Ch. 15 Gynecologic sonography overview Flashcards
Normal range for body temp
98.6°F (oral)
Normal range for adult pulse
60-100 beats per minute
Normal adult blood pressure
<120/80
Normal adult respiration rate
12-20 breaths per minute
One of the most common causes of nosocomial infections, or hospital-acquired infections, is a _______.
urinary tract infection
_______have been established to reduce the risk of microorganism transmission in the clinical setting. Standard precautions, formerly referred to as universal precautions, include (1) hand hygiene, (2) the use of personal protective equipment, (3) safe injection practices, (4) safe handling of potentially contaminated equipment and surfaces, and (5) respiratory hygiene and coughing etiquette.
Standard precautions
These precautions apply to blood, nonintact skin, mucous membranes, contaminated equipment, and all other body fluids, except for ______.
sweat
One of the most effective means of preventing spread of infection
proper handwashing
The Centers for Disease Control and Prevention now recommends that health care workers employ the use of an ________rub as the primary mode of hand hygiene in the clinical setting. Traditional handwashing should be used as well when time permits, especially in situations when the hands are visibly soiled.
alcohol-based hand
Following each examination, the transducer, ultrasound machine, stretcher, and any other equipment used during the examination should be thoroughly _______.
disinfected
Following the examination, the endovaginal transducer may be soaked in a high-level disinfectant—occasionally a glutaraldehyde-based solution—and the specified manufacturer’s instructions should be followed. Some institutions may utilize a tabletop unit that employs a _______ disinfection process.
hydrogen peroxide–based
A probe cover is placed on the endovaginal transducer before inserting the transducer into the vagina. Ultrasound gel should be placed in the probe cover over the face of the transducer to _______.
reduce artifacts from air. (ultrasound gel inside the sterile cover-absence of bubbles)
a sonographic procedure that uses saline instillation into the endometrial cavity and fallopian tubes to evaluate for internal abnormalities; also referred to as saline infusion sonohysterography
sonohysterogram
Transducers used during invasive procedures should be covered with a _____ probe cover, and ______ultrasound gel should be utilized.
sterile; sterile
Again, if a latex product is going to be utilized during the examination, the sonographer should inquire about latex _______ before the examination.
allergies
sterile field preparation is performed before the sterile procedure as well, and _______, also referred to as surgical asepsis, must be maintained
sterile asepsis (table 15-5 ten vital rules of surgical asepsis to remember)
______allows for both easy storage and comparison between sonographic findings and straightforward correlation between other imaging modality findings.
PACS
Higher frequency =
better resolution & poorer penetration
Lower frequency =
poorer resolution & better penetration
Transducers that may be used for pelvic sonography include linear array, matrix array, curved or convex array, phased array, or the vector or sector array. Transabdominal transducers employ frequencies lower than ___ MHz, unless if the patient is thin.
6
Endovaginal transducers also have varying frequencies but are typically ____ MHz or higher. Higher frequency linear array transducers (7.5 to 18 MHz or higher when appropriate) may be used for superficial structures, such as the ovaries if needed.
7.5
______________may be used for imaging some superficial structures, such as protruding masses just below the skin surface.
A standoff pad or a mound of gel
It is often used to assess or confirm the presence of a uterine malformation, to provide an accurate representation of the location of an intrauterine device, or to investigate the uterine cavity during sonohysterography
3D Sonography
a common form of birth control in which a small device is placed within the endometrium to prevent pregnancy; also referred to as an intrauterine contraceptive device
intrauterine device
Endovaginal imaging is contraindicated for ______.
virginal patients
Ovarian torsion is much more common in ______
adolescense
an abnormality that results from the ovary twisting on its mesenteric connection, consequently cutting off the blood supply to the ovary
ovarian torsion
a mass of tissue that contains abnormal cells; also called a tumor
neoplasm
Adnexal or ovarian ______ can be associated with a large ovarian mass or cyst, or result from the excessive mobility of the adnexal structures.
torsion
birth defect in which the external genitalia appear recognizably neither male nor female (is an indication for pelvic sonography for the newborn infant)
ambiguous genitalia
a chromosomal aberration where one sex chromosome is absent; may also be referred to as monosomy X
Turner syndrome
The role of sonography for patients with ambiguous genitalia is to locate the gonads, to determine the presence or absence of the uterus, and to possibly assess the ______glands for masses or swelling.
adrenal
The most common disorder of sex development is ______, also referred to as monosomy X. These patients suffer from gonadal dysfunction and have physical characteristics such as short stature and webbing of the skin on the neck.
Turner syndrome
Ovarian and uterine masses may become large enough to obstruct the flow of urine from the kidney(s) to the bladder, resulting
hydronephrosis
A ______, which is a kidney located within the pelvis, may also be discovered during a pelvic sonogram and can mimic pathology
pelvic kidney
A ___ amount of free fluid within the female pelvis is a common funding and is most often associated with normal ovarian cycles.
small
_______ amounts of pelvic ascites may be associated with some ovarian tumors, ectopic pregnancy, cirrhosis, and portal hypertension. Meigs syndrome (pelvic ascites, pleural effusion, and a benign ovarian mass) may also be suspected if there is an extensive amount of free fluid in the pelvis.
Massive
ascites and pleural effusion in the presence of some benign ovarian tumors
Meigs syndrome
Malignant ovarian tumors may leak mucinous material, a condition known as ________, as in the case of a ruptured ovarian mucinous cystadenocarcinoma.
pseudomyxoma peritonei
an intraperitoneal extension of mucin-secreting cells that result from the rupture of a malignant mucinous ovarian tumor or, possibly, a malignant tumor of the appendix
pseudomyxoma peritonei
Pelvic inflammatory disease, ovarian hyperstimulation syndrome, and Fitz-Hugh–Curtis syndrome are all associated with ______ within the pelvis as well.
free fluid
Between the pubic bone & urinary bladder, also called space of Retzius
retropubic space
Extended alongside the ascending and descending colon on both sides of the abdomen
paracolic gutter
Between the urinary bladder and rectum(Male); between the uterus and rectum, also called pouch of douglas in females and rectovescical pouch in men
posterior cul de sac
Between the urinary bladder and uterus, also called vesicouterine pouch in female
anterior cul de sac
Simple cysts (STAR criteria)
smooth walls or borders, through transmission (acoustic enhancement), anechoic, round in shape
Preparation for transabdominal imaging
drink 32 oz of water (provides acoustic window via bladder & displaces bowel)
Advantage of transabdominal imaging
global view of the entire pelvis
Disadvantage of transabdominal imaging
lack of detail (obese, retro/retroflexed uterus present unique challenge)
Advantage of transvaginal imaging
improved resolution
Number of pregnancies
gravida
How many pregnancies that have been carried to term (alive)
para
difficult or painful menstruation
dysmenorrhea
the absence of menstruation
amenorrhea
abnormally heavy and prolonged menstruation
menorrhagia
irregular menstrual bleeding between periods; intermenstrual bleeding
metrorrhagia
excessive or prolonged bleeding between periods
menometrorrhagia
inability to control urination
incontinence
the distinct layering of fluids within a cyst or cystic structure that is caused by the presence of at least two different fluid compositions
fluid-fluid level
a catheter placed into the urinary bladder via the urethra that is used to drain urine; it can also be clamped and used to temporarily distend the bladder for pelvic sonography
foley catheter
the area located posterior to the broad ligaments, adjacent to the uterus, which contains the ovaries and fallopian tubes
adnexa
growth or masses attached to the wall of a structures, most likely a cyst
mural nodules
sonographic sign obtained during an endovaginal sonogram when gentle probe pressure is used to assess whether the anterior rectum and sigmoid colon glides freely across the posterior aspect of the uterus, cervix, and vaginal wall
“sliding” sign
Lab value evaluated in cases of suspected ectopic pregnancy
hematocrit (indicated bleeding)
a decrease in hematocrit indicates ____
bleeding
Lab value evaluated in cases of pelvic inflammatory disease
white blood cell count (elevated- leukocytosis)
Patients who have some form of “itis” (such as salpingitis), or possibly even an abscess, will most likely have an _____ white blood cell count with existing infection as well.
abnormal
an infection of the female genital tract that may involve the ovaries, uterus, and/or the fallopian tubes
pelvic inflammatory disease
a pregnancy located outside the endometrial cavity
ectopic pregnancy
a syndrome characterized by anovulatory cycles, infertility, hirsutism, amenorrhea, and obesity; may also be referred to as Stein–Leventhal syndrome
polycystic ovarian syndrome
painful sexual intercourse
dyspareunia
dysuria
painful or difficult urination
CA-125
a tumor marker in the blood that can indicate certain types of cancers such as cancer of the ovary, endometrium, breast, gastrointestinal tract, and lungs; stands for cancer antigen 125
a protein produced by the fetal yolk sac, fetal gastrointestinal tract, and the fetal liver; may also be produced by some malignant tumors
alpha-fetoprotein
a hormone produced by the trophoblastic cells of the early placenta; may also be used as a tumor marker in nongravid patients and males
human chorionic gonadotropin
an enzyme found within the blood that may be used to monitor renal function; may also be used as a tumor marker for some ovarian tumors
lactase dehydrogenase
an elevated white blood cell count
leukocytosis
excessive hair growth in women in areas where hair growth is normally negligible
hirsutism
decreased or scant menstrual flow; regular timed menses but light flow
hypomenorrhea
inability to conceive a child after 1 year of unprotected intercourse
infertility
an inherited bleeding disorder that is characterized by low levels of a specific clotting protein in the blood referred to as von Willebrand factor; results in excessive bleeding and specifically vaginal bleeding in women
von Willebrand disease
a breast cancer drug that inhibits the effects of estrogen in the breast
Tamoxifen
changes within the female that are caused by increased androgens; may lead to deepening of the voice and hirsutism
Virilization
Which of the following lab tests may be used as a tumor marker for ovarian dysgerminoma? (lactate dehydrogenase, alpha-fetoprotien, CA-125, Tamoxifen)
lactate dehydrogenase
All of the following are associated with acute pelvic pain except (PID, ruptured ovarian hemorrhagic pain cyst, perforated IUD, asherman syndrome)
asherman syndrome
Which of the following would be least likely to cause abdominal distention? (ascites, multiple leiomyoma, ovarian hyperstimulation syndrome, polycystic ovarian disease)
polycystic ovarian disease
Precocious puberty is best defined as
pubertal development before the age of 8
Which of the following would most likely be associated with hirsutism(PCOS, Meigs syndrome, Adenomyosis, Adenomyomatosis)?
PCOS
Which of the following diagnostic tests is used to evaluate emitted radiation from the patients to assess the function of organs? (MRI, nuclear medicine, radiography, CT)
nuclear medicine
