Repro anatomy Flashcards
The embryologic origin of the uterus is from fusion of the _______
two Müllerian ducts
The ligaments attached to the uterus include the
broad ligament, round ligaments, cardinal ligaments, and uterosacral ligaments
Segments of the oviducts are the
interstitium, isthmus, ampulla, and infundibulum
Oviducts blood supply
They receive dual blood supply from the ascending uterine artery and
ovarian artery
The ovaries are attached by the ____ to the uterine fundus, by the suspensory ligaments to the ______, and by the
mesovarium to the _____
ovarian ligament
pelvic side wall
broad ligament
The vagina is a tubular structure,____ in length
8–9 cm
The vagina traverses the urogenital diaphragm through the genital hiatus of the _____
levator ani
Pubic Hair Tanner STage
- Tanner I: none (prepubertal state)
- Tanner II: ____
- Tanner III: ______
- Tanner IV: _________
- Tanner V: hair extends to medial surface of the thighs
small amount of long, downy hair with slight pigmentation on the labia majora
hair becomes more coarse and curly and begins to extend laterally
adult-like hair quality, extending across pubis but sparing medial thighs
______ works best when adjacent tissues have differing echodensities, particularly
fluid/tissue interfaces
Ultrasound
Pap smear should include cytologic specimens from 2 areas:
stratified squamous epithelium of ____ of the ectocervix and columnar epithelium
of the ____
transformation zone (TZ)
endocervical canal (EGG
Screening for ____, the most common cancer of the cervix (80%), involves scraping the TZ.
squamous cell carcinoma
The ______s the area of the ectocervix
between the old or “original” squamocolumnar junction (SCJ) and the new SCJ.
TZ
At puberty the vaginal pH falls, causing the ________ to be transformed by metaplasia into _______
“native” columnar epithelium
normal-appearing “metaplastic” stratified squamous epithelium
The TZ is the location where _____ of cervical dysplasia and cancer develop.
95%
Screening for adenocarcinoma, the second most common cancer of the cervix (15%), involves scraping the _______
endocervical canal with cytobrush
_______is an outpatient office procedure. It uses a binocular, short focal-length
instrument with a built-in light source to look at the cervix through a speculum
Colposcopy
Purpose of Colposcopy
1
2
(1) visually identify where the abnormal Pap smear cells originated, and
(2) biopsy that area to send for histologic diagnosis.
Areas for biopsy in colposcopy
punctation, mosaicism, white
epithelium, and abnormal vessels.
_______is a minor outpatient surgical procedure performed in the operating room under either local or general anesthesia.
It is a diagnostic test that examines the histology of cervical lesions
Cold Knife Cone Biopsy
Cold knife biopsy
• _______ is performed if the Pap smear shows changes more severe than the
colposcopically directed biopsy.
• ______ is performed if a lesion extends from the exocervix into the endocervical
canal
Wide-shallow cone
Narrow-deep cone
_____ is a minor outpatient surgical procedure performed under local anesthesia.
It is a diagnostic test that examines the histology of cervical lesions.
Advantages are low cost, high success
rate, and ease of use.
LEEP
LEEP technique
This technique is used for diagnosing and treating cervical dysplasia.
An electric current is passed through a thin wire loop to remove abnormal cervical tissues.
The heated loop seals off blood vessels as it cuts
Long-term risks of LEEP include _____ and _____
cervical stenosis and cervical insufficiency.
____ is a minor outpatient procedure performed without anesthesia.
It destroys dysplastic cervical tissue identified by colposcopy and cervical biopsy
Cryotherapy
Long-term risks of cryotherapy include cervical______
stenosis.
______ removal of the uterus, is a major inpatient surgical procedure performed under either regional or general anesthesia. It is used for both diagnosis and therapy.
Hysterectomy,
______performed for early-stage cervical carcinoma, involves removal
of the uterus, cervix, and surrounding tissues, including cardinal ligaments, uterosacral
ligaments, and the upper vagina.
Radical hysterectomy
A fiberoptic scope is placed through a previously dilated cervix to directly visualize the endometrial cavity.
A clear fluid is infused through side ports of the scope to distend the uterine cavity, allowing visualization
Hysteroscopy
The pelvic-abdominal cavity is insufflated with pressured carbon dioxide to distend
the abdomen and lift the abdominal wall away from the viscera.
Through a port that is placed through the umbilicus, a fiberoptic scope is then inserted to visually examine the pelvis and abdomen
Laparoscopy
Common gynecologic indications for laparoscopy include
1
2
3
diagnosing and treating causes of chronic pelvic pain (e.g., endometriosis or adhesions), resecting advanced ectopic pregnancies, and diagnosing and lysing tubal adhesions in infertility cases
______is a diagnostic outpatient radiologic imaging procedure performed without anesthesia. A cannula is placed in the endocervical canal and radio-opaque fluid is injected,
HSG
_____ is performed similarly to an endometrial biopsy. However, the cervix frequently requires dilation with cervical dilators prior to introduction of the curette.
The curette is used to scrape
the endometrium, obtaining larger amounts of endometrial tissue that are then sent to pathology
D&C
EMB technique
A hollow suction cannula is then placed into the uterine cavity and suction is applied.
As the cannula is rotated, endometrial tissue is aspirated into it.
When the cannula is removed, the retrieved tissue is placed in formalin and sent to pathology
This is a minor outpatient office procedure performed under local anesthesia. It is a diagnostic test that examines the histology of vulvar lesions.
Vulvar Biopsy
