Chapter 17--- the uterus and vagina
Congenital malformations of the vagina can lead to what?
Accumulation of fluid within the female genital tract secondary to an obstruction
Intramural for pedunculated fibroids that tourists what are the clinical findings?
Acute, localized pelvic pain
A focal mass of adenomyosis
Adenomyoma
The benign invasion of endometrial tissue into the myometrium of the uterus
Adenomyosis
The size and shape of the uterus depends on what?
Age of patient, parity, presence of pathology or congenital anomalies
The normal position of the uterus is considered to be what?
Anteversion or anteflexion
What are the clinical findings of a Gartner duct cyst?
Asymptomatic
Physical defects that are present in a person at Birth
Congenital malformation
Areas just inferior to the fundus of the uterus where the Fallopian tubes attached bilaterally
Cornua
The uterine body
Corpus
What is the largest part of the uterus?
Corpus or body
What are the sonography findings of adenomyosis?
Diffusely enlarged uterus, hypoechoic or academic areas adjacent to the endometrium, heterogeneous myometrium, myometrial cyst, ill-defined interface between myometrium and endometrium, thickening of the posterior myometrium
What are the sonography findings of vaginal obstructions?
Distention of the uterus, vagina, or both with anechoic or complex fluid
Area that lies between the two layers of the endometrium AKA uterine cavity
Endometrial cavity
An important differentiation should be made between endometriosis and adenomyosis. Discuss the differences.
Endometriosis tend to be younger and have fertility problems while adenomyosis are often older and multiparous
The inner mucosal layer of the uterus
Endometrium
The inferior portion of the cervix in close contact with the vagina
External OS
The functional inner layer of the endometrium that is altered by the hormones of the menstrual cycle
Functional layer
The most Superior and widest portion of the uterus
Fundus
The uterus can be divided into what four major divisions?
Fundus, Corpus, Isthmus, cervix
A benign cyst located within the vagina
Gartner duct cyst
Blood accumulation within the vagina
Hematocolpos
Fluid accumulation within the vagina
Hydrocolpos
A vaginal and Emily in which the hymen has no opening, therefore resulting in an obstruction of the vagina
Imperforate hymen
How might a Cervical Carcinoma appear sonography?
In homogeneous, enlarged cervix or a focal Mass within the cervix
The superior portion of the cervix closest to the isthmus
Internal os
A leiomyoma located within the uterine
Intracavitary
A benign smooth muscle tumor of the uterus AKA fibroid AKA uterine Myoma
Leiomyoma
During pregnancy the isthmus may be referred to as what?
Lower uterine segment
Heavy and prolonged bleeding between periods
Menometrorrhagia
Paired embryonic ducks that develop into the female urogenital tract
Mullerian ducts
The first 4 weeks after birth
Neonatal
Who are at a greater risk for development of fibroids?
Obese, black, non-smokers, perimenopause
Pseudoprecocious puberty has been linked with what?
Ovarian, adrenal, and liver tumors
Mullerian ducts AKA?
Perimesonephric ducts
What is the primary function of the uterus?
Provide a place for the products of conception to implant and develop
Congenital malformation of the uterus that results in a single septum that separates two endometrial cavities
Septate uterus
Location of leiomyoma in which the tumor grows outward and distorts the Contour of the uterus
Subserosal
The cervix is marked Superiorly by what and inferiorly by what?
Superior is the internal os and inferior is the external os
Congenital malformation of the uterus that results in the uterus with one horn
Unicornuate uterus
Besides a hysterectomy or myomectomy what is an alternative treatment for fibroids?
Uterine artery embolization
Procedure used to block the blood supply to a leiomyoma
Uterine artery embolization
What are the clinical findings of adenomyosis?
Uterine enlargement, dysmenorrhea, menometrorrhagia, pelvic pain, despareunia, multiparous
Following the neonatal period the cervical anterioposterior is equal to or slightly greater than what?
Uterine fundus
Congenital malformation of the uterus that results in complete duplication of the uterus, cervix, vagina
Uterus didelphys
What develop from the paired mullerian ducts?
Uterus, vagina, fallopian tubes
Occlusion or in perforation of the vagina, can be congenital or acquired
Vaginal atresia
With congenital malformation of the vagina the obstructions can be the result of what?
Vaginal atresia, vaginal septum, imperforate hymen
The normal pre-pubertal uterus has a cervix to uterus ratio of what?
2 to 1
Failure of an organ to grow during embryologic development
Agenesis
The absence of menstrual period
Amenorrhea
The uterine body tilts forward and comes in contact with a cervix forming an acute angle between body and cervix
Anteflexion
The typical version of the uterus where the uterine body tilts forward, forming a 90 degree angle with the cervix
Anteversion
What are the clinical findings of a nabothian cyst?
Asymptomatic
The most common uterine anomaly in which the endometrium divides into two horns AKA bicornis unicollis
Bicornuate uterus
Is the involvement of adenomyosis focal or diffuse?
Both, more often within the posterior portion of the uterus
Pelvic ligament that extends from the lateral aspect of the uterus to the side walls of the pelvis
Broad ligament
The consequence of obstructions for congenital malformation of the vagina could lead to what?
Distention of the vagina, cervix, uterus and Fallopian tubes with blood or fluid
In the neonatal period what does the uterus look like?
Distinct endometrial echoes in the first week of life
Painful sexual intercourse
Dyspareunia
Painful or difficult urination
Dysuria
The vagina is a tubular organ which extends from where to where?
External os of the cervix to the external genitalia
Adenomyosis is often present in the uterus Afflicted with what?
Fibroid tumors
Blood accumulation within the uterine cavity
Hematometra
Blood accumulation within the uterus and vagina
Hematometrocolpos
fluid accumulation within the uterus and vagina
Hydrometrocolpos
What are the sonography findings of uterine leiomyoma?
Hypoechoic Mass within the uterus, posterior shadowing from the mass, degenerating fibroids may have calcifications or cystic components, multiple fibroids appear as an enlarged irregular shaped diffusely heterogeneous uterus
The surgical removal of the uterus
Hysterectomy
What is treatment for adenomyosis?
Hysterectomy or hormone therapy
What fibroids usually lead to abnormal uterine bleeding because of their location in relationship to the endometrium?
Intracavitary
Area of the uterus between the Corpus and the cervix
Isthmus
The term used for the Isthmus of the uterus during pregnancy
Lower uterine segment
Abnormally heavy and prolonged menstruation
Menorrhagia
Having birth more than one child
Multiparous
The surgical removal of a Myoma of the uterus
Myomectomy
The muscular layer of the uterus
Myometrium
Benign cyst located within the cervix
Nabothian cysts
Hydrocolpos is often seen in what age of patient?
Neonatal
The total number of completed pregnancies that I've reached the age of viability
Parity
What are the clinical findings of vaginal obstructions?
Pelvic pain, enlarged uterus, abdominal pain, urinary retention, amenorrhea
What are the clinical findings of leiomyosarcoma
Pelvic pressure, menorrhagia, palpable abdominal Mass, enlarged bulky uterus, urinary frequency, dysuria, constipation, infertility
What are the clinical findings of the uterine leiomyoma?
Pelvic pressure, menorrhagia, palpable pelvic Mass, enlarged bulky uterus, urinary frequency, dysuria, constipation, infertility
Leiomyosarcoma are more commonly found in what woman?
Perimenopausal or postmenopausal
The outer layer of the uterus AKA serosal layer
Perimetrium
Defined as pubertal development for the age of eight, the early development of pubic hair, breasts, or genitals
Precocious puberty
Secondary sexual development induced by sex steroids or from other sources like ovarian tumors, adrenal tumors, or steroid use
Pseudoprecocious puberty
What are the sonography findings of leiomyosarcoma?
Rapidly growing Mass within the uterus, hypoechoic Mass within the uterus, posterior shadowing from the mass, degenerating fibroids may have calcifications or cystic components, multiple fibroids appear has an enlarged irregular shaped diffusely heterogeneous uterus
The uterine body tilts backward and comes in contact with the cervix for me an acute angle between body and cervix
Retroflexion
The uterine body tilts backward without a Bend where the cervix and body meet
Retroversion
The outermost layer of the uterus AKA parimetrium
Serosal layer
A leiomyoma that distorts the shape of the endometrium
Submucosal
Congenital malformation of the uterus that results in abnormal uterine Contour with an endometrium that branches into two horns
Subseptate uterus
Each fallopian tube attaches to the uterus at the level of what?
Uterine horns called the cornua
Recesses of the vagina
Vaginal fornices
Asymptomatic what are the sonography findings of a nabothian cyst?
Anechoic Mass within the cervix, maybe multiple, maybe complex
What are the sonography findings of a Gartner duct cyst?
Anechoic Mass within the vagina
The non-functional outer layer of the endometrium
Basal layer
What is the most common female malignancy in women younger than 50?
Cervical Carcinoma
The rigid region of the uterus located between the Isthmus and vagina
Cervix
Difficult or painful menstruation
Dysmenorrhea
Location of leiomyoma within the myometrium of the uterus
Intramural
What is the most common location for fibroids?
Intramural
What is the most common benign gynecologic tumors in the leading cause of hysterectomy and gynecologic surgery?
Leiomyoma
Something that grows off a stalk
Pedunculated
A drug administered to pregnant women from the 1940s to the 1970s to treat threatened abortions and premature labor that has been linked with uterine malformation in the exposed fetus
do ethyl stop best too DES
The malignant manifestation of a leiomyoma
Leiomyosarcoma
