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OBGYN > GYN registry review > Flashcards

GYN registry review Flashcards

(92 cards)

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1
Q

Boney boundaries of female pelvis

A

Sacrum, Coccyx, Ilium, Ischium, Pubic Symphysis

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2
Q

TRUE pelvis

A

Deep and below linea terminalis, structures only seen in transvaginal imaging

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3
Q

Organs of the TRUE pelvis

A

Bladder
Small bowel
Ascending/Descending colon
Rectum
Uterus
Ovaries
Fallopian Tubes
Internal Iliac
4 muscles

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4
Q

4 muscles of the TRUE pelvis

A

Levator ani
Coccygeus
Obturator internus
Piriformis

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5
Q

Hammock shaped muscles that support pelvic organs

A

Levator ani and coccygeus

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6
Q

Result of weakened levator ani and coccygeous muscles

A

Uterine prolapse

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7
Q

Muscles found in the adnexas

A

Obturator internus (lateral to bladder)
Piriformis (posterolateral)
Iliopsoas (anterolateral)

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8
Q

Broad ligaments

A

A double fold of the peritoneum, laterally attached to the walls of the pelvis, supports pelvic organs

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9
Q

Round ligaments

A

Found BETWEEN the folds of the broad ligament, superiorly supports the fundus of the uterus

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10
Q

Cardinal ligaments

A

Contains vasculature of uterus

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11
Q

Space of Retzius (retropubic space)

A

Space anterior to the bladder

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12
Q

Adnexa

A

Lower quadrants of abdomen, lateral spaces of uterus. Contains ovaries (illiacs are landmarks)

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13
Q

Anterior Cul De Sac (vesicouterine pouch)

A

Space between anterior uterus and bladder

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14
Q

Pouch of Douglas (rectouterine pouch/posterior cul de sac)

A

Space between posterior uterus and rectum

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15
Q

Uterine arteries

A

branches of internal iliac arteries

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16
Q

Arcuate arteries

A

Periphery of myometrium

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17
Q

Radial arteries

A

Deeper into myometrium

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18
Q

Straight arteries

A

Feeds basal layer of endometrium

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19
Q

Spiral arteries

A

Feeds functional layer of endometrium

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20
Q

Ovarian (gonadal) arteries

A

Originate at aorta

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21
Q

Ovarian blood supply

A

Receive blood from ovarian artery and uterine artery

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22
Q

Uterine vein

A

Drains into internal iliac veins

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23
Q

Right ovarian vein

A

Drains into IVC

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24
Q

Left ovarian vein

A

Drains into left renal vein
*longest pelvic vessel

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25
Uterus
A retroperitoneal organ, developed from fusion of paired Mullerian ducts. Sits between rectum and bladder with broad ligaments bound bilaterally
26
Uterine fundus
Most superior and widest part of uterus, fallopian tubes attach at uterine cornu
27
Uterine corpus
Body of uterus, largest area
28
Uterine Isthmus
Lower uterine segment during pregnancy
29
Cervix
Internal and external os
30
External os
Opens into most inferior part of vaginal canal, surrounded by vaginal fornix
31
Perimetrium (serosa layer)
Outermost layer of uterus (organ fascia)
32
Myometrium
Muscular layer of uterus
33
Endometrium
Mucosal layer of uterus-- consists of basal layer and functional layer
34
Basal layer
Deep endometrial layer
35
Functional layer
Superficial endometrial layer that SHEDS during menses
36
Neonatal uterus size and shape
Prominent uterus due to maternal hormone stimulation. Enlarged cervix (double size of body)
37
Prepubertal uterus size and shape
Tubular shape. Body size=cervix size
38
Puberty uterus size and shape
Increased fundal diameter (pear shape) 6-8cm during reproductive years
39
Menopausal uterus size and shape
Decreased size, 4-6cm
40
Anteverted
Body of uterus TILTS forward at 90 degree angle with cervix
41
Anteflexed
Body of uterus FOLDS forward coming in contact with the cervix
42
Retroflexed
Body of uterus FOLDS back coming in contact with the cervix
43
Retroverted
Body of uterus TILTS back without a bend, no contact with uterus
44
Detroflexed
Flexed to the right
45
Levoflexed
Flexed to the left
46
Fallopian tubes (salpinges)
7-12cm tubes extending from cornu of uterus within the broad ligaments to the adnexa. Means for fertilization and transportation to uterus
47
48
Fallopian tube cilia
Tiny, hair like structures inside tubes that move back and forth to aid the movement of the fertilized ovum
49
Interstitial segment
Most proximal segment of fallopian tube, where tube attaches to uterus cornu
50
Isthmus segment
"Bridge" that connects the interstitial segment to the ampulla segment of the fallopian tube
51
Ampulla segment
Longest and most tortuous segment of the fallopian tube *most common location of fertilization and ectopics*
52
Infundibulum segment
Distal and widest portion of fallopian tube with fimbria at the end
53
Fimbria
Fingerlike extensions of infundibulum that draw unfertilized egg into tube
54
Ovaries
Paired, intraperitoneal ENDOcrine organs Supported laterally of uterus by ovarian ligaments and laterally of pelvic walls by suspensory ligaments
55
Hormones produced by ovaries
Estrogen and Progesterone as response to FSH (follicle stimulating hormone) and LH (luteinizing hormone)
56
Outer cortex of ovaries
Site of oogenesis/follicles
57
Medulla of ovaries
Site of vasculature and lymphatics
58
Ovarian response to FSH
Follicles develop--> Graafian follicle matures--> thecal cells of follicle produce estrogen--> ovum found inside cumulus oophorus of dominant follicle--> ovulation in 36 hours
59
Ovarian response to LH
Graafian ruptured and replaced by corpus luteum--> corpus luteum releases progesterone--> corpus luteum regresses and replaced with corpus albicans
60
Hormone release order during menstrual cycle
Gonadotropin releasing hormone (via hypothalamus) stimulates anterior pituitary gland --> anterior pituitary gland releases FSH --> FSH (via pituitary) stimulates ovaries to develop and mature dominant follicle --> follicles produce estrogen --> dominant follicles mature leading to peak in estrogen --> LH surge released (via pituitary) --> stimulates rupture of dominant follicle (AKA ovulation) --> ruptured follicle = corpus luteum and releases PROGESTERONE and some estrogen
61
Estrogen affect on endometrium
Thickens endometrium
62
Progesterone affect on endometrium
Maintains and prepares endometrium for implantation
63
NO pregnancy affects on endometrium
Endometrium slough off and menses begin due to drop in progesterone levels
64
Follicular phase days 1-14
-FSH stimulates follicle development -Dominant follicle matures to ~2.5-2.7cm until ovulation -Follicles release estrogen
65
Menstrual phase days 1-5
Menses and shredding of endometrium
66
Early proliferative phase days ~6-10
-Immediately following menses -Thin, echogenic endometrium -Endo no more than 4mm
67
Late proliferative phase days ~10-14
-Endo will reach 6-10mm -"Three line sign" (echogenic basal layer surrounding hypoechoic functional layer)
68
Ovulation day 14
-LH surge ruptures dominant follicle releasing ovum -FF possibly seen in post CDS *occurs 14 days prior to start of next menstrual cycle*
69
Luteal phase days 15-28
-Graafian follicle becomes corpus luteum producing progesterone to maintain endo thickness NO fertilization by day 28 = regression of CL cyst
70
Secretory phase
-Progesterone maintains thickness for implantation -Endo thick and echogenic 7-16mm -Progesterone drop = begin menses
71
Gravida
Total number of pregnancies
72
Para
Total number of pregnancies carried to term
73
Mittelschmertz
Middle pain, pain in the middle of cycle near ovulation
74
Primary amenorrhea
Failure to have menses by age 16; never reached menarche
75
Secondary amenorrhea
Menses stopped
76
C-section scar/defect
Fluid or separation of c-section scar
77
C-section dehiscence
Myometrial walls are separating
78
Dehiscence
A partial or total separation of previously approximated wound edges, due to a failure of proper wound healing
79
Intrauterine device (IUD)
-Device that prevents implantation of fertilized ovum -Echogenic linear echo with posterior shadowing or reverberation within endometrial cavity
80
Postmenopausal asymptomatic endometrium measures
NO bleeding < or equal to 8mm
81
Postmenopausal symptomatic endometrium measures
YES bleeding < equal to 5mm
82
Postmenopausal HRT endometrium measures
Variable/premenopausal appearance
83
Early proliferative endometrium measures
4-6mm
84
Late proliferative endometrium measures
6-10mm
85
Secretory endometrium measures
< equal to 16mm
86
Amenorrhea
Without menses
87
Hypomenorrhea
Decreased menses
88
High resistance doppler
Less diastole, less volume flow
89
Lower resistance doppler
More diastole, more volume flow
90
Ovarian doppler during menstrual and early proliferative phase
High resistive, demands for blood are low *most accurate time especially in presence of mass
91
Ovarian doppler during mid cycle and luteal
Lower resistance
92
Non-gravida uterus doppler
Normally high resistance *decreased resistance can be found in cancer and traumatic AVM

OBGYN (17 decks)

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