female pelvis sg

What should the endometrium look like for postmenopausal patients who are not taking HRT (hormone replacement therapy)?

thickness of <5 mm

What should the endometrium look like for postmenopausal patients taking HRT (hormone replacement therapy)?

normal thickness up to 8 mm

What is the echogenicity of the ovaries?

ovoid medium level echogenic structure

What is the prep for a transvaginal ultrasound?

What is LMP?

last menstrual period

What does the pituitary gland secrete?

varying levels of gonadotropins

When is LH (luteinizing hormone) released?

24-36 hours before ovulation

When do progesterone levels decline?

9-11 days after ovulation, when the corpus luteum degenerates

What is GPA?

G = (gravida) the total number of times the patient has been pregnant

P = (para) the number of live births (viable children) that the patient has had

A = (abortus) the total number of miscarriages or elective abortions

Ovulation

during menarchal years, ovum released once a month by one of two ovaries

When does ovulation occur?

midcycle on about day 14 of 28 day cycle

What is the process of ovulation regulated by?

the hypothalamus within the brain

What is the first stage in ovulation?

Ovarian follicles grow, they fill with fluid (antrum) and secrete increasing amounts of estrogen

what triggers ovulation?

LH surge, accompanied by smaller FSH surge on about day 14

What is after ovulation?

the luteal phase

what happens 9-11 days after ovulation?

The corpus luteum degenerates, causing progesterone levels decline

What happens during the luteal phase?

cells in lining of ruptured ovarian follicle begin to multiply and create the corpus luteum

what does the corpus luteum do?

decretes progestrone

What does the hypothalamus release?

at puberty it begins pulsatile release of gonadotropin-releasing hormones (GnRHs)

Posterolateral wall of pelvis

formed by piriformis and coccygeus muscles

anterolateral wall of pelvis

formed by hip bones and obturator internus muscles

lower margin of pelvic cavity

formed by levator ani and cocygeus muscles

What is FSH (follicle-stimulating hormone)?

triggers the growth of follicles, stimulating them to mature eggs and produce estrogen

When is FSH released?

during the first half of the menstrual cycle before ovulation

what are the bones of the pelvic floor?

two coxal bones (ilium, ischium, pubis), sacrum, and coccyx

pelvis major (false pelvis)

located superior to the iliopectineal line

pelvis minor (true pelvis)

inferior to the caudal portion of parietal peritoneum, considered pelvic cavity

Body of the uterus

lies between the fundus and the cervix and is the largest part of the uterus

Fundus of the uterus

widest most superior portion of the uterus

Cervix

The opening to the uterus

Ampulla

widest part of the fallopian tube where fertilization occurs

Isthmus

lies lateral to the uterus

Interstitial

pierces uterine wall at cornua, narrowest segment of the fallopian tube

infundibulum

funnel shaped lateral margin of fallopian tube that projects beyond the broad ligament to overlie ovaries

fallopain tubes

muscular tube 10-12 cm in length, 1-4 mm in diameter

broad ligament

lateral aspect of uterus to pelvic sidewall

mesosalpinx ligament

upper fold of broad ligament; encloses fallopian tube

mesovarium ligament

posterior fold of broad ligament; encloses ovary

round ligament

fundus to anterior pelvic sidewalls, holds uterus forward

cardinal ligament

extend across pelvic floor laterally, firmly supports cervix

uterosacral ligament

extend from urine isthmus posteriorly, along side rectum to sacrum, firmly supports cervix

suspensory ligament

extends from lateral aspect of ovary to pelvic sidewall

ovarian ligament

extends medially from ovary to uterine cornua

vesicouterine pouch

Anterior cul-de-sac; anterior to fundus between uterus and bladder

rectouterine pouch

Posterior cul-de-sac; posterior to uterine body and cervix, between uterus and rectum

retropubic space

Space of Retzius; between bladder and symphysis pubis

premenarche

prepuberty

menarche

onset of menses

Menstrual Cycle

menstrauting every 28 days

menopause

cessation of menses

perimetrium

serous outer layer of uterus; serosa

myometrium

muscular middle layer of the uterus composed of thick, smooth muscle supported by connective tissue

endometrium

inner mucous membrane, glandular portion of uterine body

anteversion

The cervix forms a 90-degree or smaller anterior angle with the vaginal canal

- fundus is anterior

-tilt forward

anteflexion

body and fundus only angle anteriorly

-fundus is anterior

-bent forward

retroversion

the cervix forms an posterior angle of greater than 90 degrees to the vaginal canal

-tilt backwards

-fundus is posterior

retroflexion

fundus and body bent posteriorly

--uterus bent backward

-fundus is posterior

anteversion/anteflexion

normal position, entire uterus angles anteriorly

restroversion/restroflexion

entire uterus is angled posteriorly

transvesicular

wilder field of view, full bladder

transvaginal

higher resoultion, narrow field of view