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SONOCAN OB Review > Pelvic Anatomy Notes > Flashcards

Pelvic Anatomy Notes Flashcards

1
Q

What is the adnexa?

A

The region including the fallopian tube and ovary.

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2
Q

What is the false pelvis?

A

The region of the pelvis located above the pelvic brim.

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3
Q

What are fimbriae ovarica?

A

The one fimbriae attached to the ovary.

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4
Q

What is the iliopectineal line?

A

An imaginary line from the superior border of the sacrum to the superior margin of the pubis symphysis that divides the true and false pelvis.

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5
Q

What is a ligament?

A

An extension of a double layer of peritoneum between visceral organs.

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6
Q

What is menarche?

A

The onset of menstrual cycles.

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7
Q

What is menopause?

A

The cessation of menses.

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8
Q

What is the mesovarian ligament?

A

The posterior portion of the peritoneum that attaches to the ovary.

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9
Q

What is mesosalpinx?

A

The upper fold of the broad ligament that drapes over the fallopian tube.

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10
Q

What is the perineum?

A

The surface region in both males and females between the pubic symphysis and the coccyx; area below the pelvic floor.

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11
Q

What is premenarche?

A

The time before the onset of menstrual cycles.

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12
Q

What is puberty?

A

The process of physical changes by which a child’s body becomes an adult body capable of reproduction.

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13
Q

What is the true pelvis?

A

The region of the pelvis found below the pelvic brim.

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14
Q

What is the pelvic anatomy?

A

The pelvis begins at the iliac crests and ends at the symphysis pubis, divided into the true and false pelvis by the iliopectineal line.

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15
Q

What is the true pelvis also known as?

A

Pelvic cavity or lesser pelvis.

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16
Q

What are the boundaries of the true pelvis?

A

Anterior boundary—symphysis pubis; posterior boundary—sacrum and coccyx; posterolateral wall—piriformis and coccygeus muscles; anterolateral wall—hip bone and obturator internus muscles; lateral boundaries—fused ilium and ischium.

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17
Q

What does the true pelvis contain? 4

A
  1. The female reproductive system
  2. Urinary bladder
  3. Distal ureters
  4. Bowel.
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18
Q

What is the false pelvis?

A

Located superior to the pelvic brim, contains loops of bowel.

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19
Q

What is the levator ani?

A

A group of muscles forming the pelvic floor that supports and positions the pelvic organs.

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20
Q

What is the sonographic appearance of the levator ani? 3

A
  1. Low-level
  2. Mildly curved linear echoes posterior to the vagina
  3. Hypoechoic compared with the normal uterus.
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21
Q

What is the iliopsoas Formed by? What kind of landmark does it serve as?

A
  1. Formed by the psoas major and iliacus muscles
  2. Serves as a lateral landmark of the true pelvis.
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22
Q

What is the sonographic appearance of the iliopsoas?

A

Low-level gray echoes with a distinct central hyperechoic focus.

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23
Q

What does the piriformis arise from? What is it a part of?

A
  1. Muscle arising from the anterior sacrum
  2. Part of the pelvic floor.
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24
Q

What is the sonographic appearance of the piriformis?

A

Low-level linear echoes, hypoechoic compared with the normal uterus.

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25
Q

What is the psoas major?

A

Muscle that arises from the lumbar spine and descends into the false pelvis.

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26
Q

What is the sonographic appearance of the psoas major? What is the shape in the transverse plane?

A

Low-level echogenicity, round in shape in the transverse plane.

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27
Q

What is the obturator internus? What does it extend through?

A

Muscle surrounding the obturator foramen, extending through the sciatic foramen.

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28
Q

What is the sonographic appearance of the obturator internus?

A

Low-level linear echoes abutting the lateral walls of the urinary bladder.

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29
Q

Are Pelvic ligaments routinely visualized? What do they appear as?

A
  1. Not routinely visualized by ultrasound
  2. Appear as hyperechoic, moderately thin, linear structures with intraperitoneal fluid collections.
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30
Q

What is the broad ligament? What does it drape over?

A

A wing-like double fold of peritoneum that drapes over the fallopian tubes, uterus, ovaries, and blood vessels.

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31
Q

What is the cardinal ligament? What does it firmly support?

A

Continuation of the broad ligament that extends across the pelvic floor and firmly supports the cervix.

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32
Q

What is the ovarian ligament?

A

Extends from the cornua of the uterus to the medial aspect of the ovary.

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33
Q

What is the round ligament?

A

Arises in the uterine cornua, anterior to the fallopian tubes, helping to maintain anteflexion of the uterine body.

(Connects uterus to the lower abdomen)

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34
Q

What is the suspensory ligament? What is it also known as?

A

Also known as infundibulopelvic ligament, extends from the lateral portion of the ovary to the pelvic sidewall.

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35
Q

What is the uterosacral ligament?

A

Extends from the upper cervix to the lateral margins of the sacrum, firmly supporting the cervix.

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36
Q

What are the arcuate vessels? What does it branch from?

A

Prominent vascular structures in the outer one third of the myometrium, branching from the uterine artery.

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37
Q

What do the radial arteries supply? (What is another name for the radial arteries?)

A
  1. Spiral arteries supply blood to the functional layer of the endometrium
  2. Straight arteries supply blood to the basal layer.
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38
Q

Where are the internal iliac arteries located? What does it supply? 2

A
  1. Posterior to the uterus and ovaries
  2. Supplying the bladder, uterus, vagina, and rectum.
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39
Q

Where do the ovarian arteries arise from?

A

The lateral margins of the abdominal aorta, slightly inferior to the renal arteries.

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40
Q

What do the uterine arteries supply? 5

A
  1. Cervix
  2. Vagina
  3. Uterus
  4. Ovaries
  5. Fallopian tubes.
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41
Q

What are the pelvic spaces?

A

Areas created by the peritoneum draping over the uterus and fallopian tubes, dividing the pelvis into anterior and posterior sections.

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42
Q

What is the retrouterine pouch?

A

The posterior cul de sac, most common site for fluid accumulation in the pelvic cavity.

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43
Q

What is the space of Retzius?

A

The retropubic space, anterior to the urinary bladder.

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44
Q

What is the vesicouterine pouch?

A

The anterior cul de sac located anterior to the uterus.

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45
Q

What is the vagina?

A

A collapsed tube consisting of an outer muscular layer and an inner mucosal layer, extending from the vulva to the cervix.

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46
Q

What is the sonographic appearance of the vagina?

A

Vaginal walls demonstrate low-level homogeneous echoes; the vaginal canal shows a central hyperechoic linear echo pattern.

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47
Q

What is the uterus?

A

A hollow, pear-shaped organ derived from the fused caudal portion of the paired, hollow müllerian ducts.

48
Q

What are the tissue layers of the uterus?

A

Perimetrium, myometrium, and endometrium.

49
Q

What is the endometrium?

A

Highly vascular mucous membrane lining the uterine cavity, composed of functional and basal layers.

50
Q

What is the body of the uterus?

A

The largest portion of the uterus, located posterior to the vesicouterine pouch and anterior to the retrouterine pouch.

51
Q

What is the cervix?

A

The proximal and inferior portion of the uterus located between the vagina and uterine isthmus.

52
Q

What is the fundus of the uterus?

A

The dome-shaped widest, most distal and superior portion of the uterus.

53
Q

What is the isthmus?

A

The narrow waist of the uterus located between the cervix and body of the uterus.

54
Q

What is the normal sonographic appearance of the uterus?

A

Homogeneous mid-to-low level echogenic structure surrounding a hyperechoic endometrial cavity.

55
Q

How is the length of the uterus measured?

A

From the fundus to the external cervical os.

56
Q

What is the uterine size during premenarche?

A

Length: 2.0-4.0 cm, Height: 0.5-1.0 cm, Width: 1.0-2.0 cm.

57
Q

What is the uterine size during menarche?

A

Length: 6.0-8.0 cm (nulliparous) 8.0-10.0 cm (parous); Height: 3.0-5.0 cm; Width: 3.0-5.0 cm.

58
Q

What is the uterine size during postmenopause?

A

Length: 3.5-6.5 cm; Height: 2.0-3.0 cm; Width: 4.0-6.0 cm.

59
Q

What is flexion in uterine positions?

A

Refers to the relationship between the body of the uterus and the internal cervical os.

60
Q

What is anteflexion?

A

Uterine body and fundus bend significantly anterior until the fundus points inferior resting on the cervix.

61
Q

What is anteversion?

A

Uterine body and fundus are tipped anteriorly, forming an angle ≤ 90 degrees with the vaginal canal.

62
Q

What is dextroflexion?

A

Uterine body is displaced or flexed to the right of the cervix.

63
Q

What is levoflexion?

A

Uterine body is displaced or flexed to the left of the cervix.

64
Q

What is retroflexion?

A

Uterine body and fundus bend significantly posterior until the fundus is pointed inferior adjacent to the cervix.

65
Q

What is retroversion?

A

Uterine body and fundus are tipped posterior.

66
Q

What is levoflexion?

A

Uterine body is displaced or flexed to the left of the cervix.

Transverse imaging plane is best to evaluate whether the uterus is levoflexed.

67
Q

What is dextroflexion?

A

Uterine body is displaced or flexed to the right of the cervix.

Transverse imaging plane is best to evaluate whether the uterus is dextroflexed.

68
Q

What is retroflexion?

A

Uterine body and fundus bend significantly posterior until the fundus is pointed inferior adjacent to the cervix.

Transvaginal imaging is best to evaluate a retroflexed uterus.

69
Q

What is retroversion?

A

Uterine body and fundus are tipped posteriorly, forming an angle <90 degrees with the vaginal canal.

Transvaginal imaging is best to evaluate a retroverted uterus.

70
Q

What causes congenital uterine anomalies? 2

A
  1. Congenital anomalies result from improper fusion of the müllerian ducts
  2. Incomplete absorption of the septum between them.
71
Q

What percentage of congenital uterine anomalies have coexisting renal anomalies?

A

20% to 30% of cases.

72
Q

What is agenesis in terms of uterine anomalies?

A

Failure of the caudal müllerian ducts to develop, resulting in absent uterus and fallopian tubes.

Clinical findings include amenorrhea.

73
Q

What is a unicornuate uterus?

A

A congenital anomaly where one müllerian duct develops, leading to a single uterine cavity.

Clinical findings may include hypomenorrhea and infertility.

74
Q

What is a bicornuate uterus?

A

Partial fusion of the müllerian ducts resulting in two uteri in the superior portion of the uterus.

Clinical findings may include spontaneous abortion.

75
Q

What is a septate uterus?

A

Complete fusion of the müllerian ducts with failure to completely reabsorb the septum, resulting in two uterine cavities and one fundus.

Most common type of müllerian duct anomaly.

76
Q

What is the anatomy of the ovaries?

A

Paired, elliptical-shaped endocrine glands located lateral to the uterus, composed of an outer cortex and a central medulla.

77
Q

What hormones do the ovaries produce?

A

Estrogen, secreted by the follicle, and progesterone, secreted by the corpus luteum.

78
Q

What is the normal sonographic appearance of the ovary?

A

Ovoid low-to-medium-level echogenic structure, isoechoic to hypoechoic compared with the normal uterus.

79
Q

What is the normal ovarian size at menarche?

A

2.5 to 5.0 cm in length, 1.5 to 3.0 cm in width, and 0.6 to 2.2 cm in height.

80
Q

What is the function of the fallopian tubes?

A

Attract and transfer ova from the surface of the ovary to the endometrial cavity.

81
Q

What are the segments of the fallopian tube?

A

Interstitial, isthmus, ampulla, and infundibulum.

82
Q

What is the normal sonographic appearance of the fallopian tube?

A

Normal fallopian tube is not routinely visualized but may appear as a long echogenic tenuous structure extending laterally from the uterine wall.

83
Q

What is the purpose of bladder distention in transabdominal imaging?

A

Displaces uterus posteriorly and bowel laterally, providing an acoustic window to visualize pelvic structures.

84
Q

What are the contraindications for endovaginal imaging?

A

Any patient who does not or cannot willingly consent, premenarchal or virginal patients, and severe pain during examination.

85
Q

What are the indications for non-gravid female pelvis ultrasound? 7

A
  1. Pelvic pain
  2. Pelvic or uterine mass
  3. Abnormal uterine bleeding
  4. Amenorrhagia
  5. Dysmenorrhea
  6. Bloating
  7. Family history of gynecological carcinoma.
86
Q

What is the normal sonographic appearance of the urinary bladder?

A

Anechoic, fluid-filled structure located in the pelvic midline.

87
Q

What is the normal postvoid residual in adult patients?

A

Postvoid residual normally should not exceed 20 mL.

88
Q

What is the normal sonographic appearance of the bladder?

A

Anechoic, fluid-filled structure located in the pelvic midline.

89
Q

How do ureteric orifices appear on sonography?

A

Ureteric orifices appear as small echogenic protuberances on the posterior aspect of the bladder.

90
Q

What is the normal bladder wall thickness?

A

Bladder wall thickness should not exceed 5 mm.

91
Q

What is a bladder diverticulum?

A

Bladder diverticulum is caused by bladder wall muscle weakness leading to herniation of the mucosa through the muscular wall.

92
Q

What are the clinical findings of a bladder diverticulum? 4 (s/s)

A
  1. Asymptomatic
  2. Urinary tract infection, pelvic pain
  3. May be associated with bladder obstruction
  4. chronic inflammation.
93
Q

What are the sonographic findings of a bladder diverticulum?

A

Anechoic pedunculation of the urinary bladder; neck of diverticulum is small and may enlarge when bladder contracts.

94
Q

What are differential considerations for bladder diverticulum? 3

A
  1. Ovarian cyst
  2. Fluid-filled bowel
  3. Ascites.
95
Q

What is a bladder ureterocele?

A

Congenital obstruction of the ureteric orifice.

96
Q

What are the clinical findings of a bladder ureterocele? (S/S) 2

A
  1. Asymptomatic
  2. Urinary tract infection.
97
Q

What are the sonographic findings of a bladder ureterocele?

A

Hyperechoic septation seen within the bladder at the ureteric orifice.

98
Q

What are differential considerations for bladder ureterocele?

A

Artifact.

99
Q

What is bladder calculus?

A

Bladder calculus is caused by urinary stasis and can migrate from the kidneys.

100
Q

What are the clinical findings of bladder calculus? 4 (s/s)

A
  1. Asymptomatic
  2. Hematuria
  3. Urinary frequency
  4. Urgency.
101
Q

What are the sonographic findings of bladder calculus?

A

Hyperechoic focus within the urinary bladder with posterior acoustic shadowing; mobile with patient position change.

102
Q

What are differential considerations for bladder calculus? 2

A
  1. Intestinal air
  2. Calcified vessel.
103
Q

What is cystitis?

A

Cystitis is an infection with female prevalence.

104
Q

What are the clinical findings of cystitis? (S/S) 4

A
  1. Dysuria
  2. Urinary frequency
  3. Leukocytosis
  4. Hematuria.
105
Q

What are the sonographic findings of cystitis?

A

Focal or diffuse increase in bladder wall thickness; mobile internal echoes.

106
Q

What is bladder sludge?

A

Bladder sludge is debris in the bladder.

107
Q

What are the clinical findings of bladder sludge?

A

Asymptomatic.

108
Q

What are the sonographic findings of bladder sludge?

A

Homogeneous low-level echoes; mobile with patient position change.

109
Q

What are differential considerations for bladder sludge? 2

A
  1. Cystitis
  2. Hematuria.
110
Q

What are the risk factors for bladder malignancy? 6

A
  1. Elderly
  2. Male prevalence
  3. Analgesic abuse
  4. Tobacco use
  5. Excessive coffee consumption
  6. Recurrent UTI.
111
Q

What does transitional cell carcinoma present with? (S/S) 3

A

Transitional cell carcinoma presents with
1. Painless hematuria
2. Frequent urination
3. Dysuria.

112
Q

What are the sonographic findings of transitional cell carcinoma? 3

A
  1. Polypoid echogenic bladder mass with irregular margins
  2. Immobile with patient position change
  3. May demonstrate irregular bladder wall thickening.
113
Q

What are the findings of a benign tumor in the bladder? 3

A
  1. Echogenic intraluminal mass with smooth margins
  2. immobile with patient position change
  3. internal vascular flow.
114
Q

What pelvic ligament extends from the cornua of the uterus to the medial aspect of the ovary?

A

Round ligament.

115
Q

What do prominent anechoic structures near the periphery of the uterus most likely represent?

A

Nabothian cysts.

SONOCAN OB Review (23 decks)

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