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Pelvic > Quiz 1 > Flashcards

Quiz 1 Flashcards

1
Q

is the uterus retro or intra?

A

retroperitoneal

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2
Q

what is the name of the portion of the uterus where the fallopian tubes enter?

A

cornua

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3
Q

where does the vagina run?

A

midline, runs from the cervix to the external genitalia

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4
Q

what are the 3 layers of the uterus?

A
  • perimetrium
  • myometrium
  • endometrium
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5
Q

what layer of the uterus takes up most of the uterus?

A

myometrium

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6
Q

what are the 3 layers of the myometrium?

A
  • inner layer (subendometrial halo)
  • intermediate
  • outer
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7
Q

what are the 2 layers of the endometrium?

A
  • superficial functional layer

- deep basal layer

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8
Q

which layer sloughs off during mences?

A

superficial functional layer

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9
Q

what are the ligaments of the uterus?

A 
paired:
-broad
-cadinal
-uterosacral
-round
single:
-posterior
-anterior
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10
Q

where do the broad ligaments coarse?

A

lateral uterus to lateral pelvic walls

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11
Q

cardinal ligaments

A

lower extension of broad ligament

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12
Q

round ligament

A

upper outer angles of uterus through inguinal canal and attach labia majora

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13
Q

uterosacral ligaments

A

posterior uterus to sacrum

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14
Q

anterior ligament

A

anterior uterus to posterior bladder

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15
Q

posterior ligament

A

posterior uterus to rectum

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16
Q

what does the posterior ligament form?

A

pouch of douglas

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17
Q

what are the functions of the uterus?

A
  • fertilization in the endometrial lining and develops within UT
  • myometrial contractions at labour
  • myometrial contraction during menstruation
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18
Q

what is the primary arterial supply to the uterus?

A

internal iliac arteries

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19
Q

for uterine positions, what is flexion?

A

axis of the uterine body relative to the cervix

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20
Q

for uterine positions, what is version?

A

axis of the cervix relative to the vagina

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21
Q

how long are the fallopian tubes?

A

7-12 cm

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22
Q

what are the 4 portions of the fallopian tubes?

A
  • intramural
  • isthmus
  • ampulla
  • infundibulum
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23
Q

what is the narrowest portion of the fallopian tube?

A

intramural

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24
Q

what portion of the fallopian tube is tortuous and the largest portion?

A

ampulla

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25
Q

are the ovaries intra or retro?

A

intra

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26
Q

if the uterus was tiled to the left, where would the ovaries lie?

A

the left ovary would be superior to the fundus and the right ovary would be lateral

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27
Q

what are the parts of an ovary?

A
  • germinal epithelium
  • tunica albuginea
  • cortex
  • medulla
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28
Q

where do follicles of the ovary develop and mature?

A

cortex

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29
Q

what is the medulla composed of?

A

fibrous tissue and blood vessels

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30
Q

what are the ligaments of the ovary?

A
  • mesovarian
  • ovarian
  • suspensory
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31
Q

mesovarian ligament

A

anterior surface of ovary to posterior broad ligament

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32
Q

ovarian ligament

A

lower pole of ovary to uterus

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33
Q

suspensory ligament

A

upper pole to lateral pelvis wall

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34
Q

where do the ovarian vessels and nerves run?

A

suspensory ligament

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35
Q

where do the ovarian arteries come off of?

A

aorta

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36
Q

where does the ovarian veins drain?

A

right drains into the IVC and left into the left renal vein

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37
Q

what is adnexa?

A

everything lateral to the uterus

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38
Q

where does a full bladder push the uterus?

A

up and more posterior

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39
Q

which is larger, a infantile uterus or a neonate?

A

neonate due to maternal hormone stimulation

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40
Q

what is the size of an adult uterus?

A

7-8cm length x 5 cm width x 4 cm AP

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41
Q

what is the size of a menopausal uterus?

A

3.5-6.5 cm (L) x 1.2-1.8 cm (AP)

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42
Q

what is the echogenicity of a adult uterus?

A

myometrium low to medium echogenicity

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43
Q

what is the echotexture of a adult uterus?

A

homogenous

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44
Q

what is the appearance of a postmenopausal uterus?

A
  • smaller size
  • can have calcifications in the arcuate arteries
  • small echogenic foci within inner myometrium
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45
Q

what are the phases of the endometrial phase?

A
  • early proliferative phases
  • late proliferative phase
  • secretory phase
  • menses
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46
Q

what is the thickness of the endometrium in the early proliferative phase?

A

4-8 mm

47
Q

what is the thickness of the endometrium in the late proliferative phase?

A

6-10 mm

48
Q

what is the thickness of the endometrium in the secretory phase?

A

7-14 mm

49
Q

what is the average size of ovaries in the reproductive age?

A

approx. 6 cc

upper limits are 18 cc

50
Q

when are the ovaries small?

A

young females and small again in postmenopausal women

51
Q

what do ovaries look like sonographically?

A
  • oval shaped
  • anechoic follicles
  • depends in the stage of the persons cycle
52
Q

what phases of the ovarian cycle correspond to endo changes?

A

-follicular and luteal phase

53
Q

what does the rectum measure?

A

17-20 cm from internal anal

54
Q

what do we typically not see in ultrasound with the rectum?

A

recto sigmoid junction

55
Q

where does the sigmoid colon begin around?

A

fundus of uterus

56
Q

what is the posterior pelvic muscle

A

iliopsoas

57
Q

what are the muscles if the pelvic floor?

A
  • levator ani (pubococcygeus and iliococcygeus)

- coccygeus

58
Q

what are the lateral pelvic wall muscles?

A
  • obturator internus

- piriforris (posterior)

59
Q

what muscle can be confused with an ovary on ultrasound?

A

piriformis

60
Q

what is the echogenicity of muscles?

A

moderate echogenicity with echogenic striations seen long axis veiw

61
Q

what is the perineum?

A

skin covered muscular region between vaginal orifice and anus

62
Q

where does the perineum extend?

A

pubic symphysis anteriorly to the coccyx posteriorly. lateral borders are the ischial tuberosity’s

63
Q

where is the gonadotropin releasing hormone produced?

A

hypothalmus

64
Q

what does the gonadotrophin releasing hormone stimulate?

A

pituitary gland

65
Q

what does the pituitary gland release?

A

lutenizing hormone and follicle stimulating hormone

66
Q

what do the ovaries produce and what does it stimulate?

A

produce estrogen and stimulates hypothalmus

67
Q

what initiates the process of follicular development in the first place?

A

Early in the menstrual cycle, the pituitary secretes rising levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH) which causes the growth of 4 to 12 primordial follicles into primary ovarian follicles.

68
Q

What hormone is primarily responsible for ovulation? what day does ovulation occur?

A

the primary hormone responsible for ovulation is the luteinizing hormone. The spike in LH as well as ovulation occurs on day 14. This is due to the decrease of estrogen and no fertilization.

69
Q

What hormone does the granulosa cells produce?

A

estradiol

70
Q

What parts of the dominant follicle are expelled with the ovum at ovulation?

A

At ovulation, the Graafian follicle ruptures and releases the ovum which consists of the secondary oocyte, zona pellucida, and coronal radiata into the infundibular projections of the fallopian tube.

71
Q

What is the corpus Luteum? What hormone does it primarily produce?

A

The corpus luteum is a hormone secreting structure that develops in the ovary after an ovum is released. The primary hormone produced in the corpus luteum is progesterone.

72
Q

What happens to the corpus luteum if fertilization does not occur and why?

A

If not fertilized, the corpus luteum stops producing progesterone and decays after approximately 10 days and degenerates into the corpus albicans.

73
Q

If fertilization occurs what is the corpus luteals role during the first 11 to 12 weeks of pregnancy.

A

The corpus luteum produces progesterone until week 7-9 until the embryo (hCG) is able to provide its own to sustain the pregnancy. The corpus luteum is supported by the hCG and at about 10 weeks it begins to decrease in size.

74
Q

What hormones are involved in the growth of the endometrium and where are these hormones produced?

A

Estrogen and progesterone are the hormones involved in the thickening of the endometrium. Progesterone is produced by the ovaries, placenta, and adrenal glands and estrogen is produced primarily in the ovaries. Estrogen causes the growth of the lining and progesterone causes it to slough of if fertilization does not occur.

75
Q

where does the estrogen come from which initiates the growth of the endometrium after menses?

A

FSH and LH are produced by gonadotropins from the pituitary gland which stimulate the production of estrogen and progesterone. Estrogen is produced by granulosa cells within the ovaries, whereas progesterone is produced by the corpus luteum.

76
Q

When does the estrogen peak day?

A

Estrogen peaks at approximately day 13- right before ovulation/at the very end of the secretory phase.

77
Q
  1. What happens to the endometrium after ovulation and what hormone is dominant?
A

Once ovulation occurs, progesterone causes the glands in the endometrium to begin secreting a nourishing substance, which is the secretory phase of the menstrual cycle. Progesterone is the dominant hormone following ovulation.

78
Q

what does IUCD stand for?

A

Intrauterine contraceptive device

79
Q

where is the IUCD inserted?

A

into the endometrium

80
Q

what do IUCD’s trigger?

A

“Foreign Body reaction” inflammatory response

81
Q

what is IUCD toxic to?

A

sperm and probably ova

prevents fertilization

82
Q

what do some IUCD’s release?

A

progesterone acting similarly to oral contraceptives “mirena”

83
Q

what are the different types of IUCD’s?

A
  • copper T
  • copper 7
  • lippies loop
  • safe-T-coil
84
Q

what does “mirena’ IUCD do?

A
  • Releases progesterone thickens cervical mucus causing barrier to sperm
  • Makes lining inhospitable to implantation
85
Q

what is the sonographers role when scanning for IUCD?

A

-location of the IUCD

86
Q

where is the IUCD suppost to be located?

A

within the uterus in the superior aspect within the endometrium (fundus)

87
Q

can IUCD be seen on transabdominal?

A

yes but cannot determine location (need transvaginal)

88
Q

if an IUCD is not within the uterus, where would it be?

A
  • too low in the lower uterine segment
  • perforated the myometrium
  • in the adnexa
89
Q

what is the sonographic appearance of an IUCD?

A
  • highly echogenic
  • some posterior shadowing
  • copper is made of metal so there is a more prominent shadow
90
Q

what are some complications of IUCD’s?

A
  • infection
  • perforation
  • malposition
  • incomplete removal
  • located in the adnexa/pelvic region
  • pregnancy
91
Q

if ultrasound cannot find IUCD what happens?

A

pelvic X-ray will show entire pelvic region

92
Q

is IUCD seen in 1st trimester pregnancy?

A

IUD is seen on U/S maybe removed

93
Q

is IUCD seen in 2nd and 3rd trimester pregnancy?

A

can not always be seen, just leave in

94
Q

what is an advantage for transabdominal ultrasound?

A

global view

95
Q

what are the disadvantages for transabdominal ultrasound?

A
  • Limited patients ability to hold and fill bladder, obese patients, retroverted uterus (beyond focal zone of transducer)
  • Not as good for adnexal masses
96
Q

what must be done before an transvaginal ultrasound?

A
  • acoustic gel is placed within probe cover (ask about allergies)
  • sterile gel is applied to outer service to facilitate insertion
97
Q

what are the 8 steps to cleaning a TVP probe?

A
  1. Remove probe cover
  2. Wipe off excess gel
  3. Swish in enzymatic solution
  4. Rinse with water
  5. Soak in Cidex OPA or similar cleaner for 12 minutes
  6. Rinse in 3 consecutive water containers ( 1 minute for each container)
  7. Wipe off probe and check for residue
  8. place in storage area
98
Q

how long must you soak transducer in Cidex OPA for?

A

12 minutes

99
Q

what is perimenopause?

A

Stage in women’s reproductive life when the ovaries gradually produce less estrogen

100
Q

when does menopause start?

A

12 months without menses when ovulation no longer occurs

101
Q

when does perimenopause usually occur?

A

starts in womens 40’s sometimes 30’s

102
Q

can perimenopausal women still become pregnant?

A

yes

103
Q

what is Hormone Replacement Therapy?

A

supplement with estrogen alone or estrogen and progesterone in combination during and after menopause

104
Q

what happens to our hormones during menopause?

A

decrease in estrogen and progesterone

105
Q

what are some symptoms of menopause?

A
  • hot flashes
  • vaginal dryness
  • night sweats
106
Q

what is estrogens role in the uterus?

A

helps thicken endometrium

107
Q

what else does estrogen do?

A
  • influences way body uses calcium
  • Maintains healthy level of cholesterol
  • Keeps vagina healthy
108
Q

what happens if there is Lowered or fluctuating estrogen levels?

A
  • menopausal symptoms

- osteoporosis

109
Q

why is progesterone taken?

A

makes lining shed each month

110
Q

what are the types of HRT?

A
  • estrogen therapy

- progesterone/progestin-estrogen therapy

111
Q

estrogen therapy

A

lowest dose to relieve symptoms

-pill, patch, or cream

112
Q

Progesterone/Progestin-Estrogen Therapy

A

progestin is a synthetic form of progesterone

113
Q

what are the risks of HRT?

A
  • Increased risk of endometrial cancer (if not taking progesterone)
  • Increased risk of stroke and blood clots
  • Increased risk of Breast cancer when taking estrogen-progestin combo
  • Increased risk of heart disease
114
Q

what structure has colour looking like a ring of fire?

A

corpus luteum

Pelvic (5 decks)

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