Class 1 Flashcards
Uterus: Definition and Regions
Pear shaped muscular organ 4 regions: Fundus Corpus Isthmus Cervix
Layers of the Uterus: What are the 3 tissue layers?
SEROSA (PERIMETRIUM) -Outermost MYOMETRIUM -Middle layer ENDOMETRIUM -Innermost: functional layer
Uterus Shape And Size: What are they and what are their variations?
VARIES WITH AGE AND OBSTETRIC HX
Prior to menarche - cylindrical and narrow
Mature uterus - corpus & fundus enlarge
After menopause - regresses in size
Nulliparous female:
SAG = less than or equal to 8 cm
TRV = up to 5 cm
AP = 3 cm
What are the 3 variants in uterine position?
Normal
Retroverted: laid back
Anteverted: shlumped forward
Retroflexed: folded backwards
ANTEFLEXED Uterine Position
Uterine fundus and corpus tilted forward
RETROFLEXED Uterine Position
Corpus and fundus tilted posteriorly
RETROFLEXED and RETROVERTED Uterine Position
Corpus, fundus and cervix are tilted posteriorly
UTERUS MYOMETRIUM: Ultrasound Appearance
- Mid gray or medium level echoes
- Even homogeneous texture and pattern
- Smooth even contour
ENDOMETRIAL CAVITY: Ultrasound Appearance
- Thin echogenic line
- Varies in thickness in relation to menstrual phase
Vagina: Ultrasound Appearance
- Mid gray to medium level echoes
- Vaginal canal is hyperechoic line
Fallopian Tubes: What are the 4 Portions?
INTERSTITIAL (INTRAMURAL): Narrowest part, nearest cornu ISTHMUS: Slightly wavy and longer AMPULLA: Tortuous and longest part INFUNDIBULUM: Lateral, trumpet shaped, fimbriae
INTERSTITIAL (INTRAMURAL): Portion of the Fallopian Tubes
Narrowest part, nearest cornu
ISTHMUS: Portion of the Fallopian Tubes
Slightly wavy and longer
AMPULLA: Portion of the Fallopian Tubes
Tortuous and longest part
INFUNDIBULUM: Portion of the Fallopian Tubes
Lateral, trumpet shaped,
fimbriae
What are the 2 Adjacent Spaces?
ANTERIOR CUL DE SAC (VESICOUTERINE POUCH)
Reflection of peritoneum over anterior surface of uterus and bladder
POSTERIOR CUL DE SAC (RECTOUTERINE POUCH, POUCH OF DOUGLAS)
Reflection of peritoneum over posterior surface of uterus and rectum
ANTERIOR CUL DE SAC: What is it?
VESICOUTERINE POUCH
Reflection of peritoneum over anterior surface of uterus and bladder
POSTERIOR CUL DE SAC: What is it?
RECTOUTERINE POUCH, POUCH OF DOUGLAS
Reflection of peritoneum over posterior surface of uterus and rectum
What are the Ligaments?
CARDINAL LIGAMENTS - anchor uterine corpus and cervix to lateral pelvic wall
UTEROSACRAL LIGAMENTS - anchor uterine cervix to sacrum
ROUND LIGAMENTS - anchor uterine fundus anteriorly
BROAD LIGAMENT - part of peritoneum that divides true pelvis into anterior & posterior portions
CARDINAL LIGAMENTS
anchor uterine corpus and cervix to lateral pelvic wall
UTEROSACRAL LIGAMENTS
anchor uterine cervix to sacrum
ROUND LIGAMENTS
anchor uterine fundus anteriorly
BROAD LIGAMENT
part of peritoneum that divides true pelvis into anterior and posterior portions
What are the bones that make up the Pelvic Girdle?
- FOUR BONES
- SACRUM
- COCCYX
- 2 INNOMINATE BONES (ILIUM, ISCHIUM, & PUBIS)
What are the Muscles of the Pelvis?
RECTUS ABDOMINUS - form anterior abdomino - pelvic wall
PSOAS and ILIACUS - large muscles laterally, located in false pelvis
ILEOPSOAS MUSCLE - seen laterally in TRV
OBTERATOR INTERNUS - laterally in true pelvis
PIRIFORMIS -posterior in true pelvis
MUSCLES OF PELVIC FLOOR - levator ani and coccygeus
The Ovaries: Where are they located and how big are they?
LOCATION: Lateral to the uterus in the adnexa In posterior fold of broad ligament May be superior or posterior to uterine fundus, May be in posterior cul de sac
SIZE:
SAG = 2.5-5.0 cm
TRV= 1.5-3.0 cm
AP = .6-2.2 cm
What are the Ligaments of the Ovaries?
Mesovarian - anchors ovary to posterior surface of broad ligament
Ovarian ligament - anchors ovary to uterine cornu
Infundibulopelvic ligament - anchors ovary to pelvic brim
What is the only abdominal organ not covered by the peritoneum?
the Ovaries are the only abdominal organ not covered by the peritoneum?
What is produced in the ovaries?
Hormones and gametes
What are the 2 parts of the ovaries?
CORTEX (OUTER) - contains primordial follicles
MEDULLA (INNER) - contains connective tissue, nerves, blood supply, lymphatics & smooth muscle tissue
Ovarian Follicles
- Born with millions of primordial follicles
- 300-400 mature in lifetime
- Graafian Follicle - the follicle that matures each month
- Graafian Follicle ruptures with ovulation at approximately 1.8 TO 2.5 cm
- After rupture, follicular cavity becomes the corpus luteum of menstruation
- If ovum fertilized, corpus luteum remains, if not it resolves
Ultrasound Appearance of Ovaries
-SIMILAR TO MYOMETRIUM IN ECHOGENICITY
-FOLLICLES GIVE “SWISS CHEESE APPEARANCE”
-POST MENOPAUSAL OVARIES DIFFICULT TO VISUALIZE
-TIPS FOR VISUALIZATION:
Turn down gains, Look for posterior enhancement, Ovary may be anterior to internal iliac vessel
Pelvic Vascular Supply
- HYPOGASTRIC ARTERY (INTERNAL ILIAC)
- UTERINE ARTERY
- OVARIAN ARTERY
- VEINS HAVE SIMILAR PATTERN
- VEINS ARE DISTENSIBLE & VARY IN SIZE WITH CERTAIN CONDITIONS
