1
Q
What are the boundaries of the false pelvis?
A
- abdominal wall
- base of sacrum
- iliac wings
2
Q
What are the boundaries of the true pelvis?
A
- pubis and pubic rami
- sacrum and coccyx
- ilium and ischium
- pelvic diaphragm
3
Q
What are the Osseous Ligaments?
A
- Sacroiliac
- Sacrococcygeal
- Pubic
- Sacrosciatic
4
Q
What is the Cardinal Ligament?
A
Connects to uterus at level or cervix
5
Q
What is the broad ligament?
A
extend from lateral aspects of the uterus and attach to the lateral pelvic side wall
6
Q
What is the uterosacral ligament?
A
posterior support
7
Q
What is the round ligament?
A
anterior and inferior to the broad ligaments and fallopian tubes, and attach the uterine cornu to the anterior pelvic wall
8
Q
What is the ovarian ligament?
A
attach inferior ovary to the uterine cornu
9
Q
What is the mesovarium ligament?
A
attach the ovary to the posterior layer of the broad ligament on each side
10
Q
What is the infundibulopelvic (suspensory) ligament?
A
attach the lateral ovary to posterolateral pelvic wall and transmit the ovarian vessels and nerves
11
Q
What is the Rectus abdominus muscle?
A
- anterior body wall
- extends from xiphoid to pubic bone
12
Q
What is the psoas major muscle?
A
- originates from lower thoracic and lumbar vertebrae
- laterally and anteriorly
13
Q
What is the Iliacus muscle?
A
- arises at the iliac crest and extends inferiorly until is merges with the psoas major
- forms part of lateral margins of the pelvic basin
14
Q
What is the Obturator Internus muscle?
A
- Triangular sheet of muscle anchored along the brim of the true pelvis
- posteriorly and medially along side wall of true pelvis
15
Q
what is the Piriformis muscle?
A
- deeply posterior in true pelvis
- less routinely imaged to due to its deep location
16
Q
What are the Abdominopelvic Muscles?
A
- Rectus Abdominus
- Psoas Major
17
Q
What muscles are in the false pelvis?
A
Iliacus
18
Q
What muscles are in the true pelvis?
A
- Obturator Internus
- Piriformis
- Coccygeous
- Levator Ani
19
Q
What is the uterine size of a 2-8 year old?
A
33 x 7.5 mm (AP)
20
Q
What is the uterine size g-menarche?
A
43 x 13 mm (AP)
21
Q
what is the uterine size of nulliparous?
A
80 x 30 mm (AP)
22
Q
What is the uterine size of multiparous?
A
90 x 40 mm (AP)
23
Q
What is the Perimetrium of the uterus?
A
- outer serosal layer which is part of the visceral perimetrium
- laterally becomes the broad ligament
- anteriorly forms the vesicouterine pouch
- posteriorly forms the pouch of douglas
24
Q
What is the myometrium of the uterus?
A
- muscular layer
- 3 layers of smooth muscle
- inner portion of myometrium is the junctional zone
25
What is the endometrium of the uterus?
- inner mucous layer which consists of superficial functional layer and deeper permanent basal layer
26
What is the parametrium?
tissues surrounding the uterus
27
What are all the uterine layers from outer to inner?
perimetrium > myometrium > basal layer endometrium > functional layer of endometrium
28
What is an anteverted uterus?
forward placement of the uterus at the cervix
29
What is an anteflexed uterus?
bending forward of the uterus at the body
30
What is an retroverted uterus?
tilting backward of the uterus at the cervix
31
What is a retroflexed uterus?
bending backward of the uterus at the body
32
What is the most common uterine position ?
Anteverted and Anteflexed
33
What is the normal ovarian size for premenopausal?
3.5 x 2.0 x 1.5 cm
34
What is the normal ovarian size for postmenopausal?
2.0 x 1.0 x 0.5 cm
35
What are the two layers of the ovaries?
1. functional layer (cortex)
| 2. medulla
36
What is the interstitial/ intramural of the uterus?
narrow and relatively straight; located within uterine wall (cornu)
****Ectopic can cause bleed out****
37
What is the isthmus of the uterus?
median closest to uterus
38
What is the ampulla of the uterus?
longest portion; curves around ovary
| Normally site of fertilization
39
What is infundibulum?
outer, trumpet shaped
40
What are Fimbriae?
finger like projections which maintain a close relationship between tube and ovary
41
What is the Space of Retzius?
Retropubic or prevesical space
| - located between pubic bone and the anterior urinary bladder
42
What is the Vesicouterine Space?
- anterior cul-de-sac
| - anterior to the uterus and posterior to bladder
43
What is the Rectouterine Space?
- posterior cul-de-sac
| - posterior to the uterine cervix and anterior to rectum
44
What are the branches off of the uterine arteries from outer to inner?
uterine a. > arcuate a. > radial a. > spiral a.
45
What are the ovarian arteries?
Gonadal arteries are lateral branches of the aorta just below the level of the renal arteries
46
What does the right ovarian vein empty into?
IVC
47
What does the left ovarian vein empties into?
Left renal vein
48
What is LH (Luteinizing Hormone) ?
stimulates maturation of follicle and is responsible for graafian follicular rupture causing ovulation.
- stimulates endometrial growth
49
What hormone does the Hypothalamus produce?
Gonadotropic releasing hormone (GnRH)
50
What is FSH (follicle stimulating hormone)?
stimulates growth and development of ovarian follicles.
| Theca cells produce estrogen, stimulates endometrial growth
51
What does a corpus luteum cyst secrete?
Progesterone and estrogen
- ovulation of dominant follicles
- resolves by 16 weeks gestation
52
What is Mittleschmerz?
Unilateral pelvic pain occurs mid cycle at ovulation
53
What is the Follicular phase?
- days 1-14
54
What is Ovulation?
- Day 14
| - A surge of LH secretion follicular membrane usually 24-36 hours after surge
55
What is the luteal phase?
- days 15-28
56
What is the mentrual phase?
- days 1-5, endo thickeness: thin
- shedding of endometrial layer and blood cells occurs and expelled in menses
- follicular phase of ovaries
- FSH, estrogen
57
What is the proliferative phase?
- days 6-14, endo thickness: 4-8 mm
- 3 line sign
- follicular phase of ovaries, ovulation
- FSH, estrogen, LH
58
What is the secretory phase?
- days 15-28, endo thickness: 8-16 mm
- beginning at ovulation, possible implantation of uterus
- luteal phase of ovaries
- progesterone
59
What is Hydrometrocolpos?
fluid in uterus and vagina
60
What is hematocolpos?
blood in vagina
61
What is the normal measurement of endo in post menopausal women?
- 4-5 mm with Hx of bleeding
- < 8 mm in asymptomatic patient
- 10 - 12 mm on therapy
62
What is endometrial hyperplasia?
increased growth of endometrial tissue
63
What is complete agenesis?
no vagina, fallopian tubes, uterus, Cx
64
What is partial agenesis?
no upper vagina and cervix
65
What is Uterus Didelphys?
duplication of vagina, cervix, and uterus
66
What is a Bicornuate Uterus?
Most common Mullarian anomaly!!
| - single vagina, one or two cervix, lack of fusion of upper uterine cavity
67
What is a septated uterus? (Failure of Dissolution)
medium septum fails to dissolve after fusion of the two seperate mullerian ducts.
- Single vagina, cervix, and uterus with intrauterine septum
68
What is a submucous leiomyoma?
beneatth endometrial cavity
| - most commonly produce symptoms
69
What is a intramural/ interstitial fibroid?
within myometrium
70
what is a subserous fibroid?
beneath perimetrium
71
What is a intraligamentous fibroid?
between layers of broad ligament
72
What is a pedunculated fibroid?
on a pedicle or stalk, only occurs with submucous and subserous.
- can cause torsion
73
What is adenomyosis?
benign invasion of endometrial glands and stroma into myometrium
- most common affect posterior myometrium
- venetian blind shadowing
74
Cervical cancer
- second most common GYN malignancy
| - bleeding is most common symptom
75
What is hydrometra?
collection of serous fluid within endometrial cavity
76
What is endometrial carcinoma?
- most common encountered gynecologic malignancy 75-80% occurs in postmenopausal women.
- thickened endometrium >4-5 mm
77
What is endometrial hyperplasia?
proliferation of endometrial glandular tissue, can turn into endometrial carcinoma
78
What is a functional cyst of an ovary? AKA: Follicular cysts
active cysts that usually result from the stimulation of the released pituitary gonadotropins
- most common cause of ovarian enlargement in young women`
- caused by overstimulation of follicle that fails to rupture
- measure 3-8 cm
79
What is the measurement of a normal dominant follicle?
3 cm
80
What is a theca lutein cyst?
- largest functional cyst
- multilocular and bilateral
- high levels of HCG associated with gestational trophoblastic disease or hCG infertility treatment
81
What is a hemorrhagic cyst?
ovarian cyst may hemorrhage into the lumen, large size
| - internal echoes
82
What is PCOS?
Polycystic ovarian syndrome
- AKA stein- leventhal syndrome
- chronic anovulation
- bilateral multiple cysts < 1cm
- ovarian volume >10 cm
- string of pearls
83
What is a epithelial tumor?
tumors arising from the surface epithelium that covers the ovary account for 65-75% of all ovarian neoplasms.
84
What are the five categories for epithelial tumors?
1. serous
2. mucinous
3. endometroid
4. clear cell
5. transitional cell (brenner)
85
What is a serous cystadenoma tumor?
benign ovarian neoplasms
| cancer: serous cystadenocarcinoma
86
What is a mucinous cystadenoma tumor?
epithelial neoplasm
87
What is a cystic teratoma?
AKA: Dermoid
- most common benign tumor of ovary
- germ cell tumor
- " tip of the iceberg "
88
What is a Dysgerminoma?
A malignant germ cell tumor originating from the primordial germ cells of ovary
- occur in women before 30 years old
- most common malignancy in childhood
89
What is a endodermal sinus tumor? (yolk sac)
- second most common malignancy
| - Increased levels of AFP
90
What is a fibroma?
- benign stromal tumor
91
What is Meig's syndrome?
Ascites and pleural effusion with a fibrous ovarian tumor ( most common fibroma)
92
What is a thecoma?
- benign stromal tumor
- produces estrogen
- occurs in postmenopausal women
93
What is a granulosa cell tumor?
hormonal tumor, produces estrogen
| - result from precocious puberty
94
What is a krukenberg tumor?
arises from the GI primary, usually gastric carcinoma
| - also from colon or appendix
95
Know about ovarian cancer
- fifth leading cause of cancer death and fifth most common cancer in women
- family history of breast cancer
- early menses, late menopause
96
What are parovarian cyst?
persistent developmental remnants of the Wolffian ducts
| - adjacent to ovary
97
what is a endometrioma?
collection of extravasated endometrial tissue
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