Uterus and ovaries A&P, Pathophysiology Flashcards
what is the isthmus
area where the wall of the tube is thickest
What is the functional outermost layer of the uterus
stratum functionalis
what is the base layer of the uterus
stratum basalis
what occurs when endometrial tissue is outside of the uterine cavity
endometriosis
what is endometriosis hallmarked by
dysmenorrhea, dyspareunia, infertility
what is adenomyosis
enlargement of the myometrium due to presence of endometrial glands in this layer of the uterus - essentially a form of endometriosis
what is the acronym for abnormal uterine bleeding
PALM-COEIN
PALM is the structural causes
COEIN is nonstructural
What does PALM-COEIN stand for
Polyps
Adenomyosis
Leiomyoma (aka fibroid)
Malignancy
Coagulopathy
Ovulatory dysfunction
Endometrial
Iatrogenic
Not otherwise classified
what is anovulatory cycle
no spike in LH or no ovulation there will be no corpus luteum - lack of progesterone
what can occur with anovulatory cycle
elevated estrogen can cause increased bleeding from change in vascular development of the endometrium
what is an overgrowth of the endometrial glands
endometrial hyperplasia
what patients do we see endometrial hyperplasia in more
older patients and obesity
what is the presentation of endometrial hyperplasia
abnormal uterine bleeding
what is an overgrowth of endometrial glands and stroma
endometrial polyps
where are endometrial polyps formed
around a vascular bed and will hang in a pedunculated fashion
what are leiomyomas
fibroids or myomas
similar to polyps but are arising from smooth muscle and fibroblasts
what are the symptoms of leiomyomas
depend on size and location - may cause severe menorrhagia, menometrorrhagia, can become necrotic if they twist, found at infertility workup
what is an ascending infection from vagina and cervix
pelvic inflammatory disease
what can be included with pelvic inflammatory disease
salpingitis, endometriosis, myometritis, oophoritis, tubo-ovarian abscess
what can result as of PID
development of long term consequences as a result of the scaring/inflammation
what is the most common causative agent of PID
gonorrhea and chlamydia
-e.coli can be associated with post-menopausal women
often thought to be polymicrobial
What is the most common sexually transmitted disease
Chlamydia trachomatis
when assessing for chlamydia what is the lab test
only grows on living media
What is the cycle of N.gonorrhea
binds to fallopian tubes - endotoxin destroys cilia of surrounding cells - taken into the cells via endocytosis - transported in via endocytotic vacuole (of host cell) in which it multip
what is the presentation of gonorrhea
urethritis (dysuria, discharge)
can infect epididymis, prostate and rectum
septic arthritis: typically in only 1 or two joints
What is inflammation of intrauterine lining that is most commonly associkated with PID
endometritis
what is endometritis associated with
PID and transcervical procedures
What is the inflammation of the fallopian tube
salpingitis
What is tubo-ovarian abscess
complication of PID, develops in pts with salpingitis
inflammatory, infectious pathology with collection of purulent fluid within fallopian tube or ovary
what is the presentation of tubo-ovarian abscess
acute pelvic/abdominal pain
fevers/chills
discharge
adnexal tenderness/mass
what is hallmarked by ovarian cysts, obesity, alternation in menses, increased androgen production
polycystic ovarian syndrome
What are some of the genetic links associated with PCOS
P450c alteration
LH receptor gene abnormalities
DENND1A alteration
Thyroid adenoma gene
what occurs due to PCOS
incomplete ovulation
hirsutism
menorrhagia when menses occurs, dysmenorrhea as well
endometrial hyperplasia
what are signs and symptoms of PCOS
irregular or prolonged periods
fluid filled sacs or cysts
growth of extra, unwanted hair
hair loss
excessive cramping and bloating during menstruation
acne and other skin problems
psychological stress and depression
fatigue
pelvic pain
rapid weight gain
What is ovarian torsion
enlargement of ovary will cause twist around the ligament of ovary which encases the vascular supply
progression will -> arterial obstruction
necrosis = ischemia
What side is ovarian torsion most common on
right side
what is the presentation of ovarian torsion
severe, sudden onset of adnexal pain, vomitting
