Protocol Study Guide - Female Pelvis Scanning Protocol PDF

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Protocol Study Guide Female Pelvis 1. True pelvis is ____ to the linea terminalis and False pelvis is ___ to linea terminalis a. Deep; superior 2. Which pelvis houses the reproductive organs, bladder, and ureters? a. True Pelvis 3. What are 2 other names for True Pelvis a. Lesser pelvis, pelvis minor 4. True or False: Bowel loops are located in the True Pelvis. a. False, Bowel loops located in the False pelvis 5. What are the different pelvic regions? a. Right iliac region b. Hypogastric c. Left iliac region 6. What organs are located in the right iliac region? Left iliac region? a. Right iliac region: Cecum of colon, appendix, distal end of right ureter, right ovary b. Left iliac region: sigmoid colon, distal end of left ureter, left ovary 7. What organs located in the hypogastric region? a. Distal end of ileum, urinary bladder, uterus 8. Uterus is located between the _____ and ______ a. Urinary bladder and rectum 9. Is the uterus retroperitoneal or intraperitoneal? a. Retroperitoneal 10. What are the 3 layers of the uterus? a. Endometrium b. Myometrium c. Serosa 11. What are the 2 layers of the endometrium? a. Superficial and deep 12. Which layer of endometrium is the functional layer? Which one is the basal layer? a. Functional = superficial b. Basal = deep 13. Which layer of endometrium increases in size during menstrual cycle and sloughs off during menses? a. Superficial; which is why it’s called functional 14. What is the deep layer made of? a. Dense stroma and mucosa glands 15. Why layer of the uterus is the largest? a. Myometrium 16. The outer peritoneal layer, thin layer that completely covers the myometrium is the _____ a. Serosa 17. What are the 4 parts of the uterus? a. Fundus. Corpus/body, isthmus, cervix

18. Widest most superior part of uterus? a. Fundus 19. Largest part of the uterus and continuous with cervix? a. Corpus or body 20. The LUS (lower uterine segment) where is bends usually where the body meets cervix? a. Isthmus 21. The lower cylindrical part that projects into the vagina a. Cervix 22. Which part of cervix is at the same level of the isthmus? The internal os or external os? a. Internal os. opening of cx 2-4 cm approx 23. External os is closest to the _____ a. Vaginal canal 24. Uterus size depends on ____ and _____ a. Parity and age 25. Size of prepubertal uterus? a. 2.5 cm long x 2 cm wide x 1 cm AP 26. In prepubertal uterus, the ____ is the longest part and the _____ is the shortest a. Cervix; body 27. Size of postpubertal, nilluparious uterus a. 7-8cm long x 3-5 wide – 3-5 AP 28. Average size of multiparous uterus? a. 8.5 cm long and 5 cm wide 29. A post menopausal uterus size significantly _____ and usually reverts back to _______ where cervix is greater portion of uterus a. Decreases; prepubertal shape 30. What is the normal/most common position of the uterus called? a. Anteverted 31. When and why can the uterus be mobile? a. Because of ligaments and peritoneal connections, can be mobile with displacement when bladder or rectum is full or with pregnancy 32. With regards to uterine positions, define ante vs retro; and flexed vs verted a. Ante = towards anterior aspect b. Retro = towards posterior c. Flexed: fundus position d. Version: cervix position 33. The position where the cervix and vagina form 90 degree angle and corpus and fundus tilted anteriorly a. Anteverted 34. Cervix and vagina form 90 degrees and corpus and fundus bent anteriorly and fundus points inferiorly and rests on cervix a. Anteflexed 35. Corpus and fundus are tilted posteriorly and cervix and vagina linearly oriented a. Retroverted

36. Corpus and fundus bent posteriorly until fundus is adjacent to cervix pointing inferiorly. Cervix and vagina linearly oriented a. Retroflexed 37. Development variant causing 2 uterus, 2 cervices, 2 vaginas a. Didelphia uterus 38. Bicornuate uterus? a. Developmental variant causes 2 uterine bodies (divided), or 2 uterine horns (septate) with 1 vagina 39. How does the fallopian tubes direct the mature ovum to the uterus? a. Gentile peristalsis of the smooth muscle wall 40. Length of fallopian tubes? a. 7-12cm 41. What is the widest diameter of the fallopian tube? a. 3cm 42. What are the 4 parts of the fallopian tubes? a. Interstitial or intramural b. Isthmus c. Ampulla d. Infundibulum 43. What is the narrowest segment of the FT? a. Interstitial or intramural segment 44. What is the most dangerous location for ectopic pregnancy to occur? a. Interstitial because of the close proximity to the uterus. if ruptures, risking the FT and uterus to both be ruptured /more bleeding/ risk for losing both 45. Longest segment of the FT? a. Ampulla 46. Most common location for ectopic? a. Ampulla 47. The _____ segment of the FT is the widest segment – funnel shaped end with fingerlike extensions called ______ a. Infundibulum; fimbria 48. Ovaries are located in the ____, the peritoneal cavity spaces located posterior to _____ within the ___ pelvis a. Adnexa; broad ligaments; true 49. What is a good landmark to look for when scanning ovaries?’ a. Internal illiac arteries are often posterior to the ovaries 50. Prepubertal, postpubertal, and postmenopausal size of ovaries? a. Prepubertal i. Large at birth with little change until 5-6 b. Postpubertal i. 2.5-5cm long; 9.9mL volume... higher volumes seen preovulatory phase with lower volume during luteal phase c. Postmenopausal i. Mean volume 5.8 mL

51. Days 1-14 corresponds with the _____ of the ovaries and the ______ phase of the endometrium a. Follicular; proliferative 52. During the follicular phase, ____ is released by the _____ a. FSH; pituitary gland 53. Menses usually occurs days _____ then the endometrium does into the ____ phase a. 1-5; proliferative phase 54. What is occurring during the proliferative phase? What hormone is involved? a. Follicles are releasing estrogen that initiates the thickening and swelling of the endometrium that is preparing for implantation by fertilized ovum 55. Ovulation occurs on day ____ a. 14 56. Days 15-28 in the ovaries is called ______ and in the endometrium is called _____ a. Luteal; secretory 57. Following ovulation, the ruptured follicle fills with blood and is called ____. This occurs during the ___ phase in the ovaries a. Corpus luteum; luteal phase 58. Absence of _____, _____, and ______ diminish the corpus luteum. It then regresses into ______. a. Fertilization; estrogen; progesterone; corpus albicans 59. What hormones promote continuing thickening of endometrium during the secretory phase? a. Estrogen and progesterone 60. Sonographic appearance of each: a. Menstrual phase i. Endometrium thin and bright b. Early proliferative (day 5-9) i. Thin bright line measures 4-8mm c. Late proliferative (days 10-14) i. Multilayered; Bright stripe is surrounded by thick functional zone that appears hypoechoic relative to the basal layer that is surrounded by the hypoechoic inner layer of myometrium. Normally meas 6-10mm d. Secretory phase (days 15-28) i. Functional zone even thicker and brighter becomes isoechoic to basal layer and canal . Meas 7-14mm 61. Sonographic appearance of uterus? a. Mid-gray medium echoes even texture b. Smooth contour c. Round anechoic venous structures may be seen in periphery 62. Sonographic appearance of ovaries? a. Mid-gray medium echoes even texture b. Iso or more hyperechoic than normal uterus c. Anechoic follicles seen round or oval around periphery 63. Sonographic appearance of fallopian tubes? a. Normal FT not usually seen or visualized unless abnormal or filled with fluid 64. Patient prep for female pelvis a. Full urinary bladder

b. 32 to 40 oz of clear fluid (water) 1 hr prior to exam within 15-20 min time period 65. Why do you need a full bladder? a. Fully distended urinary bladder displaces bowel to view pelvic organs and acts as an acoustic window 66. Transducer for pelvic exam a. 3.0-3.5 Mhz; 5 for thin patients 67. What patient history should be obtained? a. LMP, GPA, symptoms, Hx of pelvic surgeries, pelvic exam results...