Uterus and Vagina

"colpo" and "metra" ?

"colpo" - vagina "metra" - uterus

how are fibroids described by their location?

-intramural: within the myometrium *most common* -subserosal: grows outward and distorts the contour of the uterus -pedunculated: usu. subserosal fibroids that are connected by a stalk *can undergo torsion* -submucosal: located adjacent to the endometrial cavity and distort shape of endometrium -intracavitary: located within uterine cavity

sonographic findings of a nabothian cyst?

1. Anechoic mass within cervix 2. May be multiple 3. May be complex

congenital uterine anomalies?

1. agenesis 2. bicornuate uterus - endometrium divides into two endometrial cavities with one cervix 3. unicornuate uterus - uterus only has one horn 4. septate uterus - two complete separate uterine cavities separated by an anterioposterior septum 5. subseptate uterus - incomplete septum, normal uterine contous with an endometrium that branches into two horns 6. uterus didelphys - complete duplication of the vagina, cervix, and uterus *"coll" = neck or cervix *"cornu" = horn of the uterus

clinical findings of a nabothian cyst?

1. asymptomatic

clinical findings of vaginal obstructions?

1. cyclic pelvic pain (often at the time of menses in adolescent girls) 2. enlarged uterus 3. abdominal pain 4. urinary retention 5. amenorrhea (adolescent girls)

sonographic findings of adenomyosis?

1. diffusely enlarged uterus 2. hypoechoic or echogenic areas adjacent to endometrium 3. heterogeneous myometrium 4. myometrial cysts 5. ill-defined interface between myometrium and endometrium 6. thickening of the fundus or posterior myometrium

sonographic findings of vaginal obstructions?

1. distention of the uterus, vagina, or both with anechoic or complex fluid

four major divisions of the uterus?

1. fundus - widest, most superior portion 2. corpus - largest part, inferior to fundus 3. isthmus - between corpus and cervix (during pregnancy isthmus may be referred to as the lower uterine segment) 4. cervix - portion of uterus that projects into vagina

sonographic findings of a uterine leiomyoma?

1. hypoechoic mass within the uterus 2. posterior shadowing from the mass 3. degenerating fibroids may have calcifications or cystic components 4. multiple fibroids appear as an enlarged, irregularly shaped, diffusely heterogeneous uterus

three layers of vagina?

1. inner mucosal layer 2. middle muscular layer 3. outer layer aka adventitia

clinical findings of leiomyosarcoma?

1. pelvic pressure 2. menorrhagia 3. palpable abdominal mass 4. enlarged, bulky uterus 5. urinary frequency 6. dysuria 7. constipation 8. infertility

clinical findings of a uterine leiomyoma?

1. pelvic pressure 2. menorrhagia 3. palpable pelvic mass 4. enlarged, bulky uterus (if multiple) 5. urinary frequency 6. dysuria 7. constipation 8. constipation 9. infertility

three layers of uterine wall?

1. perimetrium aka serosal (outermost) 2. myometrium muscular layer 3. endometrium - deep or basal layer and superficial or functional layer (thickness of functional layer varies with menstrual cycle)

sonographic findings of leiomyosarcoma?

1. rapidly growing mass within the uterus 2. hypoechoic mass within the uterus 3. posterior shadowing from the mass 4. degenerating fibroids may have calcifications or cystic components 5. multiple fibroids appear as an enlarged, irregularly, shaped, diffusely heterogeneous uterus

clinical findings of adenomyosis?

1. uterine enlargement 2. boggy, tender uterus 3. dysmenorrhea: painful menstruation 4. menometrorrhagia: excessive and prolonged bleeding at irregular intervals 5. pelvic pain 6. dyschezia :painful defecation 7. dyspareunia: painful intercourse 8. multiparous

congential malformation of the vagina?

1. vaginal atresia 2. vaginal septum 3. imperforate hymen

gartner duct cyst?

a benign cyst located within the vagina - typically noted along the wall of the vagina clinical findings? asymptomatic sonographic findings? anechoic mass within the vagina

congenital malformations?

aka mullerian anomalies physical defects that are present in a person at birth; in urogenital tract anomalies due to incomplete fusion, partial fusion or agenesis of mullerian ducts

mullerian ducts?

aka paramesonephric ducts paired embryonic ducts that develop into the female urogenital tract

leiomoma?

aka uterine myoma, fibroid benign, smooth muscle tumor of the uterus

normal position of the uterus?

anteversion or anteflexion

normal variants of uterine position?

anteversion: uterine position in which body tilts forward or anterioly forming 90 degree angle with the vagina anteflexion: uterine body folds forward retroversion: uterus body tilts posteriorly retroflexion: uterine body tilts backward and comes in contact with cervix

endometrial cavity?

area that lies between the two layers of the endometrium; may also be referred to as the uterine cavity

adenomyosis?

benign invasion of the endometrial tissue into the myometrium *often present in a uterus affected by fibroids* adenomyoma: a focal mass of adenomyosis

most common female malignancy in women younger than 50 years old?

cervical carcinoma cervical width should not exceed 4 cm

hematometra vs hematrocolpos?

hematometra: blood components from menstruation in the uterine cavity hematocolpos: blood components from menstruation in the vagina hematometrocolpos: blood components from menstruation in the uterus and vagina

hydrocolpos? vs hydrometrocolpos?

hydrocolpos: fluid accumulation within the vagina (often seen in the neonatal period) hydrometrocolpos: fluid accumulation in the vagina and uterus

diethylstilbestrol (DES)

intrauterine exposure to DES has resulted in the formation of congenital mullerian anomalies

if congenital malformation found in uterus which other organ should we be concerned with?

kidney -uterus and kidney develop at the same embryonic period

most common benign gynecologic tumors and leading cause of hyperectomy and gynecologic surgery?

leiomyomas

leiomyosarcoma?

malignant counterpart of leiomyoma

uterus in neonate?

newborn baby girl may have a thickened endometrium caused by the stimulation of the baby's endometrium by maternal hormones

precocious puberty?

pubertal development before the age of 8 *associated with intracranial tumors or may simply be idiopathic*

pseudoprecocious puberty?

secondary sexual development induced by sex steroids or other sources such as ovarian tumors, adrenal tumors, and liver tumors *linked with ovarian, adrenal, and liver tumors*

most common mullerian duct anomaly?

septate uterus

hysteroscopic uterine septoplasty?

the surgical repair of a uterine septum in a septate uterus using hysteroscopy