OB/GYN Registry Review Flashcards
Bony boundaries of the pelvis
sacrum
coccyx
innominate bones (ilium, ischium, pubic symphysis)
innominate bones include:
ilium
ischium
pubic symphysis
imaginary line from pubic symphysis to sacral prominence (top of sacrum)
linea terminalis
are deep and below the linea terminalis
true pelvis
The true pelvis includes:
bladder
small bowel
ascending and descending colon
rectum
uterus
ovaries
fallopian tubes
internal iliacs
5 muscles
hammock shaped muscles that give support to pelvic organs;
pelvic diaphragm
The pelvic diaphragm includes:
levator ani and coccygeus muscles
The true pelvic muscles are located posterior toL
bladder
vagina
rectum
O.P.I. muscles in the adnexa
obturator internus
piriformis
iliopsoas
The obturator internus muscle is located ____ to the bladder
lateral
The pirfiormis is located _____
posterolateral
The iliopsoas is located ____
anterolateral
appear as ovoid hypoechoic structures that elongate in the sagittal plane in the adnexa; adjacent or lateral to bladder/ovaries/uterus
O.P.I muscles
double fold of peritoneum. From lateral sides of uterus to walls of pelvis
broad ligaments
located between folds of peritoneum. Only ligaments every visualized on sono, only when there is pelvic ascites
round ligaments
contains vasculature of uterus
cardinal ligaments
______ are when fluid can collect in the pelvis
intraperitoneal cavities
The retropubic space or _______ is located ____ to the bladder
space of Retzius
anterior
lower quadrants of abdomen and lateral spaces to uterus
adnexa
The anterior cul-de-sac or ______ is located between the ____ and _____
vesicouterine pouch
bladder
uterus
The posterior cul-de-sac or ______ or ______ is located between the _____ and _____
rectouterine pouch
pouch of Douglas
uterus
rectum
The uterine arteries are branches of the:
internal iliac arteries
The ______ supply the periphery of myometrium
arcuate arteries
The _____ supply deeper into the myometrium
radial arteries
The ___ and ____ arteries supply the layers of the endo.
straight
spiral
The straight arteries feed the _____ layer of the endometrium
basal
The spiral arteries feed the _____ layer of the endometriu,
functional
The ovarian arteries originate from the ____
aorta
The ovaries receive a dual blood supply from the _____ and _____ arteries
ovarian
uterine
The uterine veins return or drain into the ______
internal iliac veins
The right ovarian vein drains into the ______
IVC
The left ovarian vein drains into the _______
left renal vein
longest vein in the pelvic vessel
left ovarian vein
The uterus is a ______peritonal organ
retro
The uterus is located _____ to the rectum
anterior
The uterus is located ____ to the bladder
posterior
The uterus is bound laterally by the ____ ligament
broad
The uterus is developed from the fusion of paired ______
Mullerian ducts
Four divisions of the uterus
fundus
corpus
isthmus
cervix
most superior and widest portion of the uterus
fundus
The fallopian tubes attaches to the _____
uterine cornu
The body of the uterus; the largest area
corpus
the lower uterine segment of the uterus in pregnancy
isthmus
internal and external os.
cervix
The ______ opens into the vaginal canal (most inferior part)
external os
The external os is surrounded by ______
vaginal fornix
Three layers of the uterus
serosa
myometrium
endometrium
The serosa layer is also known as the
perimetrium
Outermost layer of the uterus
serosa/perimetrium
muscular layer of the uterus
myometrium
mucosal layer of the layers consisting of the basal and functional layers
endometrium
prominent uterus due to maternal hormone stimulation. Cervix is enlarged with approximate 2:1 ratio (double the size) to the body
neonatal uterus
uterus is tubular in shape
: body = cervix
prepubertal uterus
increase in fundal diameter = pear shaped uterus
pubertal uterus
during the reproductive years the fundus of the uterus measures between __ and __ cm
6
8
decreased uterine size (4-6 cm)
menopausal uterus
body of uterus tilts forward; 90 degree angle with cervix
anteverted uterus
body of uterus folds forward; comess in contact with the cervix
anteflexed uterus
body of uterus tilts back and comes in contact with back of cervix
retroflexed uterus
body of uterus tilts back without a bend
retroverted uterus
oviducts, uterine tubes, salpinges
fallopian tubes
Fallopian tubes are between __-__ cm long
7
12
The fallopain tubes extend from the ____ within the broad ligaments to the ____
cornu
adnexa
Means of fertilization and transportation to the uterus
fallopian tubes
Tiny, hairlike structures, located inside the fallopian tubes that move back and forth to aid in the movement of the fertilized ovum
cilia
5 segments of the fallopian tube
interstitial, isthmus, ampulla, infundibulum, fimbria
The most proximal portion of the fallopian tubes; where the tube attaches to the cornu
interstitial
“bridge” of the fallopian tubes that connects the interstiital portion to the ampulla portion
isthmus
The longest and most tortuous segment of the fallopian tube
ampulla
The most common location of fertilization and ectopics
ampulla
distal and widest portion of the fallopian tubes
infundibulum
fingerlike extensions at the end of the infundibulum that draw the unfertilized egg into the tube
fimbria
The ovaries are ______, _____ organs
intraperitoneal
endocrine
The ovaries and surrounded by ____ muscles and _____ vessels
OPI
internal iliac
The _____ ligament supports the ovary from the lateral side of the uterus to the ovary
ovarian
The _____ ligament supports the ovaries from the lateral pelvic side walls
suspensory
The ovaries produce _____ and ____
estrogen
progesterone
The ovaries and stimulated by ____ and ___
FSH
LH
The outer cortex of the ovary is the side of:
oogenesis/follicles
The medulla of the ovaries houses the
vasculature
lymphatics
Ovarian volume equation
L x H x W x 0.523
The dominant follicle of the ovary
Graafian
Thecal internal cells of follicles produce _____
estrogen
Ovum is inside of the ______ of dominant follicle (seen as a daughter cyst within dominant follicle_
cumulus oophorus
Ovulation will occur within ___ hours of seeing cumulus oophorus within the dominant follicle
36
The ___ ruptures the Graafian follicle
LH
The Graafian follicle is replaced by the ______
corpus luteum
The corpus luteum releases _____
progesterone
When the corpus luteum regresses, the ______ takes its place
corpus albicans
The hypothalamus releases _____ to regulate release of hormones by the anterior pituitary gland.
gonadrotropin releasing hormone
The pituitary gland releases _____
FSH
stimulates ovaries to develop follicles and maturation of the dominant follicle
FSH
The follicles produce _____
estrogen
As the dominant follicle reaches maturity, there is a peak in _____ levels
estrogen
The peak in estrogen levels signs the pituitary gland to release the ____ surge
LH
The LH surge stimulates the rupture of the dominant follicle -
ovulation
The ruptured dominant follicle is known as the _____
corpus luteujm
The corpus luteum secretes _____ and small amounts of _____
progesterone
estrogen
The endometrium is directly affected by ______ and _____
progesterone
estrogen
______ thickens the endometrium
estrogen
______ maintains the thickened endometrium and prepares for implantation
progesterone
If no pregnancy occurs, the corpus luteum regresses and ______ levels drop.
progesteron
When the ______ decreases, the endometrium begins to slough off and menses begin
progesterone
follicular phase of ovary
days 1-14
FSH stimulates follicle development and dominant follicle matures increasing to about 2.5-2.7 cm until ovulation around day 14. Follicles release estrogen
follicular phase of ovary
menstrual phase of endometrium
days 1-5
menses and shedding of endometrium (no specific appearance)
menstrual phase of endometrium
proliferative phase of endometrium
days 6-14
The endometrium changes so much during this phase, so we must use ___ and ___ depending on where we are in this phase
early proliferative
late proliferative
immediately following menses, endometrium is thin, echogenic and measures no more than 4mm
early proliferative phase of endometrium
The late proliferative phase is also known as the
periovulatary phase
The endometrium will reach 6-10 mm and appears as a “3 line sign”
late proliferative phase of endometrium
The echogenic rim of the three line sign is the _____
basal layer
The hypoechoic border of the three line sign is the _______
functional layer
ovulation occurs of day __
14
LH surges cause rupture of the dominant follicle, releasing ovum. Free fluid may settle in the posterior cul de sac
ovulation
When calculating the ovulation day=
subtract 14 from the number of total cycle days
luteal phase of the ovary
days 15-28
Graafian follicle becomes corpus luteum which produces progesterone to maintain endo thickness., Towards the end of the phase corpus luteum regresses if no fertiliation
luteral phase of ovary
progesterone maintains endos thickness to prepare for implantation. Endo appears thick and echogenic and measures 7-16mm.
secretory phase of endo
