T10 - RP

BICORNUATE UTERUS

Paired uterine horns extend into the fallopian tubes

UNICORNUATE UTERUS

Occurs when the uterine cavity is elongated and has a single fallopian tube emerging from it

UTERUS DIDELPHYS

rare congenital anomaly with complete duplication of the uterus, cervix, and vagina

ANTEVERTED

fundus of the uterus lies anterior to the cervix and away from the rectum

RETROVERTED

uterus is more vertical than normal and points backward toward the bowel

RETROFLEXED

uterus is completely bent back and lies against the rectosigmoid region of the bowel

ANTEFLEXED

uterus that is tilted vertically forward is and it lies on top of the urinary bladder

PYOSALPINX

fallopian tubes fill with pus

HYDROSALPINX

tubes filled with a watery fluid

ENDOMETRITIS

inflammation of the inner lining of the uterus

• may occur after childbirth or in association with PID

TRANSABDOMINAL UTZ

extent of the disease process

ENDOVAGINAL UTZ

• most sensitive for detecting dilated tubes, inflammatory changes, and abscesses.

• status of the fallopian tubes can be assessed radiographically by hysterosalpingography

OVARIAN CYSTIC MASSES

• Physiologic ovarian cysts are most common in female infants and in women of childbearing age

• They include follicular cysts and corpus luteum cysts 

  • Follicular ovarian cysts result from faulty reabsorption of the fluid from incompletely developed follicle

  • Corpus luteum ovarian cysts occur when reabsorption of any blood leaked into the cavity after ovulation leaves a small cyst behind

FOLLICULAR OVARIAN CYSTS

result from faulty reabsorption of the fluid from incompletely developed follicle

CORPUS LUTEUM OVARIAN CYSTS

occur when reabsorption of any blood leaked into the cavity after ovulation leaves a small cyst behind

ENDOMETRIOSIS

• Presence of normal-appearing endometrium in sites other than their normal location inside the uterus.

• Ovaries, uterine ligaments, rectovaginal septum, and pelvic peritoneum, gastrointestinal and urinary tracts can also be affected

• These blood-filled cysts (also referred to as chocolate cysts) are often visible on ultrasonographic examination

POLYCYSTIC OVARIAN SYNDROME

• is characterized by multiple ovarian cysts, which may interfere with the physiology of the ovary. This is considered the most common genital disorder found in young women.

• On ultrasound, ovarian cysts appear as rounded, anechoic adnexal masses

DERMOID CYSTS (TERATOMA)

Most common type of germ cell tumor, contains skin, hair, teeth, and fatty elements, all of which typically derive from ectodermal tissue.

CYSTADENOCARCINOMA

• malignant tumor of the ovary, accounting for more than 60% of all ovarian cancers cause of this neoplasm is unknown

• signs and symptoms

  • urinary bladder or rectal pressure, back pain, and bloating.

  • In many cases, the disease is completely asymptomatic and discovered only on routine pelvic examination.

CERVICAL CARCINOMA

• Common malignancy of the female reproductive system

• caused by an abnormal growth pattern of epithelial cells around the neck of the uterus 

• Is essentially a sexually transmitted disease, as a history of multiple sexual partners or prior sexually transmitted infections predisposes women to this disease

• Symptoms

  • abnormal bleeding, especially postcoital bleeding.

  • impaired renal function resulting from ureteral obstruction is often seen

UTERINE FIBROIDS (LEIOMYOMAS)

• Benign smooth-muscle tumors

• Develop only during the reproductive years and tend to shrink after menopause

• Abnormal bleeding between periods or excessively heavy menstrual flow is the most common symptom

• cause of this neoplasm is unknown; however, leiomyomas tend to grow under the influence of estrogen, may enlarge during pregnancy, and stop growing at menopause.

FIBROADENOMA

• common benign breast tumor.

• usually unilateral and consists of a solid, well-defined mass that does not invade surrounding tissue.

• is formed by an overgrowth of fibrous and glandular tissues and is commonly located in the upper, outer quadrant of the breast.

• Fibroadenomas almost always occur in women under 30 years of age and most frequently in those 21 to 25 years of age.

• appear to be estrogen dependent and may grow rapidly during pregnancy

BREAST CARCINOMA

• common malignancy among women

• incidence continues to rise throughout the postmenopausal years because of changes in estrogen levels, with the mean age for breast cancer being age 60 years.

• Approximately 60% of all palpable lesions occur in the upper outer quadrant of the breast

• Heredity, endocrine influence, oncogenic factors (such as viruses), and environmental factors (such as chemical carcinogens) appear to play a role in the development of this disease

• Disorders during pregnancy

AMNIOTIC FLUID

• is the protective liquid contained by the amniotic sac of a gravid amniote

• Polyhydramnios refers to an excessive accumulation of amniotic fluid

• Oligohydramnios refers to a very small volume of amniotic fluid.

POLYHYDRAMNIOS

refers to an excessive accumulation of amniotic fluid

OLIGOHYDRAMNIOS

refers to a very small volume of amniotic fluid

ECTOPIC PREGNANCY

• Embryo attaches outside the uterus

• Is a life-threatening condition

• Responsible for up to one fourth of maternal deaths

• More than 95% of ectopic pregnancies occur within the fallopian tubes, and more than half the patients with this complication of pregnancy have a history or pathologic evidence of PID

PLACENTA PREVIA

• is a condition in which the implantation of the placenta leaves part or all of the cervical is covered.

• Several degrees are recognized: total, partial, marginal, and lowlying previa.

PLACENTAL ABRUPTION

• Occasionally, normally implanted placenta may prematurely separate from the uterus

• May be life-threatening to the fetus

• factors for abruption include a history of a prior abruption, pregnancy-induced hypertension, smoking, alcohol abuse, cocaine abuse, external abuse, and multiple gestation

HYDATIDIFORM MOLE

• refers to an abnormal conception in which usually no fetus is present 

• the presenting sign is a uterine size that is inappropriate for the date

BENIGN PROSTATIC HYPERPLASIA

• Enlargement of the prostate gland

• common in men older than 60 years of age

• disturbance of hormone secretions from the sex glands 

  • reproductive activity declines

• Results to the inability to empty the bladder completely 

  • lead to partial urinary tract obstruction, bilateral ureteral dilation, and hydronephrosis

• Transrectal ultrasound imaging

ABDOMINOPELVIC SCAN

• residual urine volume

• hydronephrosis

EXCRETORY UROGRAPHY

produces elevation and a smooth impression on the floor of the contrast material–filled bladder

RESIDUAL URINE

• medium for bacterial infection

• cystitis

• infection may ascend from the bladder to the kidney, resulting in pyelonephritis

TESTICULAR TORSION

• Twisting of the gonad on its pedicle

• leads to compromise of the circulation and the sudden onset of severe scrotal pain.

• Color Doppler ultrasound or radionuclide studies are of value

  • Torsion vs Epididymitis

EPIDIDYMITIS

• Inflammation of the epididymis

• The preferred imaging modality for testicular torsion or epididymitis depends on the patient’s age—generally, color Doppler ultrasound in adults and radionuclide studies in children.

• Treatment

  • For torsion, immediate surgery must be performed within 5 or 6 hours of the onset of pain to preserve the testis.

  • For epididymitis, bed rest, scrotal support, and antibiotics are prescribed for all bacterial infections.