Chapter 17--- the uterus and vagina

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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


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