Pelvic US, Embryology, Pelvic Muscles + cavity, correlative imaging

most common used tdx for pelvic US

curvilinear/convex probe

2nd most common probe for pelvic US

transvaginal (endovaginal)

common reasons for pelvic US

pain, abnormal bleeding, palpable mass, procedure guidance, etc

sagittal plane notch is at

12 o’clock

sagittal plane labeled top/bottom and sides

anterior, posterior, superior/cephalic, inferior/caudal

transverse plan notch is at

9 o’clock

transverse plane labeled top/bottom and sides

anterior, posterior, right, left

transabdominal usually requires a — — and shows a — view

full bladder, global

transvaginal US usually requires a — — and a more — view

empty bladder, narrow

transperineal US is most similar to a — view

transvaginal (TV)

MRI uses a

very strong magnet and radiofrequency waves

CT uses

ionizing radiation and images in 3 planes

in MRI T1 shows fluid as — (low signal intensity)

dark

in MRI T2 shows liquid as —

bright

genitourinary tracts develop from

mesoderm (embryonic tissue)

embryology is dating from the

day of conception

in obstetrics (gestational age), dating is from the

LMP (2 weeks before conception)

embryo stage is

10 weeks from LMP

fetal stage is

10 weeks until delivery from LMP

ovum contributes — chromosomes + — chromosome, —

22, sex, X

sperm contributes — chromosomes + — chromosome, either - or -

22, sex, X or Y

fertilization yields a —, which is — chromosomes

diploid, 46

How many chromosomes (including sex chromosome) are in the non-fertilized ovum? 

23

How many chromosomes (including sex chromosome) are in the sperm? 

23

How many TOTAL chromosomes (including sex chromosome) are in the fertilized ovum?

46

gametes are either — or —

sperm or oocyte

gametes are created by —- migrating to the wall of the yolk sac in the 2nd week after conception

primordial germ cells

gonads are either

testicles or ovaries

gonads are formed by — developing on — part of —

urogenital ridges, anteromedial, mesonephros

paramesonephric duct also known as

Mullerian duct

mesonephric duct also known as

Wolffian duct

without testosterone, — ducts disappear and — ducts develop in both directions along gonads

mesonephric, paramesonephric

proximal paramesonephric ducts remain unfused and become —

fallopian tubes

distal paramesonephric ducts create —

uterus, cervix, upper 4/5 vagina

in genetic males, growth of — ducts occur and — ducts regress

mesonephric, paramesonephric

the vagina has dual origin, which are from the — and the —

paramesonephric duct, urogenital sinus

the paramesonephric duct forms the — part of the vagina

upper

the urogenital sinus forms the — part of the vagina

lower

hymen

thin tissue separating vagina from urogenital sinus

What is the embryologic origin of the lower part of the vagina? 

urogenital sinus

What duct regresses in the biologic female?

mesonephric duct

What duct forms the fallopian tubes, uterus, and upper 4/5 of the vagina?

paramesonephric duct

Primordial germ cells migrate to the ________ _______ and form the gametes (sperm/oocytes)

yolk sac

external genitalia is the same in both genders until

week 7

genital tubercle elongates to become the — —-

primordial phallus

primordial phallus becomes the — or —

penis, clitoris

day 1 of embryology

conception/fertilization 46X or 46XY, genetic gender determined

week 2 embryology

gametes are created by primordial germ cells migrating to yolk sac wall

week 5 embryology

primordial germ cells enter embryo from yolk sac

by the end of the 5th week of embryology, PGCs are on the — — of the mesonephros

urogenital ridge

week 6 embryology

inducer germ cells implant on the genital ridges, eventually forming gonads

before week 7 embryology

male and female embryos have indifferent gonads

after week 7 embryology

SRY on Y chromosome causes testosterone production forming male structures

4th month oogenesis

primitive germ cells become oogonia

primary oocytes

surrounded by epithelial cells to become primordial follicles

primordial follicles

precursor to follicle that releases oocytes with menstrual cycle

primordial germ cells become —, which become primary —

oogonia, oocytes

genital tubercle

primordial (early) phallus

urogenital sinus forms the

lower vagina

rectus abdominis muscles

anterior muscles just lateral to midline surrounded by RECTUS SHEATH 

arcuate line

invisible line that marks the lower limit of the posterior rectus sheath

Inferior to arcuate line, the — —- lies directly on the TRANSVERSALIS FASCIA 

rectus abdominis

linia alba

fascia between 2 rectus abdominis muscles (the midline)

pelvic cavity is the — portion of the abdominopelvic cavity

lower

organs in the pelvic cavity

part of the large intestine, rectum, urinary bladder, reproductive organs

muscles of the pelvic diaphragm include

iliopsoas, piriformis, obturator internus, levator ani, coccygeus, rectus abdominis muscle

iliopsoas

combined iliacus (pelvic side wall) + psoas major muscles (distally) + psoas minor

piriformis

posterolateral wall muscle forming most of posterior pelvic floor

obturator internus

anterolateral pelvic sidewall, lateral to ovaries l

levator ani

pelvic floor, keeps organs from falling through the hole in the bottom of the boney pelvis

coccygeus

posterior muscle part of posterior pelvic floor

rectus abdominis muscle

anterior midline abdominal wall

inferior pelvic muscles include

piriformis, coccygeus, levator ani

what are the muscles of the pelvic floor collectively called?

pelvic diaphragm

what muscle lies on the lateral pelvic wall and is the pelvic sidewall

obturator internus

the pelvic skeleton includes what 5 bones?

ilium, ischium, pubis, sacrum, coccyx

what are the 4 innominate bones?

ilium, pubis, ischium, sacrum

male vs. female pelvis

female pelvis is wider

male vs female peritoneal cavity

male is a closed cavity, female has communication due to fallopian tubes

true vs false pelvis separated by —

linea terminalis

false pelvis is — and includes the —

above, bowel

true pelvis is — and includes — and —

below, pelvic organs and urinary bladder

true pelvis anterior compartment contains the — and —

bladder and reproductive organs

the true pelvis posterior compartment contains the (4)

posterior cul-de-sac, rectosigmoid muscle, perirectal fat, and presacral space

the cartilage that separates the 2 anteroinferior pelvic bones is called the

symphysis pubis

potential spaces is a

location where fluid could accumulate, normal or abnormal

the uterus is — to the rectum and — to the bladder

anterior, posterior

vesicouterine pouch also known as the

anterior pouch

rectouterine pouch also known as

posterior pouch, pouch of douglas, posterior cul de sac

space of Retzius

retropubis between bladder + pubic bone

Space of Retzius located between

symphysis pubis + bladder

space of Retzius is also know as

retropubic pouch

anterior cul de sac located between the

bladder and uterus

posterior cul de sac located between

uterus and rectum

vesicouterine pouch also known as

retropubic pouch

innominate bone is fused

ischium, ilium, and pubic bones

iliospoas

iliacus m + psoas major m (lateral)

psoas major is the large —- from — abdomen to —

bilateral muscle, upper, pelvis

linea alba is the the

midline fascia between 2 rectus abdominis muscles

rectus sheath is the

covering of rectus abdominis muscles