Pelvic Anatomy

Question 1

Compartmental Anatomy of the Female pelvis

Answer 1

1. Anterior
2. Middle
3. Posterior

Question 2

Anterior compartment:

Answer 2

1. Urinary bladder, urethra
2. Ureters
3. Peritoneal recesses
4. Fat planes

Question 3

Middle compartment:

Answer 3

1. Ovaries, fallopian tubes, uterus, vagina
2. Broad ligament
3. Meso-ovarium = double fold of peritoneum

Question 4

Posterior comparment

Answer 4

1. Rectum & surrounding connective tissues
2. Peritoneal recesses
   - recto uterine folds: uterosacral ligaments
   - recto vaginal pouch (POD)
3. Fat planes
   - rectovaginal septum

Question 5

Other term of POD

Answer 5

Recto-vaginal pouch

Question 6

Meaning of POD

Answer 6

Pouch of Douglas

Question 7

Normal ovary of NEONATAL/INFANTS

Answer 7

Small follicles; may be >9mm
Seen in 84% of ovaries in infants <2 yrs

Question 8

Normal ovary of CHILD (Pre-menarchal)

Answer 8

Small follicles; <9mm ; mean 6-7mm
Seen in 68% of ovaries in girls 2-12 yrs

Question 9

Normal ovary of ADULT (Post-menarchal)

Answer 9

Increase in size ; descend deeper into the pelvis
Multiple follicles

Question 10

Normal ovary of ADULT (Post-menopausal)

Answer 10

Decrease in size ; follicles disappear

Question 11

Ovarian size best described by ovarian volume

Answer 11

0.523 x Width x Thickness x Length

Question 12

Normal ovarian volume of NEONATAL/INFANT

Answer 12

1.0 cm3

Question 13

Normal ovarian volume of PRE-PUBERTAL GIRLS (2-12 yrs)

Answer 13

0.7 to 4.0 cm3

Question 14

Normal ovarian volume of POST-MENARCHAL

Answer 14

10 cm3 (2 x 3 x 4)

Question 15

Main ovarian artery

Answer 15

Aorta

Question 16

Dual blood supply:

Answer 16

1. Aorta
2. Adnexal branches of the uterine artery

Question 17

Where the right ovarian vein drains into?

Answer 17

IVC

Question 18

Where the left ovarian vein drains into?

Answer 18

Left renal vein

Question 19

AP diameter of cervix prominent due to maternal hormones

Answer 19

Neonate

Question 20

Decrease in size due to declining level of hormones

Answer 20

Child

Question 21

Descends with adnexa deeper into pelvis; fundus elongates and thickens; pear-shaped uterus

Answer 21

Adult (post-menarchal)

Question 22

Uterus atrophies such that uterine corpus is equal to or even smaller than cervix

Answer 22

Adult (post-menopausal)

Question 23

3 layers of cervix

Answer 23

1. Cervical mucosal layer
2. Submucosal layer
3. Cervical stromal layer

Question 24

Inner layer of Cx

Answer 24

Cervical mucosal layer

Question 25

Can be hypo-, iso- or slightly hyperechoic

Answer 25

Cervical mucosal layer

Question 26

Thin hypoechoic layer

Answer 26

Submucosal layer (only sometimes seen)

Question 27

Outer layer of the Cx

Answer 27

Cervical stromal layer

Question 28

Usually of same echogenicity as myometriun

Answer 28

Cervical stromal layer

Question 29

Normal mucosal folds of the cervical mucosa. They can invaginate deeply within the mucosa.

Answer 29

Plicae palmitae

Question 30

Central echogenic band

Answer 30

Endometrium

Question 31

Common benign uterine masses of Endometrium

Answer 31

1. Polyp 2. Endometrial hyperplasia

Question 32

Common malignant uterine masses of Endometrium

Answer 32

1. Endometrial carcinoma 2. Endometrial stromal sarcoma

Question 33

Common benign uterine masses of myometrium

Answer 33

1. Leiomyoma 2. Adenomyosis/adenomyoma

Question 34

Common malignant uterine mass of myometrium

Answer 34

Leiomyosarcoma

Question 35

Common benign uterine masses of endocervix?

Answer 35

1. Polyp 2. Leiomyoma

Question 36

Common benign uterine mass of endocervix

Answer 36

Cervical carcinoma

Question 37

Endometrial thickness of Menstrual Phase

Answer 37

4mm

Question 38

Endometrial thickness of Proliferative Phase

Answer 38

5-12mm

Question 39

Endometrial thickness of Secretory Phase

Answer 39

12-15mm

Question 40

Endometrial thickness of Menopausal

Answer 40

4mm

Question 41

Endometrial thickness of Patient on Tamoxifen/HRT

Answer 41

8mm

Question 42

3 layers of endometrium

Answer 42

1. Basal layer 2. Functional layer 3. Subendometrial layer

Question 43

Trilaminar appearance

Answer 43

Late proliferative phase

Question 44

The most appropriate first line imaging modality to asses the UT and ovaries in an adult

Answer 44

TV US

Question 45

The appearance of the UT and ovaries depends on

Answer 45

1. The stage of life cycle 2. Phase of Menstrual Cycle

Question 46

Solid appearing pattern with concave margins with no vascularity

Answer 46

Haemorrhagjc ovarian cyst

Question 47

Fluid fluid level

Answer 47

Haemorrhagic cyst

Question 48

“Fish-net” or reticular pattern within a cyst

Answer 48

Haemorrhagic cyst

Question 49

XY karyotype; gonads fail to develop into testes in-utero and thus testosterone production

Answer 49

Swyer syndrome

Question 50

Mullerian ducts develop into UT and fallopian tubes

Answer 50

Swyer syndrome

Question 51

Normal UT length of NEONATE

Answer 51

3.5cm

Question 52

b:c ratio of neonate

Answer 52

2:1

Question 53

The appearance of endometrium is echogenic line with small amt of fluid

Answer 53

Neonate

Question 54

Normal UT length of Paediatric

Answer 54

1-3cm

Question 55

b:c ratio of paediatric

Answer 55

1:1

Question 56

The appearance of endometrium is thin echogenic line

Answer 56

Paediatric

Question 57

Appearance of UT is smaller and tubular in shape

Answer 57

Paediatric

Question 58

Normal ut length of pre-pubertal/pubertal?

Answer 58

3-8cm

Question 59

b:c ratio of pre-pubertal?

Answer 59

1.5 to 2:1

Question 60

Normal ut length of reproductive?

Answer 60

8-9cm

Question 61

b:c ratio of reproductive?

Answer 61

2:1

Question 62

Normal ut length of post partum?

Answer 62

9-20cm

Question 63

Endometrium thickness of menstrual phase

Answer 63

1-4mm

Question 64

Endometrium thickness of proliferative phase (D5-13)

Answer 64

5-12mm

Question 65

Endometrium thickness of secretory phase (D14-28)

Answer 65

12-15mm