Practice Test 1- Anatomy & Female Pelvis Flashcards
What are the three regions that the pelvis occupies?
Hypogastric, left and right iliac
What is the name of the imaginary line that separates the true pelvis from the false pelvis?
Linea terminalis
The false pelvis is more posterior then the true pelvis true or false
False. The true pelvis is inferior and posterior to the false pelvis
The pelvis is part of the peritoneal cavity, extending from the _______superiorly to the______ inferiorly
Iliac crest to
Pelvic diaphragm
What does the true pelvis contain
Pelvic colon, rectum, bladder, ureter's, vagina, uterus, ovaries, fallopian tube's, urethra
Where does the false pelvis extend to superiorly?
Iliac crest to linea terminalis
What organs does the false pelvis contain?
Mostly bowel and small intestines
Linea terminalis extends between the _____superiorly and the inferiorly______
Sacral promontory
Pubic bone
When the urinary bladder is empty it is positioned in the false pelvis true or false?
False the bladder is in the true pelvis unless very full and distended.
The ureter courses _____to the ovaries and inserts into the _______\of the urinary bladder
Posterior
Trigone
________ is the peritoneal process that attaches the colon to the posterior abdominal wall
Mesocolon
What is the most dependent area in the pelvis?
Pouch of Douglas
What are the terms that refer to the peritoneal space between the uterus and the rectum?
Pouch of Douglas
Posterior cul-de-sac
Rectouterine pouch
What are the most common abnormalities seen in the space of Retzius?
Hematoma
Abscess
Mention four conditions where you might see fluid in the cul-de-sac
Etopic pregnancy
Cyst rupture
Pelvic infection
Ascites
The space of Retzius is contagious with the abdominal pelvic cavity he true or false?
False.
The recto pubic space is between the pubis and anterior bladder it is filled with fat and extra peritoneum.
Where is the space of Retzius located?
Between the anterior bladder wall and the pubis
What is the area in the uterus where the fallopian tube originates?
The cornua-located in the lateral portion of the fundus
Fundus of the uterus is the same as the dome true or false?
True
What is the other term for the body of the uterus?
Corpus- Latin for body
What are the three ligaments that provide structural support to the uterus?
Round ligament’s
Cardinal ligament’s
Utero sacral ligament’s
Is the broad ligament a real ligament?
No, it is a dual layer of peritoneum and not considered a supportive ligament
What are the three sections of the broad ligament?
Mesometrium
Mesovarium
Mesosalpinx
What is the term used for the connective tissue between the two layers of broad ligament’s?
Parametrium
What structures are located between the two layers of the broad ligaments?
Uterus
Most of the fallopian tube’s and round ligaments
Uterine vessels ovarian ligaments, portions of ovarian vessels
Where is the ovary located in regards to the broad ligament?
The ovary is located posterior and lateral in regards to the broad ligament
The cardinal ligament connects the cervix with the posterior pelvic wall true or false?
False the cardinal ligament connects the cervix with the lateral pelvic wall
What are the two ligaments that are attached to the ovaries?
Which area does each ligament attach the ovary to?
Medial ovarian Pole attached to the utero ovarian ligament-which is a fibrous ligament.
Lateral ovarian pole attached to lateral pelvic wall by suspensitory ligament – a non-rigid ligament an extension of the broad ligament. This houses the ovarian vessels and nerves
The________ arises from the uterine cornua and extends in the_________ and more specifically to the _______.
This ligament is responsible for the ______tilt of the uterus
Round ligament’s
External genitalia
Labia majora
Anterior
What is the other term for the suspensory ligament of the ovary? And is it a real ligament?
Infundibulopelvic ligament.
No, it is two layers of peritoneum and an extension of the broad ligament
What structures course through the suspensory ligament of the ovary?
The ovarian nerves and vessels
The proper ovarian ligament attaches the superior medial pole of the ovary with the uterus true or false
False the proper ovarian ligament attaches to the medial lower pole of the ovary
The______ separates the pelvis into anterior and posterior compartments
Broad ligament
The other name for the cardinal ligament is_____. The cardinal ligament and the utero sacral ligament support the_____.
Trans cervical ligament’s
Cervix
_______ constitutes the largest part of the broad ligament.
Mesometrium
_________ anchors the ________surface of the ovary to the posterior surface of the broad ligament
A short mesovarium
Anterior
_______ The free margin of the broad ligament is where the fallopian tube’s travel
Superior portion of
Which bone constitutes the anterior lateral pelvic wall?
The innominate bones a.k.a. the hip bones
Ilium ischium &
What is the term used to describe cysts in the cervix?
Nabothian or Mucoretention cyst
What is the length of a normal cervix?
4-5 cm in Nulliparous women
The cervical canal extenze between the______ Os inferiorly and the______ Os superiorly
External
Internal
The continuous space between the cervix and the vaginal wall is called the______.
Cervical canal
The cervix is anchored to the bladder by the____
Parametrium
The parametrium is the outer layer of the uterus true or false?
False- the perimetrium
______ is the portion of the cervix surrounding the cervical canal which is lined with columnar cells that secrete mucus
The endocervix
__________ refers to the outer layer of the cervix which consists of squamous epithelium it is continuous with the vagina
The Exocervix
In order to see the cervix on transvaginal scan, you have to angle the transducer toward the patients anterior pelvic wall true or false
False. Posterior angulation with transvaginal scanning is better to see the cervix
The Endo cervix can always be seen on transvaginal scan true or false
False unless properly positioned the entire cervix may not be visualized
When you measure cervical length in a pregnant woman you measure it between the ______and the _____Women who have a short cervix can go into_______ labor.
Internal os
External os
Premature
The cervix usually looks ________on transverse plane, while the vagina is more_______
Round
Flattened
What are the other terms used for nabothian cyst?
Epithelial inclusion cyst
Mucous retention cyst
It is normal to see anechoic fluid in the endocervical canal, particularly during the peri ovulatory phase. True or false
True
It is normal to see small amounts of fluid in the cul-de-sac. True or false
True trace amounts are typical around ovulation
What are the conditions when you might see fluid (serious blood or pus) in the cul-de-sac?
Abscess, ectopic pregnancy, ascites, hematoma
The sides of the vagina or enclosed between the ________muscles.
Levitator ani
The anterior wall of the vagina is longer than the posterior wall true or false?
False posterior wall is 8.5 cm the anterior wall is 6.5 cm
The vagina is posterior to the_____ and_____and anterior to the_______.
Bladder
Urethra
Rectum
How does the central mucosa of the vagina look like on ultrasound?
A bright, thin linear structure
The infundibulopelvic ligament arises from the posterior pelvic wall true or false
False the infundibulo pelvic ligament arises from the broad ligament
Fallopian tube’s are routinely seen on ultrasound true or false
False fallopian tubes are seen on ultrasound when there is surrounding free fluid or pathology
What is the other name for the internal iliac artery
The hypogastric artery
The uterine artery is a branch of the Extertal iliac artery true or false?
False
the uterine artery is a branch of the internal iliac artery
The radial artery’s penetrate the Miami trim and become the street arteries when they reach the basal layer of the endometrium true or false?
True
The arcuate arteries are seen in the periphery of the uterus on ultrasound true or false
True – they may be mistaken for cysts but they are in fact arteries.
Apply color to find out
The______ are responsive to hormonal changes during the menstrual cycle and they constrict at messes due to the drop in estrogen levels, leading to ischema in the ________layer of the endometrium, which then sheds during menses
Spiral arteries
Functional
The other name for basal arteries in the endometrium is______
Straight arteries
What are the two layers of the endometrium? And which one is responsive to hormonal changes?
Basal layer
Functional layer – which is responsive to hormonal changes
The arcuate vessels course between the_____ and the_______ of the myometrium
Outer
Middle layers
The uterine artery divides into _____and _____at the level of the Cervix
Vaginal
Uterine branches
Do uterine branches supply blood to the______,the_____,and the _______.
Cervix
Fallopian tube’s
Ovaries
What are the sources of blood supply to the ovaries?
The ovarian artery’s and branches of the uterine artery
The ovarian artery arises from the internal iliac artery true or false
False the ovarian artery is also known as the gonadal artery and arises from the aorta
During early stages of ovarian torsion, you might be able to detect arterial flow but not venous flow true or false
True venous flow is first affected
Where do the right and left ovarian vein’s drain into?
The right ovarian vein drains directly into the IVC.
The left ovarian vein drains into the left renal vein
What is the vessel that runs through the functionalis layer of the endometrium?
The spiral arteries
_____ arteries can get calcified in elderly women and are seen as calcifications in the uterine periphery
Arcuate
Where do the ovarian arteries arise from?
Ovarian arteries are also known as the gonadal artery’s and they arise from the aorta
Which bones constitute the posterior pelvis wall
Sacrum and coccyx
Where does the fertilized egg implant?
Hopefully in the endometrium within the endometrial cavity of the uterus
Where does fertilization normally occur? And which segment?
Fertilization normally occurs in the ampulla section of the fallopian tube
Where does the embryo grow?
In the endometrial layer of the uterine cavity within a gestational sac
At which segments of the uterus is the uterus most flexible?
The isthmus
What is the other name for the cervix?
Proximal portion of the uterus
What is the length of the isthmus of the uterus
1cm
What hormone causes the uterine muscles to contract during labor?
Oxytosin
What are the three layers of the uterus?
Perimetrium, myometrium, endometrium
How many muscular layers are there in the uterus?
Which one is the thickest layer?
Which one is the most echogenic?
Which one is the most hypoechoic?
Three
Middle
Most echogenic middle
Most hypoechoic inner
What are the portions of the uterus?
Which portion is the largest?
Which portion is the widest?
Fundus/dome
Body/corpus
Isthmus/lower uterine segment
Cervix
Largest is the body
Widest is the fundus
The endometrium changes its appearance depending on the woman’s menstrual cycle phase true or false?
True
What type of muscles make up the myometrium?
Smooth muscles
The endometrium is continuous with the mucous membranes of fallopian tube’s and vagina but with different cells. True or false
True
The functionalist layer of the endometrium is the Deep layer true or false
False. The basalis layer is the deep layer of the endometrium
The basalis layer of the endometrium sheds during menses true or false
False the functionalis layer sheds during menses
What is the other name for perimetrium?
Serosa
The ovaries are attached to the anterior layer of the broad ligament by the mesovarium. True or false
False the ovaries are attached to the posterior layer of the broad ligament
Why is it important to evaluate the perimetrium?
For contour to rule out small serosal fibroids
The Myometrium is composed of skeletal muscle. True or false?
True. Skeletal muscles ate smooth muscles
Ovaries are extraperitoneal organs true or false
False the ovaries are intraperitoneal organs
Ovaries are not covered with a visceral peritoneum true or false
True and they are called nude ovaries
Ovaries are _____and _____to the fallopian tube. The fimbriae of the fallopian tube’s lie_____ and _____to the ovary. The ______surface of the ovary is attached to the _______surface of the broad ligament by a short________.
Posterior Distal Superior Lateral Anterior Posterior Mesovarium
The internal iliac artery and the ureter are posterior to the ovary. The IIA is more posterior than the ureter. True or false?
True
Usually, the medial pole of the ovary is more superior than the lateral pole true or false?
False the lateral pole is more superior and the medial pole is more inferior
Both the _____of the ovary and the _____of the fallopian tube attached to the superior surface of each ovary
Suspensitory ligament
Fimbrae
The characteristic appearance of ovaries is: they are _______shaped and they look like ______due to the presence of follicles
Almond/ovoid
Swiss cheese
It might be hard to see ovaries in postmenopausal women due to _______and the lack of________
Atrophy
Follicles
Identifying the External iliac vessels running along the posteriolateral aspect of the ovary can help in locating the ovaries true or false
False it is the internal iliac artery which can help in identifying the location of the ovaries
If ovarian torsion is suspected parentheses unilateral sharp pain parentheses, ______Doppler should be applied to demonstrate ______and _______flow
Spectral Doppler should be applied in addition to color Doppler to demonstrate arterial and venous flow
What are the parts of fallopian tube’s?
Interstitial, isthmus, ampulla, infundibulum, Fimbrae
Fallopian tube’s typically measure_______ x_________
10cmx10mm
What are the three layers of fallopian tube’s?
Outer serosa
Middle muscular
Inner mucosal – which is contagious with the uterus
Etopic pregnancy in the ________section of fallopian tubes is life-threatening.
Interstitial
Most etopic pregnancies occur in the _____, especially in the _______part of it
Ampulla of the fallopian tubes
Widest
Which part of the fallopian tube is the widest and largest?
The ampulla is the largest and the widest- this is where most ectopic pregnancies occur
Where does the infundibulum of the fallopian tube open into
The peritoneal cavity
What are the fingerlike projections of fallopian tubes called?
Fimbrae
Fallopian tubes arise from the of the uterus
Cornua
The ________becomes the common fee moral artery at the level of the inguinal canal
External iliac artery
________ are used as a landmark to look at the ovary as they are located posterior to the ovaries in most cases
Internal iliac arteries & ureters
What are the muscles of the false pelvis?
Rectus abdominis and transversus abdominis, psoas muscle, iliopsoas muscle
What are the muscles of the true pelvis?
Piriformis muscle, obturator internus muscle, levitator ani muscles (iliococcygeus and pubococcygeus)
coccygeus muscles
The______ muscles form the anterior abdominal pelvic wall
Rectus abdominis
The muscles form the anterior lateral wall of the abdominal pelvic wall
Transversus abdominis
The rectus abdominal muscle extends between the _______and the______
Xiphoid process
Pubic symphasis
The right and left columns of the rectus abdominis muscles are separated by the midline
Linea alba
Muscles are paired, elongated, ovoid, relatively hypoechoic structures surrounded by________
Fascia
Rectus abdominis muscles are best seen on the ______axis of the pelvis
Transverse
The thin bright lines seen on traverse plane of the anterior abdominal wall represent the rectus abdominis _______and delineate the anterior and posterior borders.
Sheath
The psoas muscle originates in the pelvis true or false?
False the psoas muscle originates at T 12
Below the level of the_______, the psoas muscle fuses with the ______becoming the iliopsoas bundles of the false pelvis. They form the pelvic______.
Iliac crest
Iliacus
Sidewall
The iliopsoas muscle enters the true pelvis true or false?
False it does not, but is considered the lateral landmark of the true pelvis
The ileopsoas muscles insert into the _______trochanter of the______.
Lesser
Femur
The iliopsoas muscles are considered the ________landmarks of the true pelvis
Lateral
What is the distinctive feature about the iliopsoas muscle on ultrasound? What does that represent?
A central, hyperechoic bright focus is observed when viewing the ilio psoas us due to the iliopsoas tendon, femoral nerve, and fat running between the two contributing muscles
The external iliac vessels are ______to the iliopsoas muscles
Anterior
Where does the psoas muscle originate? And where does it insert?
The psoas muscle originates in the lumbar bodies of T 12 through L2
Where does the piriformis muscle originate? Where does it insert?
The piriformis muscle originates posterior to the uterus at the lateral sacrum and the gluteal surface of the ilium. The piriformis muscle inserts on to the greater trochanter of the femur
Where does the iliacus muscle originate?
The iliac crest
The piriformis muscle is often mistaken for ovaries. True or false?
True – but on turning the piriformis muscle will elongate where as ovaries will not
The piriformis muscle is a muscle of the false pelvis true or false
False the piriformis muscle is a muscle of the true pelvis and lies in its most posterior aspect
The piriformis muscles aid in rotation of the hip and are not directly concerned with support of the pelvic floor true or false
True
The piriformis muscle is more anterior then the obterator internus muscle. true or false
False the piriformis muscle is posterior and medial to the obturator internus
Piriformis muscle is more superior and lateral to the levitator ani muscles.
true or false
False the piriformis muscle is posterior and medial to the levitator ani muscles
The piriformis muscle passes through the _______sciatic notch and inserts into the________
Greater
Greater trochanter
The obturator internus muscle is seen as long, thin, longitudinal bands on both sides of the urinary bladder upon ultrasound true or false
True
The obturator internus muscle is more anterior then the piriformis muscle true or false
True
The _______muscles originate along the arcuate line of the innominate bones, while the _____muscle originates from the sacrum
Obturator internus
Piriformis
The obturator internus muscle narrows inferiority to pass through the ______sciatic notch and inserts into the medial aspect of the ________of the femur.
Lesser
Greater trochanter
The pelvic diaphragm consists of:
1
2
Levatator ani muscles
Coccygeus muscles
The first component of the pelvic diaphragm is composed of _______which is more medial. And _____which is more lateral.
Coccygeus muscles
Lam
Pelvic diaphragm is the most _______muscular structure of the pelvis
Inferior
Muscles of the false and true pelvis or skeletal muscles true or false?
True
The levitate or any muscles are primarily supporting structures and are considered the floor of the pelvis. Between the right and left pairs of muscles, there are three openings for the______, the_______, and the______.
Ureter
Vaginal canal
Rectum
________Muscle is the most posterior part of the pelvic diaphragm.
Coccygeus
The pelvic diaphragm muscles are seen______ to the obturator internus muscles-adjacent and ________to the vagina.
Medial
Posterior
Levatator ani I muscles are seen at the level of the cervix true or false
False the LAM are seen in the most inferior level and are part of the pelvic floor
Identifying the X ternal iliac vessels running along the posterior lateral aspect of the ovary can help in identifying the ovaries true or false?
False the internal iliac is the vessel which helps in locating the ovaries
