The Reproductive System Flashcards
(155 cards)
1
Q
What are congenital anomalies of the female reproductive organs usually in the form of?
A
Duplications
2
Q
What are the normal positions of the uterus?
A
Slight anteflexion, which means the fundus is anterior to the cervix and also anteverted in that the fundus is away from the rectum
3
Q
What is retroversion of the uterus?
A
When the fundus is tipped backward so that there is no longer a 90 degrees angle between the vagina, cervix, and uterine body. The fundus is now posterior to cervix
4
Q
What is retroflexion of the uterus?
A
When there is a backward flexion and the uterine body is not pointing toward the rectum
5
Q
What is acute anteflexion of the uterus?
A
When the fundus of the uterus is flexed forward more than it should be
6
Q
What is the uterus made from?
A
Paired ducts called Mullerian ducts
7
Q
Where do the Mullerian ducts fuse from?
A
The lower ends
8
Q
What do the lower ends of the Mullerian ducts form when the fuse together?
A
The uterus
9
Q
What do the top ends of the Mullerian ducts form when they fuse together?
A
Each become a fallopian tube
10
Q
Many malformations of the mullerian ducts can be detected by what radiographic studies?
A
Hysterosalpingography
11
Q
What is uterine aplasia?
A
When the Mullerian ducts do not form in utero which results in no uterus
12
Q
What is unicornuate uterus?
A
When only one ducts forms, there can be no fusion. One duct remains as one half of an elongated uterus and only one fallopian tube. Normal vagina present and successful pregnancy can occur.
13
Q
What condition is usually associated with a missing kidney on the same side as the missing half of the uterus?
A
Unicornuate uterus
14
Q
What is didelphic uterus?
A
A rare condition that occurs when there is nonfusion of the two Mullerian ducts
15
Q
What is the result of didelphic uterus?
A
Complete duplication including two cervixes and two uterine bodies but the normal number of fallopian tubes. In most cases the vagina is septate, causing a double vagina
16
Q
What is a bicornuate bicollic uterus?
A
It occurs when the ducts fuse to the level of the cervix, creating one vagina, two cervixes, and two uterine bodies
17
Q
What is a bicornuate uterus?
A
When the ducts fuse to the level of the body so that there are two fundi
18
Q
What is a arcuate uterus?
A
If the nonfusion of the Mullerian ducts begins at the level of the fundus
19
Q
What is the most common anomaly?
A
A arcuate uterus
20
Q
What is a septate uterus?
A
A septum extends through the normal uterine body to reach the cervix, dividing the uterus into two complete compartments
21
Q
What is a subseptate uterus?
A
It has a partial septum dividing the body only. The septum does not extend to the cervix
22
Q
What occurs more often in women with a subseptate uterus?
A
Twins occur three times more often than women with a normal uterus
23
Q
What complications are associated with a subseptate uterus?
A
Abortion, premature delivery, hemorrhages, retained placenta, and breech presentation
24
Q
What is endometriosis?
A
Defined as the growth of endometrial tissue outside the uterus
25
Where does endometriosis occur?
Usually in the ovary, fallopian tube, broad ligament, pouch of Douglas, or retrovaginal septum
26
Who does endometriosis occur more often in?
Women who have never been pregnant and are over the age of 30
27
What is the term used for women who have never been pregnant?
Nulligravida
28
What happens when the endometrium sloughs off during the monthly cycle?
Some of the blood and mucus refluxes into the pelvis and attaches to the aforementioned ectopic areas
29
What is the term used for women who have never given birth?
nullipara
30
Even though the endometrial tissue lies outside the usterus, what does it still respond to?
Hormonal changes and undergoes a proliferative and secretory phase along with sloughing a subsequent bleeding
31
What happens to the old blood?
It turns brown
32
What are chocolate cysts?
The pockets of endometrial tissue
33
What are the symptoms of endometriosis?
severe pain with the period and a dull aching pain during the remainder of the month
34
What is the term used when a woman experiences pain with the period?
dysmenorrhea
35
What is adenomyosis?
The ingrowth of endometrium into the uterine musculature
36
What condition may coexist with endometriosis?
Adenomyosis
37
What is pelvic inflammatory disease?
an inflammation of the female upper genital tract including the fallopian tubes
38
What is the most serious complications of sexually transmitted disease?
Pelvic inflammatory disease
39
How may an infection occur with PID?
By routes such as an intrauterine contraceptive device and nonsterile abortions or deliveries
40
What are the different types of PID?
Acute and Chronic
41
What does acute PID cause?
Slight uterine enlargement
42
What happens in the early stages of acute PID?
The pelvic sidewall structures can still be identified
43
If the infundibulum is not closed by scar tissue with acute PID, what happens?
An infection may spread to the ovaries and adjacent structures because the fallopian tubes open into the pelvic cavity
44
What happens as acute PID progresses?
The adnexa become thicker and begins to merge with the sidewall
45
What are the complications associated with acute PID?
Ectopic pregnancy, infertility, and/or chronic abdominal pain
46
What happens if acute PID is left untreated?
A pyosalpinx will develop
47
What is a pyosalpinx?
Pus in the tube
48
What does pyosalpinx eventually lead to?
A tubal ovarian abscess (TOA)
49
What happens if a TOA or pyosalpinx ruptures?
Peritonitis may ensue which can be localized in the RUQ under the liver
50
What is usually seen with PID?
Free fluid in the cul-de-sac
51
What happens in chronic PID?
All the signs of acute PID are gone and the uterus has sharp borders
52
What does the adnexa demonstrate with chronic PID?
It may demonstrate nonspecific thickening because of continued scarring
53
What is chronic PID a common cause of?
Ectopic pregnancy
54
What are leiomyomas of the uterus?
they are the overgrowth of the normal muscular wall of the uterus
55
What is another term used for leiomyomas?
Fibroids
56
At what age are leiomyomas most common after?
The age of 35 years
57
What do leiomyomas thrive on?
Estrogen
58
Because leiomyomas thrive on estrogen, what occurs in postmenopausal women?
Postmenopausal women do not grow new tumors and if a neoplasm exists before menopause, it will atrophy as the estrogen levels drop after menopause
59
What are the most common benign tumor of the uterus?
Leiomyomas
60
What are the three different types of leiomyomas?
Submucosal, intramural, and subserous
61
What are submucosal leiomyomas?
They are the least common and grow off the endometrium into the uterine cavity
62
What are intramural leiomyomas?
They are the most common type and grow within the myometrium
63
What are subserous leiomyomas?
They are mostly pedunculated and grow off the perimetrium into the pelvic cavity
64
What often happens with myomas?
They will calcify with time
65
What can myomas be present with?
Pregnancy and can cause an abortion or an abruption placenta
66
What can myomas cause with pregnancy?
They can prevent a normal vaginal delivery if they are located near the cervix
67
What are teratomas?
benign "cysts" of the ovary that contain skin, hair, teeth, and fatty elements that derive from ectodermal tissue
68
What is another name for teratomas?
Dermoids
69
What do one-half of teratoms contain?
Calcifications usually in the form of teeth, but may include the wall of the cyst
70
What are single cystic lesions?
Lesions of the ovaries that are rarely significant and are usually a follicular cyst or a corpus luteum cyst
71
What might be an indication of endometriosis?
Multiple cystic areas
72
What are polycystic ovaries?
Enlarged ovaries consisting of many small cysts
73
What manifestation is associated with polycystic ovaries?
Stein-leventhal syndrome, which is characterized by facial hair, excess weight, amenorrhea, and infertility
74
What is fibrocystic disease of the breast?
A common benign condition occurring in about 20% of women who are premenopausal
75
What term is used that encompasses a variety of changes that occur?
Fibrocystic disease
76
What are the most obvious changes associated with fibrocystic disease?
fibrous and cystic dilation of the ducts (it is usually bilateral with cysts of various sizes distributed throughout the breasts)
77
What will the breast contain with fibrocystic disease?
an increased amount of fibrous tissue
78
What is a important change to note with fibrocystic disease?
hyperplasia of the ducts (thought to be a precursor to cancer)
79
If hyperplasia is present with fibrosis and cystic dilation, what term is used?
Proliferative fibrocystic disease
80
What is a fibroadenoma?
The most common benign breast tumor
81
How does a fibroadenoma generally appear?
As a smooth, well-circumscribed mass with no invasion of surrounding tissue
82
TRUE OR FALSE
With fibroadenoma, the masses may be moved around within the breast as they have no attachments to the overlying skin or underlying tissue
True
83
What is adenocarcinoma?
It is the most common invasive gynecologic malignancy of the endometrium
84
What are the different classifications of adenocarcinoma?
Type 1 and Type 2
85
Who does Type 1 adenocarcinoma occur most often in?
Pre- and perimenopausal women
86
Who does Type 2 adenocarcinoma occur most often in?
In older, postmenopausal women who have never born a viable baby
87
What has been associated with increased frequency of endometrial carcinoma?
Prolonged estrogen stimulation and therefore women on hormone replacement therapy are at an increased risk
88
What are the clinical symptoms associated with adenocarcinoma?
bleeding, hypermenorrhea, or postmenopausal bleeding
89
Where may adenocarcinoma project into?
Into the uterine cavity or it may infiltrate the wall of the uterus
90
What will an IVU show with adenocarcinoma?
It will show the bladder wall depressed by an enlarged uterus
91
What is cystadenocarcinoma?
Ovarian cancer
92
Where does cervical cancer arise from?
Epithelial tissue around the neck of the uterus
93
What is cervical cancer caused by?
It is caused by certain types of human papillomavirus (HPV)
94
What happens when a female has been infected by certain types of HPV and the virus does not go away on its own?
Abnormal cells can develop in the lining of the cervix
95
What does an IVU demonstrate with cervical cancer?
Hydronephrosis in one-third of the patients
96
What is the most common cause of death in patients with carcinoma of the cervix?
Impaired renal function caused by ureteral obstruction
97
What is breast cancer?
The most common malignancy among women
98
What factors increase the risk of women getting breast cancer?
The age at which a woman has her first full-term pregnancy, women who delay childbirth (higher risk), early menarche (those who begin a the age of 12 or younger are at higher risk)
99
How are all breast cancers seen mammographically?
As a tumor mass, clustered calcifications, or both
100
What are some secondary changes of breast carcinoma?
skin thickening around the areola and nipple retraction
101
What is the typical malignant tumor mass with breast cancer?
Poorly defined, has irregular margins, and demonstrates numerous fine linear strands or spicules radiating out from the mass
102
What are clustered calcifications in breast cancer?
They are typically numerous, very small, and localized to one segment of the breast, They demonstrate a wide variety of shapes including fine linear, curvilinear and branching forms
103
Where do the testes normally descend from?
The intra-abdominal area through the inguinal canal into the scrotum near the end of the gestational period
104
What is cryptorchidism?
Condition of undescended testes
105
What is the most common birth defect of male genitalia?
Cryptorchidism
106
What modality is used as a screening mechanism to determine the location of an undescended testical in the inguinal canal, pelvis, or abdomen?
Ultrasonography
107
What are undescended testes associated with?
reduced fertility, testicular torsion, and a higher rate of malignancy
108
What is orchiopexy?
When the undescended testicle must be brought down and surgically fixed in the scrotum
109
What is orchiectomy?
When the testicle is removed
110
When is orchiectomy performed?
On patients who are diagnosed after the onset of puberty
111
What is prostatic hyperplasia?
An enlargement of the prostate gland
112
What is prostatic hyperplasia related to?
decreased hormone secretions
113
What happens as the prostate gland enlarges?
It pushes on the bladder, which results in an inability to completely empty the bladder
114
When the enlarged prostate gland pushes on the bladder, which results in an inability to completely empty the bladder, what happens?
It leads to obstruction, bilateral ureteral dilation, and hydronephrosis
115
What does an IVU demonstrate with prostatic hyperplasia?
it demonstrates the elevation and smooth impression on the floor of the bladder by the prostate. The elevation of the bladder also causes the elevation of the insertion of the ureters on the trigone
116
What is the characteristic associated with prostatic hyperplasia?
J-shape, or fish-hook appearance of the distal ureters
117
What does a transurethral resection of the prostate do?
It relieves symptoms of obstruction associated with prostatic hyperplasia
118
What are prostatic calculi?
Small, multiple calcifications found in the prostate gland
119
What are visible on radiographs with prostatic calculi?
The calculi, if dense enough
120
What is testicular torsion?
Occurs when the testicle twists over on its pedicle
121
What symptoms are associated with testicular torsion?
A sudden onset of severe scrotal pain and swelling
122
What will diagnose testicular torsion?
Doppler ultrasound through the absence of the sound of blood flow
123
What is epididymitis?
Inflammation of the epididymis and also leads to swelling of the scrotum accompanied by pain and erythema
124
What may be associated with epididymitis?
Orchitis
125
What is orchitis?
inflammation of the testes
126
What is the difference between epididymitis and testicular torsion?
Arterial perfusion is decreased or absent in testicular torsion, whereas in epididymitis the blood flow is increased
127
What is gynecomastia?
Enlargement of the male breast
128
What is the result of estrogen stimulation in gynecomastia?
Proliferation of ducts and connective tissue
129
What stimuli can cause males to secrete more estrogen than normal causing gynecomastia?
Cirrhosis, certain neoplasms, TCH, difitalis, and Klinefelter syndrome
130
What is usually the cause of bilateral gynecomastia?
Aging, with decreased androgen production
131
What can cause masses in the testes?
Trauma or inflammation
132
What age is often affected most by benign neoplasms of the testes?
Males between the ages of 25 and 40
133
What are the benign masses of the testes?
Hydrocele and spermatocele
134
What is hydrocele?
A collection of fluid in the testis or along the spermatic cord
135
What is spermatocele?
A cystic dilation of the epididymis
136
Are benign or malignant tumors more common in the testes?
Malignant
137
What are the two major types of malignant testicle cancer?
Seminomas and teratomas
138
What are malignant seminomas?
They arise from the seminiferous tubules and are extremely radiosensitive and prognosis is excellent
139
What are malignant teratomas?
They have poor prognosis and arise from a primitive germ cell and consist of a variety of structures
140
How are seminomas and teratomas spread?
Spread by lymphatics and the blood to the area of the renal hilum
141
What is the second most common malignancy in men?
Adenocarcinoma of the prostate gland
142
What does an IVU demonstrate with adenocarcinoma of the prostate gland?
An elevated bladder with an irregular impression of the bladder floor because of the irregular, lobulated borders of the tumor
143
Why is CT a good modality to use when imaging seminomas and teratomas of the testes?
It is the best because it will also detect metastasis to the lung, liver, or bone
144
What modality is used to detect carcinoma of the prostate gland?
Ultrasonography with the use of a transrectal probe
145
Why is it important to determine carcinoma of the prostate early?
Because it spreads to the rectum directly
146
What is hysterosalpingography?
A procedure that may be diagnostic as well as therapuetic
147
What are the diagnostic indications for hysterosalpingography?
Abnormal bleeding or spotting between menstrual periods, patency of tubes, anomalies, habitual spontaneous abortions, amenorrhea, dysmenorrhea and a lost intrauterine contraceptive device
148
What are the therapeutic indications for hysterosalpingography?
Restoring patency to the tubes, stretching adhesions, dilation of the tubes, or straightening of the tubes
149
What are some contraindications of hysterosalpingography?
pregnancy, pelvic inflammatory disease, vaginal or cervical infection, or menses
150
What two types of contrast media are used for hysterosalpingography?
Water soluble and oily
151
What forms does the water soluble medium come in?
Salpix or sinografin
152
What is the advantage to water-soluble contrast?
It is absorbed quickly and leaves no residue
153
What is the disadvantage to water-soluble contrast?
the great deal of pain they produce
154
What is the advantage to oily contrast?
It is very opaque and causes little or no pain
155
What is the disadvantage to oily contrast?
The oil persists in the body
