OBG-anatomy Flashcards
What does the posterior wall of the pelvis contain?
Sacrum and coccyx
Upper part of the pelvis is the ______ pelvis, the lower is the ______ pelvis.
False (superior), true (inferior)
What does the anterior wall of the pelvis contain?
2 pubic bones
What does the inferior wall of the pelvis contain?
2 iliac wings and ischium
What divides the pelvis into the true and false pelvis?
Linea terminalis or iliopectineal line
What is at the anterior wall of the false pelvis?
Rectus abs
What does the inferior wall of the true pelvis contain?
Pelvic diaphragm, levator ani muscle, coccygeal muscle, and perineal muscle
What are the osseous ligaments?
Sacroiliac (between the sacrum and ilium), sacrosanct (or sacrotuberous), sacrococcygeal, and pubic symphysis
what are the suspensory ligaments?
Cardinal ligament (lateral cervical ligament), broad ligament (extends from lateral pelvic walls), uterosacral ligament (posterior), round ligament (anterior to broad ligament), ovarian ligament, and infundibulopelvic ligament
what is the broad ligament made out of?
peritoneum
what does the round ligament attach?
the upper uterus to anterior pelvic wall
what does the ovarian ligament attach?
upper/anterior uterus to ovary
what does the infundibuloplevic ligament attach?
lateral aspect of the ovary to the pelvic wall transmits the ovarian artery and vein to ovary
This muscle is from anterior wall to pelvis, extends from xiphoid process to pubic symphysis, responsible for the refraction/ “ghosting” artifact occasionally seen while imaging the middle pelvis in a transverse plane
rectus abdominum muscle
this muscle originates from the lower throracic and lumbar vertebra (posterior wall), joins the iliacus muscle in the pelvis forming the iliopsoas muscle
psoas muscle
inserts on the lesser pouch anterior to the femur
iliopsoas muscle
sits in the anterior iliac fossa (lateral wall), arises at the liiac creast and extends inferiorly to join the psoas muscle forming the iliopsoas, part of the false pelvis
iliacus
triangular muscle anchoring pelvic brim, lateral side wall of the true pelvis
obturator internus muscle
deep and posterior in true pelvis “turn out muscle”
piriformis muscle
holds pelvic organs inside, made out of levator muscle (anterior and middle floor), coccygeal muscle (posterior floor), perineal muscle (outerside)
pelvic diaphragm
what 3 structures pass through the pelvic diaphragm?
urethra (anterior), vagina (middle), rectum (posterior)
hollow muscle membranous organ, located posterior to pubic symphysis, anterior to the vagina, superior convexity is the dome, utterers insert on the inferior posterior of this organ
urinary bladder
what are the 3 layers of the bladder wall?
outer epithelial layer, middle muscular layer, and inner mucosal layer
describe the bladder when it is full and empty
empty bladder- can see folds (rugae) on sonogram
full bladder- cannot see the mucosa
______ arises along the inferior and middle part of the bladder
urethra
7-10 cm canal of smooth muscle, extends from the external introitus to the cervix
vagina
upper portion of vagina surrounds the cervix and forms gutters call ______
fornicies, 3 parts: anterior fornix, lateral fornicies, and posterior fornix (usually the deepest and can see fluid within)
pear shaped, hallow organ, located anterior to the rectum posterior to the bladder
uterus, the fundus is the dome, body is the main portion, and isthmus is the lower uterine segment (most flexible part)
“neck” of the uterus, provides an alkaline secretion favorable for sperm penetration for fertilization
cervix
uterine cavity in endometrium
endocervical canal
what are the sizes of the cervix and body/fundus?
adult: cx lower 1/3 body/fundus upper 2/3
new born: cx lower 1/2 body/fundus upper 1/2
pediatric: cx lower 2/3 body/fundus upper 1/3
post menopausal is same as adult
what are the layers of the uterus?
perimeterium (outer layer), myometrium (middle layer), endometrium (inner mucus layer)
what are the parts of the perimetrium layer?
broad ligament (laterally), vesicoutererine pouch (anteriorly), rectouterine pouch/pouch of douglas (posteriorly)
what is the most dependent portion of the abdomen?
pouch of douglas
has 3 layers of smooth muscle that contract during delivery, then inter most layer is the junctional zone (always seen on MRI)
myometrium
consists of a superficial functional layer and a deeper permanent basal layer, varies in thickness during different phases of the cycle
Endometrium
how is the thickness of the endometrium measured?
with the uterus in the sagital plane taken as a double layer
tissue surrounding the uterus, also known as adnexa
parametrium
______ uterus position has no bend, endometrium is straight forward tilt of uterus with respect to the vagina
anteversion
______ uterus postion is posterior or neutral with respect to the vagina
retroversion
______uterus postion is bending forward at the uterus body
anteflexion
______ uterus postion is bending backward at the uterus body
retroflexion
soild, paired, oval organ, suspends in the pelvic peritoneum, posterior to broad ligament, location varies esp. during pregnancy
ovaries
what are the layers of the ovaries?
outer functional layer (cortex), and inner medullary contains vessels and connective tissue
______ are channels through which vessels and nerves is situated at the anterior of the ovary
hilum
paired muscle membranous tubes, extends laterally from uterus cornee
fallopian tubes
what does CIAIF for the fallopian tube stands for?
Cornual/interstitial/intramorial Isthmus Ampulary Infundibulum Fimbriae
potential space in the pelvic cavity location of organs and suspensory structures
peritoneal recesses
prevesical or retropubic space located between pubic symphysis (anterior) and bladder (posterior), masses in this space will displace the bladder posteriorly
space of retzius
anterior to the cul de sac, anterior to the uterus, posterior to the bladder, usually empty, may contain loops of bowel
vesicoutrerine space
also known as pouch of douglas, posterior cul de sac, posterior to rectum, the most common dependent portion of the abdomen and place for fluid to collect
rectouterine space
complex free fluid in the peritoneal recess is associated with ______ or ______
hemorrhage or infection
the ______ and its branches supply blood to the pelvic organs
abdominal aorta
divides at L4 into RoL common iliac artery
aorta
what are the common iliac branches?
external iliac artery, and internal iliac artery (uterus artery and vaginal artery)
crosses over the uterus on each side of the uterus and ascends along the lateral portion of the uterus within the broad ligament, at the cornue they course laterally to join the ovarian arteries
uterine arteries
which arteries supply the majority of blood to the uterus?
uterine arteries
multipul radial arteries that supply the deepest layer of the myometrium and endometrium
arcuate arteries
what are the branches of the uterus arteries from outer to inner?
uterine, arcuate, radial, spiral
empties into the IVC
Rt ovarian vein
empties into the Lt renal vein
Lt ovarian vein
Uterine veinous flexus is larger and more sonographic than the ______ flexus
arterial
______ tortus veins near the uterus and in adnexa are a significant finding in patients with pain and may be associated with pelvic congestion syndrome
dilated
what is the doppler characteristics of uterus arteries?
uterus arteries are moderately high resistance, higher resistance in proliferative phase than in secretory phase, higher resistance in post menopausal
______ arteries have higher resistance flow in proliferative than in secretory phase, increasing difficulty to see in posterior menopausal
radial
in the follicular phase, flow is low velocity and high resistance, during the periovulatory period and luteal phase impedance drops dramatically on the side of the dominant follicle
ovarian arteries
