Ovaries

Question 0

Ovaries or testis by

Answer 0

7 weeks

Question 1

Clinical signs of ovarian cancer

Answer 1

Abdominal pain
Vaginal bleeding
Nausea/Vomiting
Increased abdominal girth (ascites)
Inc CA125 (blood test)
Diarrhea/GI symptoms

Question 2

Ovary size

Answer 2

3 cm L adult

Volume 9.8cm Adult
Volume 3cm child
Volume 5.8cm post menopausal

Question 3

Ovarian ligament

Answer 3

Inf ovary to uterine cornu

Question 4

Infundibulopelvic ligament

Answer 4

Suspends superior ovary from post/lat pelvic wall

Question 5

Mesovarium

Answer 5

Post surface of broad ligament

Question 6

Ovarian layers

Answer 6

• Germinal epithelial: outer
• Fibrous capsule: tunica albuginea
• Ovarian parenchyma: cortex. Has follicles
• Central medulla

Question 7

Graafan follicle reaches ___ before rupture

Answer 7

1.8-2.4cm

Question 8

Mittelschermz

Answer 8

Pain with ovulation

Question 9

Corpus Luteum

Answer 9

Supports pregnancy

If not pregnant becomes corpus albicans

Question 10

Location

Answer 10

True pelvis

Ovarian fossa aka Waldeyer’s Fossa

Question 11

Vessels

Answer 11

Adnexal branch of uterine artery
Ovarian artery
Ovarian vein: rt dumps to IVC, left dumps to lt renal vein to IVC

High resistance, early dicrotic notch

Abnl: < 1
Low resistance with cancer.

Question 12

Functional Cyst

Answer 12

MC cause of ovarian enlargement

1. Follicular
2. Corpus Luteum after ovulation. Ring of fire. Unilateral. Makes progesterone.
3. Hemorrhagic
4. Theca-Lutein in molar preg. Inc hCG. Large. Bilateral. Septated.

Normal follicles 2.5 cm.
Regress
CDS fluid

Question 13

Ovarian Remnant Syndrome

Answer 13

Take out ovary and residual tissue produces functional cyst.

Question 14

Para ovarian cyst

Answer 14

Embryonic remnant. Separate from ovary.

Question 15

Polycystic Ovaries

Answer 15

Endocrine disorder. LH/FSH ratio inc
Anovulatory.
Numerous small follicles that don’t mature. Displaced.
String of pearls

Assoc: Stein Leventhal Syndrome: infertility, oligomenorrhea, hirsutism:hairy, obese.

Question 16

Ovarian Torsion

Answer 16

Ovary rotates cuts off blood supply 
Hemorrhage/infarction 
Pain fever palp mass 
Adolescence/children 
Assoc with adnexal mass

Enlg hypo ovary with little-no Doppler flow

Question 17

Endometrioma / Chocolate Cyst

Answer 17

Localized endometriosis ectopic endo tissue

Homogeneous mass

Question 18

Cystic Teratoma / Dermoid Cyst

Answer 18

MC germ cell tumor
MC ovarian tumor
Malignant degeneration rare
Ca+, hair, fat, complex
Tip of iceberg sign. Shadow

Question 19

Serous cystadenoma

Answer 19

Post menopausal
Epithelial
2nd MC tumor
Large thin septations

Question 20

Mucinous Cystadenoma

Answer 20

Less common
Very large 15-30cm
Multi septated, debri

Question 21

Benner Tumor

Answer 21

Benign epithelial tumor

Rare

Question 22

Fibroma

Answer 22

Benign stromal tumor
Rare
Post menopausal

Question 23

Meig’s Syndrome

Answer 23

Fibroma & Brenners tumor cause it
Massive ascites
Pleural effusion

Question 24

Thecoma / Theca Cell Tumor

Answer 24

Stromal tumor Estrogen producing Abnl ut bleeding

Question 25

Sertoli-Leydig Cell / Androblastoma

Answer 25

Secretes hormones Masculinization Can become malignant

Question 26

Granulosa Cell Tumor

Answer 26

Feminizing Post menopausal Precocious puberty & full breasts

Question 27

Arrhenoblastoma

Answer 27

Masculizing tumors | Amenorrhea

Question 28

Ovarian cancer

Answer 28

``` Post menopausal 90% epithelial 94% cystic components Inc CA125 Silent killer ``` Stage 1: ovary Stage 2: 1 or both ov with pelvic extension Stage 3: 1 or both ov, intraperitoneal mets, nodes, omentum/sm bowel involvement. In true pelvis. Stage 4: ovaries, mets, pleural effusion. ``` History of breast cancer. Fam hx ov Cancer Nulliparous Hx colon cancer Talcum powder ```

Question 29

Serous cystadenocarcinoma

Answer 29

MC ovarian cancer | Bilateral. Large. Older.

Question 30

Mucinous cystadenocarcinoma

Answer 30

Young. Huge. Bilateral. Thick septation.

Question 31

Endometroid Tumor

Answer 31

Malignant. | Assoc with endo cancer and endometriosis

Question 32

Teratoma

Answer 32

Rare Child/young adults Germ cell. Ca+ shadow

Question 33

Dysgerminoma

Answer 33

MC pediatric ovarian mass Rapid growth May torse

Question 34

Mets to ovary

Answer 34

GI, Endo, Breast, melanoma, lymphoma

Question 35

Krukenberg Tumor

Answer 35

Specific type of ov met. Has signet ring cells. Usually from gastric primary.

Question 36

Tunners Syndrome

Answer 36

``` MC gonadal dysgenesis 45XO Complete/ partial absent ov Coarctation of aorta Cystic hygroma : neck webbing Shield chest ```