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2nd Year GYN > Chapter 40: Sonographic & Doppler Eval of Female Pelvis > Flashcards

Chapter 40: Sonographic & Doppler Eval of Female Pelvis Flashcards

1
Q

The Doppler measurement that takes the highest systolic peak minus the highest diastolic peak divided by the highest systolic peak is what?

A

Pourcelot Resistive Index

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2
Q

What are the small vessels found along the periphery of the uterus?

A

arcuate vessels

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3
Q

What is a horizontal plane through the longitudinal axis of the body to image structures from anterior to posterior?

A

coronal

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4
Q

What is the pulsatility index?

A

the Doppler measurement that uses peak systole minus peak diastole divided by the mean over one cardiac cycle

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5
Q

The endometrium is at its greatest thickness and echogenicity with posterior enhancement in which phase?

A

secretory

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6
Q

The difference between the peak systole and the peak diastole is what?

A

S/D ratio

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7
Q

To image the fundus with TV, how do you angle the handle?

A

towards the bed

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8
Q

With EV sonography, the cervix of an anteverted uterus is seen to the _______ of the screen, while the fundus is seen to the ________ of the screen.

A

right, left

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9
Q

Which plane should the endometrium be measured in?

A

longitudinal

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10
Q

How long should a TV transducer be soaked in disinfectant between uses?

A

10-20 minutes

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11
Q

Symmetrical bilateral pelvic masses are likely to be what?

A

pelvic muscles

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12
Q

The thin outer layer of the uterus is separated from the intermediate layer by what?

A

arcuate vessels

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13
Q

Flexion refers to the axis of the uterine body relative to the

A

cervix

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14
Q

Nabothian cysts are found where?

A

endocervical canal

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15
Q

Arcuate artery calcifications are observed in what patients?

A

postmenopausal and diabetic

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16
Q

What technique is the best way to measure the cervical-fundal dimension of the uterus

A

transabdominal

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17
Q

Sonohysterography is usually performed on premenopausal women between days _____-____ of the menstrual cycle.

A

6-10

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18
Q

After soaking a transvaginal transducer in Cidex, what do you do?

A

rinse in water

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19
Q

What are a few contraindications for TV U/S?

A
  • age of patient
  • patient discomfort
  • patient refusal
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20
Q

When a mass is found with U/S, what features should be characterized?

A
  • location (intra or extrauterine)
  • size
  • external contour
  • internal consistency
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21
Q

With a retroverted uterus, which side of the screen would show the cervix?

A

left side, fundus on right

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22
Q

For TV, when the probe is rotated 90 degrees from saggital plane, image orientation represents what?

A

coronal plane

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23
Q

Movement of the TV transducer is centered around what?

A

introitus

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24
Q

Describe the sections of the obturator internus muscle how they appear sonographically

A

seen at the posterior lateral corners of the bladder at the level of the vagina and cervix..muscle is hypoechoic and ovoid

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25
Q

The levator ani muscle is best visualized how?

A

In the transverse plane with caudal angulation at the most inferior aspect of the bladder…it is hypoechoic, hammock-shaped area that is medial, caudal, and posterior to the obturator internus

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26
Q

Where are the coccygeus and piriformis muscles located?

A

deep, cranially, and posteriorly

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27
Q

What is the most common muscle to be mistaken for the ovary?

A

piriformus muscle

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28
Q

Describe the uterine artery’s Doppler waveform

A

high velocity, high resistance characteristics but this varies with the menstrual cycle

29
Q

What vessels can be used as landmarks for the lateral pelvis and ovary

A

internal iliac vessels

30
Q

Where is the internal iliac vessel commonly seen?

A

lateral and deep to ovary

31
Q

Describe the ovarian artery Doppler typical to the follicular phase

A

low velocity, high resistance

32
Q

When does the resistance in the ovarian artery on the side with the dominant follicle drop dramatically?

A

during the periovulatory or luteal phase..then it rises during the late luteal phase

33
Q

At the time of ovulation, what happens to velocity and RI?

A

both velocities increase and the RI decreases

34
Q

What are echogenic foci in the inner layer of the myometrium, which are usually nonshadowing thought to represent?

A

dystrophic calcification related to previous instrumentation

35
Q

Cervical inclusion cyst AKA

A

nabothian cyst

36
Q

What is the size and shape of the uterus related to?

A

age, hormonal status, and parity

37
Q

Prepubertally the cervix occupies how much of the uterine length?

A

2/3

38
Q

How large is the uterus prepubertally?

A

1-3cm in length, 0.5-1cm in width

39
Q

Describe the nulliparous cervix?

A

occupies 1/3 of uterine length

40
Q

Describe the nulliparous uterine size

A

6-8cm in length and 3-5 cm in width

41
Q

Describe the multiparous uterine size

A

an aditional 2cm in each direction from nulliparous

42
Q

How much of the uterine length does the postmenopausal cervix occupy?

A

2/3

43
Q

Describe the size of the postmenopausal uterus

A

3-5cm in length and 2-3 cm in width

44
Q

Which method is best for imaging endometrium?

A

TV

45
Q

Describe how the endometrial canal looks sonographically?

A

thin echogenic line as a result of specular reflections from the interface between the opposing surfaces of the endometrium

46
Q

How does the endometrial canal appear during menstruation?

A

hypoechoic central line representing blood and tissue

47
Q

Which endometrial phase corresponds to the 3 line sign

A

proliferative phase (late)

48
Q

T/F: fluid in the endometrial cavity should be included in the endometrial measurement?

A

False

49
Q

How may an infant’s endometrium appear?

A

thick and echogenic

50
Q

During childbearing years, what is the range of endometrial thickness?

A

4-14mm

51
Q

During menopause what happens to the endometrium?

A

becomes atrophic because no longer under hormonal control

52
Q

Describe the postmenopausal endometrium without a hormone regimine?

A

a thin echogenic line measuring less than 8mm

53
Q

What is the normal cut-off measurement for a nonhormonally stimulated endometrium postmenopausally?

A

4-10mm

54
Q

When should patients be seen for further evaluation postmenopausally?

A

postmenopausal bleeding and endometrial double-layer thickness greater than 5mm

55
Q

Where are ovaries located compared to the internal iliacs?

A

antermedial

56
Q

Endovaginally, which plane is best to find the ovaries?

A

transverse

57
Q

Describe the ovaries during the proliferative phase?

A

many follicles may develop and increase in size until day 8 or 9 of the menstrual cycle

58
Q

Following ovulation, what happens within the ovary if no fertilization?

A

corpus luteum develops

59
Q

How do corpus luteum cysts appear sonographically?

A

unilocular, anechoic structures with well-defined thing walls and posterior enhancement

60
Q

What is the best marker for ID an ovary?

A

seeing a follicular cyst

61
Q

Normal range for Graafian follicle?

A

1.8-2.4 cm

62
Q

What is the best method for determining ovarian size?

A

volume

63
Q

How is ovarian volume calculated?

A

0.523 X length X widthX thickness

64
Q

A difference in size of one ovary greater than twice the volume of the contralateral ovary is considered

A

abnormal

65
Q

What is recommended for postmenopausal women with cysts greater than 5 cm and for those who have cysts containing septations or solid nodules in the ovaries?

A

surgery

66
Q

Focal calcifications in the ovary are thought to be

A

a stromal reaction to previous hemorrhage or infection..followups suggested to rule out neoplasm

67
Q

What is frequently the initial site for intraperitoneal fluid?

A

posterior cul-de-sac

68
Q

Why is sonohysterography used?

A

when the endometrium exceeds the normal thickness or shows focal areas of thickness for the patients clinical picture

69
Q

Hope this quiz is easier than last weeks!!

A

prolly wont be tho :(

2nd Year GYN (9 decks)

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