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CNIH > OB review- normal female pelvis > Flashcards

OB review- normal female pelvis Flashcards

1
Q

Name the portions of the fallopian tube medial to lateral

A
  • cornual
  • isthmus
  • ampulla
  • infundibulum
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2
Q

what is the narrowest and widest portion of the Fallopian tube?

A

narrowest: isthmus
widest: ampulla

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3
Q

what part of the fallopian tube penetrates the myometrium?

A

cornual

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4
Q

rectouterine pouch aka?

A
  • posterior cul de sac

- pouch of douglas

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5
Q

rectouterine pouch location?

A
  • anterior to rectum
  • posterior to uterus
  • most inferior point in the pelvic cavity
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6
Q

what is the most common site for fluid to accumulate?

A

rectouterine pouch

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7
Q

space of retzius aka? (2)

A
  • retropubic space

- prevesical space

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8
Q

location of space of retzius?

A
  • anterior to urinary bladder

- posterior to symphysis pubis

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9
Q

vesicouterine pouch aka?

A

anterior cul de sac

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10
Q

vesicouterine pouch loaction?

A
  • anterior to uterus

- posterior to urinary bladder

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11
Q

how to measure the length of the uterus?

A

from fundus to the external cervical os

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12
Q

how to measure the height of the uterus?

A

perpendicular to the length of the widest portion of the uterine body

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13
Q

how to measure width of the uterus?

A

widest portion of the uterine body in the short axis

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14
Q

premenarche uterus measurements? (L,H,W)

A

Length: 2-4cm

height: 0.5-1.0cm
width: 1-2cm

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15
Q

menarche uterus measurements?

  • nulliparous
  • parous
A

nulliparous-6-8.5cm x 3-5cm x 3-5cm

parous-8-10.5cm x 3-5cm x 5x6 cm

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16
Q

postmenopausal uterus measurements?

A

3.5-7.5cm x 2-3 cm x 4-6 cm

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17
Q

the outer layer of the endometrium?

A
  • basal layer

- appears as hypoechoic

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18
Q

inner layer of endometrium?

A
  • inner functional layer typically appears hyperechoic
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19
Q

the inner layer of the endometrium should not exceed what measurement?

A

14mm

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20
Q

what is not included in an endometrium measured?

A
  • subendometrial halo

- fluid

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21
Q

what are ovaries?

A
  • almond shaped
  • intraperitoneal
  • endocrine glands
  • composed of cortical and medullary tissue covered by epithelium
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22
Q

what is the ovarian cortex?

A
  • site of follicular development

- medulla is the vascular core of the ovary

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23
Q

what 2 sources are ovaries supplied blood from?

A
  • ovarian artery arises from the aorta

- ovarian branch of the uterine artery

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24
Q

function of ovaries?

A

produce ova

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25
Q

2 hormones in ovaries?

A

estrogen and progesterone

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26
Q

what is estrogen secreted by?

A

secreted by follicle

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27
Q

what is progesterone secreted by?

A

corpus luteum

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28
Q

ovaries measurement- menarche?

A

length: 2.5-5cm
wide: 1.5-3cm
height: 0.6-2.2 cm

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29
Q

what does the measurement of ovaries depend on?

A
  • age
  • menstrul status
  • body habitus
  • pregnancy status
  • phase of menstrul
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30
Q

ovaries measurement- menarche?

A

9.8cm^3

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31
Q

ovaries measurement- postmenopausal?

A

5.8cm^3

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32
Q

estradiol function?

A

primarily reflects the activity of the ovaries

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33
Q

during pregnancy how is estradiol affected?

A

levels will steadily rise

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34
Q

where is estradiol present?

A

small amounts are present in the adrenal cortex and arterial walls

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35
Q

what is estrogen? what is it produced by?

A
  • primary female sex hormome

- produced by developing follicles and placenta

36
Q

what stimulates the production of estrogen in the ovaries?

A

FSH and LH

37
Q

what parts of the body produce estrogen?

A
  • breasts
  • liver
  • adrenal glands
38
Q

estrogen normal levels?

A

5 to 100 μg/24 h (urine)

39
Q

estrogen functions?

A
  • promotes formation of female secondary sex characteristics
  • accelerates growth in height and metabolism
  • reduces muscle mass
  • stimulates endometrial growth and proliferation
  • increases uterine growth
40
Q

what is the function FSH-follicle stimulating hormone?

A
  • initiates follicular growth and stimulates the maturation of the graafian follicle
41
Q

what is FSH secreted by?

A

anterior pituitary gland

42
Q

levels of FSH in children?

A

normally low and slightly higher after menopause

43
Q

FSH levels decline and increase in what phase?

A
  • Levels decline in the late follicular phase and demonstrate a slight increase at the end of the luteal phase
44
Q

Luteinizing hormone function?

A
  • reproduction in both genders
45
Q

what is LH secreted by?

A

anterior pituitary gland

46
Q

what stimulates LH production?

A

increasing estrogen

47
Q

what triggers ovulation?

A

a surge in LH levels

48
Q

what does a surge in LH trigger?

A
  • ovulation

- initiates the conversion of the residual follicle into a corpus luteum

49
Q

what does the corpus luteum produce?

A

progesterone to prepare the endometrium for possible implantation

50
Q

how long does LH surge last?

A

typically only 48 hours

51
Q

When does FSH become active?

A

before puberty

52
Q

what is FSH produced by?

A

hypothalamus

53
Q

where is FSH released?

A
  • released into the bloodstream reaching the anterior pituitary gland
54
Q

What stimulates FSH production?

A

Low levels of estrogen

55
Q

Luteinizing hormone-releasing factor (LHRF)?

  • becomes active when?
  • produced by?
  • released into?
A
  • Becomes active before puberty
  • Produced by the hypothalamus
  • Released into the bloodstream, reaching the anterior pituitary gland
56
Q

when are progesterone levels low?

A
  • in childhood

- in postmenopause

57
Q

where is progesterone produced?

A
  • adrenal glands
  • corpus luteum
  • brain
  • placenta
58
Q

when are increased amounts of progesterone produced?

A

during pregnancy

59
Q

in what phase are progesterone levels low?

A
  • preovulatory phase
60
Q

in what phase are progesterone levels high?

A
  • after ovulation

- luteal phase

61
Q

functions of progesterone?

A

Preparing the endometrium for possible implantation or starting the next menstrual cycle

62
Q

4 endometrial phases?

A
  1. menstrual
  2. early proliferation
  3. late proliferation
  4. secretory phase
63
Q

menstrual phase?

  • what days
  • function
  • hormones
A
  • Days 1-5
  • Functional layer necroses
  • Decreased estrogen and progesterone
64
Q

Early proliferation phase?

  • days
  • endo
  • hormones
  • coincides with
A
  • Days 6-9
  • Thin echogenic endometrium
  • Increasing estrogen
  • Coincides with follicular phase of the ovary
65
Q

Late proliferation phase?

  • days
  • endo
A
  • days 10-14
  • preovulatory
  • triple line apperance
66
Q

in what phase is the triple line appearance seen?

A

late proliferation

67
Q

secretory phase?

  • days
  • phase of cycle
  • endo
  • hormones
A
  • day 15-28
  • post ovulatory or premenstrul plase
  • functional layer thickeness
  • progesterone increases
68
Q

Ovulation is regulated by the?

A

hypothalamus within the brain

69
Q

when does LH usually reach its peak?

A

10 to 12 hours before ovulation

70
Q

what triggers ovulation?

A

A surge in LH accompanied by a smaller FSH surge

71
Q

5 ovarian phases?

A
  1. early follicular
  2. late phase
    3, ovulatory phase
  3. early luteal
  4. late luteal
72
Q

early follicular- ovarian phase?

  • days?
  • size of follicles
A

Days 1-5

5-11 small follicles

73
Q

late phase- ovarian?

  • days
  • ovulation
  • size of graafian follicle
  • hormones
A
  • Days 6-13
  • Before ovulation
  • Graafian follicle: 2-2.4 cm
  • Estrogen levels increase
74
Q

ovulatory phase- ovarian phases?

  • day
  • graafian follicle
  • what occurs?
A
  • Day 14
  • Rupture of Graafian follicle
  • Pelvic pain-Mittelschmerz
75
Q

early luteal phase- ovarian?

  • days
  • ovulation
  • hormones
  • what is seen
A
  • Days 15-18
  • Post ovulation
  • Corpus luteum secretes estrogen and progesterone
  • Free fluid in cul de sac
76
Q

late luteal- ovarian phases?

A

If fertilization does not occur, the corpus luteal cyst regresses

77
Q

what defines pose menopause?

A

Cessation of menstruation for twelve (12) months

78
Q

approximately ___% of cases will demonstrate a simple ovarian cyst?

A

15%

79
Q

when is most likely the size of a benign simple ovarian cyst?

A

<5.0cm

80
Q

what does hormone replacement therapy contain?

A

both estrogen and progesterone

81
Q

normal endometrial thickness?

A
  • <8mm
82
Q

what does the post menopause uterus look like?

A
  • decreased size
  • Endometrial thickness should not exceed 8mm in asymptomatic patients or 5mm in patients with vaginal bleeding
  • Decreases in estrogen can shorten the vagina and decrease cervical mucus
83
Q

function of oral conreaceptives?

A

inhibit ovulation; endometrium has a thin echogenic line

84
Q

3 examples of oral contraceptives?

A
  1. deopt- medroxyprogesterone
  2. levonorgesterel implant
  3. intauterine devices
85
Q

Depot-medroxyprogesterone?

A

inhibits ovulation; endometrium has a thin echogenic line

86
Q

Levonorgestrel implant?

A

thin capsule is placed under the skin for 5 yrs; endometrium is thin

CNIH (69 decks)

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