 to 25 mU/mL.

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35
Q

What are normal FSH levels postmenopause?

A

4 to 30 mU/mL.

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36
Q

What does FSH do?

A

Initiates follicular growth and stimulates the maturation of the graafian follicle(s).

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37
Q

What are normal LH levels during the follicular phase?

A

2 to 10 μ/L.

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38
Q

What are normal LH levels during the midcycle peak?

A

15 to 65 μ/L.

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39
Q

What are normal LH levels during the luteal phase?

A

10 to 12 μ/L.

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40
Q

What are normal LH levels postmenopause?

A

1.3 to 2.1 mg/dL.

41
Q

What triggers ovulation?

A

A surge in LH levels.

42
Q

What is the lifespan of the corpus luteum?

A

Constant 14-day lifespan.

43
Q

What does the corpus luteum do if the ovum is fertilized?

A

The corpus luteum will continue to secrete progesterone.

44
Q

What happens if fertilization does not occur?

A

The corpus luteum regresses after approximately 9 days.

45
Q

What is the endometrium?

A

The inner lining of the uterus.

46
Q

What should the endometrial thickness not exceed?

A

14 mm.

47
Q

What is premenarche?

A

Time before the onset of menses.

48
Q

What is menarche?

A

Onset of menstruation.

49
Q

What occurs during the menstrual phase of the endometrium?

A

Menstruation occurs from days 1–5.

50
Q

What is the sonographic appearance of the early menstrual phase?

A

Hypoechoic central line during menstruation measuring 2-4 mm.

51
Q

What occurs during the proliferation phase of the endometrium?

A

Increasing estrogen levels regenerate the functional layer.

52
Q

What is the sonographic appearance of the late proliferation phase?

A

A triple-line appearance measuring around 6–10 mm.

53
Q

What occurs during the secretory phase of the endometrium?

A

Functional layer continues to thicken.

54
Q

What is the sonographic appearance of the secretory phase?

A

Functional layer appears hyperechoic, basal layer appears hypoechoic.

55
Q

What is the typical number of primary follicles in each ovary at birth?

A

Approximately 200,000.

56
Q

What does FSH stimulate?

A

Follicular development.

57
Q

How many follicles typically begin to develop each cycle?

A

5 to 11 follicles.

58
Q

What indicates follicular maturity?

A

Visualization of a cumulus oophorus.

59
Q

What is the sonographic appearance of the early follicular phase?

A

Multiple small anechoic functional cysts.

60
Q

What occurs during the ovulatory phase?

A

Occurs at the rupture of the graafian follicle.

61
Q

What is the sonographic appearance during the ovulatory phase?

A

Irregular-shaped cystic structure.

62
Q

What is the sonographic appearance of the early luteal phase in the Cul de sac?

A

Amount of cul-de-sac fluid reaches peak volume.

63
Q

What is a corpus luteal cyst?

A

Formed by the ruptured graafian follicle.

64
Q

What is the sonographic appearance of a corpus luteal cyst?

A

Small, irregular cystic ovarian mass with hyperechoic, thin to thick walls.

65
Q

What is a functional cyst?

A

Benign cyst that responds to hormonal stimulation.

66
Q

What is the appearance of a simple cyst?

A

Anechoic mass with smooth wall margins.

67
Q

What happens to the ovaries after menopause?

A

They atrophy and may be difficult to visualize.

68
Q

What is the effect of hormone replacement therapy on the endometrium?

A

Thickness varies but should measure <5 mm if on continuous HRT.

69
Q

What do oral contraceptives do?

A

Inhibit ovulation and LH surge.

70
Q

What is the appearance of the endometrium on oral contraceptives?

A

Appears as a thin echogenic line.

71
Q

What is depot-medroxyprogesterone acetate?

A

Inhibits ovulation and thickens cervical mucus.

72
Q

What is the appearance of the endometrium on depot-medroxyprogesterone acetate?

A

Appears as a thin echogenic line.

73
Q

What are fallopian tube microinserts?

A

Spring-like coils inserted into the fallopian tubes.

74
Q

What is the appearance of fallopian tube microinserts?

A

Bilateral echogenic linear structures located lateral to the uterine cornua.

75
Q

What do levonorgestrel implants do?

A

Inhibit ovulation and thicken cervical mucus.

76
Q

What is the injection frequency for certain contraceptives?

A

Every 3 months

77
Q

What should not occur during the ovulatory phase with certain contraceptives?

A

Ovulatory phase should not occur

78
Q

How does the endometrium appear with certain contraceptives?

A

Appears as a thin echogenic line

79
Q

What are Fallopian tube microinserts also known as?

A

Essure®

80
Q

What are the characteristics of Fallopian tube microinserts?

A

Spring-like coils inserted into the interstitial and isthmus portion of the fallopian tubes

81
Q

How long does it take for tissue to grow into the coils of Fallopian tube microinserts?

A

About 3 months

82
Q

What do Fallopian tube microinserts block?

A

Sperm from reaching the ovum

83
Q

Where are bilateral echogenic linear structures located in relation to the uterus?

A

Lateral to the uterine cornua

84
Q

What do levonorgestrel implants inhibit?

A

Inhibits ovulation and thickens cervical mucus

85
Q

Where is the thin capsule of levonorgestrel implants placed?

A

Under the skin typically in the medial upper arm

86
Q

How long do levonorgestrel implants last?

A

5 years

87
Q

How do levonorgestrel implants appear on an ultrasound?

A

Appears as a hyperechoic linear structure

88
Q

What is the purpose of an intrauterine device (IUD)?

A

Foreign body placed in the endometrial cavity to prevent pregnancy

89
Q

What are the two types of IUDs mentioned?

A

Paraguard—copper T-shape, Mirena—plastic T-shape that releases levonorgestrel

90
Q

What are the risk factors associated with IUDs? 3

A
  1. Infection
  2. Perforation
  3. Attachment to the basal layer
91
Q

How do IUDs appear on an ultrasound?

A

Series of hyperechoic linear T-shaped echoes located in the center of the endometrium

92
Q

What is the appearance of the Copper IUD on ultrasound?

A

Hyperechoic entrance and exit reflections with marked posterior acoustic shadowing

93
Q

How does the Plastic IUD differ in appearance from the Copper IUD?

A

Not as reflective and with less posterior shadowing compared with metal IUD

94
Q

What continues with a nonhormonal IUD like Paraguard?

A

Ovulation and formation of a corpus luteum continue

95
Q

What is the vaginal ring also known as?

A

Nuva® ring

96
Q

What is the function of the vaginal ring?

A

Releases hormones to prevent pregnancy

97
Q

How long may the vaginal ring be left in?

A

21 days

98
Q

How does the vaginal ring appear on an ultrasound?

A

Hyperechoic ring in the superior portion of the vaginal canal near the external cervical os

99
Q

Where may the vaginal ring appear in relation to the external cervical os?

A

Near the external cervical os

SONOCAN OB Review (23 decks)

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