Ch 1 (intro) & 2a (normal anatomy) Flashcards
What is dysmenorrhea?
Painful menses
What is amenorrhea?
Lack of menses
What is menorrhagia?
Excessive menstrual bleeding
What is metrorrhagia?
Irregular uterine bleeding
What is menometrorrhagia?
Excessive irregular bleeding
What is GPAT?
Gravida - # pregnancies
Para - # pregnancies to term (over 36w)
Abortion - # failed pregnancies
Term - # birthed children
Where to place calipers in uterus measurement?
Outer to outer
What is the sliding sign?
Shows if pelvic organs can move with probe pressure
(most pelvic organs are mobile + should slide)
What 4 bones make up pelvic skeleton?
-Sacrum (posterior + middle)
-Coccyx (posterior + middle below sacrum)
-2 innominate bones (anterior/lateral, join at symphysis pubis under coccyx)
Difference b/w true + false pelvis?
True - internal deep center part
False - outer wings + superior part
True: pelvic colon, rectum, bladder, uterus, ovaries, fallopian tubes, vagina, suspensory ligaments
False: ileum + sigmoid colon
What are the 3 pelvic muscle categorizes?
- Abdominopelvic
- False pelvis
- True pelvis
What are the m/c abdominopelvic muscles?
-Rectus abdominis
-Psoas
What is the m/c false pelvic muscle?
Iliacus that turns into the iliopsoas
What are the m/c true pelvic muscles?
-Obturator internus
-Piriformis
+
Innermost layers of pelvis:
-Levator ani (iliococcygeus, pubococcygeus + puborectalis)
-Coccygeus
What is the levator ani like?
A hammock
What is the space of retzius?
Space b/w symphysis pubis + bladder
What layers of the bladder are visible?
-Inner mucosa layer
-Middle thick muscularis layer
(outer serosal layer not seen b/c too thin)
Is the vagina considered a potential space?
Yes
What are the 4 segments of the uterus?
Fundus - top
Corpus - largest
Isthmus - transition b/w corpus + cervix
Cervix - neck going into vagina
What is the external oz?
Part connects cervix to vagina, closest to exit body
What is internal oz?
Part b/w cervix + body uterus
Layers of uterus?
Perimetrium - outer
Myometrium - thick middle
Endometrium - inner
What layers of uterus do we see on u/s?
-Myometrium
-Endometrium (composed of basalis that does NOT shed + functionalis that DOES shed during menstruation)
What are the 3 uterine ligaments?
-Cardinal
-Round
-Broad
Where is the cardinal/TRV cervical ligament?
Lateral region cervix + lateral margin uterine corpus
(think cervix)
Where is the round ligament?
From uterine cornua/horn across the pelvic space from posterior to anterior
What does version + flexion refer to in uterine positions?
Version: cervix angle
Flexion: uterine body angle
Where is the broad ligament?
-Divides true pelvis into anterior + posterior parts
-Hardest to see b/c is actually a double fold of peritoneum
-Not a true ligament
What are the 4 segments of the fallopian tubes?
Intramural - where tube connects to uterus
Isthmic - only tube
Ampullary - longest + tortuous
Infundibulum - finger like + must catch egg from ovary
What are the 3 ovarian ligaments?
Ovarian - connects uterus to ovary
Infundibulopelvic - connects pelvis to ovary
Mesovarium - encases ovary
3 parts of pelvic vascular system?
Arteries, veins, lymphatics
What artery feeds the pelvic organs?
Internal iliac artery
What artery is most important to sonographers in OB imaging?
Uterine artery
(comes off internal iliac + enters uterus at cervix)
What does the internal iliac artery + external iliac vein do to the ovaries?
Internal: feed ovaries
External: drains ovaries
How much water to drink for TA exam?
32 oz, 1 hour before
Do we need a full bladder for an EV?
No, empty
Frequency for TA/TP probe?
2.5-5 MHz
Frequency for EV probe?
3-7.5 MHz
Uterus length in child + nulliparous adult?
Child: 2.5cm long, 1cm AP
Adult: 8cm long, 5.5cm wide, 3cm AP
Fallopian tube length?
7-14cm
Ovary measurement?
2.5-5cm in length
1.5-3cm in width
0.6-2.2cm AP
Volume = 6-9cm^3
Where do the right and left ovarian veins drain into?
Right: directly into IVC
Left: directly into left renal vein, then IVC
What is the bimanual maneuver?
Aid in optimizing EV imaging as the sonographer puts hand on pt’s pelvic area + gently applies pressure over site of interest to move bowel out of the way or other organs/structures that are high up in the pelvis into FOW (ex this helps visualize an ovary better)
What 2 muscles m/c seen in TRV on pelvic u/s?
-rectus abdominis (from 5,6,7 ribs + xiphoid process to symphysis pubis + pubic crest)
-psoas
What is linea alba?
Midline separation (space) b/w R/L aspects of rectus abdominis (our 6 pack)
Is the rectus abdominus muscle superficial?
Yes, very!
Where does psoas originate from?
Lower thoracic + lumbar vertebrae
What happens at L5 to the psoas?
Goes more lateral now creating a gutter within the space, the common iliacs run through here
What does the iliacus turn into?
Iliopsoas (happens below level of iliac crest)
SF of iliopsoas?
Long hypoechoic strip beside uterus + bladder
Where is the obturator internus?
-true pelvis
-it is triangular
-extends posteriorly + medially along sides of true pelvis
-hard to see
Where is the piriformis?
-true pelvis
-from sacrum, goes laterally + inserts on greater trochanter of femur
-usually obscured from gas unless bladder very full
What muscles make up pelvic floor?
Levator ani
Is the anterior or posterior bladder wall composed of the trigone region?
Posterior (orifices of 2 ureters + urethra)
What layers of bladder can we see?
-inner mucosa
-thick middle muscularis
Vag length?
7-10cm long
What is a vaginal fornice?
Little lip/ring in the vagina where the cervix is. The posterior fornix is deeper than the anterior fornix. Spaces normally collapsed.
Cervix length?
2-3cm long
What does the endocervical mucosa do?
Prevents upward migration of bacteria from vag into uterus (forms mucous plug in pregnancy which seals the uterus)
Which endo layer sheds?
Functionalis (NOT basalis)
Names of the superficial + deep layer of endo?
Superficial: functionalis that sheds
Deep: basalis does not shed
Location of ovarian ligs?
Ovarian: from uterus to inferior pole ovary (connects uterus to ovary)
Infundibulopelvic: brim of pelvis to lateral pole ovary (connects pelvis to ovary)
Mesovarium: double layer peritoneum from posterior surface of broad lig (encases ovary)
3 locations ovaries could be?
-posterior cul de sasc
-adnexa
-above or behind fundus of uterus
Space of Retzius location?
B/w bladder + sym pubis
Anterior cul de sac location?
B/w bladder + uterus
Posterior cul de sac location?
B/w sigmoid colon/rectum + uterus
Where does the external iliac go?
Out of pelvis
Primary blood supply for uterus, vag, bladder + muscles of pelvic floor?
Internal iliac artery (feeds pelvic organs)
Where does the ovarian artery arise from?
Aorta
What does the ovarian artery connect with?
Uterine artery, they provide a fail safe blood supply
(so that if ovary can’t get blood supply from ovarian artery it has another way to get blood so it doesn’t die)
Where does uterine artery arise from?
Internal iliac artery
Does IVC bifurcate above or below level of AO bif?
Slightly below AO BIF
What do the external + internal iliac veins do?
External: drain legs
Internal: drain pelvic organs + muscles
What is a plexus?
Fabric of veins that cover an area or organ
