Winter Exam 2 Flashcards by Jonathan Crispin

A condition where blood accumulates in both the uterus (hematometra) and the vagina (hematocolpos), usually due to an obstruction preventing menstrual blood from exiting.
Causes:
-Imperforate hymen (most common)
-Transverse vaginal septum
-Cervical atresia or stenosis
-Müllerian anomalies (e.g., vaginal agenesis, Mayer-Rokitansky-Küster-Hauser syndrome)
-Acquired causes (e.g., post-surgical scarring, radiation, infections)

Hematometrocolpos

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Is a condition that affects females and causes the underdevelopment or absence of the uterus and upper part of the vagina. However, the external genitalia and ovaries usually develop normally, so affected individuals typically go through puberty and have normal hormone levels but do not have menstrual periods.
During fetal development, the Müllerian ducts (structures that normally form the uterus, fallopian tubes, and part of the vagina) do not develop properly. This leads to the absence or incomplete formation of these reproductive organs. However, the ovaries develop separately, so they are usually normal, allowing normal hormone production and secondary sexual characteristics (such as breast development).
AKA Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome

Mullerian Hypoplasia

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is a congenital condition where the uterus has two cavities instead of one, giving it a heart-like shape. This occurs during fetal development when the two structures that normally fuse to form a single uterine cavity only partially merge. As a result, the uterus is divided into two sections, or “horns.”

bicornuate uterus

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is a specialized X-ray procedure used to examine the inside of the uterus and fallopian tubes. It’s commonly performed to investigate potential causes of infertility or recurrent miscarriages.

Purpose:
-Assess Uterine Shape and Structure: Detects abnormalities such as a bicornuate uterus, uterine fibroids, or polyps.
-Evaluate Fallopian Tube Patency: Determines if the fallopian tubes are open or blocked, which can affect fertility.

hysterosalpingogram

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Bicornuate vs septated uterus

Septated uterus: apex of uterus is more than 5mm above the imaginary line place at the top of the endometrium line
Bicornuate uterus: apex of uterus is less than 5mm below the imaginary line at the tope of the endometrium line

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is a mild congenital uterine anomaly characterized by a slight indentation at the top (fundus) of the uterine cavity. This condition arises during fetal development when the Müllerian ducts, which typically fuse to form the uterus, do not completely merge at the top, resulting in a subtle dip in the uterine fundus.

arcuate uterus

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Is a synthetic estrogen that was prescribed to pregnant women between 1940 and 1971 to prevent miscarriage, premature labor, and related complications. However, it was later discovered that the drug exposure during pregnancy led to significant health issues in the offspring, particularly affecting the reproductive systems of female children. The most characteristic anomaly is the T-shaped uterus, where the uterine cavity is constricted, resembling the shape of the letter “T.” This malformation results from disrupted development of the uterine muscle layers during fetal growth.

Diethylstilbestrol (DES)

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is a benign (non-cancerous) fluid-filled sac that can develop along the walls of the vagina. These cysts originate from remnants of the Gartner duct, an embryonic structure present during fetal development. Typically, the Gartner duct regresses before birth, but if portions persist, they can form cysts later in life.

Gartner Duct Cyst

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serves as a repository for nitrogenous waste products produced by the developing embryo. In humans, it contributes to the formation of the urachus, a duct that connects the fetal bladder to the yolk sac, facilitating the removal of waste.

allantois

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also known as paramesonephric ducts, are paired structures in the embryo that play a crucial role in the development of the female reproductive system. During fetal development, these ducts differentiate to form the uterus, fallopian tubes, cervix, and the upper two-thirds of the vagina.

Müllerian ducts

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also known as mesonephric ducts, are paired structures present during early embryonic development in humans and other vertebrates. They play a crucial role in the formation of the male reproductive system.

Wolffian ducts

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is a pair of longitudinal ridges that appear during the fifth week of embryonic development. These ridges are located on the medial side of the mesonephros, the embryonic kidney. They serve as the precursor to the gonads—the reproductive organs that will develop into either testes in males or ovaries in females.

gonadal ridge

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is a crucial structure in embryonic development that contributes to the formation of the urinary and reproductive systems. It originates from the ventral part of the cloaca during the fourth to seventh weeks of fetal development.

urogenital sinus

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is a pivotal structure in female embryonic development, formed by the fusion of the caudal (tail-end) portions of the paramesonephric ducts, also known as Müllerian ducts. This fusion results in a median tubular structure that serves as the precursor to the uterus and the superior part of the vagina.

uterovaginal canal

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are the female germ cells responsible for producing oocytes (egg cells) during the process of oogenesis. They are formed during fetal development and serve as the foundation for a woman’s reproductive potential.

Oogonia

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is a female germ cell, or egg cell, that plays a crucial role in reproduction. It is produced in the ovaries during a process called oogenesis and is essential for fertilization and the development of a new organism.

oocyte

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Absence of menstruation

Amenorrhea

Male hormones produced in a small quantities by the female ovaries and adrenal glands, with the greatest quantities occurring at the midpoint of a woman’s menstrual cycle

Androgens

Regulates the release of FSH and LH by gonadotropes from the anterior pituitary

Gonadotropin releasing hormones (GnRH)

Abnormally light or infrequent menstruation. Opposite of menorrhagia

Oligomenorrhea

Frequent or many irregular periods

Polymenorrhea

The two layers of the endometrium during the menstruation phase

-functional layer
-basal layer

refers to the thinning and reduction in size of the endometrium, the inner lining of the uterus. This condition is commonly observed in postmenopausal women due to decreased estrogen levels.

Endometrial atrophy

The endometrium, or uterine lining, undergoes cyclical changes in thickness throughout the menstrual cycle. What are the measurements of the endometrium in each phase.

Menstrual Phase (Days 1–5):

Thickness: Approximately 1–4 mm.
-Description: The endometrium sheds its functional layer, leading to menstruation.

Proliferative Phase (Days 6–14):

Early Proliferative Phase (Days 6–10):
-Thickness: Around 5–8 mm.
Description: Estrogen stimulates the regeneration of the endometrial lining.

Late Proliferative Phase (Days 11–14):
-Thickness: Up to 11 mm.
Description: The endometrium continues to thicken in preparation for potential implantation.

Secretory Phase (Days 15–28):

-Thickness: Ranges from 7–16 mm.
Description: Progesterone secretion transforms the endometrium into a secretory lining, rich in nutrients, to support a fertilized egg.

Uterine sizes

Prepubertal (Before Puberty): Length: Approximately 3.5 cm Width: Around 1 cm Description: In this stage, the uterus is small and undeveloped. Postpubertal (After Puberty): Length: Approximately 7.6 cm Width: Around 4.5 cm Thickness: About 3 cm Description: Following puberty, the uterus becomes pear-shaped and increases in size due to hormonal changes. Postmenopausal: Length: Approximately 6.5 cm Width: Around 3.5 cm Thickness: About 2.5 cm Description: After menopause, the uterus typically decreases in size due to reduced estrogen levels.

is a benign, mucus-filled bump that forms on the cervix—the lower part of the uterus that opens into the vagina. These cysts are common and typically harmless. Causes: cysts develop when the mucus-producing glands in the cervix become blocked, leading to the accumulation of mucus. This blockage can result from minor trauma, childbirth, or inflammation.

Nabothian cyst

is a condition where the lining of the uterus (endometrium) becomes abnormally thickened. This thickening can lead to irregular menstrual bleeding and, in some cases, may increase the risk of developing endometrial cancer.

Endometrial hyperplasia

also known as intrauterine adhesions or uterine synechiae, is a condition where scar tissue forms inside the uterus, leading to the fusion of the uterine walls. This scarring can result from trauma to the endometrial lining, often due to surgical procedures.

Asherman's syndrome

Is a medication primarily used to treat and prevent certain types of breast cancer. It functions as a selective estrogen receptor modulator (SERM), blocking estrogen's effects on breast tissue, thereby inhibiting the growth of estrogen-dependent cancer cells. Serious Risks: While the drug is effective, it carries certain risks: Increased risk of uterine cancer -Blood clots, including deep vein thrombosis (DVT) and -pulmonary embolism -Stroke

Tamoxifen

Uterine abscesses are localized collections of pus within the uterus, often resulting from infections. They can be classified based on their location and the underlying cause.

Endometrial Abscess: -Description: An infection confined to the inner lining of the uterus (endometrium). -Causes: Often arises from pelvic inflammatory disease (PID), which can lead to the formation of an abscess in the uterus. -Symptoms: May include fever, pelvic pain, and abnormal vaginal discharge. Tubo-Ovarian Abscess: -Description: A collection of pus involving the fallopian tubes and ovaries, but can also develop in the uterus or other pelvic organs. -Causes: Typically a complication of PID. -Symptoms: Similar to endometrial abscesses, with additional signs such as nausea and vomiting. Pelvic Abscess: -Description: A broader term encompassing abscesses in the pelvic region, including those near the uterus. -Causes: Can result from various infections, including those of the reproductive organs. -Symptoms: High fever, pelvic mass, vaginal bleeding or discharge, and lower abdominal pain.

is an abnormal accumulation of lymphatic fluid within the body, typically occurring after surgical procedures that disrupt normal lymphatic flow. These fluid collections are not lined by epithelial cells but are instead surrounded by dense fibrotic tissue.

lymphocele

Ovarian benign cysts are fluid-filled sacs that develop on or within the ovaries. They are common and typically noncancerous, often resolving on their own without treatment.

Types of Benign Ovarian Cysts: Functional Cysts: -Follicular Cysts: Form when the follicle (the sac that contains the egg) doesn't release the egg and continues to grow. -Corpus Luteum Cysts: Develop after the follicle releases the egg; if the sac doesn't shrink, it can fill with fluid or blood. Dermoid Cysts (Mature Cystic Teratomas): -Contain various types of tissue, such as hair, skin, or teeth, due to the presence of multiple germ layers. Endometriomas: Result from endometriosis, where tissue similar to the uterine lining grows outside the uterus and attaches to the ovary, forming a cyst. Cystadenomas: Develop from cells on the outer surface of the ovary and can be filled with a watery or mucous-like substance.

is a type of functional cyst that occurs when a blood vessel within a normal ovarian cyst ruptures, leading to bleeding into the cyst. These cysts are typically benign and often resolve on their own without intervention.

hemorrhagic ovarian cyst

also known as a dermoid cyst, is a common type of germ cell tumor that typically occurs in the ovaries. These tumors are composed of well-differentiated tissues derived from multiple germ layers, including ectoderm, mesoderm, and endoderm. As a result, they can contain a variety of tissue types such as hair, skin, teeth, fat, and sometimes even more complex structures.

benign cystic teratoma

is a type of benign epithelial tumor that commonly arises in the ovary. These tumors are characterized by cystic structures lined with mucin-producing epithelial cells. They account for approximately 15–20% of all ovarian tumors and are known for their potential to grow quite large, sometimes extending into the abdomen.

mucinous cystadenoma

is a rare ovarian neoplasm that falls under the category of surface epithelial-stromal tumors and resembles the cells found in the urinary tract (urothelium). These tumors are typically benign, though borderline and malignant variants exist. They are most commonly diagnosed incidentally during pelvic examinations or imaging studies, as they often do not produce noticeable symptoms and commonly occurs in women between the ages of 40-70.

Brenner tumor

is a rare, typically benign ovarian tumor arising from the ovarian stromal cells, specifically the theca cells. These tumors are part of the sex cord-stromal tumor category and are known for their potential to produce hormones, predominantly estrogen.

thecoma

is a benign tumor arising from the connective tissue of the ovary. These tumors account for approximately 4% of all ovarian neoplasms and are most commonly diagnosed in women during perimenopause and postmenopause, with a median age of around 52 years. Ovarian fibromas are composed of spindle-shaped fibroblastic cells that produce collagen. Under the microscope, these tumors display intersecting bundles of these cells.

ovarian fibroma

is a rare type of ovarian neoplasm that originates from the sex cord-stromal cells of the ovary. These tumors are characterized by the presence of both Sertoli cells, which are typically involved in nurturing sperm cells, and Leydig cells, known for producing male sex hormones like testosterone. The cell tumors account for less than 0.5% of all ovarian tumors and are most commonly diagnosed in women aged 20 to 30, though they can occur at any age.

Sertoli-Leydig cell tumor

is a rare tumor that arises in the gonads (ovaries or testes) and comprises a mixture of germ cells and sex cord-stromal cells, such as immature Sertoli or granulosa cells. While they are typically benign, they have a significant potential to develop into malignant germ cell tumors, most commonly dysgerminomas

gonadoblastoma