Chapter 19:Pelvic Anatomy Flashcards
Which pelvic ligament extends from the cornua of the uterus to the medial aspect of the ovary?
a) round
b) broad
c) cardinal
d) ovarian
d: The ovarian ligament extends from the cornua of the uterus to the medial aspect of the ovary. The round ligament arises in the cornua of the uterus and extends to the pelvic sidewalls.
Prominent anechoic structures near the periphery of the uterus most likely represent:
a) endometriomas
b) arcuate vessels
c) nabothian cysts
d) physiological cysts
b: Arcuate vessels are commonly visualized near the periphery of the uterus as anechoic circular structures. Nabothian cysts are located in the cervix.
Which of the following muscles abuts the lateral walls of the urinary bladder?
a) ileopsoas
b) piriformis
c) levator ani
d) obturator internus
d: The obturator internus muscles abut the lateral walls of the urinary bladder. The iliopsoas muscles are lateral landmarks of the true pelvis lying lateral and anterior to the obturator internus muscles.
The region including the ovary and Fallopian tube is termed the:
a) oviduct
b) adnexa
c) fimbriae ovarica
d) space of Retzius
b: Adnexa is the term used to describe the region of the ovary and fallopian tube. Space of Retzius is located anterior to the urinary bladder and posterior to the symphysis pubis. The one fimbriae attached to the ovary is termed the fimbriae ovarica.
Which segment of the Fallopian tube connects with the uterus?
a) ampulla
b) isthmus
c) interstitial
d) infundibulum
c: The interstitial segment of the fallopian tube passes through the cornua of the uterus. The ifundibulum is the most lateral segment of the oviduct.
The flanged portions of the iliac bones form the:
a) lateral border of the true pelvis
b) posterior border of the true pelvis
c) inferior border of the true pelvis
d) posterior border of the false pelvis
d: The flanged portions of the iliac bones and the base of the sacrum form the posterior boundary of the false pelvis.
Which uterine position displays the fundus of the uterus anterior to the cervix?
a) anteversion
b) anteflexion
c) retroversion
d) retroflexion
b: With anteflexion, the fundus of the uterus bends on top of the cervix. The uterus bends behind the cervix in retroflexion.
When measuring endometrial thickness, calipers are placed from:
a) superior interface to inferior interface
b) echogenic interface to echogenic interface
c) echogenic interface to hypoechoic interface
d) hypoechoic interface to hypoechoic interface
b: Only the functional layer (echogenic) is included when measuring endometrial thickness. The hypoechoic basal layer or fluid within the endometrium cavity is not included when measuring the thickness of the endometrium.
The ovary is attached to the pelvic sidewall by the:
a) broad ligament
b) round ligament
c) ovarian ligament
d) suspensory ligament
d: The suspensory ligaments extend from the lateral aspect of the ovary to the lateral aspect of the ovary to the pelvic sidewalls. The broad ligaments extend from the lateral aspect of the uterus to the pelvic sidewalls.
Failure of the Müllerian ducts to fuse will most likely result in:
a) uterine septae
b) uterine agenesis
c) bicornuate uterus
d) uterine didelphys
d: Failure of the mullerian ducts to fuse will result in uterine didelphys. Partial failure of these ducts to fuse will result in a bicornuate uterus. Failure of the mullerian ducts to develop results in uterine agenesis.
Which of the following correctly measures endometrial thickness?
a) anterior-posterior dimension in the coronal plane
b) transverse dimension in the coronal plane
c) anterior-posterior dimension in the sagittal plane
d) anterior-posterior diameter in the transverse plane
c) The anterior-posterior dimension of the endometrium is only measured in the sagittal plane.
Which of the following most accurately describes the peritoneum?
a) the perimetrium lines the uterine cavity
b) the perimetrium is composed of smooth muscle
c) the serosal surface of the uterus is termed the perimetrium
d) the perimetrium is composed of connective tissue and large blood vessels
c: The external or serosal layer of the uterus is termed the perimetrium
Secondary blood supply to the ovaries is through the:
a) arcuate arteries
b) uterine arteries
c) ovarian arteries
d) hypogastric arteries
b: The ovaries receive blood primarily from the ovarian arteries and secondarily through the uterine arteries. The uterine arteries arise from the hypogastric arteries.
The vesicouterine pouch is located:
a) posterior to the uterus and anterior to the rectum
b) anterior to the uterus and posterior to the urinary bladder
c) posterior to the symphysis pubis and anterior to the uterus
d) anterior to the symphysis pubis and posterior to the rectus abdominus
b: The vesicouterine pouch (anterior cul de sac) is located anterior to the uterus and posterior to the urinary bladder. The retrouterine space (posterior cul de sac) is located posterior to the uterus and anterior to the rectum.
In premenarche, the size of the uterine cervix is expected to be:
a) half the size of the corpus
b) equal to the uterine corpus
c) twice as large as the corpus
d) equal to the uterine fundus
c: The cervix is twice as large as the corpus during premenarche. The cervix-to-corpus ratio is 2:1.
This sagittal image of the uterus most likely represents a :
a) septae uterus
b) bicornuate uterus
c) premenarche uterus
d) postmenopausal uterus
d: The cervix and corpus appear equal in size (1:1). This is most consistent with a postmenopausal uterus. The cervix is twice the size of the corpus in a premenarche patient (2:1).
In this sagittal sonogram, the uterus is lying in which of the following positions?
a) anteversion
b) retroflexion
c) anteflexion
d) retroversion
a: The uterus bends slightly anterior (forward), characteristic of anteversion. With anteflexion, the uterus bends on the cervix. Dextroflexion displaces the uterus to the left of the cervix.
Which pelvic muscles are the arrows identifying?
a) iliopsoas
b) levator ani
c) uterosacral
d) obturator internus
b: The levator ani and pisiform is muscles form the pelvic floor and lie posterior to the vagina. Obturator internus and iliopsoas muscles are located in the lateral true pelvis.
A peri menopausal patient presents with a history of pelvic fullness and pain. A sagittal sonogram displays a fluid collection in the:
a) prevesical
b) space of Retzius
c) pouch of Douglas
d) vesicouterine pouch
C: Fluid is demonstrated posterior to the uterus in the pouch of Douglas. The vesicouterine pouch is located anterior to the uterus.
The position of the uterus is:
a) anteverted
b) anteflexed
c) retroflexed
d) retroverted
a: The uterus is lying in the anteverted position. In retroflexion, the fundus and body curve backward on the cervix.
The ovary is most likely demonstrating a(n):
a) pyosalpinx
b) parovarian
c) benign neoplasm
d) anatomical variant
d: An L-shaped homogeneous ovarian contour is a normal anatomical variant.
A patient presents with a history of multiple miscarriages. Her last menstrual period was 3 weeks earlier. On the basis of this clinical history, the sonogram is most suspicious for a(n):
a) arcuate uterus
b) septae uterus
c) uterine didelphys
d) bicornuate uterus
d: The uterus displays myometrial tissue between two individual endometrial cavities. This is most consistent with a bicornuate uterus.
A 30yr old patient presents with a history of dysmenorrhea. The arrows in the sonogram are most likely identifying:
a) leiomyomas
b) adenomyosis
c) arcuate vessels
d) uterine arteries
c: Evenly spaced, hypoechoic or anechoic, circular structures identified in the outer portion of the myometrium most likely represent arcuate veins. Uterine arteries are located in the broad ligament lateral to the uterus.
A patient presents with a history of chronic cirrhosis and abdominal distention. The hyperechoic linear structures lateral to the uterus most likely represent the:
a) Fallopian tubes
b) broad ligaments
c) round ligaments
d) ovarian ligaments
b: The hyperechoic linear structure extends from the uterus to the pelvic sidewall. This is most consistent with the broad ligaments. The Fallopian tubes are tortuous and do not attach to the pelvic sidewall.
The hypoechoic structure identified by the arrow most likely represents the:
a) pelvis bone
b) levator ani muscle
c) piriformis muscle
d) obturator internus muscle
d: The obturator internus muscles abut the lateral walls of the urinary bladder. Iliopsoas muscle demonstrate a classic hyperechoic central echo. Levator ani muscles lie lateral to the vagina.
The coronal sonogram most likely identifies:
a) arcuate uterus
b) didelphys uterus
c) septae uterus
d) bicornuate uterus
d: Two distinct endometrial cavities are identified with myometrial tissue between the cavities and a single uterine cervix consistent with bicornuate uterus. Uterine didelphys demonstrates two individual endometrial cavities and cervixes.
Identification of free fluid in the pelvis is located in the:
a) prevesical and retrouterine spaces
b) retrouterine and retropubic spaces
c) vesicouterine and retrouterine spaces
d) retrouterine, vesicouterine, and retropubic spaces
c: Free fluid is identified anterior and posterior to the uterus in the vesicouterine and retrouterine spaces. The small anechoic area represents a small amount of urine in an otherwise empty bladder.
The position of the uterus in this sagittal sonogram is termed:
a) Anteflexion
b) levoflexion
c) retroflexion
d) retroversion
d: The uterus displays a posterior tilt and the cervix forms an angle less than 90º to the vaginal canal, characteristic of retroversion.
