OB review- normal female pelvis Flashcards
Name the portions of the fallopian tube medial to lateral
- cornual
- isthmus
- ampulla
- infundibulum
what is the narrowest and widest portion of the Fallopian tube?
narrowest: isthmus
widest: ampulla
what part of the fallopian tube penetrates the myometrium?
cornual
rectouterine pouch aka?
- posterior cul de sac
- pouch of douglas
rectouterine pouch location?
- anterior to rectum
- posterior to uterus
- most inferior point in the pelvic cavity
what is the most common site for fluid to accumulate?
rectouterine pouch
space of retzius aka? (2)
- retropubic space
- prevesical space
location of space of retzius?
- anterior to urinary bladder
- posterior to symphysis pubis
vesicouterine pouch aka?
anterior cul de sac
vesicouterine pouch loaction?
- anterior to uterus
- posterior to urinary bladder
how to measure the length of the uterus?
from fundus to the external cervical os
how to measure the height of the uterus?
perpendicular to the length of the widest portion of the uterine body
how to measure width of the uterus?
widest portion of the uterine body in the short axis
premenarche uterus measurements? (L,H,W)
Length: 2-4cm
height: 0.5-1.0cm
width: 1-2cm
menarche uterus measurements?
- nulliparous
- parous
nulliparous-6-8.5cm x 3-5cm x 3-5cm
parous-8-10.5cm x 3-5cm x 5x6 cm
postmenopausal uterus measurements?
3.5-7.5cm x 2-3 cm x 4-6 cm
the outer layer of the endometrium?
- basal layer
- appears as hypoechoic
inner layer of endometrium?
- inner functional layer typically appears hyperechoic
the inner layer of the endometrium should not exceed what measurement?
14mm
what is not included in an endometrium measured?
- subendometrial halo
- fluid
what are ovaries?
- almond shaped
- intraperitoneal
- endocrine glands
- composed of cortical and medullary tissue covered by epithelium
what is the ovarian cortex?
- site of follicular development
- medulla is the vascular core of the ovary
what 2 sources are ovaries supplied blood from?
- ovarian artery arises from the aorta
- ovarian branch of the uterine artery
function of ovaries?
produce ova
2 hormones in ovaries?
estrogen and progesterone
what is estrogen secreted by?
secreted by follicle
what is progesterone secreted by?
corpus luteum
ovaries measurement- menarche?
length: 2.5-5cm
wide: 1.5-3cm
height: 0.6-2.2 cm
what does the measurement of ovaries depend on?
- age
- menstrul status
- body habitus
- pregnancy status
- phase of menstrul
ovaries volume- menarche?
9.8cm^3
ovaries measurement- postmenopausal?
5.8cm^3
estradiol function?
primarily reflects the activity of the ovaries
during pregnancy how is estradiol affected?
levels will steadily rise
where is estradiol present?
small amounts are present in the adrenal cortex and arterial walls
what is estrogen? what is it produced by?
- primary female sex hormome
- produced by developing follicles and placenta
what stimulates the production of estrogen in the ovaries?
FSH and LH
what parts of the body produce estrogen?
- breasts
- liver
- adrenal glands
estrogen normal levels?
5 to 100 μg/24 h (urine)
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
what is the function FSH-follicle stimulating hormone?
- initiates follicular growth and stimulates the maturation of the graafian follicle
what is FSH secreted by?
anterior pituitary gland
levels of FSH in children?
normally low and slightly higher after menopause
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
Luteinizing hormone function?
- reproduction in both genders
what is LH secreted by?
anterior pituitary gland
what stimulates LH production?
increasing estrogen
what triggers ovulation?
a surge in LH levels
what does a surge in LH trigger?
- ovulation
- initiates the conversion of the residual follicle into a corpus luteum
what does the corpus luteum produce?
progesterone to prepare the endometrium for possible implantation
how long does LH surge last?
typically only 48 hours
When does FSH become active?
before puberty
what is FSH produced by?
hypothalamus
where is FSH released?
- released into the bloodstream reaching the anterior pituitary gland
What stimulates FSH production?
Low levels of estrogen
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
when are progesterone levels low?
- in childhood
- in postmenopause
where is progesterone produced?
- adrenal glands
- corpus luteum
- brain
- placenta
when are increased amounts of progesterone produced?
during pregnancy
in what phase are progesterone levels low?
- preovulatory phase
in what phase are progesterone levels high?
- after ovulation
- luteal phase
functions of progesterone?
Preparing the endometrium for possible implantation or starting the next menstrual cycle
4 endometrial phases?
- menstrual
- early proliferation
- late proliferation
- secretory phase
menstrual phase?
- what days
- function
- hormones
- Days 1-5
- Functional layer necroses
- Decreased estrogen and progesterone
Early proliferation phase?
- days
- endo
- hormones
- coincides with
- Days 6-9
- Thin echogenic endometrium
- Increasing estrogen
- Coincides with follicular phase of the ovary
Late proliferation phase?
- days
- endo
- days 10-14
- preovulatory
- triple line apperance
in what phase is the triple line appearance seen?
late proliferation
secretory phase?
- days
- phase of cycle
- endo
- hormones
- day 15-28
- post ovulatory or premenstrul plase
- functional layer thickeness
- progesterone increases
Ovulation is regulated by the?
hypothalamus within the brain
when does LH usually reach its peak?
10 to 12 hours before ovulation
what triggers ovulation?
A surge in LH accompanied by a smaller FSH surge
5 ovarian phases?
- early follicular
- late phase
3, ovulatory phase - early luteal
- late luteal
early follicular- ovarian phase?
- days?
- size of follicles
Days 1-5
5-11 small follicles
late phase- ovarian?
- days
- ovulation
- size of graafian follicle
- hormones
- Days 6-13
- Before ovulation
- Graafian follicle: 2-2.4 cm
- Estrogen levels increase
ovulatory phase- ovarian phases?
- day
- graafian follicle
- what occurs?
- Day 14
- Rupture of Graafian follicle
- Pelvic pain-Mittelschmerz
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
late luteal- ovarian phases?
If fertilization does not occur, the corpus luteal cyst regresses
what defines pose menopause?
Cessation of menstruation for twelve (12) months
approximately ___% of cases will demonstrate a simple ovarian cyst?
15%
when is most likely the size of a benign simple ovarian cyst?
<5.0cm
what does hormone replacement therapy contain?
both estrogen and progesterone
normal endometrial thickness?
- <8mm
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
function of oral conreaceptives?
inhibit ovulation; endometrium has a thin echogenic line
3 examples of oral contraceptives?
- deopt- medroxyprogesterone
- levonorgesterel implant
- intauterine devices
Depot-medroxyprogesterone?
inhibits ovulation; endometrium has a thin echogenic line
Levonorgestrel implant?
thin capsule is placed under the skin for 5 yrs; endometrium is thin
