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Normal Anatomy > Test 3 > Flashcards

Test 3 Flashcards

1
Q

what is the echogenicity of muscles?

A

moderate echogenicity with echogenic striations seen in long axis view

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2
Q

what can muscles be mistaken with?

A

ovaries or masses within pelvis

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3
Q

what is a common muscle to be mistaken for an ovary?

A

iliopsoas

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4
Q

is the uterus intra or retro?

A

retro

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5
Q

when does the uterus descend into the true pelvis

A

between birth and puberty

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6
Q

what is anterior to the uterus

A

pubic bone and bladder

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7
Q

what is posterior to the uterus?

A

rectum

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8
Q

what are the 3 major portions that make up the uterus?

A
  • fundus
  • body
  • cervix
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9
Q

cornua

A

area of body that tubes enter

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10
Q

what is superior to the cornua?

A

fundus

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11
Q

what area is between cervix and cornua?

A

body

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12
Q

what is the cervix?

A

slight narrowing btw body and proximal cervix

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13
Q

what opens into the upper vagina?

A

cervix

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14
Q

what is the canal of the cervix made up o internally?

A

external and internal os

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15
Q

what is located at the distal end of the cervix space between vagina?

A
  • 2 lateral fornix
  • anterior fornix
  • posterior fornix
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16
Q

vagina

A

Fibromuscular canal that lies in the midline

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17
Q

where does the vagina run?

A

cervix to the external genitalia

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18
Q

what does the cervix protrude into?

A

proximal vagina

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19
Q

what are the 3 layers of the uterus?

A
  • perimetrium
  • myometrium
  • endometrium
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20
Q

what is the big muscle in the uterus taking up majority of the uterus?

A

myometrium

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21
Q

what is the myometrium divided into? (inner to outer)

A
  • subendometrial halo (inner layer)
  • intermediate
  • outer
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22
Q

what layer of the uterus sloughs off each menses?

A

superficial functional layer

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23
Q

what part of uterus stays attached during menstration?

A

deep basal layer

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24
Q

what ligaments are paired?

A
  • broad ligament
  • cardinal
  • uterosacral
  • round
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25
Q

what ligaments are single?

A
  • posterior

- anterior

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26
Q

where do the broad ligaments extend?

A

lateral aspect of uterus to the lateral pelvic walls

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27
Q

what ligament of the uterus is double folds of parietal peritoneum?

A

broad ligaments

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28
Q

what ligament is the lower extension of broad ligament?

A

cardinal ligament

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29
Q

what is the coarse of the round ligaments?

A

Fibromuscular cords extends from upper outer angles of uterus through inguinal canal and attach labia majora

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30
Q

where are the uterosacral ligaments?

A

Posterior uterus to sacrum, each side of rectum

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31
Q

what does the anterior ligament form?

A

-anterior cul de sac
OR
-vesicouterine pouch

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32
Q

where does the anterior ligament coarse?

A

anterior surface of the uterus to posterior surface of bladder

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33
Q

what does the posterior ligament form?

A 
-Pouch of Douglas (PCDS)
OR
-posterior cul de sac
OR
-rectouterine recess
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34
Q

what happens to the uterus when fertilization occurs?

A

implants into the endometrial lining and develops within UT

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35
Q

what uterus layer contracts at labor?

A

myometrial

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36
Q

what happens to the uterus when fertilization does not occur?

A
  • menstruation occurs

- myometrial contractions aide sloughing off endometrium

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37
Q

where does the blood supply run?

A

within the broad ligament and within the ovary

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38
Q

blood supply read over

A

female pelvis slide 24

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39
Q

what part of the female reproductive organs are fixed?

A

cervix is fixed in midline

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40
Q

what part of the female reproductive system is mobile?

A

body and fundus

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41
Q

what is uterus flexion?

A

axis of the uterine body relative to the cervix

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42
Q

what is the uterus version?

A

axis of the cervix relative to the vagina

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43
Q

can the bladder affect position of uterus?

A

yes bladder being full or empty changes uterus position

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44
Q

what is the normal position of the uterus?

A

anteverted (or anteflexed)

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45
Q

what normal variants in position can the uterus be?

A
  • retroverted

- retroflexed

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46
Q

retroverted

A

Entire uterus is tilted backward (relative to vagina)

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47
Q

retroflexed

A

Body is tilted posteriorly (relative to cervix)

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48
Q

what is the size and shape of an infantile uterus?

A
  • 2.8 cm in length
  • cervix 2/3rds total length
  • tubular or inverse pear shape
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49
Q

what is the size and shape of an neonate uterus?

A
  • slightly larger than infantile die to maternal hormone stimulation
  • 3.4 cm in length
  • inverse pear shape
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50
Q

what is the size and shape of an after age 8 until puberty uterus?

A

-uterus gradually increases in size

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51
Q

what is the size and shape of an uterus at puberty?

A
  • increase in size, especially the body
  • diameter and length of body about double cervical size
  • becomes adult size and shape
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52
Q

what is the size and shape of an uterus in an adult?

A
  • 7-8 cm length x 5 cm width x 4 cm AP (max. dimensions before pregnancies)
  • pear shaped
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53
Q

what does parity mean?

A

pregnancy

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54
Q

how much does the uterus grow in a pregnancy?

A

increases normal size by 1 cm in each dimension

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55
Q

what is the size and shape of a menopausal uterus?

A
  • atrophies 3.5 to 6.5 cm (L) x 1.2 to 1.8 cm (AP)

- pear shaped but small

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56
Q

what is the regular size of an adult uterus on ultrasound?

A

7-8 cm in length (8 length cm x 5 width cm x 4 AP cm )

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57
Q

what is the shape of an uterus?

A

pear shaped

58
Q

what is the contour of the uterus?

A

smooth

59
Q

what is the echotexture of the myometrium?

A

homogenous

60
Q

what are the 3 layers of the uterus in ultrasound?

A
  • subendometrial halo
  • intermediate layer
  • outer layer
61
Q

what is the echogenicity of the subendometrial halo?

A

hypoechoic

62
Q

what is the thickest layer of the uterus?

A

intermediate layer

63
Q

what is the echogenicity of the intermediate layer?

A

low to moderate echogenicity

64
Q

what is the echotexture of the intermediate layer?

A

homogenous

65
Q

is the outer layer thin or thick?

A

thin

66
Q

what is the echogenicity of the outer layer?

A

slightly less echogenic than the intermediate layer

67
Q

what separates the outer layer ad the intermediate layer?

A

arcuate arteries

68
Q

is the uterus bigger or smaller in post menopausal stage?

A

smaller

69
Q

what can happen in the arcuate arteries in the postmenopausal sonographic uterus?

A

calcifications

70
Q

read slide 39

A

don’t make sense

71
Q

LMP

A

last menstrual period

-Day 1 is the first day of menses

72
Q

how long is the average menstrual cycle?

A

28 days

73
Q

what are some reasons we scan the female pelvis?

A
  • pelvic pain

- pregnancy

74
Q

what procedure gives you a global scan of the pelvis?

A

transabdominal ultrasound

75
Q

what can be some reasons not to do transabdominal ultrasound?

A
  • patients unable to hold bladder
  • obese patients
  • retroverted uterus (beyond focal zone of transducer)
76
Q

how much do patients fill bladder?

A

24-32 oz

77
Q

physically how much do patients fill their bladder?

A

4 glasses finish 1 hour prior to exam

78
Q

why do we get patients to fill their bladder?

A
  • displaces uterus from pelvis
  • displaces gas filled bowel
  • acoustic window
79
Q

what are some technical difficulties for doing an transabdominal ultrasound?

A
  • obese patients
  • surgical scars
  • barium or gas filled
  • abdominal dressings
80
Q

what is the patient prep for transvaginal?

A
  • discuss what is involved
  • verbal consent
  • empty bladder
  • 5-8 MHz transducer
  • cover transducer with probe cover
  • follow proper cleaning procedures after exam
81
Q

what are some advantages of TVU?

A
  • higher frequency so better resolution
  • can use on obese patients
  • can use on patients that cant fill bladder
  • can use on retroverted uterus
  • better distinction
  • better detail
82
Q

what can you see better on a TVU?

A
  • difference between adnexal masses and bowel
  • characterization of internal pelvic mass
  • pelvic lesion
  • endometrium
83
Q

what is a disadvantage to TRU?

A

smaller field of view

84
Q

when would we not give a transvaginal exam?

A
  • when we were not given consent
  • when the patient is young
  • when the patient is old
85
Q

what runs laterlly from uterus in the upper free margin of broad ligament?

A

fallopian tubes

86
Q

how long are the fallopian tubes?

A

7-12 cm in length

87
Q

what are the 4 portions the fallopian tubes are divided into?

A
  • intramural
  • isthmus
  • ampulla
  • infundibulum
88
Q

where is the intramural?

A

contained within muscular wall uterus (closest to the uterus)

89
Q

what is the narrowest portion the fallopian tubes?

A

intramural

90
Q

where is the isthmus?

A

medial third of tube

-slightly wider and cordlike

91
Q

what is the longest part of the fallopian tube?

A

Ampulla

1/2 the tube (tortuous)

92
Q

what is the most distal portion of the fallopian tubes?

A

infundibulum

93
Q

what is the shape of the infundibulum?

A

funnel shaped end

-opens into the peritoneal cavity

94
Q

what is the shape of the ovaries?

A

oval or elliptical

95
Q

what are the ovaries covered by?

A

single layer called germinal epithelium becomes continuous with peritoneum at the hilum of ovary

96
Q

are the ovaries intra or retro?

A

intra

97
Q

what are the layers of the ovary?

A
  • germinal epithelium
  • tunica albuginea
  • cortex
  • medulla
98
Q

where do the follicles develop and mature?

A

cortex

99
Q

is the medulla smaller or bigger in volume compared to the cortex?

A

smaller

100
Q

what is the medulla composed of?

A

fibrous tissue and blood vessels

101
Q

what does the mesovarian attach?

A

anterior surface of ovary to posterior surface of broad ligament

102
Q

what does the ovarian ligament attach?

A

lower pole of ovary to uterus

103
Q

what does the suspensory ligament attach/

A

upper pole to lateral wall of pelvis

104
Q

what carries the ovarian vessels and nerves?

A

suspensory ligament

105
Q

is the suspensory ligament rigid?

A

no

106
Q

is the ovary fixed or mobile?

A

mobile

107
Q

what is the lateral extension of the broad ligament?

A

suspensory ligament

108
Q

where do the ovarian arteries run?

A

within suspensory ligament

109
Q

where do the ovarian arteries come from?

A

aorta just inferior to renal arteries

110
Q

where does the right ovarian vein drain?

A

into the IVC

111
Q

where does the left ovarian vein drain?

A

left renal vein

112
Q

when looking at the ovaries what does uterine position influence?

A

ovarian position

113
Q

what is the method for finding size of ovaries?

A

length x width x height (AP) x 0.523

-first 2 years

114
Q

0 to 5 years ovarian volumes remain ________

A

stable

115
Q

5 to menarche ovaries gradually increases in________

A

size (4cc)

116
Q

Menstruating adult female variable size of ovaries

A
  • Mean ovarian volume TVP 6.8 cc

- Upper limit 18cc

117
Q

Post menopause size of ovaries

A

Mean volume 1.2 to 5.8 cc (atrophy)

118
Q

over ______ in ovaries is considered abnormal in a post menopausal women

A

8cc

119
Q

what is echotexture of ovaries?

A

homogenous

120
Q

what is the echogenicity of ovaries?

A
  • more echogenic medulla

- echogenic ovarian foci (commonly seen, non shadowing)

121
Q

what may be seen in the periphery in the cortex of a ovary?

A

small, well defined anechoic or cystic follicles

122
Q

Focal calcification

A
  • Occasionally seen
  • Stromal reaction previous hemorrhage or infection
  • ***maybe early neoplasm (follow up)
123
Q

what hormones are stimulated in early proliferative stage?

A
  • FSH (follicle stimulating hormone)

- LH (luteinizing hormone)

124
Q

in early proliferative stage ? increases in size until day _______

A

8 or 9

125
Q

in early proliferative phase one follicle becomes _________

A

dominant

126
Q

what develops if fluid in one of the nondominant follicles is not resorbed

A

follicular cyst

127
Q

what develops after ovulation?

A

corpus luteum (empty house)

128
Q

how is the corpus luteum seen on ultrasound?

A

Seen as a small, hypoechoic or isoechoic structure in periphery of ovary

129
Q

corpus luteum involutes before _________

A

menstration

130
Q

what is less likely to be seen after a hysterectomy?

A

corpus luteum

131
Q

what does postmenopausal ovaries look like on an ultrasound?

A

lack of follicles or completely absent

132
Q

what is ADNEXA?

A

appendages or accessory structures of an organ

133
Q

adnexa refers to?

A

adjacent structures

  • uterine tubes
  • ligaments
  • ovaries
134
Q

what are the days of the early proliferative cycle?

A

days 5-13

135
Q

what are the days of the late proliferative (periovulatory) cycle?

A

days 14-16

136
Q

what are the days of the secretory stage?

A

days 16-28

137
Q

what are the days of the menses cycle?

A

day 1-5 approx

138
Q

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

A

5-7mm

139
Q

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

A

under 11 mm

140
Q

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

A

16mm

Normal Anatomy (7 decks)

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