The Female Reproductive System (Female Organs: Normal Uterus, Fallopian Tubes and Ovaries) Flashcards
The Normal Uterus
Derived from the embryonic _______ (paramesonephric) ducts as they elongate, fuse and form a lumen between ___-___ weeks of embryonic development
Largest organ in female pelvis when _______ is empty and comprised of _______ muscle
_____-walled muscular, hollow, ‘_____’ shaped organ
Lies in ____/____/____ pelvis between the shallow ______ pouch (between _____ and _____) anteriorly and the deep _____ pouch ( between _____ and ____) posteriorly
Usual position is _____/_____
Covered with peritoneum except anteriorly below the ______ os
Supported by _______ Ani, _______, _______ and _______ Ligaments
_______ Ligaments hold uterus in anteverted position
Size varies depending upon _____, _____ pregnancies, _______
Average adult parous (haven’t been pregnant) size approx. ___cm L, ___cm W, ____cm AP
mullerian 7-12 bladder smooth thick pear lesser true minor vesicouterine bladder uterus rectouterine rectum Uterus anteflexed anteverted cervical Levator cardinal round uterosacral round age number menopause 8, 6, 5
The _____ is anterior to the cervix and the _______
Adjacent to the _______, laterally, the _______ ligament maintains the cervix as the most immobile portion of the organ
There is a cavity within uterus and is called the _______ cavity and is seen sonographically as more echogenic than the myometrium of the uterus
bladder vagina cervix cardinal endometrial
Uterus is supprted by the _______ ani muscles, paired _______ ligaments, paired _______ ligament and _______ ligaments; these muscles maintain the uterus in its midline position and the fallopian tube and ovaries suspended within the pelvis
levator
broad
round
uterosacral
Overview of the Normal Uterus
“Suspended”/supported in it’s normal position with the _____/_____/_____ female pelvis by muscles and ligaments
female organ; made up of several portions and _______
Function: _______ and _______
Function of Uterus/Endometrium assoc. with the _______ and _______ cycle
Varies in size from _______ age to post _______ age
Varies in size pre/post _______ and _______ of pregnancies
Varies in _______
May develop _______ and/or _______ pathology which can be seen sonographically
Attached and associate _______ tubes bilaterally
minor true lesser layers menses pregnancy ovary ovarian newborn menopausal pregnancies number position benign malignant fallopian
Anatomy of the Uterus
Fundus
-Upper tip portion of Uterus near the ______ tubes/cornu
-_______, contains no _______ cavity
Body/Corpus
-major central part; between ______ and _______
- Posterior to _______ pouch and superior surface _______
- Anterior to _______ pouch (of Douglas), the _______ and _______
- Medial to _______ ligament. and Uterus ______
- Contains _______ cavity
Isthmus
-Junction between _______ and _______
-Contains _______ cavity
Cervix
-Lower portion of _______
- connects uterus with the _______
- Contains _______ canal
fallopian curved endometrial fundus cervix vesicouterine bladder rectouterine ilium colon broad vessels endometrial body cervix endometrial uterus vagina cervical
Cervix (CX)
the lowest constricted segment of the _______
connects _______ to uterus
normally > _____ cm in length
young child: CX is twice the length of the uterine _______
nulliparous: the cervix can be ____ the length of the body
postmenopausal: ____cm - ____cm in length
The cervix has 2 portions and 2 openings:
-_______ portion is the cervical canal which runs within the cervix
-_______ which continues on to become the distal end of vagina
The _______ OS (opening): junction where the endometrial cavity becomes the endocervical canal
The _______ OS (opening): junction where the endocervical canal becomes the vaginal canal
uterus vagina 3.0 body 1/2 3.5 6.5 endocervix exocervix internal external
Measuring the Uterus
Length, Width, AP Dimensions
Sagittal/Longitudinal Plane from tip of _______ to posterior _______ for length
Width - Transverse Plane at _______ portion, near _______/_______ area
AP - Ant/Post measurement, in either _______
fundus cervix widest body fundus plane
Normal Varying Sizes of the Uterus
Size and shape varies greatly depending on _____, _____ of/HX of pregnancy and ______
Uterus body changes it’s size from _____ to ______
Newborn and 4 years of age:
Uterus _____ smaller than cervix
Premenarcheal-PrePuberty Female
(before and up to menses):
_____cm L x .5-1cm W : Uterus _____ larger than cervix
Nulliparous female (never been pregnant): \_\_\_\_-\_\_\_\_cm L, \_\_\_\_-\_\_\_\_cm H(AP), \_\_\_\_-\_\_\_cm W; Uterus \_\_\_\_\_ larger than cervix
Parous female/Multiparity (multiple pregnancy) dimensions from Nulliparous increase by ____-____cm; average : ____-____cm L, ___cm W, ____cm AP; _____ greatly smaller than uterus body; postpartum uterus remains enlarged ____-____ weeks following delivery
Postmenopausal female:
____-____cm L, ____-____cm H(AP), ____-____cm W
age number menopause newborn menopausal body 1.0 .5 1 body 6 8 3 5 3 5 body 1 2 8 10 6 5 cervix 4 8 3 5 2 3 2 3
Function of the Uterus
function = _______ and _______
conduit for _______ transport, site for _______ of fertilized ova, _______, growth/development of _______, and parturition (L/D)
The _______ of the uterus is a target tissue for estradiol from the ovarian follicles, creating a smooth cellular, proliferative lining for sperm transport prior to ovulation. _______ from the corpus luteum of the ovaries, changes the lining to a thicker, softer, secretory lining for blastocyst implantation
menses reproduction sperm implantation placentation fetus endometrium progesterone
Uterine Structure Layers
Made up of 3 layers:
_______, _______, _______
Perimetrium/Serosa
a.k.a. _______ layer
Thin _______ layer of uterus
part of the _______ peritoneum
laterally becomes _______ ligament
anteriorly, wraps over the _______; forms the _______ cul-de-sac
Posteriorly reflect onto the _______, forms the deep Pouch of Douglas (_______ pouch/_____ cul-de-sac)
Sono findings: not easily visualized but is hyperechoic on US
perimetrium myometrium endometrium serous outer parietal broad bladder anterior rectum rectouterine posterior
Myometrium
a.k.a. muscular _______ thickest layer
forms bulk of _______
contains 3 layers of _______ muscle, meshed together and is dense/firm
Sono Findings: medium echos, homogenous, hypoechoic to surrounding area
middle
uterus
smooth
Endometrium- a.k.a. mucosal layer
A thin, _______ mucous cavity made up of 2 endometrial cavity layers distinguishable within the uterus; continuous through the _____ tubes but not visible; through the _______ os as the cervical canal and through the _______ as vaginal canal
Between the 2 endometrial layers from ant to post is a cavity that is not visible unless a _____ or _____ is present; the double layers touch each other from ant to post
Endometrium of the Uterus is divided into 2 sublayers:
a) Decidual layer (Stratum (zona) _______)- functional superficial layer of the endometrial cavity; thickens, changes appearance through out menses; sheds during menstrual cycle each month
b) Basal layer (Stratum (zona) ______)- permanent thin layer; regenerates new decidual functional layer after menses for the next cycle
smooth fallopian cervical vagina GS pregnancy functionalis basalis
Endometrium-Sono Findings:
Visualization of a normal endometrial cavity can vary sonographically depending on day/week of menstrual cycle; may be referred to as endometrial _______
Functional Layer:
_______ layer of endometrium that sheds
Appearance changes throughout all phases of _______ cycle
Basal Layer
Thin, hyperechoic, _______ layer of the endometrium
stripe
innermost
menstrual
outermost
Measuring the Endometrium
Most accurate when measured in midline ______ plan AP at widest area (near fundus) from basal layer to the opposite basal layer (includes both layers of endometrium) = bilayer AP measurement
can be measured in _______
thickness depends on phase of _______ cycle
Normal Endometrial Measurements/Thickness:
menstruating female: _____ mm - ____ mm
postmenopausal female: (less than _____ cm)
sag transverse menstrual 4.0 12.0 5.0
Vagina- position, shape, size
a collapsible tube that is somewhat constricted at the introitus (entrance), dilated in the _____, and narrower at the ______
____-shaped , distensible muscular passage approx ____ x _____cm., (transverse x length)
connects to the uterus via the _____ which extends _____-____ cm into the vagina and has vaginal fornices (already discussed)
Above the pelvic floor, the vagina angles ______, Postero-superiorly inside the _______, the vagina is covered by _______ peritoneum, representing much of the anterior-medial wall of the _______ pouch
middle uterus H 5 15 cervix 2 3 posteriorly pelvis visceral rectouterine
