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Author:
rbeacr
ID:
120645
Filename:
ob
Updated:
2011-12-04 11:00:52
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41
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Description:
Pathology of the Uterus
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  1. sonohysterography
    catheter introduces saline to endometrium to define intracavity submucosal lesions
  2. Vagina
    • anterior and caudal from cervix
    • most common cong. anomoly is inperforate hymen results in obstruction
  3. Gartner's duct cyst
    most common cystic lesion of vagina
  4. hydrometra
    hematometra
    pyometra
    ...colpos
    • vagina/uterus accumulation of...
    • fluid
    • blood
    • pus
    • colpos=vagina
  5. vaginal cuff
    • upper limit of normal vagina after hysterectomy
    • 2.1 cm
  6. Pouch of Douglass
    • Rectouterine recess or posterior cul-de-sac
    • most posterior and inferior area of peritoneal cavity btwn rectum and uterus
    • accumulated fluid goes here
    • can be due to ruptured ectopic, hemorragic cyst, pus, or normal ovulation
    • can detect 5ml with tv us
  7. internal os
    external os
    • where cervix joins uterine cavity
    • where cervix joins vaginal canal
  8. Cervix
    • 2-4cm in legnth
    • handle upward to view tv
  9. nabothian cyst
    • most common finding in cervix from chronic cervicitis in middle age women
    • aka epithelial inclusion cyst
    • <2cm
    • can block canal
  10. cervical polyps
    • benign
    • resutls from hyperplastic protrusion of epithelium of endo or ectocervix
    • from chronic inflammation
    • late middle age
  11. ectocervix
    part of uterine cervix canal lined with squamous epithelium
  12. endocervix
    epithelial and glandular lining of uterine cervix
  13. cervical stenosis
    • acquired conditon with obstruction of cervical canal at internal or external os from
    • radiation therapy
    • cone biopsy
    • postmen atrophy
    • chronic infection
    • laser/cryo surgery
    • cervical carcinoma

    casues a fluid filled uterus
  14. cervical carcinoma
    • Squamous cell carcimoma in the most common type
    • detection from PAP smears
    • may appear as solid retrovesical mass like myoma, obst ureter
    • all women of menstural age
    • vaginal discharge/bleeding
    • if untreated goes to bladd and rectum
    • HPV major catalyst
  15. squamous cell carcinoma
    most common cervical carcinoma
  16. leiomyoma/myoma/fibroid
    • most common gynecologic tumor in women over 30 yrs (african american)
    • smooth muscle
    • myometrial tissue
    • can outgrow blood supply- atrophy
    • estrogen dependant- decrease post men.
    • tamoxifen causes growth
    • cause irregular bleeding
    • can contribute to infertility-delivery
    • subser, intramural, submuc
    • can have calcification 10%
  17. submucosal
    • myoma distruption into endometrial cavity
    • heavy bleeding/infertility
  18. intramural
    • myoma in myometrium
    • most common type
    • infertility/ preg loss
  19. subserosal
    • myoma from peritoneal surface of uterus
    • may be peduncluated and mimic extrauterine mass
  20. uterine calcifications
    • myomas are a common cause of calc
    • less common is arcuate artery calc
  21. mockenberg's arteriosclerosis
    calcification of arteries in the body due to dm, htn, crf
  22. adenomyosis
    • benign (diffuse more common)
    • bulky uterus with endometrial infiltration into myometrium
    • atleast 2.5mm from basal layer(post)
    • managed with horomone therapy
    • heavy abn periods, uterus 3xs as big
  23. hypermenorrhea
    abnormal uterine bleeding
  24. menorrhagia
    prolonged/profuse bleeding
  25. metrorrhea
    irragular/ acyclic bleeding
  26. dysmenorrhea
    pelvic pain during menstruation
  27. arteriovenous malformations (AVMs)
    • vascular plexuses of ateries and veins with out intervening capillary network
    • rare
    • myometrium
    • most are aquired- trauma surgery
    • D&C leads to catastrophic hemorrhage
    • color doppler mosaic pattern
  28. leiomyosacroma
    • rare 1%
    • solid tumor from endometrium/myometrium
    • commonly in fundus
    • rapid growth
    • resemble myoma
  29. DNC
    • dilation and curettage
    • scrape endometrium
    • used in adenomyosis not avmalformation
  30. endometrial size
    • 2-14mm depending on cycle
    • hypechoic halo not included in measurement
    • <5mm for postmenopausal women (unless hrt)
  31. tamoxifen
    • drug used to treat breast cancer pts.
    • antiestrogenmay have thickened endometruim
  32. sonohysterography
    • saline infused sonography (SIS)
    • distend endo cavity with saline
    • menstural women preformed days 6-10
    • not with PID
  33. endometrial hyperplasia
    • most common cause of abnormal uterine bleeding in pre & post meno. women
    • from prolonged estrogen stimulation
    • thick endometrium
    • precursor for endmet. cancer
    • premenopausal=endomet >14mm
    • postmenopausal=endomet >8mm
  34. estrogen - positive & negative
    • positive
    • alleviated menopausal symptomes (hot flashes)
    • reduced risk osteoporosis
    • reduce risk of heart attack and stroke

    • negative
    • increased endometrial hyperplasia/cancer
  35. progesterone- positive & negative
    • positive
    • endometrial atrophy reduce hyperplasia/cancer

    • negative
    • increased breast cancer risk
    • iritabilty, depression, breast tenderness
  36. endometrial polyps
    • overgrowths of endometrial tissue covered by epithelium
    • pedunculated, broadbased, think stalk
    • peri and post menopausal women
    • sonohysterography
    • hypoechoic
  37. endometritis
    • infection with inflammed endometrium
    • occurs with PID
    • postpartum
    • following instrumentation
    • intense pelvic pain
    • endometrium appears prominent irregular with small amt fluid, pus in culdesac
    • advanced- TOA
  38. synechiae
    • scarring/adhesions in uterus from post surgery (curettage)
    • infertility
  39. endometrial carcinoma
    • most common gyn maligancy in north america
    • associated with estrogen stimulation
    • postmenopausal bleeding
    • enlarged uterus irreg areas of low echos
    • prominent endometrium
    • myometrial invasion
  40. IUCD
    • intrauterine contraceptive device
    • string in cervix
    • can be removed during 1sr trimester
    • increased risk for ectopic preg and PID
    • preforation usually at time of insertion

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