Normal Female Pelvis
Terms
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- For a transabdominal scan, what transducer is needed?
- 3.5 to 5.0
- For Transvag, what is necessary and what type of probe?
- empty bladder and 7.5 to 10
- ____is behind bladder and in front of rectum
- vagina
- Name parts of the external landmarks anterior to posterior
-
-clitoris
-urethral opening
-vagina
-anus - anterior to urethra and hidden within labia
- clitoris
- between vagina and labia
- urethral opening
- False pelvis (_____)
- greater or major pelvis
- the false pelvis is located ___the iliopectineal line
-
above
(oblique plane from sacrum to symp. pubis) - False pelvis has how many bones? LIST
-
4 2 inominate
sacrum
coccyx - true pelvis (_____)
- minor or lesser
- True pelvis is located ____the iliopectineal line
- below
- Muscles of False pelvis.
-
psoas major
iliacus - Muscles of true pelvis.
-
piriformis
obturator internus
coccygeus
levator ani(pelvis floor) - piriformis (muscle of true pelvis) is located on the
- posterior lateral wall
- the obturator internus (muscle of true pelvis) is located on the
- anterior lateral wall
- the coccygeus (muscle of true pelvis) is located
- posterior to pelvic floor
- parts of bladder:
- apex and base
- the apex of bladder is located
- posterior to pubic bones (most ant)
- the base (part of bladder) is located
- anterior to vagina
- the ____cross anterior to iliac arteries
- ureters
- The ureters cross ___to iliac arteries, ____to ovaries and ut arteries, _____to vagina, and enter ___bladder at trigone
- anterior, posterior, anterior lateral, postinferior
- when are urerters normally seen?
- not normally seen unless compressed
- causes of compression
-
pregnancy
fibroids
ov masses - vagina extends ___ to __
- ext. geni. to cervix
- the vagina is ____to bladder/urethra
- posterior
- the vagina is ____to rectum
- anterior
- the vagina is ___to cervis
- 90 degrees
- The vagina is ___cm in length
- 9
- In the vagina, there are 4 archlike recesses where the cervix forms called ___
- fornices
- arterial supply to vagina
- vag. and ut arteries
- within the vagina, venous drainage,
- int. iliac vein
- The vagina is the
- pathway of products of menstruation
- pear shaped largerst organ in pelvis
- uterus
- uterus size during menarche
- 6-8 cm long x3-5 AP width
- Size of uterus varies with ___and ___
- age and parity
- parts of uterus
- fundus- widest most superior
-
lower end uterus, isthmus
____or ____is based on isthmus - anteverted or retroverted
- 2 parts of cervix
-
endo-inside
exo-outer, continous with vagina - constrictions with cervix
-
internal os-upper end
external os-lower end - uterine layers
-
perimetrium-outer, serosa
myometrium-middle, muscular
endometrium-inner layer - 2 layers of endometrium
-
zona functionalis- superficial
zona basilis-deep basal layer
(shed with menses) - uterine ligament that is uterus to pelvic sidewall, lateral
- broad
-
uterine ligament
encloses fallop tube - mesosalpinx
-
uterine ligament
fold of broad, encloses ov - mesovarium
-
uterine ligament
hold ut forward - round
-
2 uterine ligament
supports cervix - cardinal and uterosacral
-
lateral ov to pelv sidewall
uterine ligament - suspensory
-
uterine ligament
lateral ov to pelv sidewall - suspensory
-
medial from ov to uterine cornua
uterine ligament - ovarian
- average uterine positions is ___and ___
- antevert and anteflex
- cervix is 90 degree angle or less with vag. most common position, forward angulation
- antevert
- body and fundus are folded forward on cx
- anteflex
- entire ut is tilted posteriorr
- retroverted
- fund and body folded back on cx
- retroflexed
- ut is shifted to right
- dextro
- ut is shifted to left
- left
- abnormal dropping of ut if muscles are weak
- prolapse
- fallopian tubes are _cm long; ____mm diameter
- 10-12; 1-4
- fallopian tubes extend from ___of uterus
- cornua
- fallopian tubes curve over ___
- ovary
- fallopian tubes are ___to uteroova ligament, round ligament, tuboova lig.
- superior
- fallopian tubes are supplied by___ and ____
- ov arteries and veins
- 4 parts of fallopian tubes
-
infundibulum
ampulla
isthmus
interstitial -
most lateral, overlies the ovary has fimbrae
part of fallopian tube - infundibulum
-
longest part , fertiliz occurs here
fallopian tube part - ampulla
-
fallopian tube part
hardest, ust lateral to uterus - isthmus
-
fallopian tube part
pierces uterine wall at cornua - interstitial
- ovaries are ___shaped
- almond
- ovaries are ___to uterus at level of cornua
- posterior
- ovaries are ___cm long in menarche
- 3
- ovaries are ___to internal illiac, and ___to ext illiac
- anterior and medial
- ovaries get blood flow from
- ov arteries and ut artery
- ovaries are drained by
- ovarian vein
- ovaries produce the
- ovum
- ovaries produce 2 hormones
- estrogen and progesterone
- estrogen is secreted by
- follicles
- progesterone is secreted by
- corpus luteum
- progesterone is responsible for what 3 things:
-
gender characteristics
prepare ut for implanting fertiliz ovum
deve. of mammary glands - 3 layers of ovaries:
-
cortex- outermost
medulla-inner
tunica albungia- innermost - uterus is supplied by
- uterine artery
- brances of uterine artery
-
arcuate vessels
radial arteries
spiral and straight
spiral
-
outer third of ut myometrium
branches of ut artery - arcuate vessels
-
from myo to endo
branches of ut artery - radial arteries
-
supply zona basalis
branches of ut artery -
spiral and straight
-
supply zona functionalis
branches of ut artery - spiral
- average days of menstrual cycle
- 28 days
- occurs less than 21 days
- polymenrrheic
- prolonged over 35 days
- oligomenorrheic
- prepuberty, premenses
- premenarche
- after puberty having menses
- menarche
- cessation of menses
- menopause
- absence of menstruation
- amenorrhea
- painful periods
- dysmenorrhea
- abnormally heavy or long
- menorrhagia
- in follicular development/ovulation. What happens
- one of the two ovaries releases an ovum monthly; normally midcycle ovulation occurs; alternates 200,000 oocytes at birth;
- ovulation is regulated by
- hypothalamus
- releases gonadotropin releasing hormones at puberty
- hypothalamus
- Pituitary then releases ____
- gonadotropin
- ____causes 5-8 follicles to develop first 14 days of cycles (from menses start) yet only one matures.
- FSH
- 1-13 days
- Follicular Stage
- 14 Day
- Ovulation
- name of a mature follicle (2 cm)
- graafian follicle
- _____then inhibit FSH and LH kickss in
- High estrogen levels
- LH rises ______hrs prior to ovulation
- 24 to 36
- LH surge ____before ovulation
- 10-12hrs
- WHen LH 10-12 hrs. before ovulation triggers ovulation
- the release of ovum from ruptured graafian follicle
- Ovulation is assoc with
- post cul de sac fluid
- Mittelschmertz is german for
- middle pain
- Days 15 -28
- luteal phase
- which phase does not vary in length
- luteal
-
which phase?
cells in ruptured graafian multiply and form corpus luteum or yellow body - luteal phase
-
which phase?
secretes progesterone - luteal
- produced by corpus luteum
- progesterone
- If fertilization occurs, ___will remain and release progesterone to maintain preg. up to sixteen weeks
- corpus
- endometrial changes vary according to
- estrogen and progest.
- 3 phases of endometrial
-
menstrual
proliferative
secretory - phase of endometrium lasts up to 5 days
- menstrual
- days 1-14(3 line phase)
- proliferative
-
thin endo
increasing estrogen causes lining to thicken
ovulate on day 14 - proliferative
- 15-28; luteal phase; endo thickens
- secretory
- menstrual phase- sono app. of ut
- fluid debris in endom
- sono appearance of ut in early proliferative
- thin line
- sono app. of ut. in mid proliferative
- three line
-
sono app. of ut
near oulation - endom is iso with myometrium
- sono app. of ut. secretory phase
- after ovulation, thickest, brightest endo, post enhancement
-
endometrium variants
IF on BC, post menopausal -
endom. is thin, echogenic
post. not on hormone should have endom. Less than 5mm
Post meno. on HRT or tamoxifen can have thickness up to 8 - vesicouterine recess or ant cul de sac
- ant to fund. beteen bladder and ut
- post to ut, ant to rectum, pouch of douglas
- rectouturine recess
- retropubic space between ant bladder and pub, symp.
- space of retzius
-
peritoneal pelvic recesses
anterior to fund., between bladder and ut - vesicouterine recess ant cul de sac
-
peritoneal pelvic recesses
posterior to ut, ant to rectum
also known as pouch of douglas - rectourine recess or post cul de sac
-
peritoneal pelvic recesses
retropubic space,between ant bladder and pub. symp. - space of retzius