OB-GYN Surgical Procedures

Define adnexa

Appendages or accessory structures of an organ

In OB/GYN, adnexa (or adnexa uteri) refers to the structures directly connected to the uterus—primarily the ovaries, fallopian tubes, and supporting ligaments

Involves the use of a laser to remove warts, which can appear on the vagina, vulva, cervix, rectum, or groin.

Ablation of Condyloma

Condyloma (genital warts) are soft, often skin-colored, benign growths on the skin or mucous membranes in the anogenital area caused by high-risk, sexually transmitted HPV

What does “fetal distress” mean?

• sustained low heart rate

• shrill crying

• difficulty breathing

Sustained low heart rate

List the four stages of labor

1. True onset of labor

2. Cervical dilation to completion of birth

3. Birth to placental delivery

4. Placental delivery to stabilization of mother

Which stage of labor starts with true labor and is complete when the cervix is fully dilated?

1st stage of labor/vaginal delivery

Refers to the total removal of, or, in OB-GYN, the removal of the vagina, uterus, cervix, fallopian tubes, ovaries, bladder, and rectum for the surgical treatment of cancer.

Exenteration; total pelvic exenteration

Another name for the infundibulopelvic ligament is the ________ ligament, and it contains crucial _____ vessels.

Suspensory, ovarian

The ________ ligament contains the uterine artery and vein

Cardinal

Define menorrhagia

Excessive menses

Define dyschezia

Painful defecation

Define dyspareunia

Painful intercourse

Define dystocia

Difficult labor

Condition in which the mother’s pelvis is too small or the baby’s head is too big, causing obstructed labor and often requiring a cesarean section.

Cephalopelvic Disproportion (CPD)

Benign lesions of the uterus (specifically the muscular wall of the uterus)

Leiomyoma (aka myoma or uterine fibroids)

Which stage of delivery results in complete dilation of the cervix and terminates with the birth of the infant?

2nd stage of vaginal delivery

The ______ follicle releases the oocyte

graafian

FSH and LH drive the development of the Graafian follicle during the ovarian cycle. FSH promotes follicle growth, granulosa cell proliferation, and estrogen production, while LH triggers ovulation and converts the ruptured follicle into the progesterone-producing corpus luteum.

Menstrual cycle hormone chart for reference

Surgical procedure that uses the ESU coupled to a loop electrode on the cautery pencil to excise a cone of tissue to remove an area of neoplasia

LEEP (loop electrosurgical excision procedure)

The procedure for the treatment of uterine cervix carcinoma which includes removal of the uterus, fallopian tubes, ovaries, the upper third of the vagina, and all associated lymph nodes

Wertheim Radical Hysterectomy

The _____ nerve can become damaged or irritated as a result of the following regional anesthetic types: spinal and epidural. This nerve being damaged or irritated produces an excruciating leg/hip pain that can last months and sometimes years

Sciatic

The uterine artery originates from the _____ _____ artery

internal iliac

ID this structure

Ureter

The cervical test called a pap smear is performed to rule out _____ _____

Cervical dysplasia

Which dye is used in chromotubation studies, in which the dye is injected directly into the os of the fallopian tube to assess tubal patency?

Methylene blue

Name the two endometrial layers and identify which one is permanent

The stratum functionalis (functional layer) is the thick, superficial layer of the endometrium that grows, changes in response to hormones, and is shed during menstruation. The stratum basalis (basal layer) is the deeper, permanent layer that remains intact and acts as the regenerative source to rebuild the functionalis layer after each menstrual cycle

Describe the exocrine and endocrine portions of the ovaries

Exocrine - eggs/ova are delivered to a duct system (i.e. the fallopian tubes)

Endocrine - the ovaries secrete progesterone and estrogen directly into the bloodstream to regulate the menstrual cycle, pregnancy, and secondary female sex characteristics

Which type of regional anesthesia is delivered into the subarachnoid space?

Spinal anesthesia

Describe the Le Fort procedure

The Le Fort procedure is a partial colpocleisis. It is an obliterative surgery for pelvic organ prolapse that sews together the anterior and posterior vaginal walls, creating small, narrow, lateral drainage tunnels for cervical secretions. It is often used for elderly women with a uterus who no longer wish to engage in sexual intercourse and also cannot undergo more extensive surgery.

The _____ ligament attaches the ovaries (medially) to the uterus

ovarian

What is the most common site for ectopic pregnancies?

Fallopian tube

Define dysmenorrhea

Painful menses

Number of times a woman has been pregnant, regardless of outcome

Gravida

Number of pregnancies carried to a viable gestational birth of 20 weeks or more, regardless of whether the fetus was born alive or stillborn

Parity or para

Hormonal medication used to induce or continue contractions necessary for labor to continue/progress

Pitocin (oxytocin)

Condition in which the placenta covers or partially covers the internal cervical os

Placenta previa

Widened area just proximal to the fimbriae of the fallopian tubes

Infundibulum

Condition where the placenta ruptures/detaches from the lining of the uterus prematurely

abruptio placenta

The three layers of the uterine wall from the outermost to the innermost are the _____

perimetrium, myometrium, endometrium

A Foley catheter is used routinely during pelvic procedures to:

Decompress the bladder to prevent injury

The ________ test involves the use of _____ solution, an iodine-based medication that causes abnormal tissue to not stain, thus permitting an accurate biopsy of affected tissue

Schiller’s, Lugol’s

Note that when using Lugol’s, healthy cervical tissue stains brown, while abnormal, glycogen-deficient areas remain unstained (yellow), guiding doctors on where to take a biopsy

The drugs used to control bleeding or hemorrhage post-delivery include:

• Carboprost (hemabate)

• Oxytocin (pitocin, syntocinon)

• Ergonovine/methylergonovine (Methergine/Ergotrate)

The _____ suction catheter is used to remove meconium (fecal-like substance emitted from the fetus in-utero) from newborns’ airways.

DeLee

Occurs when loops of the intestine herniate into the vagina

Enterocele

The pelvic girdle consists of the ______

Iliac crests, ischia, pubic bones, and sacrum

A fibroid is a benign tumor of the _______

myometrial layer of the uterus

*Uterine fbroids are also called myomas or leiomyomas

The uterina artery and uterine vein are enmeshed in the _________ ligament

Cardinal

What is the trade name for Warfarin, an anticoagulant?

Coumadin or Jantoven

What is the drug classification of Hypaque and Conray?

Contrast media

Give the generic name and classification of the drug Lasix

Furosemide, loop diuretic