OB/GYN quiz 1

False Pelvis

located superior to the pelvic brim. it is considered part of the abdominal cavity. supports and contains portions of the intestine

protects abdominal organs and serves as a transition area between the abdomen and pelvis

True pelvis

inferior to the pelvic brim and contains the pelvic cavity

• houses the bladder, reproductive organs and rectum

• forms the birth canal in females

Uterus

a hollow, muscular, pear-shaped reproductive organ located in the female pelvis between the urinary bladder and rectum

layers of the uterine wall

Endometrium, Myometrium, and Perimetrium

Endometrium

inner mucosal lining that undergoes cyclic hormonal changes

• central echogenic stripe that varies in thickness and appearance throughout the menstrual cycle

Myometrium

thick muscular middle layer responsible for uterine contractions

myometrium

homogeneous, medium-level echogenicity

perimetrium

outer serosal covering

anterior uterus =

vesicouterine pouch (uterus and bladder)

posterior uterus =

rectouterine pouch = pouch of douglas (uterus and rectum)

fallopian tubes

paired muscular tubes that extend from the superior lateral aspect of the uterus. Serves as a passageway for the ovum to travel to the uterus

obturator internus

lines the lateral pelvic wall; triangular sheets of muscle that arise from the anterolateral

Psoas (major) muscle

originate at the transverse process of the lumbar vertebrae; decrease inferior through false pelvis; pelvic sidewalls

iliopsoas

made up of psoas + iliacus muscle; posterior border lies along the iliopectineal line; may be used as separation landmark of the true from false

Piriformis muscle

form the posterior pelvic wall; flat triangle at muscle arise from anterior sacrum

levator ani

a group of 3 muscles that extend across the pelvic floor; pubococcygeus, iliococcygeus; puborectalis

pubococcygeus

anterior and medial

iliococcygeus

extend from anterolateral pelv-coccyx

puborectalis

arise from lower part of pubic symphysis

Broad ligaments

lateral aspect of uterus to pelvic sidewall; double fold of peritoneum that drapes over the fallopian tube, uterus, ovaries; contains uterine blood vessels + nerves

mesosalpinx

upper fold; encloses the fallopian tube extends from the cornua of the uterus

mesovarium

posterior portion that is drawn out to enclose the ovary

round ligaments

fundus to anterior pelvic sidewalls; hold uterus forward fibrous cords that occur in front of and below the fallopian tubes b/t layers of the broad ligament

Ovaries

almond shaped structures; 3cm long; posterior to the uterus at the level of the cornua; medial to external iliac vessels

pre menarche

status of prepuberty; time before the onset menses

menarche

after reaching puberty in which menses occurs normally every 28 days

premenopause

transitional stage of 2-10 years before menstrual cycle ends

menopause

menses have ceased permanently (1 year)

common iliac arteries

bifurcate into external and internal

external iliacs

common femoral arteries; supplying blood to the lower extremities

internal iliacs

along posterior wall, branches to bladder uterus vagina and rectum

left ovarian vein

drains into the left renal vein

right ovarian vein

drains right into IVC

uterine artery

anterior branch of the internal iliac

arcuate arteries

myometrium

radial arteries

supply blood to endometrium (zona basalis)

spiral arteries

supplies zona functionalis

FSH ( Follicle-stimulating hormone)

secrete by anterior pituitary gland during first half of menstrual cycle known as follicular phase (day 1-14)

LH ( luteinizing hormone)

mature follicle

graafian follicle

sono appearance of ovaries

estrogen

progesterone

secreted by the corpus luteum; begins the secretory

Endometrium

measurement based on cycle and age

Menstrual

day 1-4; 4-8mm anechoic (menstruation)

menstrual days 3-7

hypoechoic blood gone; discrete thin hyper= 2-3mm

proliferation

early proliferative phase (thin single)

triple line sign; days 5-9; thin 4-8mm

late proliferative phase

thicker 10mm; days 10-14; before ovulation

secretory

endo becomes thickened and very hypoechoic due to luteal phase; days 15-28; 7-14mm

follicular

ovary follicular

ovulatory

known as follicular phase, begins with the first day of menstrual bleeding and continues until ovulation on day 14

luteual

days 15-28; endometrium at its greatest thickness and echogenicity

cervical carinoma

malignant neoplasm of the cervix; strongly associated with HPV

nabothian cyst

benign cyst in cervix

Adenomyosis

benign disease, commonly diffuse, infiltration of endo, ectopic endo tissue in the myometrium; commonly in posterior aspect

leiomyoma (fibroid)

most common benign smooth muscle tumor of the myometrium

leiomyosarcoma

rare malignant; originate from myometrium or endo lining; highly aggressive solid or mixed-solid and cystic texture

anti estrogen therapy

asherman syndrome

patients present with uterine synechiae and infertility

endo carcinoma

most common malignancy; thickened endo

endometritis

infection within the endo of the uterus; associated with PID

Hematometra

accumulation of blood within the uterine cavity

hyperplasia

most common cause of abnormal uterine bleeding; develops from unopposed estrogen stimulation

endo polyp

overgrowth of endometrial tissue covered by epithelium; asymptomatic or uterine bleeding

cystadenocarinoma

malignant

mucinous cystadenoma

epithelial tumor that is lined by the mucinous element of endocervix and bowel; bilateral on ovaries; may occur in menopausal; large = likely to rupture

PCOS

endocrine disorder associated with chronic anovulation; ovaries are rounded 2-5x; increased follicles, infertility, oligomenorrhea, hirautism, obesity