Female Pelvis Flashcards
Muscle appearance
Moderate echogenicity with ecogenis striations within the long axis
Muscles can be mistaken with
Ovaries or masses within pelvis
Muscles are image in ____ planes
2
Uterus location
Retroperitoneal
Pelvic cavity
Between birth and puberty the uterus descends gradually from
The lower abdomen into the true pelvis
Uterus anatomic locations
Pubic bone, bladder anterior
Rectum posteriorly
Three major portions of the uterus
Fundus body cervix
What is cornua
Area of the body where the tubes enter
What is at and superior to the cornua
Fundus
Where is the body
Area between cervix and cornua
Cervix
Slightl narrowing between body and proximal vagina
Opens into the upper vagina
Canal made up by internal and external os
Distal end of cervix space between vagina
2 lateral fornix
Anterior and posterior fornix
Vagina
Fibromuscular canal that lies in the midline
Runs from the cervix to the external genitalia
The cervix protrudes into the proximal vagina
Rectum lies posteriorly
Uterus _____ walled muscular organ
3 layers
Thick
Perimetrium (layer of serous membrane)
Myometrium
Endometrium
Myometrium
Big muscle, majority of uterus
3 layers of mymetrium
Inner layer ‘subendometrial halo”
Intermediate
Outer
Endometrium 2 layers
Superficial functional later - part that sloughs off each menses
Deep basal layer - stays attached to uterus
Uterus paired ligaments
Broad
Cardinal
Uterosacral
Uterus unparied ligaments
Posterior
Anterior
Round
Broad ligament
Boudle folds of parietal peritoneum
Uterus is suspended between these folds
Extend lateral aspect of uterus to the lateral pelvic walls
Cardinal ligaments
Lower extension of broad
Round ligaments
Fibromuscular cords extends from upper outer angles of the uterus through inguinal canal and attach labia majora
Uterosacral ligaments
Fold like extensions of pertitoneum
Posterior uterus to sacrum, each side of rectum
Anterior ligament
Fold peritoneum goes from anterior surface of uterus to posterior surface of bladder
Forms anterior cul de sac or vesicouterine pouch
Fluid collects in this area
Posterior ligament
Extends from posterior side of uterus to rectum
Forms deep pouch, pouch of duglas, or posterior cul de sac, rectouterine recess
Fluids collect in this area
Functions of uterus
If fertilization occurs, implants into endometrial lining and develops within UT
Myometrial contractions at labour
No fertilization
Menstration occurs
Myometrial contractions aide sloughing off. endometrium
Blood supply to uterus
Uterine arteries arises —> internal iliac arteries (primary supply to uterus)
Travels within broad ligament, at cornua anastomose with ovarian artery->then enter the myometrium
Uterine plexus of veins runs along with arteries
Uterus position
Cervix is fixed in midline, body and fundus is mobile
Flexion
Axis of the uterine body relative to the cervix
Version
Axis of the cervis relative to the vagina
What can affect or change position of uterus
Distension of bladder
Rectal fullness
Uterus positioning
Usually anteverted and anteflexed
Can be retroverted-> entire uterus tilted backwards realtive to vagina
Retroflexed — body is tilted posteriorly (relative to cervix)
Uterus size and shape
Vary through out life
Age, hormonal status, parity
Infantile uterus size, cervix size, shape
2.8 length uterus
Cervix 2/3 of total length
Tubular or inverse pear shape
Neonate uterus size and shape
Slightly larger the infantile due to maternal hormone stimulation
3.4 cm
Inverse pear shape
From 8 to puberty
Uterus gradually increases in size
Puberty
Uteurs increase in size, especially body of uterus
Diameter and lenth of the body about boudle cervical size
Becomes adult shape and size
Adult size of uterus
7-8 length x 5 w x 4 ap
Parity (pregnancy increases normal size by 1 cm in each dimension
Pear shaped
Menopausal uterus
Atropies 3.5-6.5 L and 1.2-1.8 width
Calcifications in arcuate arteries —> linear calcific foci
Small echogenic foci within inner myometrium
All of these are incidental findings with no clinical significance
Contour of uterus
Smooth
Walls of uterus that are echogenic
Myometrium and endometrium
Echotexture of myometrium
Homogenous
3 distinguishable layers with US in myometrium
Inner - hypo
Intermediate - low to moderate echos, homogenous
Outer - thin, less echos than inter
