Module 1 - Lesson 2 Flashcards
what are the pelvic organs?
bladder
uterus
fallopian tubes
vagina
what is the order of pelvic organs from anterior to posterior?
front of body:
- skin
- abdominal muscles
- pubic bone
- bladder
- uterus
- vagina
- rectum
back of body
SAPBUVR
What is SAPBUVR?
the order of the pelvic organs from anterior to posterior
skin
abdomen muscles
pubic bone
bladder
uterus
vagina
rectum
what pelvic structures lie in the midline of the body?
bladder
uterus
vagina
what pelvic structures lie in the adnexa?
adnexa - R/L sides
fallopian tubes
ovaries
muscles
bones
what two pelvic structures does the bladder sit between?
Pubic bone and uterus -
it is posterior to the pubic bone
it is anterior to the uterus and vagina - kinda sits below uterus - when we fill up it pushes uterus
the _______ is a hollow, muscular organ with an internal surface of rugged ________
bladder
mucosa
what is rugae?
folds in the bladder wall - allows for it to expand
what is the capacity of the bladder?
700-800ml
what is the difference between ureters and the urethra?
ureters - to bladder - from kidney
urethra - bladder to exit
what is the trigone?
- small triangular area in the floor of the bladder with smooth mucosa
- three openings - two - receive urine from kidneys (ureters) - one - urethral opening - urine drains
the bladder fills in what directions?
descends superior and posteriorly - up and back
fluid is an excellent enhancer. T/F.
true. fluid acts as an excellent acoustic medium
In u/s the bladder acts as an _________ and why?
acoustic window - fluid is an excellent acoustic medium, allowing sound waves to efficiently travel through and enhance structures we need to see.
what does the bladder do to other pelvis organs when it expands?
- pushes the uterus back to a more superior/posterior position (flat) and echos can increase
the cervix is _______, while the uterus is _________
fixed position
flexible
draw the position of the uterus in relation to the bladder, as it fills
For U/S when is the bladder optimally full?
when the dome of the bladder extends past the superior of the uterus (fundus)
- the walls will appear thin and smooth and bladder will extend across the whole screen
In U/S when is the bladder too full?
when it compresses the uterus and you cannot distinguish between the detail
what is the appearance of the bladder in the sagittal plane?
triangular - has that nice wave on posterior wall
what is the appearance of the bladder in the transverse plane?
square appearance
How is bladder volume calculated?
length - SAG
depth - SAG or TRN
width - TRN
what are the two small tissue projections that can be seen on the posterior inferior surface of the bladder wall?
ureteral orifices - the openings of the ureters to the bladder - part of the trigone
- urine jets can be visualized with color doppler
the _____ is longer in males
urethra
how does the urethra appear in SAG and TRN U/S?
- seen as small hypoechoic structure anterior to the vagina
where does the uterus sit in relation to the other pelvic organs?
SAPBUVR
between the bladder and vagina and rectum
posterior to bladder and anterior to rectum and superior to the vagina
what are the segments of the uterus from superior to inferior?
fundus
body
isthmus
cervix
what is the widest part of the uterus?
the fundus
what is the largest part of the uterus?
body
what is the most flexible part of the uterus?
the isthmus
what meets at the isthmus?
the body and cervix
what is the most inferior part of the uterus and connects to the vagina?
the cervix
what is considered normal uterine position?
antiverted
what is antiverted uterine position?
fundus tips toward the anterior aspect - tips toward front of body
what is retroverted uterine position?
fundus tips toward the posterior aspect of the body - back
retro -
back/behind - posterior
what is retroflexed uterine position?
fundus tipped back and body/isthmus flexed posteriorly
- bent in half backwards
what is antiflexed uterine position?
the fundus is tipped and the body/isthmus flexed in the anterior direction
- bent in half forewards
that are the terms related to uterine tipping?
dextrorotated
levorotated
midline
dextrorotated
tipped to the right
midline uterus
uterus positioned in the midline - normal
it is normal for uterus to tip tho
levorotated
tipped left
draw the uterine positions
what are the layers of the uterine wall?
1- perimetrium or serosa
2- myometrium or muscle layer 3- endometrium
4- cavity - hollow
how old is neonatal?
0-8weeks
what is classified as pediatric in gyne?
8 weeks - menarche
what is menarche?
a females first period
what is nulliparous?
never been pregnant - but adult
what is parous?
been pregnant
during pregnancy, and after the uterus ________ but then __________ after menopause
expands
shrinks
what is the cervix to body ratio in neonatal?
2:1
cervix double the size
what is the cervix to body ratio in pediatric?
1:1
what is the cervix to body ratio in nulliparous?
1:2 - body double size
what is the cervix to body ratio in parous?
1:3 - body triple size
what is the cervix to body ratio in post menopausal?
1:1
what is the progression of the cervix to body ratio?
2:1
1:1
1:2
1:3
1:1
what are the cornua?
the “horns” where the fallopian tubes enter the uterus
do not include the _______ in the measurement of the uterus in TRN
cornua
when we evaluate the endometrium we assess what 3 aspects?
1 -appearance
2- size
3- history correlation - how it relates to the stage of her cycle
what are the two layers of the endometrium?
zona basalis
zona functionalis
what is the zona basalis?
the deep layer of the endometrium - generates new endometrium after menses occurs
what is the zona functionalis?
the superficial layer of the endometrium
shed with menses
most responsive to hormones
changes throughout cycle
when measuring the endometrium, you will include all layers and fluids. T/F
false - do not include fluid - if present measure anterior and posterior walls separately.
what is the shape of the cervix?
cylindrical
the cervix connects to the vagina at a 45 degree angle. T/F
false - connects at 90 degrees
what is the endocervical canal?
opening that runs through the inner part of the cylinder
- continuous with endometrial canal and vaginal canal
- lined with mucosal layer
what is the internal os?
the opening of the endocervical canal into the endometrial canal
- internal b/c its further inside you
what is the external os?
the opening of the endocervical canal into the vaginal canal
- external b/c its further outside you
what is the fornices?
tiny recesses (spaces) where the inferior part of the cervix projects into the superior vagina - create vertical shadow in TRN
closer to vagina
the _______ is composed of a muscular tube with a collapsed canal
vagina
In the vagina, the ___________ wall is _________ than the __________ wall.
posterior wall is longer than the anterior wall
how long is the vaginal canal
approximately 9 cm long
the _______ canal is connected to the cervical canal through the ___________
the endovaginal canal is connected to the cervical canal through the external os
what is the oviduct?
fallopian tube
how does the endovaginal canal appear in u/s
echogenic line - bright
what are the 4 parts of the fallopian tube?
interstitial/intramural
isthmus
ampulla
infundibulum with fibriae
where do the fallopian tubes connect to the uterus?
at the cornua
- where fundus and body join
what are the fallopian tubes?
tubes made of muscle lined with mucosa
- cant see on u/s
how long are the fallopian tubes?
10-12 cm
<1 cm diameter
describe the infundibulum
- portion of fallopian tube that lies close to the ovary but is open to the pelvic cavity - ends in fimbriae - fingerlike projections
describe the ampulla
long central portion of the fallopian tube
describe the isthmus
isthmus is a small region, that connects the ampulla and infundibulum to the uterus.
describe the intramural
located in the top portion (fundus) of the uterus; it is a narrow tube continuous with the isthmus, and it leads through the thick uterine wall to the uterine cavity, where fertilized eggs normally attach and develop. The channel of the intramural duct is the narrowest part of the fallopian tube.
