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Ultrasound OBGYN > Handouts > Flashcards

Handouts Flashcards

1
Q

What are the 4 regions of the Uterus?

A

Fundus
Corpus
Isthmus
Cervix

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2
Q

What is the most common uterine position?

A

Anteverted and Anteflexed

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3
Q

What is the 3 tissue layers of the uterus?

A

Perimetrium
Myometrium
Endometrium

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4
Q

What are the 4 portions of the fallopian tubes?

A

Interstitial (Intramural)
Isthmic
Ampullary
Infundibulum

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5
Q

What is the widest portion of the fallopian tubes?

A

Ampullary

*check with Amy

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6
Q

What are the bones of the pelvis?

A

Coccyx, sacrum, 2 innominate bones (ilium, ischium, & pubis)

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7
Q

What is the only abdominal organ NOT covered by peritoneum?

A

Ovaries

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8
Q

What produces hormones and gametes?

A

Ovaries

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9
Q

Where will free fluid collect first in the pelvic cavity?

A

Posterior Cul de sac (pouch of douglas)

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10
Q

What phase of the menstrual cycle typically lasts from 1 - 5 days?

A

Menstrual phase

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11
Q

What phase of the menstrual cycle typically lasts from 6 - 14 days?

A

Proliferative phase

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12
Q

If the endometrium measures 7mm in this phase is it normal?

A

No

*check with Amy

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13
Q

What hormone is the most influential in this phase? (proliferative)

A

Estrogen

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14
Q

What phase of the menstrual cycle typically lasts from 15-28 days?

A

Secretory Phase

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15
Q

What hormone causes ovulation to occur?

A

Luteinizing Hormone (LH)

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16
Q

What phase begins at ovulation and is also called the luteal phase?

A

Around the 14th day - Secretory phase

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17
Q

What phase is mainly under the influence of estrogen and is regrowth of endometrium?

A

Proliferative phase

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18
Q

During what phase does the endometrium degenerate?

A

Menstrual Phase

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19
Q

What secretes Gonad Releasing Hormone (GnH)?

A

Hypothalamus

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20
Q

The rise in GnH causes what organ to release follicle stimulating hormone (FSH)?`

A

Anterior Pituitary

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21
Q

A rise in LH (Lutenizing Hormone) causes what to occur?

A

Ovulatory Phase

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22
Q

What is the dominant follicle known as?

A

Graafian Follicle

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23
Q

What is polymenorrhea?

A

Frequent regular cycles but less than 21 days

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24
Q

What is oligomenorrhea?

A

Irregular cycles greater than 35 days apart

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25
Q

What menorrhagia?

A

(hypermenorrhea) Abnormal, heavy and long menstruation

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26
Q

What is dysmenorrhea?

A

Painful or difficult menstruation

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27
Q

What is Amenorrhea?

A

Absence of menstruation

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28
Q

What is Mittelschmerz pain?

A

Sudden sharp pain on one side of lower abdomen occuring on same side as ovulation. “Mid Cycle Pain”

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29
Q

Oral Contraceptives limit the release of what?

A

FSH and LH

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30
Q

Corpus Luteum Cysts produce what?

A

Progesterone

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31
Q

What is the normal measurement of an ovary?

A

2.5 x 1.5 x 0.6

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32
Q

Gravidity refers to what?

A

The # of times a women has been pregnant

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33
Q

Nulligravida refers to what?

A

Never been pregnant

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34
Q

Know sizes of uterus - nulliparous and multiparous uterus

A

Nulliparous - 8cm L, 5.5 cm W, 3cm in AP

Parity - 7.5 - 9cm L, 4.5 - 6cm W. 2.5 - 4cm AP

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35
Q

Which hormone causes ovulation to occur?

A

Luteinizing Hormone (LH)

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36
Q

What are all the ligaments?

A

Cardinal
Uterosacral
Round
Broad

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37
Q

Cardinal ligament

A

Anchor Uterine Corpus and Cervix to lateral pelvic wall

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38
Q

Uterosacral ligament

A

Anchor uterine cervix to sacrum

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39
Q

Round ligament

A

Anchor uterine fundus anteriorly

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40
Q

Broad ligament

A

Part of peritoneum that divides true pelvis into ANT and POS positions

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41
Q

What are the bones of the Pelvis?

A

Sacrum
Coccyx
2 Innominate ( ilium, ischium, pubic) x2

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42
Q

Know size of ovaries

A

2.5-5cm L, 1.5 - 3cm W, 0.6 - 2.2cm AP

(LxWxH)/2 = vol cm^3

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43
Q

Corpus luteum cyst - what is it, what hormone does it produce?

A

A Corpus luteum cyst is a type of ovarian cyst which may rupture about the time of menstruation

Produces Progesterone

44
Q

What hormones are produced by the hypothalamus?

A

Gonadotropin-releasing hormone (GnRH)

45
Q

What hormones are released by the Anterior Pituitary gland?

A 
FSH
LH
GH
Prolactin
TSH
Adrenocorticotropic hormone
46
Q

WHat hormones are released by the Posterior Pituitary gland?

A

ADH

Oxytocin

47
Q

DES what is it and what are the effects of it?

A

Diethylstilbestrol (DES) is a synthetic form of the female hormone estrogen. It was prescribed to pregnant women between 1940 and 1971 to prevent miscarriage, premature labor, and related complications of pregnancy

Responsible for CC vaginal carcinoma, Uterine hypoplasia, and “T” - shaped uterus

48
Q

Hematometra

A

retention of blood in uterine cavity

49
Q

Hematocolpos

A

Accumulation of menstrual blood in vagina

50
Q

Hematometrocolpos

A

Accumulation of blood in uterus and vagina as a result of obstruction or imperforate hymen

51
Q

Adenomyosis

A

Uterine condition in which endometrial glands and stroma are located in the myometrium proximal to the basalis layer of endometrium

52
Q

Where are leiomyomas located?

A 
Intramural - in myometrium
Submucosal - below endometrium
Sub- Serosal/ Serosal - at serosal surface of uterus
Pedunculated - extras uterine
Intracavity - Prolapsing from a cavity
53
Q

Sonohysterogram - What is this procedure, what does it help to identify?

A

Injecting 25 - 30 mL of saline into the endometrial cavity to highlight polyps and other problems. It is also used to check for obstruction of the fallopian tubes

54
Q

What are all the cysts?

A

Theca lutein
Graafian
Corpus luteum
Paraovarian

55
Q

Theca lutein cysts

A

Largest functional cyst 3 - 20cm. Results from exaggerated corpus luteum response in patients with high levels of hCG. Associated with gestational trophoblastic disease such as hydatidiform mole, chorioadenoma, and choriocarcinoma. Multilocular and bilateral

56
Q

Graafian cysts

A

Follicular Cysts - Result from either non- rupture of dominant follicle or failure of immature follicle to undergo atresia. 3 - 10cm. Usually resolves in 6 - 8 weeks can cause pelvic pain, hemorrhage to torsion or rupture

57
Q

Corpus Luteum cysts

A

Failure of the follicular cyst. Corpora Lutea must be greater than 3 cm to be considered luteal cyst. Usually uniocular and unilateral. regresses usually after 3 menses cycles

58
Q

Paraovarian cysts

A

Developed from vestigial wolffian duct structures or tubal epithelium uniocular, do not change w/ ovarian cycle.

59
Q

What are the differential diagnosis of cervical carcinoma?

A

Leiomyoma involving cervix
Endometrial carcinoma involving cervix
Endometrial polyps prolapsed into vagina

60
Q

What are Signs and symptoms of Uterus Leiomyomas?

A 
Pelvic pain
Menorrhagia
Asymptomatic
Bladder and rectum pressure
Infertility
Spontaneous Abortion
61
Q

What are US appearance of uterus leiomyomas?

A

Wide variety of US appearance: whorled appearance, lobulated uterus, hypo - anechoic

62
Q

What is Krukenberg tumor?

A

Malignant ovarian tumor that has most likely metastasized from G.I. or breast, signet - ring cells are key histologic sign.
US appearance: Moth eaten pattern

63
Q

Meigs Syndrome

A

Presentation of Ascites, Pleural effusion and ovarian tumor (most commonly, fibroma)
Symptoms subside after removal of tumor

64
Q

What is Ovarian Torsion?

A

Complete or incomplete rotation of ovary on its vascular pedicle

65
Q

Ultrasound Appearance of Ovarian Torsion

A

On ultrasound, may appear as a large ovary with hypoechoic and hyperechoic areas

66
Q

Ovarian Torsion occurs most commonly in what age group?

A

Most common in childhood or women < 30 years of age

67
Q

Signs and symptoms of Ovarian Torsion?

A
  • Acute onset of pelvic pain
  • Nausea
  • Vomiting
68
Q

Stein Leventhal Syndrome is also known as?

A

Polycystic Ovaries

69
Q

In Polycystic Ovaries, endocrine disorders result in?

A

High free serum testosterone

High LH or FSH

70
Q

Ultrasound Appearance of Polycystic Ovaries

A
  • Normal ovaries

- Bilaterally enlarged ovaries with multiple small follicles around periphery

71
Q

What are the categories of benign Ovarian Neoplasms?

A

Epithelial tumors
Germ cell tumors
Stromal tumors

72
Q

What is another name for Dermoid Tumor?

A

Dermoid Cyst or Benign Cystic Teratoma

73
Q

Benign Cystic Teratoma

A

AKA: dermoid cyst, teratoma

  • Common germ cell tumors
  • Most common in premenopausal women
  • Most common ovarian tumor for women less than 20 years of age
  • Have little malignant potential
74
Q

What are Functional Cysts?

A 
OVARIAN FOLLICLES
FOLLICULAR CYSTS
CORPUS LUTEUM CYSTS
THECA LUTEIN CYSTS
PARAOVARIAN CYSTS
75
Q

Ovarian Follicles

A
  • LOCATED ON BOTH OVARIES
  • SMALL ANECHOIC STRUCTURES
  • USUALLY MULTIPLE
  • DOMINANT FOLLICLE REACHES 2.0-2.5 CM BEFORE OVULATION OCCURS
76
Q

Follicular Cysts

A 
OVER DISTENSION OF A GRAAFIAN FOLLICLE THAT DID NOT RUPTURE
FOLLICLE THAT DID NOT RESOLVE
USUALLY UNILATERAL
1.0 - 10.0 CM IN SIZE
FOLLOW UP MAY BE ORDERED
MOST RESOLVE OR CHANGE IN SIZE
77
Q

Corpus Luteum Cysts Menstruation

A
  • Corpora lutea forms after dominant follicle ruptures.. REACHES 3 CM IN SIZE
  • Usually unilateral and simple.. CORPUS LUTEUM CYST MAY MEASURE 5-8 CM
  • Hemorrhage and rupture may cause pain
  • Usually resolves within 14 days
78
Q

Corpus Luteum Cysts Pregnancy

A
  • Remains if fertilization occurs
  • Holds the pregnancy
  • Produces progesterone
  • Resolves between 10 and 16 weeks from LMP
  • Rupture may cause pain
79
Q

Theca Lutein Cysts

A
  • Caused by high levels of human chorionic gonadotropin
  • 50% Associated with gestational trophoblastic disease (MOLAR PREGNANCY).
  • Associated with drug therapy for infertility (ovarian hyperstimulation syndrome)
  • Are bilateral, multilocular, and large (3-20 cm)
  • May persist 2-4 months after evacuation of molar pregnancy
80
Q

Paraovarian Cysts

A
  • Found in broad ligament
  • Difficult to determine if ovarian or paraovarian
  • Can be small up to 15 cm
  • Do not regress or change with time
  • Can be complicated by hemorrhage, torsion, rupture or infection
81
Q

Differential Diagnoses for Paraovarian Cysts

A

DIFFERENTIAL DIAGNOSES:
Serous cystadenoma
Endometrioma

82
Q

What are the malignant Tumors of the Ovaries

A 
Ovarian Carcinoma
Epithelial Types:
Epithelial Neoplasms
Sex Cord Neoplasms
Germ Cell Neoplasms 
Metastases to the the Ovary
83
Q

What are the most common of the Sex Cord Neoplasms?

A
  • GRANULOSA-THECA CELL TUMOR

- ANDROBLASTOMA (SERTOLI-LEYDIG CELL TUMOR)

84
Q

Sex Cord Neoplasms: GRANULOSA-THECA CELL TUMOR

A
  • 1-2% of all tumors
  • Most common in postmenopausal patients
  • Abnormal uterine bleeding (estrogen)
  • Associated with endometrial hyperplasia or carcinoma
  • Unilateral
  • Solid and homogeneous
85
Q

Sex Cord Neoplasms: SERTOLI-LEYDIG CELL TUMOR

A

AKA: androblastoma

  • Rare (less than .5% of ovarian tumors)
  • Most common in adolescence
  • Present with virulization
  • Almost always unilateral
  • Usually solid
86
Q

Sex Cord Neoplasms: SERTOLI-LEYDIG CELL TUMOR

A

AKA: androblastoma

  • Rare (less than .5% of ovarian tumors)
  • Most common in adolescence
  • Present with virtualization
  • Almost always unilateral
  • Usually solid
87
Q

Germ Cell Neoplasms:

3 Types

A
  • Choriocarcinoma
  • Teratocarcinoma
  • Endodermal Sinus Tumor
88
Q

Germ Cell Neoplasms: Choriocarcinoma

A
  • Very rare as ovarian neoplasm
  • Most common in infants and young children
  • May cause precocious puberty
  • Elevated serum hCG levels
  • Usually unilateral
  • Solid hemorrhagic tumor
  • Aggressive
89
Q

Germ Cell Neoplasms: Teratocarcinoma

A
  • AKA: immature teratoma
  • Occurs in children and young adults
  • Composed of immature neuroepithelium
  • Usually unilateral
  • Variable US appearance, possible with cystic and highly echogenic components
90
Q

Germ Cell Neoplasms: Endodermal Sinus Tumor

A
  • AKA: yolk sac tumor
  • 2nd most common malignant ovarian germ cell tumor
  • Common in childhood, adolescence and young adults
  • Elevated levels of AFP
  • Usually unilateral
  • Can be solid, or cystic and solid
91
Q

Metastases to the Ovary

A

KRUKENBERG TUMOR

  • Metastases to ovary from primary elsewhere
  • Most common site of primary is GI tract, but can be breast, lung, pancreas, or lymphoma
  • Usually bilateral
  • May be cystic, mixed, or solid on ultrasound
  • May demonstrate the “moth-eaten” sign
92
Q

What is Pseudomyxoma Peritonei?

A

Mucinous Cystadenoma with a rupture

93
Q

What are risk factors for development of Endometrial Carcinoma?

A
  • OBESITY
  • DIABETES
  • HIGH BLOOD PRESSURE
  • SHORT IN HEIGHT
  • JEWISH
  • AGE (postmenopausal)
  • ESTROGEN USE AFTER MENOPAUSE
94
Q

Signs and symptoms of Endometrial Carcinoma?

A
  • BLEEDING OR DISCHARGE AFTER MENOPAUSE

- Pain

95
Q

Endometrial Carcinoma: Where does it begin and where does it grow to?

A
  • BEGINS IN THE ENDOMETRIUM

- GROWS TOWARD THE MYOMETRIUM

96
Q

Endometrial Carcinoma: STAGING is based on?

A

Degree of tumor spread

97
Q

Endometrial Carcinoma: GRADING is based on?

A

Degree of tumor differentiation

98
Q

Dysfunctional Uterine Bleeding (DUB)

A

Vaginal Bleeding not related to menstrual cycle

99
Q

HYPERmenorrhea

A

excessive volume during cyclic menstrual bleeding

100
Q

HYPOmenorrhea

A

abnormally small amount of menstural bleeding

101
Q

Polymenorrhea

A

Frequent menstrual bleeding less than 21 days apart

102
Q

Oligomenorrhea

A

menstrual bleeding greater than 35 days apart

103
Q

Menorrhagia

A

excessive bleeding in time and/or volume

104
Q

Dysmenorrhea

A

painful uterine bleeding

105
Q

Amenorrhea

A

absence of menstrual flow

106
Q

Vaginal Agenesis

A

Absent vagina

107
Q

Vaginal Atresia

A

Lack of vaginal development

Ultrasound OBGYN (9 decks)

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