Chapter 17: The Uterus and Vagina

"colli"= "cornu"=

"colli"= neck/cervix of the uterus "cornu"= horn of the uterus Examples: bicornis unicollis= 2 horns with one cervix bicornis bicollis= 2 horns with double cervix

"colpo"= "metra"=

"colpo"= refers to the vagina "metra"= refers to the uterus Examples: hydrocolpus= fluid in the vagina hydrometrocolpus= fluid in both the uterus and vagina

What is the normal position of the uterus?

Anteversion or anteflexion

Uterus didelphys

Complete duplication of the uterus, cervix, and vagina ("cut in half"

The most common benign gynecologic tumor and the leading cause of hysterectomy and gynecologic surgery.

Leiomyomas

Unicornate uterus

Uterus connects to one ovary while the other ovary is not connected due to incomplete development of one of the paramesonephric ducts

Which of the following is typically not a clinical complaint of women who are suffering from adenomyosis? a. Amenorrhea b. Dysmenorrhea c. Dyspareunia d. Menometrorrhagia

a. Amenorrhea

The uterine position in which the corpus tilts forward and comes in contact with the cervix describes: a. Anteflexion b. Anteversion c. Retroflexion d. Retroversion

a. Anteflexion

The largest part of the uterus is the: a. Corpus b. Isthmus c. Cervix d. Fundus

a. Corpus

Abnormally heavy and prolonged menstrual flow between periods is termed: a. Menometrorrhagia b. Menarche c. Menorrhagia d. Dysmenorrhea

a. Menometrorrhagia

All of the following are clinical findings associated with leiomyoma except: a. Myometrial cysts b. Infertility c. Palpable pelvic mass d. Menorrhagia

a. Myometrial cysts

A 38-year-old female patient presents to the sonography department for a pelvic sonogram with an indication of pelvic pain. Upon sonography interrogation, the sonographer notes an anechoic mass within the cervix. This mass most likely represents a: a. Nabothian cyst b. Benign follicular cyst c. Dermoid cyst d. Gartner duct cyst

a. Nabothian cyst

Which of the following fibroid locations would most likely result in abnormal uterine bleeding because of its relationship to the endometrium? a. Submucosal b. Intramural c. Subserosal d. Subserosal pedunculated

a. Submucosal

Hematometra (uterus) Hematocolpos (vagina)

accumulation of fluids into the uterus (may have blood components from mestruation retained in the uterine cavity or vagina)

Precocious puberty is defined as the development of pubic hair, breasts, and the genitals before the age of: a. 13 b. 8 c. 5 d. 10

b. 8

The inner mucosal lining of the uterus is the: a. Myometrium b. Endometrium c. Serosal layer d. Perimetrium

b. Endometrium

A 24-year-old female patient presents to the sonography department for a pelvic sonogram with an indication of pelvic pain. Upon sonographic interrogation, the sonographer notes an anechoic mass within the vagina. This mass most likely represents a: a. Nabothian cyst b. Gartner duct cyst c. Dandy-Walker cyst d. Ovarian cyst

b. Gartner duct cyst

A simple fluid accumulation within the vagina secondary to an imperforate hymen is: a. Hydrometrocolpos b. Hydrocolpos c. Hematometra d. Hematocolpos

b. Hydrocolpos

Anechoic fluid noted distending the uterus and vagina within a pediatric patient is termed: a. Hydrocolpos b. Hydrometrocolpos c. Hydrometra d. Hematometrocolpos

b. Hydrometrocolpos

The recesses of the vagina are the: a. Cornu b. Isthmi c. Fornices d. Parity

b. Isthmi

What section of the uterus is also referred to as the lower uterine segment? a. Cervix b. Isthmus c. Fundus d. Cornu

b. Isthmus

A patient presents to the sonography department for a pelvic sonogram with a history of adenomyosis that was diagnosed following an MRI of the pelvis. What are the most likely sonographic findings? a. Complex, bilateral adnexal masses b. Myometrial cysts with enlargement of the posterior uterine wall c. Endometrial thinning and cervical dilation d. Uterine atrophy with bilateral ovarian cysts

b. Myometrial cysts with enlargement of the posterior uterine wall

Which of the following would be most indicative of a leiomyosarcoma? a. Vaginal bleeding b. Rapid growth c. Dysuria d. Large hypoechoic mass

b. Rapid growth

Upon sonographic evaluation of a patient complaining of abnormal distention, you visualize a large, hypoechoic mass distorting the anterior border of the uterus. What is the most likely location of this mass? a. Intramural b. Subserosal c. Submucosal d. Intracavitary pedunculated

b. Subserosal

Hydrometrocolpus

both uterus and vagina are filled with blood

The uterus is bound by the...

broad ligaments

Absence of a menstruation is referred to as: a. Dysuria b. Dysmenorrhea c. Amenorrhea d. Menorrhagia

c. Amenorrhea

The normal position of the uterus is: a. Retroverted b. Retroflexed c. Anteverted d. Dysverted

c. Anteverted

The rigid region of the uterus located between the vagina and the isthmus is the: a. Cornu b. Corpus c. Cervix d. Fundus

c. Cervix

Difficult or painful intercourse is referred to as: a. Dysuria b. Dysmenorrhea c. Dyspareunia d. Hydrocolpos

c. Dyspareunia

The inferior portion of the cervix closest to the vagina is the: a. Cornu b. Internal os c. External os d. Inferior fornix

c. External os

The layer of the endometrium that is significantly altered as a result of hormonal stimulation during the menstrual cycle is the: a. Myometrium b. Endometrial cavity c. Functional layer d. Basal layer

c. Functional layer

The superior portion of the cervix is the: a. Cornu b. Corpus c. Internal os d. External os

c. Internal os

The surgical removal of a fibroid is termed: a. Hysterosonogram b. Total abdominal hysterectomy c. Myomectomy d. Uterine artery embolization

c. Myomectomy

What leiomyoma location would have an increased risk to undergo torsion? a. Subserosal b. Intracavitary c. Pedunculated d. Submucosal

c. Pedunculated

Leiomyosarcoma of the uterus denotes: a. The benign invasion of endometrial tissue into the myometrium b. The ectopic location of endometrial tissue in the adnexa c. The malignant counterpart of a fibroid d. An anechoic, simple cyst located within the cervix

c. The malignant counterpart of a fibroid

Congenital malformation of the uterus that results in complete duplication of the genital tract is: a. Unicornuate uterus b. Bicornis bicollis c. Uterus didelphys d. Subseptate uterus

c. Uterus didelphys

Hydrocolpus

condition is which the vagina is distended with simple, anechoic fluid (more often seen in neonatal period)

Septate uterus

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

The invasion of endometrial tissue into the myometrium of the uterus is referred to as: a. Amenorrhea b. Endometriosis c. Adenomyomatosis d. Adenomyosis

d. Adenomyosis

The outer layer of the endometrium is the: a. Myometrium b. Endometrial cavity c. Functional layer d. Basal layer

d. Basal layer

Pseudoprecocious puberty may be associated with all of the following except: a. Ovarian tumor b. Adrenal tumor c. Liver tumor d. Brain tumor

d. Brain tumor

All of the following are sonographic findings consistent with adenomyosis except: a. Diffuse, enlarged uterus b. Myometrial cysts c. Hypoechoic areas adjacent to the endometrium d. Complex adnexal mass

d. Complex adnexal mass

The area of attachment of the fallopian tubes to the uterus is the: a. Fundus b. Corpus c. Isthmus d. Cornua

d. Cornua

The most superior and widest portion of the uterus is the: a. Corpus b. Isthmus c. Cervix d. Fundus

d. Fundus

A 13-year-old girl presents to the sonography department with a history of cyclic pain, abdominal swelling, and amenorrhea. Sonographically, you visualize an enlarged uterus and a distended vagina that contains anechoic fluid with debris. What is the most likely diagnosis? a. Cervical stenosis b. Adenomyosis c. Endometriosis d. Hematocolpos

d. Hematocolpos

The location of a fibroid within the myometrium is termed: a. Submucosal b. Intracavitary c. Subserosal d. Intramural

d. Intramural

The paired embryonic ducts that develop into the female urogenital tract are the: a. Fallopian ducts b. Wolffian ducts c. Gartner ducts d. Müllerian ducts

d. Müllerian ducts

Leiomyomas that project from a stalk are termed: a. Submucosal b. Intramural c. Subserosal d. Pedunculated

d. Pedunculated

What congenital malformation of the uterus is common and has a clear association with an increased risk for spontaneous abortion? a. Anteflexed uterus b. Levoverted uterus c. Dextroverted uterus d. Septate uterus

d. Septate uterus

Which of the following would be considered the more common uterine anomaly? a. Bicornis univernus b. Bicornis bicollis c. Uterus didelphys d. Septate uterus

d. Septate uterus

Adenomyoma

focal adenomyosis in the form of a mass.

Adenomyosis

is the invasion of endometrial tissues into the myometrium and it is often present in the uterus afflicted with fibroid tumors.

During pregnancy the isthmus may be referred to as the...

lower uterine segment

After menopause the uterus typically becomes...

much smaller than the premenopausal uterus

Most common Mullerian duct anomaly:

septate uterus

What are the three layers of the uterine wall?

serosal layer (AKA perimetrium, adventitia)= outer layer muscular layer (AKA myometrium)= middle layer mucosal layer (AKA endometrium)= inner layer * endometrium is divided into the deep basal layer (outer) and the superficial function layer (inner) that shedsNorma

Arcuate uterus

slight indentation of fundus

The endometrial cavity is located between the....

two functional layers of the endometrium

The endometrial cavity is also referred to as the...

uterine cavity

Leiomyomas are also called

uterine fibroid or uterine myoma

intramural means

within the myometrium