OB review- normal female pelvis Flashcards
1
Q
Name the portions of the fallopian tube medial to lateral
A
- cornual
- isthmus
- ampulla
- infundibulum
2
Q
what is the narrowest and widest portion of the Fallopian tube?
A
narrowest: isthmus
widest: ampulla
3
Q
what part of the fallopian tube penetrates the myometrium?
A
cornual
4
Q
rectouterine pouch aka?
A
- posterior cul de sac
- pouch of douglas
5
Q
rectouterine pouch location?
A
- anterior to rectum
- posterior to uterus
- most inferior point in the pelvic cavity
6
Q
what is the most common site for fluid to accumulate?
A
rectouterine pouch
7
Q
space of retzius aka? (2)
A
- retropubic space
- prevesical space
8
Q
location of space of retzius?
A
- anterior to urinary bladder
- posterior to symphysis pubis
9
Q
vesicouterine pouch aka?
A
anterior cul de sac
10
Q
vesicouterine pouch loaction?
A
- anterior to uterus
- posterior to urinary bladder
11
Q
how to measure the length of the uterus?
A
from fundus to the external cervical os
12
Q
how to measure the height of the uterus?
A
perpendicular to the length of the widest portion of the uterine body
13
Q
how to measure width of the uterus?
A
widest portion of the uterine body in the short axis
14
Q
premenarche uterus measurements? (L,H,W)
A
Length: 2-4cm
height: 0.5-1.0cm
width: 1-2cm
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
16
Q
postmenopausal uterus measurements?
A
3.5-7.5cm x 2-3 cm x 4-6 cm
17
Q
the outer layer of the endometrium?
A
- basal layer
- appears as hypoechoic
18
Q
inner layer of endometrium?
A
- inner functional layer typically appears hyperechoic
19
Q
the inner layer of the endometrium should not exceed what measurement?
A
14mm
20
Q
what is not included in an endometrium measured?
A
- subendometrial halo
- fluid
21
Q
what are ovaries?
A
- almond shaped
- intraperitoneal
- endocrine glands
- composed of cortical and medullary tissue covered by epithelium
22
Q
what is the ovarian cortex?
A
- site of follicular development
- medulla is the vascular core of the ovary
23
Q
what 2 sources are ovaries supplied blood from?
A
- ovarian artery arises from the aorta
- ovarian branch of the uterine artery
24
Q
function of ovaries?
A
produce ova
25
2 hormones in ovaries?
estrogen and progesterone
26
what is estrogen secreted by?
secreted by follicle
27
what is progesterone secreted by?
corpus luteum
28
ovaries measurement- menarche?
length: 2.5-5cm
wide: 1.5-3cm
height: 0.6-2.2 cm
29
what does the measurement of ovaries depend on?
- age
- menstrul status
- body habitus
- pregnancy status
- phase of menstrul
30
ovaries volume- menarche?
9.8cm^3
31
ovaries measurement- postmenopausal?
5.8cm^3
32
estradiol function?
primarily reflects the activity of the ovaries
33
during pregnancy how is estradiol affected?
levels will steadily rise
34
where is estradiol present?
small amounts are present in the adrenal cortex and arterial walls
35
what is estrogen? what is it produced by?
- primary female sex hormome
| - produced by developing follicles and placenta
36
what stimulates the production of estrogen in the ovaries?
FSH and LH
37
what parts of the body produce estrogen?
- breasts
- liver
- adrenal glands
38
estrogen normal levels?
5 to 100 μg/24 h (urine)
39
estrogen functions?
- 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
what is the function FSH-follicle stimulating hormone?
- initiates follicular growth and stimulates the maturation of the graafian follicle
41
what is FSH secreted by?
anterior pituitary gland
42
levels of FSH in children?
normally low and slightly higher after menopause
43
FSH levels decline and increase in what phase?
- Levels decline in the late follicular phase and demonstrate a slight increase at the end of the luteal phase
44
Luteinizing hormone function?
- reproduction in both genders
45
what is LH secreted by?
anterior pituitary gland
46
what stimulates LH production?
increasing estrogen
47
what triggers ovulation?
a surge in LH levels
48
what does a surge in LH trigger?
- ovulation
| - initiates the conversion of the residual follicle into a corpus luteum
49
what does the corpus luteum produce?
progesterone to prepare the endometrium for possible implantation
50
how long does LH surge last?
typically only 48 hours
51
When does FSH become active?
before puberty
52
what is FSH produced by?
hypothalamus
53
where is FSH released?
- released into the bloodstream reaching the anterior pituitary gland
54
What stimulates FSH production?
Low levels of estrogen
55
Luteinizing hormone-releasing factor (LHRF)?
- becomes active when?
- produced by?
- released into?
- Becomes active before puberty
- Produced by the hypothalamus
- Released into the bloodstream, reaching the anterior pituitary gland
56
when are progesterone levels low?
- in childhood
| - in postmenopause
57
where is progesterone produced?
- adrenal glands
- corpus luteum
- brain
- placenta
58
when are increased amounts of progesterone produced?
during pregnancy
59
in what phase are progesterone levels low?
- preovulatory phase
60
in what phase are progesterone levels high?
- after ovulation
| - luteal phase
61
functions of progesterone?
Preparing the endometrium for possible implantation or starting the next menstrual cycle
62
4 endometrial phases?
1. menstrual
2. early proliferation
3. late proliferation
4. secretory phase
63
menstrual phase?
- what days
- function
- hormones
- Days 1-5
- Functional layer necroses
- Decreased estrogen and progesterone
64
Early proliferation phase?
- days
- endo
- hormones
- coincides with
- Days 6-9
- Thin echogenic endometrium
- Increasing estrogen
- Coincides with follicular phase of the ovary
65
Late proliferation phase?
- days
- endo
- days 10-14
- preovulatory
- triple line apperance
66
in what phase is the triple line appearance seen?
late proliferation
67
secretory phase?
- days
- phase of cycle
- endo
- hormones
- day 15-28
- post ovulatory or premenstrul plase
- functional layer thickeness
- progesterone increases
68
Ovulation is regulated by the?
hypothalamus within the brain
69
when does LH usually reach its peak?
10 to 12 hours before ovulation
70
what triggers ovulation?
A surge in LH accompanied by a smaller FSH surge
71
5 ovarian phases?
1. early follicular
2. late phase
3, ovulatory phase
4. early luteal
5. late luteal
72
early follicular- ovarian phase?
- days?
- size of follicles
Days 1-5
| 5-11 small follicles
73
late phase- ovarian?
- days
- ovulation
- size of graafian follicle
- hormones
- Days 6-13
- Before ovulation
- Graafian follicle: 2-2.4 cm
- Estrogen levels increase
74
ovulatory phase- ovarian phases?
- day
- graafian follicle
- what occurs?
- Day 14
- Rupture of Graafian follicle
- Pelvic pain-Mittelschmerz
75
early luteal phase- ovarian?
- days
- ovulation
- hormones
- what is seen
- Days 15-18
- Post ovulation
- Corpus luteum secretes estrogen and progesterone
- Free fluid in cul de sac
76
late luteal- ovarian phases?
If fertilization does not occur, the corpus luteal cyst regresses
77
what defines pose menopause?
Cessation of menstruation for twelve (12) months
78
approximately ___% of cases will demonstrate a simple ovarian cyst?
15%
79
when is most likely the size of a benign simple ovarian cyst?
<5.0cm
80
what does hormone replacement therapy contain?
both estrogen and progesterone
81
normal endometrial thickness?
- <8mm
82
what does the post menopause uterus look like?
- 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
function of oral conreaceptives?
inhibit ovulation; endometrium has a thin echogenic line
84
3 examples of oral contraceptives?
1. deopt- medroxyprogesterone
2. levonorgesterel implant
3. intauterine devices
85
Depot-medroxyprogesterone?
inhibits ovulation; endometrium has a thin echogenic line
86
Levonorgestrel implant?
thin capsule is placed under the skin for 5 yrs; endometrium is thin
