Ch 40 Sonographic Evaluation of the Female Pelvis

Question 1

The full bladder ________ the bowel and its contained gas from the field of view and _______ the anteflexed uterus slightly so that it is more perpendicular to the transducer angle.

Answer 1

displaces, flattens

Question 2

The bladder shape may be helpful because a well-distended bladder typically has a ________ or elongated shape on midline scans.

Answer 2

triangular

Question 3

The ____ vessels can be used as a landmark to identify the lateral adnexal borders.

Answer 3

iliac

Question 4

If pathology is present, documentation of the _______ (Morison’s pouch and subphrenic area) and bilateral ______ areas must be obtained.

Answer 4

RUQ, renal

Question 5

In transvaginal scanning, it is necessary to advance the transducer slightly, angling _______ to visualize the fundus, and to withdraw slightly, away from the external os, while angling ______ to see the cervix and the rectouterine recess.

Answer 5

anterior, posterior

Question 6

These measurements of the uterus and ovaries should documented: ________, __________, _________.

Answer 6

length, width, axial

Question 7

The thickness of the endometrium should be measured in the ________ plane.

Answer 7

sagittal

Question 8

Pelvic muscles may be mistaken for ovaries, fluid collections, or masses. A _______ bilateral arrangement indicates that they are muscles.

Answer 8

symmetrical

Question 9

Sonographically, sections of the _________ muscle are seen at the posterior lateral corners of the bladder at the level of the vagina and cervix.

Answer 9

obturater internus

Question 10

The muscle that is best visualized sonographically in a transverse plane with caudal angulation at the most inferior aspect of the bladder is the _________ muscle.

Answer 10

levator ani

Question 11

The muscle that are located on either side of the midline posterior to the upper half of the uterine body and fundus are the ________ muscles.

Answer 11

piriformis

Question 12

To assess the uterine vessels, the sonographer interrogates just ______ to the cervix and lower uterine segment at the level of the internal os.

Answer 12

lateral

Question 13

A _______ , highly resistive flow pattern in the ovary is shown during the follicular phase of the menstural cycle

Answer 13

low-velocity

Question 14

At ovulation, the maximum velocity increases and the RI ______

Answer 14

decreases

Question 15

The middle uterine layer is the ________ of the uterus; this layer should have a homogeneous ecotexture with smooth-walled borders.

Answer 15

myometrium

Question 16

The ________ of the uterus is hypoechoic and surrounds the relatively echogenic endometrial stripe, creating a subendometrial halo.

Answer 16

endometrium

Question 17

calcifications may be seen in the _______ arcuate arteries in postmenopausal women and appear as peripheral linear echos with shadowing.

Answer 17

arcuate

Question 18

The body of the uterus is separated from the cervix by the isthmus at the level of the ________ and is identified by narrowing of the canal.

Answer 18

internal os

Question 19

The axis of the uterine body relative to the cervix is referred to as the ______, whereas________ refers to the axis of the cervix relative to the vagina.

Answer 19

flexion, version

Question 20

The best way to measure the cervical-fundal dimension of the uterus in the longitudinal plane is the ________ technique.

Answer 20

transabdominal

Question 21

During menstruation (days 1 -4), the ________ canal appears as a hypoechoic central line representing blood and tissue reaching 4 to 8 mm, including the basal layer in this measurement.

Answer 21

endometrial

Question 22

As menses progress (day 3 to 7), the hypoechoic echo that represented blood disappears, and the endometrial stripe is a discrete thin _______ line that is usually only 2 to 3 mm long.

Answer 22

hyperechoic

Question 23

In the early proliferative phase (days 5 to 9), the endometrial canal appears as a ________ stripe.

Answer 23

single thin

Question 24

The layer that is seen as a hyperechoic halo encompassing the stripe is the ________ layer

Answer 24

functionalis

Question 25

The layer of the endometrium that represents the thin surrounding hyperechoic outermost echo is the ______ layer.

Answer 25

basalis

Question 26

During the _______ (luteal) phase (days 15 to 28), the endometrium is at its greatest thickness and echogenicity with posterior enhancement.

Answer 26

secretory

Question 27

Sonographically, the postmenopausal endometiral complex is seen as a thin _______ line measuring less than 8mm, unless a hormone regimen is being followed.

Answer 27

echogenic

Question 28

If the tunes are distended with or surrounded by a sufficient amount of _____, they can be easily outlined by the contrasting fluid.

Answer 28

fluid

Question 29

Typically, the ovary is located just _____ to the uterus and ________ to the internal iliac vessels, which can be used as a landmark to localize the ovary.

Answer 29

lateral, anteromedial

Question 30

The best sonographic marker for the ovary is identification of a _________ , which has the classic appearance of being think walled and anechoic with through-transmission posteriorly.

Answer 30

follicular cyst

Question 31

The posterior cul-de-sac, or _________, is the most posterior and inferior reflection of the peritoneal cavity. It is located between the rectum and the vagina and is known as the pouch of douglas.

Answer 31

rectouterine recess

Question 32

___________ involves the instillation of sterile saline solution into the endometrial cavity.

Answer 32

sonohysterography