Mod 2 Flashcards
Why are pelvic ultrasounds done
Pelvic pain Dysfunctional bleeding IUCD placement Mass felt on bumanual pelvic exam ? Pregnancy
What is the prep for a transabdominal ultrasound
4 x 250ml of water 1 hr prior to exam
What does a full bladder do to the uterus
Pushes uterus from anteflexed position into a perpendicular plane
Allows for better visualization
What does a full bladder do to intestines
Displaced them
What does a full bladder do for a pelvic ultrasound
great window for pelvic anatomy
Landmark
Indicates mobility of pelvic pathology
Allows for comparison for cystic lesions
What is the most ideal full bladder contour for a pelvic ultrasound
Covering just the top of the uterus fundus
What does gravidity mean
Have been pregnant, including if they are currently pregnant
LMP
Last menstral period
Parity
Have ever given live birth
Symptoms
Any pain
Previous pelvic surgery
Looking for any disease that remained
What are the different kinds of abortions
Spontaneous
Therapeutic
What is a spontaneous abortion
Ex: miss carriage
what is a Therapeutic abortion
Ex: physician assisted
What does T term mean
Live births
What does nulliparous mean
Never been pregnant
What does parous mean
Currently pregnant
What does prima gravida mean
First time pregnant
where do you start scanning a pelvic ultrasound and why
Sagittal plane
Asses bladder fullness
What do you charge on the machine before you start scanning
HGen to HRes
How do you sweep while in the Sagittal plane
From midline to the side wall of pelvis in each direction
How do you sweep while in the transverse plane during a pelvic ultrasound and why
Vagina to umbilicus
Looking for a etopic pregnancy
What plane are ovaries best visualized
Transverse
Why do we scan contralateral when scanning ovaries
Because the best images occur when the bladder covers a ovary entirely
What can help when scanning an obese patient for a pelvic ultrasound
Trendelenburg postion
Assistance from the patient
Endovaginal scan
Get patient to move panniculus out of way so you have access to the symphsis
What is a panniculus
Fatty apron
What are the advantages of EV scanning
Higher frequency
Better resolution
Empty bladder
Larger image
What are the limitations of EV scanning
Pathology may be outside of the field of view
Must have an empty bladder (some patients can’t empty completely)
What must you do when performing a EV scan
Over the probe with a condom or non latex transducer cover
Ask patient if they have a latex allergy
Hat do you have to do a EV probe before it is inserted
Have the transducer firing
When can you not use a EV
Effaced or dilated cervix Young girl Virgin Infection Strophic anatomy
What do you do when documenting fibroids
Document in 2 planes
Measure in 3 dimensions
Colour Doppler in 2 planes
What do you do when documenting ovarian cysts
Must be over 2 cm
Document in 2 planes
Measure in 3 dimensions
Colour Doppler in two planes
What do you do when documenting an IUCD
Document in two planes
What do you do when documenting nabothian cysts
Demonstrate in two planes Do not need to measure Do not need to use colour Doppler Annotate sag cervix Trans cervix
What do you do when documenting free fluid
Image in two planes to demonstrate that free fluid was seen
Measure in all three planes
Annotate sag uterus and trans cervix
Do not annotate FF or free fluid
What is the female pelvic routine
Sag: uterus, cervix, vagina, endometrial canal, right/left ovary
Trans: vagina, cervix, uterus at fundus, right/left ovary
Also document images of pathology and variants
How do you finish a pelvic scan
Sag right kidney measured
Transverse right kidney: mid at renal pelvis
Sagittal left kidney measured
Transverse left kidney: mid at renal pelvis
Should the emphasis be on evaluation of each organ and not just on taking pictures
Yes
Dyspareunia
Painful or difficult intercourse
Amenorrhea
Absence of periods
Caused by pregnancy
Caused by menopause
Ovarian dysfunction
Dysmenorrhea
Painful periods with cramps
Menorrhagia
Excessive bleeding during period
Menometrorrhagia
Excessive bleeding during menses and throughout cycle
Mittelschmerz
Pain at ovulation
Oligomenorrhea
Infrequent or very light menstration
Intervals of > 35 days
Only having 4-9 periods a year
Anechoic
An echo-free appearance on a sonographic image
Echogenic
Produces echoes
A basis of comparison for:
*hyperechoic
*hypoechoic
Hyperechoic
Describes echoes that are brighter than normal or brighter than adjacent structures
Hypoechoic
Structures that are not as bright as normal or less bright than adjacent structures
Isoechoic/isosonic
Structures with the same relative echodensity
Heterogeneous
Refers to an uneven echo pattern or reflections of varying echo-densities
Homogeneous
Refers to an even echo pattern of reflections that are relative and uniform in composition
Cystic
Features all characteristics of a true cyst
What are the characteristics of a true cysts
- Anechoic
- Through-transmission
- Smooth walls
- Round
Quasi-cystic
Papers cystic but is missing the through-enchacement due to actual small reflector echoes
Solid
Refers to a structure or medium that is echogenic- contains echoes
Often attenuates the sound and causes a posterior shadow
Shadow
Refers to an area where no or little reflection is obtained. Structures in this area are obscured
Enhancement
Refers to an area where there is little attenuation of sound
Good sound transmission
The area behind appears clearer and brighter because it is better visualized
