The Normal Ovary Flashcards
Normal Ovary
_____ (2)
_____ shape, small
Measure in _____ and _____ planes
___-___cm (L), ____cm (W), ___cm (AP) =size/volume
formula to manually calculate OV volume:
- Vol = ___ x ___ x ___ divided by 2
Lie in a shallow depression - _____ fossa (Adnexa)
OVs are “held” in the ovarian fossa near and lateral UT by several structures:
- Connected bil to UT by the _____
- Connected medially by _____ ligament
- Held post to broad ligament by _____
- Connected to pelvic wall laterally by _____ (suspensory) ligament and NOT surrounded by peritoneum
anterior to _____
Lymphatic drainage from OVs are: _____-_____, _____ iliac, _____ iliac, _____ iliac, _____, _____, _____, _____, inguinal nodes
paired almond sagittal transverse 3 4 2 1 h w l ovarian FTs ovarian mesovarium infundibulopelvic rectum para-aortic internal external common sacral obturator pelvis retroperitoneal
Sonographic Vessel Landmarks:
-Internal Iliac _____
-Internal Iliac _____
-Both lie _____ to the ovaries bilaterally
-Iliac _____ is immediately lateral to ovaries and easier to image
(Iliac Vein is the largest)
The OVs are made up of 2 distinct areas:
1) Cortex:
- _____ portion of ovarian tissue is the cortex area of connective tissue/stroma
- Responds to _____ stimulation
- _____ located within the cortex
2) Medulla:
-_____-middle germinal layer
coats the ovary, made of cuboidal epithelial cells
-area of the _____ vasculature
Artery Vein lateral vein outer hormonal follicles inner ovarian
Each Ovary presents with:
- _____ border - uterine end (closest to UT) surfaces
- _____ border - tubal end (further away from UT)
-_____ and _____
free borders
-_____ and _____ borders
medial lateral anterior posterior superior inferior
Ovarian/Gonad Function
2 Functions: _____ and _____
1) Producing eggs (_____ function)
2) Secreting hormones (_____ function)
The term _____ refer to the ovaries in females and testes in males
Each month, during the menstrual cycle, an ovum (egg) is released form 1 ovary; this process is called _____; repeats the next month on the opposite ovary and so forth. The egg is released when a mature follicle ruptures in response to a hormonal signal. Ovulation occurs around 14-15 days from the 1st day of the woman’s last menstrual cycle. When ovulation occurs, the ovum moves into the FTs and becomes available for fertilization. If fertilization does not occur, the egg is “spilled out” through the endometrial cavity.
exocrine endocrine exocrine endocrine gonads ovulation
Women are born with a limited reserve of _____ (oocytes are the cells within the ovaries that produce the ovum)
This supply diminishes during a woman’s life, reaching critical low #s of oocytes by age _____
A fetal ovary contains ___-___ million oocytes by the 20th week of gestation.
At approx. 50 years old, the number of oocytes left is exhausted and enter the _____ phase, making pregnancy almost impossible
oocytes 40 6 7 menopause
Hormones Secreted
_____ is produced by the follicle and responsible for the appearance of secondary sex characteristics of anatomically female people at puberty and for the maturation and maintenance of the reproductive organs in their mature functional state.
_____ is produced by the CL and functions with estrogen by promoting menstrual cycle changes in the endometrium.
Levels of both change through out the menstrual cycle and directly correspond with menstrual cycle each moth
estrogen
progesterone
Ovarian Follicle stages
The UT and OV are driven largely by 4 hormones:
- _____-stimulating hormone (FSH)
- _____ hormone (LH)
- _____
- _____
An ovarian _____ progresses through several distinct phases before it finally matures and releases it’s ovum
follicle leutenizing estrogen progesterone follicle
Stages of an Ovarian Follicle
Stage 1: \_\_\_\_\_ Follicle Stage 2: \_\_\_\_\_ Follicle Stage 3: \_\_\_\_\_ Follicle Stage 4: \_\_\_\_\_ Follicle Stage 5: Corpus \_\_\_\_\_ Stage 6: Corpus \_\_\_\_\_
Primordial primary secondary vesicular luteum albicans
Stage 1 : Primordial Follicle
During the first 5 month of development, a finite number of primordial follicles form in the fetal _____
These follicles consist of _____ surrounded by a single layer if squamous follicular cells.
These primordial follicles remain in the process of the _____ meiotic divison
At puberty, begin to develop further and become _____ follicles
ovary
oocytes
1st
primary
Stage 2 : Primary Follicle
At the start of each menstrual cycle a limited number of _____ follicles are triggered to develop.
1st apparent histological stage is the early _____ follicle: that consists of a central oocyte surrounded by a single layer of follicular cells which have become cuboidal (granulosa) cells.
The zona _____ is a thin band of glycoproteins that separates the oocyte and follicular cells.
Tiny _____ may/may not be imaged on US
As development proceeds, the number of follicular cells _____ by mitosis forming several layers around the primary oocyte.
As these cells enlarge they release steroid hormones called _____ of which estradiol is the dominant one prior to ovulation
During each cycle, a few primary follicles will continue to develop into _____ follicles.
primordial primary pellucida cysts increase estrogens secondary
Stage 3 : Secondary or Late Follicle
Consists of several layers of cuboidal/columnar follicular cells, now collectively called the membrana granulosa which begin to secrete _____ fluid. Antrum begins to form
A thick, amorphous layer, zona _____, forms within it and follicular fluid secreted accumulates, small pockets of fluid between granulosa cells begin to appear and may be imaged on US
Normally, this is the stage in which only _____ of the primary early follicle will continue and develop into this secondary follicle
follicular
pellucida
one
Stage 4 : Graafian Follicle
is the stage after the meiotic division has completed but before \_\_\_\_\_. The follicle is characterized by a large follicular antrum that makes up most of the follicle. An oocyte (egg) is now fully developed/matured and located eccentrically, surrounded by the zona pellucida and a layer of several cells. follicle become large; usually extend from the deepest parts of the cortex and protrude from the surface of the ovary. The bigger = the more \_\_\_\_\_
Graafian Follicle will release the _____ (egg) and the remaining cells of GF will form the corpus luteum
ovulation
mature
oocyte
Stage 5 : Corpus Luteum (CL)
Approx. a ___ cm, round lobulated structure with a cystic (anechoic) center, varies in size, shape, located on ovary
is the follicle which matured (_____) and underwent ovulation (pushed the egg out) and produces progesterone and some estrogen in case the egg gets fertilized
If fertilization occurs, the _____ produces the required progesterone needed to sustain the pregnancy until the placenta is formed near the end of 1st trimester and will then sustain the pregnancy.
Because of fertilization and during the 1st trimester pregnancy, the CL “cyst” of pregnancy may become large before it finally _____ and diminishes near the end of 1st trimester when the placenta finally forms
CL “cyst” should disappear by then end of _____ trimester
In the absence of fertilization, the life span of the CL “cyst” is approx _____ days.
Once the CL “cyst” ruptures, there may be a small amount of free fluid imaged in the _____
2 graffian CL ruptures 1st 14 PCDS
Stage 6: Corpus Albicans
Degenerated corpus _____ (CL)
Pregnancy did not occur; _____ degenerates
luteum
follicle
Sonographer needs to know ovarian sono appearances of the different stages of a _____ to know normal vs pathology at a particular time in the ovarian cycle
follicle
