Ob/GYN Midterm- Ovaries & Fallopian Tubes

The portion of the broad ligament that attaches the ovary to the posterior aspect of the broad ligament is called the mesovarium.

The infundibulum is the part of the uterine tube that contains fingerlike extensions called fimbriae. The fimbriae help to capture the released egg from the ovary and guide it into the uterine tube for fertilization.

Salpingitis is the medical term used to describe inflammation of the fallopian tube. This condition can be caused by various factors such as infections, sexually transmitted diseases, or pelvic inflammatory disease. Inflammation of the fallopian tube can lead to symptoms such as pelvic pain, abnormal vaginal discharge, and fertility problems. Prompt diagnosis and treatment are necessary to prevent complications and preserve reproductive health.

Functional cysts are cysts that form as a result of the menstrual cycle. These cysts develop when the normal process of egg release (ovulation) is disrupted, causing the follicle to continue growing and form a fluid-filled sac. Functional cysts are the most common type of ovarian cysts and are usually harmless, resolving on their own within a few menstrual cycles. They are typically not associated with any underlying disease or abnormality and do not require treatment unless they cause symptoms or complications.

A follicular cyst forms when a mature follicle fails to ovulate or involute postovulation. This means that the follicle does not release an egg as it should or does not break down after releasing the egg. As a result, the follicle continues to grow and fills with fluid, forming a cyst. Therefore, the statement "True" is correct in this case.

The fallopian tubes are divided into four anatomic portions: infundibulum, ampulla, isthmus, and interstitial segment. The infundibulum is the funnel-shaped opening near the ovary that captures the released egg. The ampulla is the wider middle portion where fertilization usually occurs. The isthmus is the narrower part that connects to the uterus. The interstitial segment is the short segment that passes through the uterine wall.

During the reproductive years, the normal measurements of the ovaries are 3 cm in length, 2 cm in width, and 1 cm in anterior-posterior (AP) dimension.

Following the rupturing of the graafian follicle, fluid is most likely to be found in the posterior cul-de-sac. The posterior cul-de-sac, also known as the pouch of Douglas, is a space located between the rectum and the back wall of the uterus. When the follicle ruptures during ovulation, the released fluid can accumulate in this space. This is a normal physiological process and allows the released egg to potentially be fertilized by sperm. The fluid in the posterior cul-de-sac can then be absorbed by the body or eventually drained through the fallopian tubes.

Functional ovarian cysts are the most common cause of ovarian enlargement in young women. These cysts are typically benign and result from the normal functioning of the ovaries. They usually resolve on their own without treatment and are often discovered incidentally during routine pelvic examinations or imaging studies. Endometriosis, pregnancy, and metastatic disease can also cause ovarian enlargement, but they are less common causes compared to functional ovarian cysts in young women.

Corpus luteum cysts are prone to hemorrhage and rupture, often causing pain. They can also grow to a size of 10 cm. Therefore, all of the given statements are correct.

Fertilization most often occurs in the fallopian tubes, specifically in the ampulla region. The interstitial segment refers to the part of the fallopian tube that connects to the uterus, and fertilization rarely occurs in this area. Therefore, the statement that fertilization most often occurs in the interstitial segment is false.

The uterine arteries do not branch off of the abdominal aorta. Instead, they arise from the internal iliac arteries, which are branches of the common iliac arteries. The uterine arteries supply blood to the uterus and play a crucial role in reproductive functions.

The correct answer is that the ovaries have a dual blood supply. This means that they receive blood from both the ovarian arteries and the uterine arteries. The ovarian arteries provide the majority of the blood supply to the ovaries, while the uterine arteries contribute a smaller portion. This dual blood supply ensures that the ovaries receive an adequate oxygen and nutrient supply for their proper functioning.

The left ovarian vein does not drain into the IVC. Instead, it drains into the left renal vein. This is an important anatomical fact to be aware of in the field of medicine and can have implications for surgical procedures and the management of certain conditions.

The sonographic appearance of developing follicles in the ovaries can be described as anechoic, meaning they appear as black or dark areas on the ultrasound image. They also exhibit posterior enhancement, which refers to increased echogenicity or brightness behind the follicle. Additionally, developing follicles in the ovaries can vary in size, ranging from small to large. Therefore, all of the given options accurately describe the sonographic appearance of developing follicles in the ovaries.

The ovaries are not suspended from the anterior aspect of the broad ligament. Instead, they are suspended in a fold of peritoneum called the mesovarium. The other options are true about the ovaries. They usually lie posterior to the uterus at the level of the cornua, and their location can vary as ligaments loosen, especially after pregnancy.

At birth, the ovaries are relatively large as a result of maternal hormone stimulus. This is because during pregnancy, the fetus is exposed to high levels of hormones from the mother, including estrogen, which stimulate the development of the ovaries. These hormones play a crucial role in the growth and maturation of the reproductive organs in female infants. Therefore, it is true that at birth, the ovaries are relatively large due to maternal hormone stimulus.

The fallopian tubes are not directly connected to the ovaries. They are connected to the uterus, and their function is to transport eggs from the ovaries to the uterus. The ovaries are connected to the fallopian tubes by small structures called fimbriae, which help in capturing the released eggs and guiding them into the tubes. Therefore, the statement that the fallopian tubes are directly connected to the ovaries is false.

The innermost region of the fallopian tube is called the ampulla, and it is the widest part of the tube. It connects to the mucosal layer of the uterus through a small opening called the uterotubal junction. This junction allows for the passage of sperm and fertilized eggs between the fallopian tube and the uterus. Therefore, the statement that the innermost region of the fallopian tube runs directly into the mucosal layer of the uterus is true.

A mature Graafian follicle measures within the range of 16 to 28 mm. This is the correct answer because Graafian follicles are the mature ovarian follicles that contain the oocyte (egg) and are ready for ovulation. These follicles typically reach a size of 16 to 28 mm before they rupture and release the egg during the menstrual cycle. The other options of 16 to 28 cm, 2 to 4 mm, and 2 to 4 cm are not within the typical range for a mature Graafian follicle.

All of the options listed, corpus luteum cysts, hemorrhagic cysts, and theca-lutein cysts, are considered functional cysts. Functional cysts are the most common type of ovarian cysts and are formed during the normal menstrual cycle. Corpus luteum cysts occur when the follicle that releases the egg does not shrink after ovulation. Hemorrhagic cysts are formed when bleeding occurs within a functional cyst. Theca-lutein cysts are associated with hormonal imbalances and can be caused by conditions such as gestational trophoblastic disease. Therefore, all of these options are considered functional cysts.

Follicular cysts are generally asymptomatic, meaning they do not typically cause any noticeable symptoms. This is in contrast to other types of cysts that can cause pelvic pain and bleeding. Sonographically, follicular cysts appear echogenic, which means they reflect sound waves and appear brighter on the ultrasound image. However, they do not cause posterior shadowing, which is a characteristic seen in some other types of cysts.

Corpus luteum cysts are indeed known to appear as complex masses with a central blood clot and echogenic septations. This is a characteristic feature of these cysts, which are formed after the release of an egg during the menstrual cycle. The corpus luteum, which is responsible for producing progesterone, can sometimes become filled with fluid, forming a cyst. The presence of a central blood clot and echogenic septations helps in distinguishing corpus luteum cysts from other types of ovarian cysts.

Theca-Lutein cysts are most frequently seen associated with gestational trophoblastic disease. These cysts are caused by an excessive production of human chorionic gonadotropin (hCG) by the trophoblastic tissue. The high levels of hCG stimulate the ovaries to produce multiple cysts, known as theca-lutein cysts. These cysts are typically bilateral and can be quite large. They are often seen in cases of molar pregnancies or choriocarcinomas, which are types of gestational trophoblastic diseases.

The correct answer is that fallopian tubes are not generally visualized on ultrasound. This is because the fallopian tubes are small and narrow structures located deep within the pelvis, making them difficult to visualize using ultrasound. Additionally, they are usually not filled with fluid, which further limits their visibility on ultrasound. Therefore, it is not common to visualize the fallopian tubes during a routine ultrasound examination.

The ovaries produce two hormones: estrogen secreted by the follicles, and progesterone secreted by the corpus luteum. Estrogen is responsible for the development and maintenance of female reproductive structures and secondary sexual characteristics. Progesterone, on the other hand, prepares the uterus for pregnancy and helps maintain a pregnancy if it occurs.

The small scar tissue left behind on the ovary following the regression of the corpus luteum is called the corpus albicans.

The external iliac and internal iliac vessels are sonographic landmarks that can be used to locate the arteries. These vessels are located in the pelvis and can be visualized using ultrasound. By identifying these landmarks, healthcare professionals can accurately locate and assess the arteries in this region.

The "ring of fire" is a term used to describe the appearance of a corpus luteum cyst on ultrasound. Corpus luteum cysts are fluid-filled sacs that form on the ovary after the release of an egg. They are typically benign and can cause pain or discomfort. When visualized on ultrasound, a corpus luteum cyst may appear as a round or oval structure with a bright, echogenic rim surrounding a hypoechoic center, resembling a ring of fire. Therefore, the correct answer is Corpus Luteum Cysts.

High levels of hCG (human chorionic gonadotropin) are associated with Theca-Lutein Cysts. Theca-Lutein Cysts are typically caused by excessive stimulation of the ovaries due to high levels of hCG. hCG is a hormone that is produced during pregnancy and is responsible for maintaining the production of progesterone, which is essential for the development and maintenance of the pregnancy. In cases where there is an overproduction of hCG, such as in molar pregnancies or certain types of ovarian tumors, it can lead to the development of Theca-Lutein Cysts.

The correct answer is "Hypoechoic." In ultrasound imaging, hypoechoic refers to a structure or tissue that appears darker or less echogenic compared to the surrounding tissues. In the context of the question, the ovaries would appear hypoechoic relative to the uterine myometrium, indicating that they would have a different echogenicity or density compared to the surrounding muscular layer of the uterus.

During the luteal phase, the ovarian volume is the lowest. This is because during this phase, the corpus luteum, which is the remnant of the ruptured follicle, forms in the ovary. The corpus luteum is a temporary structure that secretes progesterone and estrogen. As the luteal phase progresses, the corpus luteum starts to degenerate, leading to a decrease in ovarian volume. This decrease in ovarian volume is a normal physiological response and is a characteristic feature of the luteal phase.

After ovulation, the corpus luteum appears as a rounded structure with a smooth and regular shape on ultrasound imaging. It also contains internal echoes, which are reflections of sound waves that create a pattern within the structure. Therefore, the statement that the corpus luteum appears irregular in shape and contains no internal echoes after ovulation is false.