Test 4 part 4 Flashcards
A transperitoneal endoscopic technique that allows visualization and instrumentation of the pelvic structures through small incisions
Allows for diagnosis and management of gynecologic disorders without laparotomy
Laparoscopy
The surgical opening of the abdomen for exploration
Laparotomy
Complete removal of the uterus
May or may not remove ovaries and fallopian tubes (bilateral salpingo-oophorectomy or BSO
Hysterectomy
Removal of uterus without removal of cervix
Theory for use of this procedure is that innervation of bladder is less likely affected and patient belief that cervix removal leads to decrease in sexual pleasure
Partial hysterectomy
Removal of uterine body and cervix
Done for invasive cancer
May occur with or without BSO
Total hysterectomy
Removal of uterus, cervix, & BSO & portion of vagina. Performed for invasive cancers of the cervix
Radical hysterectomy
Cysts that occur secondary to hormonal stimulation. Rare prior to menarche or after menopause (
Functional types
Most common type of cyst
Follicle fails to rupture and release egg during ovulation
Follicular
Cyst that forms from failure of corpus luteum to degenerate-seals and generates a cavity filled with fluid or blood
Luteal (hemorrhagic)
cysts that are usually larger than 5 cm
Forms from skin precursor cells and develop when ovarian cells multiply
Most common ovarial germ cell tumor
Dermoid
treatment for endometrial cancer
Hysterectomy with BSO
May need additional chemo or radiation
is a dynamic entity formed during puberty and, histologically, is the area where the glandular epithelium is being replaced by squamous epithelium
Transformation zone
is adjacent to the borders of the ectocervix and the endocervix of the canal.
Squamocolumnar junction
most cervical dysplasia occurs where
The transformation zone
when does the onset of menses typically happen
between 9 and 16 average age is 12
when does puberty usually occur
between ages 8 and 13
puberty is triggered by
the production of GnRH from the hypothalamus
GnRH stimulates
the pituitary to produce Gonadotropins that stimulate ovarian estrogen
appearance of breast tissue and or pubic hair before age 8
precocious puberty
begins day 1 of menstruation, lasts for 12-14 days. Graafian follicle (GF) matures under the influence of LH and FSH. It is the GF that produces estrogen
Follicular phase
Begins when estrogen peaks and ends with release of the oocyte from mature GF – referred to as ovulation.
LH surge 12- 36 hours prior to ovulation
Decrease in estrogen and increase in progesterone levels prior to LH surge
The ovulatory phase
begins after ovulation, last for ~ 14 days. Corpus luteum (CL) forms from the empty follicle
High levels of progesterone from the corpus luteum
If pregnant – corpus luteum continues progesterone production
No pregnancy – Corpus luteum degenerates decrease in progesterone menstruation
Luteal phase
Starts after the end of menstruation and ends with ovulation
Endometrium prepares for implantation thicker & vascular
Changes results from increase in estrogen Graafian foll:
proliferative phase
Begins after ovulation & ends with the onset of menstruation
Endometrium continue to thicken – primary hormone here is the progesterone produced by corpus luteum
Pregnancy endometrium develops further
No pregnancy corpus luteum degenerates endometrium degenerates
secretory phase
In response to hormonal changes sloughing off of the endometrium
menstrual phase
normal cycles last from
21-35 days
how many days of menstrual flow
2-7 days
average blood loss is
20-60 cc
Absence of menarche beyond the age of 16. May or may not occur with other signs of puberty such as secondary sex characteristics.
Primary amenorrhea
Cessation of menses after menarche has occurred and periods have been successive for a period of time
Secondary amenorrhea
Painful menstrual cramps without underlying pathology
Occurs only during ovulatory cycles
First occurrence happens within a year after menarche
Primary dysmenorrhea
Treatment for primary dysmenorrhea
NSAIDS Birth control Warm application Rose tea rarely CCB
This type of pain often lasts longer than normal cramps, it may begin long before the period starts
The pain may get worse when menstruation begins and not go away after the period ends
Occurs later in life
Secondary dysmenorrhea
Common causes of secondary dysmenorrhea
Endometriosis
Fibroids/leiomyomas
Tissue from the lining of the uterus is located outside of the uterus, such as in the ovaries and fallopian and responds to monthly fluctuations of hormones. This tissue also breaks down and bleeds. This bleeding occurs outside of the uterus and vagina, can cause pain, especially right before, during, or after a period.
Endometriosis
(also called myomas)—muscle tumors or growths that form on the outside, the inside, or in the walls of the uterus. These tumors are not cancerous, but they can cause pain and heavy menstrual bleeding
Fibroids/ leiomyomas
is abnormal uterine bleeding related to hormones that directly affect the menstrual cycle.
Disruption of normal cycle and no another pathology
Eventually the uterine lining outgrows its blood supply and begins to slough off at irregular intervals.
Anovulatory uterine bleeding
Excessive and prolonged bleeding at regular intervals.
menorrhagia
Bleeding between periods or after menopause – most significant
Metrorrhagia
Irregular, frequent, prolonged, and excessive bleeding
Menometrorrhagia
Infrequent and or scant bleeding of variable duration
Oligomenorrhea
Uterine bleeding occurring at regular intervals of
Polymenorrhea
Abnormal ovualtory cycles regular and cyclic, but with abnormal patterns of bleeding.
Abnormal bleeding that occurs with ovulatory cycles may be physiologic, pathologic, or pharmacologic in nature
Ovulatory AUB
