Female genital natomy

Question: What is the origin of the female genital tract?

Answer: The paramesonephric (Müllerian) duct.

Front: What forms the lower part of the vagina?

Back: The sinovaginal bulb.

Front: What does the fusion of the Müllerian ducts form?

Back: The uterus and the upper vagina.

2. What is the clinical significance of incomplete fusion of the Müllerian ducts?

a) Ovarian torsion

b) Bicornuate uterus

c) Rectocele

d) Vaginal cyst

3. At what embryonic stage does the primitive gonad first become evident?

a) 3 weeks

b) 5 weeks

c) 8 weeks

d) 12 weeks

5week

Case: A 30-year-old woman presents with recurrent pregnancy loss. Imaging reveals a bicornuate uterus.

Question: What embryological defect could be responsible for this condition?

Answer: Incomplete fusion of the Müllerian ducts.

Question: Which imaging technique is most appropriate to confirm the diagnosis of a bicornuate uterus?

Answer: Hysterosalpingography or MRI.

Front: What type of cyst can result from remnants of the Müllerian duct?

Back: Gartner duct cyst.

1. Which part of the reproductive tract is derived from the sinovaginal bulb?

a) Ovary

b) Uterus

c) Lower one-third of the vagina

d) Fallopian tubes

C

3. When do Müllerian ducts begin fusing to form the uterus?

a) 5 weeks gestation

b) 12 weeks gestation

c) 20 weeks gestation

d) 24 weeks gestation

Answer: c) 20 weeks gestation

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Case: A 25-year-old woman presents with a painless vaginal mass. On ultrasound, a cyst along the vaginal wall is identified.

Question: What is the most likely diagnosis?

Answer: Gartner duct cyst.

Question: What is the appropriate treatment for a symptomatic Gartner duct cyst?

Answer: Surgical excision if symptomatic.

1. At what stage of gestation is the maximum number of primordial follicles present?

a) 12 weeks

b) 16 weeks

c) 20 weeks

d)weekseeks

C

2. What process causes the reduction of primordial follicles throughout life?

a) Apoptosis

b) Atresia

c) Meiosis

d) Necrosis

B

3. Where do the primitive gonads first develop?

a) Lateral pelvic wall

b) Medial aspect of the mesonephric ridge

c) Abdominal aorta

d) Ureteric bud

B

Front: What is the anatomical difference between the anterior and posterior vaginal walls?

The posterior wall is longer than the anterior wall.

Front: What can result from a weakness in the anterior vaginal wall?

Cystocele

2. What condition results from the weakening of the posterior vaginal wall?

a) Cystocele

b) Rectocele

c) Prolapse

d) Enterocele

B

Case: A 45-year-old woman presents with a bulge in her vagina and urinary incontinence. Physical exam reveals anterior wall herniation.

Question: What is the most likely diagnosis?

Answer: Cystocele.

Question: What imaging modality is best to evaluate pelvic organ prolapse?

Answer: Dynamic pelvic MRI.

2. What is the longest segment of the fallopian tube?

a) Infundibulum

b) Ampulla

c) Isthmus

d) Interstitial part

Answer: b) Ampul

3. Where is the cervix located in relation to the ureters?

a) 1 cm laterally

b) 2 cm medially

c) Anteriorly

d) Posteriorly

Answer: a) 1 cm laterally

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Case: A 29-year-old with chronic pelvic pain is found to have adhesions between the uterus and rectum.

Question: What is the likely diagnosis?

Answer: Endometriosis.

Front: What are the three layers of the uterine wall?

Back: Perimetrium, Myometrium, Endometrium

Front: How does the position of the uterus affect clinical procedures?

Back: The uterus is typically anteverted and anteflexed, which must be considered during procedures like curettage to avoid perforation.

1. What is the normal length of the uterus?

a) 5 cm

b) 7.5 cm

c) 10 cm

d) 12 cm

B

2. Which layer of the uterus contains the main blood vessels?

a) Perimetrium

b) Endometrium

c) Myometrium

d) Serosa

Answer: c) Myometrium

3. In what percentage of women is the uterus retroverted?

a) 10%

b) 15%

c) 20%

d) 25%

Answer: c) 20%

Question: What is the surgical procedure to correct a retroverted uterus associated with severe symptoms?

Answer: Uterine suspension surgery.

Question: What is the preferred imaging method to evaluate the position of the uterus?

Answer: Transvaginal ultrasound.

1. Which part of the fallopian tube is widest?

a) Isthmus

b) Infundibulum

c) Ampulla

d) Interstitial part

Answer: c) Ampull

C

2. What complication can occur if an ectopic pregnancy develops in the interstitial part of the tube?

a) Infertility

b) Ovarian torsion

c) Uterine rupture

d) Hydrosalpinx

C

3. What is the length of a typical fallopian tube?

a) 5 cm

b) 8 cm

c) 10 cm

d) 12 cm

C

Case: A patient presents with severe abdominal pain and positive pregnancy test. Ultrasound shows no intrauterine pregnancy but a mass in the right fallopian tube.

Question: What is the diagnosis?

Answer: Ectopic pregnancy.

Question: What is the treatment of choice for a stable ectopic pregnancy?

Answer: Methotrexate injection.

Front: What is the length of the cervix?

Back: 2.5 cm.

Front: What is the transformation zone in the cervix?

Back: The area where columnar epithelium transitions to stratified squamous epithelium, where most cervical cancers arise.

1. What type of epithelium covers the external os of the cervix?

a) Columnar

b) Transitional

c) Stratified squamous

d) Cuboidal

C

Answer: c) Stratified squamous

2. What is the significance of the transformation zone in the cervix?

a) Site of fetal implantation

b) Area where HPV infection often occurs

c) Primary site of menstrual shedding

d) Area resistant to infections

B

3. What cervical change occurs after childbirth?

a) The external os becomes circular

b) The external os becomes longitudinal

c) The internal os widens

d) The cervix shortens permanently

B

Case: A 35-year-old patient presents with post-coital bleeding. Pap smear shows abnormal cells in the transformation zone.

Question: What is the most likely diagnosis?

Cervical intraepithelial neoplasia (CIN).

Question: What is the best imaging modality for detecting ectopic pregnancy

Transvaginal ultrasound.

2. Which structure connects the ovary to the lateral pelvic wall?

a) Broad ligament

b) Ovarian ligament

c) Suspensory ligament

d) Round ligament

Answer: c) Suspensory ligament

3. What is the diameter of a fallopian tube?

a) 1 cm

b) 2 cm

c) 0.5 cm

d) 1.5 cm

Answer: a) 1 cm

Front: What is the function of the uterosacral ligament

: It provides posterior support to the uterus.

1. Which ligament supports the uterus anteriorly?

a) Uterosacral ligament

b) Round ligament

c) Broad ligament

d) Transverse cervical ligament

Answer: b) Round ligament

2. Which ligament contains the ovarian vessels?

a) Round ligament

b) Broad ligament

c) Suspensory ligament

d) Uterosacral ligament

Answer: c) Suspensory ligament

3. Which ligament is most prone to injury during hysterectomy?

a) Uterosacral ligament

b) Round ligament

c) Cardinal ligament

d) Suspensory ligament

Answer: c) Cardinal ligament

Case: During a hysterectomy, the ureter is accidentally damaged near the cervix.

Question: Which ligament’s proximity to the ureter makes it vulnerable?

Answer: Cardinal ligament

Pelvic ultrasound showing the "string of pearls" sign.

1. Which of the following is NOT part of the levator ani muscle group?

A) Pubococcygeus

B) Puborectalis

C) Iliococcygeus

D) Coccygeus

Answer: D) Coccygeus

2. What is the function of the urogenital hiatus?

A) Passage of the rectum

B) Passage of urethra and vagina

C) Attachment of levator ani muscle

D) Drainage of lymph nodes

Answer: B) Passage of urethra and vagina

1. The __ muscle is part of the levator ani group and helps maintain rectal angle for continence

Puborectalis

2. Which ligament is a condensation of connective tissue that provides uterine support?

1. Which gland is located near the external urethral orifice?

A) Skene’s gland

B) Bartholin’s gland

C) Adrenal gland

D) Prostate gland

Answer: A) Skene’s gland

The __ is a fatty area located above the pubic bone.

Answer: Mons pubis

2. Where does the right ovarian vein drain?

A) Inferior vena cava

B) Left renal vein

C) Internal iliac vein

D) Portal vein

Answer: A) Inferior vena cava

2. Which lymph nodes drain the external genitalia?

A) Para-aortic nodes

B) Lumbar nodes

C) Superficial inguinal nodes

D) Deep inguinal nodes

Answer: C) Superficial inguinal nodes