Chapter 17 the uterus and Vagina

What is normal position of the uterus considered?

Anteversion, anteflex

Clinical findings of nabothin cyst

Asymptotic

Gartner's duct cyst clinical findings

Asymptotic

Separate uterus

Common congenital malformation of the uterus that results in a single septum that separates two endo cavities

bicornuate uterus

Common uterine anomaly, endo divides into two horns

Uterus didelphys

Complete duplication of the uterus, cervix, and vagina

What is the area of attachment of the Fallopian tubes to the uterus is?

Cornua

Clinical findings of vaginal obstruction.

Cycle pelvic pain Enlarged uterus Abdo pain Urinary retention Amenorrhea

Sono findings for vaginal obstruction

Dissension of the uterus, vagina, or both with anehcoic complex fluid

up to 20% of patients w andeomyoiss suffer from

Endometriosis as well

The inner mucosal lining of the uterus is the?

Endometrium

Fibroid growth has been assoc w?

Estrogen stimulation their size may increase during pregnancy

The inferior portion of the cervix closest to the vagina is?

External os

mullerian ducts develop into

Female urogenital tract

The recesses of the vagina are?

Fornices

What layer of the endo that is significantly altered as a result of hormonal stimulation during menstural cycle is?

Functional layer

Most superior widest protion of the uterus?

Fundus

What is the most superior widest portion of the uterus/?

Fundus

What is the medial treatment for fibroids

Hormone therapy

Where is a Gartner's Duct cyst located?

In vagina

Fibroids may impact fertility if they are?

Intracavity, submucosal

True precocious puberty is associated with:

Intracranial tumors or idiopathic

True precocious puberty is assoc w

Intracranial tumors or may be idiopathic

Most common location for fibroids?

Intramural (within myometrium)

Most common location for fibroids are?

Intramural or within myometrium

Lower uterine segment is used for __ during pregnancy?

Isthmus

If there is congenital anomalies of the uterus what do you also need to check?

Kidneys

What are the most common benign gynecologic tumors and the leading cause of hysterectomy surgery

Leiomyoma

___ are commonly found in perimenopausl or postmeno women

Leiomyosarcoma

Pedunclated fibroids may undergo torsion thus cutting off the blood supply to the mass the lack of blood results in?

Necrosis, patient will have acute localized pelvic pain

Cervial stenosis can be the result of an

Obstructing tumor, fibroid, polyp in the cervix

Adenoymosis is often found in :

Older and multiparous women

perimetrium

Outer layer of the uterus

Serousal layer is

Outermost layer of the uterus aka perimetrum

Patients who present with indication of precocious puberty should be seen sonographically assessed for

Ovarian hepatic and adrenal gland tumors

Pseudoprecocious puberty/ peripheral pseudosexual precocity or gonadotropin independent precious puberty has been linked w

Ovarian, adrenal gland tumors

Pseudoprecious puberty has been linked with?

Ovarian, adrenal, liver tumors

Dyspeurina

Painful sex

What leiomyoma location would have an increased risk to undergo torsion?

Pedunclated

What congenital malformation of the uterus is common and has a clear assoc w increased risk for spontaneous abortion?

Septate uterus

What is said to be one of the most common Müllerian duct anomalies?

Septate uterus

hydrocolpos the vagina is distended with? And is common in?

Simple anechoic fluid fluid, children

A newborn baby girl may have a thickened endo bc of

Stimulation of maternal hormones

What fibroid location would result in ABU bleeding bc of its relationship to the endo?

Submucosal

________ fibroids are associated with recurrent abortion

Submucosal intracavity fibroids

What fibroid grows outward and distorts the contour of the uterus?

Subseroal fibroid

internal os

The superior portion of the cervix closest to the isthmus

The endometrial cavity also referred to as the uterine cavity is located between

The two functional layers of the endi

Retroversion

Tilts backwards WITHOUT A BEND

Pendunclated fibroids may undergo

Torsion cutting off blood supply to mass

anteversion

Typical version of the uterus where uterine body tilts forward forming 90 degree angle

retroflexion

Uterine body tilts backwards forming acute angle

anteflexion of the uterus

Uterine body tilts forward forming acute angel

Clinical findings with adenomyosis

Uterine enlargement Body tender uterus Dysmenorrhea Menometrorrhagia Pelvic pain' Dyschezia Dyspareunia Multiparous

each fallopian tube attaches to the uterus at the level of the

Uterine horns called cornua

Unicornuate uterus

Uterus with one horn

hematometra

blood within the uterine cavity

What layer of the endometrium is shed during menstruation?

functional layers

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

Vagina cuff should not exceed

2cm

Cervical width should not exceed?

4cm

Menometrorrhagia

Abnormally heavy prolonged bleeding between periods

Myometrial cyst with enlargement of the posterior wall describes:

Adenomyosis

submucosal fibroid is

Adjacent to endo

Where are the submucosal fibroids located?

Adjacent to endo cavity

Sono findings of nabothin cyst

Anechoic mass May be multiple May be complex

Sono findiNg of Gartner duct cyst

Anechoic mass within vagina

Normal uterus is:

Anteverted and anteflexed

Outer layer of the endo is

Basal

The outer layer of the endo is?

Basal

What is a uterine leiomyoma

Benign smooth muscle tumor of the uterus

Hematocolpus

Blood within vagina

The uterus lies anterior to the rectum, posterior to the urinary bladder and is bounded laterally by?

Broad ligament

Subserosal fibroids that are pedunclated are those assoc w

Broad ligament could resemble adnexl mass

What is the most common malignancy in women younger then 50?

Cervical carcinoma

external os of uterus

Closes to Vagina

sono findings of adenomyosis

Diffusely enlarged uterus Hypo echo areas adjacent to endometrium Hetro myometrium Myometrial cyst Iill defined interface between myo and endo Thick fundus

The corpus is located inferior to the ?

Funds

A 13 yr old w history of cyclic pain, abdo swelling, amenorrhea, enlarged uterus, distended vagina w/ anechoic fluid diagnosis?

Hematocolpos

Anechoic fluid noted distending the uterus and vagina in a PEDIATRIC PATIENT is termed?

Hydrometrocolpos

Sono findings of uterine leiomyoma

Hypo mass within uterus Posterior shadowing Degenerating fibroids may have calcification or cystic components Multiple fibroids enlarged, irregular shaped, hetro uterus

Treatment for adenomysois is

Hysterectomy or hormone therapy

Subsequent uterus

Incomplete septum, normal contour with an endo that branches into two horns

The location of a fibroid within myometrium is?

Intramural

Patient has history of adenomyosis what is a sono appearance?

Myo cyst with enlargement of the posterior wall

Uterine wall middle layer :

Myometrium/ muscular layer; constitutes the bulk of uterine tissue providing area w contractile motion occurs

Clinical findings of uterine leiomyoma

Pelvic pressure Menorrhagia Palpable pelvic mass Enlarged bulk uterus Urinary frequency Dysuria Constipation Infertility

What indication would be the most indicative of leiomyosarcoma?

Rapid growth

Sono findings of leiomyosarcoma

Rapidly growing mass within uterus Hypo mass in uterus Posterior shadowing from mass Degenerating fibroid may have calcification or cystic components Multiple fibroids appear enlarged irregular shaped hetro ut

Patients w leiomyosarcoma may be asymptotic or present w

Same symptoms of benign leiomyoma

What is the most common Müllerian duct anomaly

Septate uterus

Pedunculated

Something that grows off a stalk

A patient complaining of abnormal distention, u visualize a large hypoechoic mass distorting the anterior border of the uterus what is the location of the mass:

Subserosal

Leiomyosarcoma of the uterus denotes ?

The malignant counterpart of a fibroid

Hematometrocolpos is? & associated w?

Uterine cavity & vagina are filled w blood; imperforated hymen in young girls

Metra refers to:

Uterus

Septate uterus common Müllerian duct describes

Uterus w two complete separate uterine cavities separated by anteroposterior septum

External os is in close contact with:

Vagina

Hydrocolpos describes :

Vagina is distended w w simple anechoic fluid seen in *NEONATAL PERIOD*

Intracavity Fibroid are located

Within uterine cavity

Those who are at a greater risk for the development of fibroids are?

Women who are obese, black, nonsmockers, perimenopausal

focal adenomyosis in the form of a mass is termed:

adenomyoma

leiomyoma

benign tumor of smooth muscle

Hydrometrocolpos

collection of fluid in the vagina and uterus'

Each Fallopian tube attaches to the uterus at the level of uterine horns called:

cornua

Largest part of the uterus is?

corpus

The largest part of the uterus is:

corpus/ body

The inner mucosal layer of the uterine wall is the

endometrium; which can be divided into basal & functional layer

menometrorrhagia

excessive uterine bleeding at both the usual time of menstrual periods and at other irregular intervals

Adenomyosis is often present in the uterus afflicted with what kind of tumors:

fibroid

hydrocolpos

fluid filled vagina

What is the most superior and widest portion of the uterus ?

fundus

A simple fluid accumulation within the vagina secondary to an imperforate hymen:

hydrocolpos

Anechoic fluid noted distending the uterus and cervix within a pediatric patient is termed: a. hydrocolpos b. hydrometrocolpos c. hydrometra d. hematometrocolpos

hydrometrocolpos

the cervix is marked superiorly by the...

internal os which is in contact w the isthmus

Adenomyosis is?

invasion of endometrial tissue into the myometrium

leiomyosarcoma

malignant tumor of smooth muscle

the uterus, vagina, and fallopian tubes develop from the paired....

mullerian ducts (paramesonephric ducts)

Dysmenorrhea

painful menstruation

Dyschezia

painful or difficult bowel movement

dysuria

painful urination

What leiomyoma location would have an increased risk to undergo torsion?

pedunculated

The outermost layer of the uterine wall is:

perimetrium/ serousal layer ; continuous w fascia of the pelvis

precocious puberty

puberty begins before the age of 8

Adenomyosis

the benign invasion of endometrial tissue into the myometrium of the uterus

Levoverted uterus

the long axis of the uterus deviating to the left of midline

Dextroverted uterus

the long axis of the uterus deviating to the right of the midline

colpo refers to

vagina

Nabothian cysts are benign cysts located __

within cervix