Week 1 Introduction To Femal Pelvis

Question 1

Brevity list and describe the 7 stages of the ovarian cycle

Answer 1

1. Primordial follicle: begining of28 day cycle, made of single locate egg surrounded by granulosa cells which become numerous and produce estrogen, progesterone and inhibin
2. Primary follicle: layer of granulosa cell and egg separated by layer called the zone pellucida
3. Pre-antral follicle: granulosa cells proliferating, cell wall called theca has receptors for luteising hormone from the exterior pituitary. LH binds to theca cells which produces androstendinone which is given to the granulosa cells which w=converts that to oestrogen which is released into blood
4. Early-Antral follicle: cell expanding, only able to mature one, lose 15-20 per cycle
5. Dominant follice: enlarges due to expanding antrum, granulosa cell develops mound (called cumulus oophorus) and protrudes. The CO and eggs separate from wall of follicle and float in module of atrum. Size of follicle increased due to fluid produced by granulosa cell
6. Mature follicle: start to budge side of ovary, push against edge of wall. Enzymes in the follicle then break down the common wall and egg pops into surface of ovary about day 14, This can have pelvic pain, egg will separate from follicle
7. Corpus lutem: follicle collages and transforms into corpus leteum. Granulosa cells get bigger and produce more est/pro/inhibin. the corpus Leteum then reaches max since in about 10 days (so this is at day 25) then degenerates by apoptosis which is a self destruction and dies of. However, if the egg ends up being fertilised then the corpus luteum persists as wants to continue producting estrogen and progesterone as they prepare the endo for implantation

Question 2

List some possible reasons for eno thickness increase

Answer 2

Submucosal fibroids
Polyps
Hyperplasia
Trophoblastic disease
Adhesion
Intrauterine pregnancy
Collection of pus/fluid to to cervical infection/disease

Question 3

List the sonographic appearance of each stage of the menstural cycle

Answer 3

1. Mensturation: hypoehoic central line represent blood, surrounded by hyperechoic
2. Late mensturation: the hypoechoic line disappears and is a single hyperechoic line
3. Proliferative: single thin stripe with a hypoechoic halo, 3 lines
4. Late proliferative / early secretory: the endo thickness increased, appears trilaminar, the outer basal layer is echogenic and the middle function layer is hypoechoic and the centre layer is an echogenic stripe
5. Secretory: is the maximalthicness and the echogenicity is uniform. The functional layer becomes oedematous and isoechoic to the echogenic basal layer

Question 4

Why might the endo thickness appear larger in an transvaginal scan

Answer 4

In a transabdominal scan, the endo may appear compressed by a distended bladder
Visualisation and resolution is decreased by a TA transducer