Class 1 Flashcards by Christian Tinio

Uterus: Definition and Regions

Pear shaped muscular organ
4 regions:
Fundus
Corpus
Isthmus
Cervix

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Layers of the Uterus: What are the 3 tissue layers?

SEROSA (PERIMETRIUM)
-Outermost
MYOMETRIUM 
-Middle layer
ENDOMETRIUM
-Innermost: functional layer

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Uterus Shape And Size: What are they and what are their variations?

VARIES WITH AGE AND OBSTETRIC HX
Prior to menarche - cylindrical and narrow

Mature uterus - corpus & fundus enlarge

After menopause - regresses in size

Nulliparous female:
SAG = less than or equal to 8 cm
TRV = up to 5 cm
AP = 3 cm

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What are the 3 variants in uterine position?

Normal
Retroverted: laid back
Anteverted: shlumped forward
Retroflexed: folded backwards

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ANTEFLEXED Uterine Position

Uterine fundus and corpus tilted forward

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RETROFLEXED Uterine Position

Corpus and fundus tilted posteriorly

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RETROFLEXED and RETROVERTED Uterine Position

Corpus, fundus and cervix are tilted posteriorly

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UTERUS MYOMETRIUM: Ultrasound Appearance

Mid gray or medium level echoes
Even homogeneous texture and pattern
Smooth even contour

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ENDOMETRIAL CAVITY: Ultrasound Appearance

Thin echogenic line

- Varies in thickness in relation to menstrual phase

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Vagina: Ultrasound Appearance

Mid gray to medium level echoes

- Vaginal canal is hyperechoic line

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Fallopian Tubes: What are the 4 Portions?

INTERSTITIAL (INTRAMURAL): Narrowest part, nearest cornu
ISTHMUS: Slightly wavy and longer
AMPULLA: Tortuous and longest part
INFUNDIBULUM: Lateral, trumpet shaped,
fimbriae

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INTERSTITIAL (INTRAMURAL): Portion of the Fallopian Tubes

Narrowest part, nearest cornu

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ISTHMUS: Portion of the Fallopian Tubes

Slightly wavy and longer

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AMPULLA: Portion of the Fallopian Tubes

Tortuous and longest part

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INFUNDIBULUM: Portion of the Fallopian Tubes

Lateral, trumpet shaped,

fimbriae

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What are the 2 Adjacent Spaces?

ANTERIOR CUL DE SAC (VESICOUTERINE POUCH)
Reflection of peritoneum over anterior surface of uterus and bladder
POSTERIOR CUL DE SAC (RECTOUTERINE POUCH, POUCH OF DOUGLAS)
Reflection of peritoneum over posterior surface of uterus and rectum

ANTERIOR CUL DE SAC: What is it?

VESICOUTERINE POUCH

Reflection of peritoneum over anterior surface of uterus and bladder

POSTERIOR CUL DE SAC: What is it?

RECTOUTERINE POUCH, POUCH OF DOUGLAS

Reflection of peritoneum over posterior surface of uterus and rectum

What are the Ligaments?

CARDINAL LIGAMENTS - anchor uterine corpus and cervix to lateral pelvic wall
UTEROSACRAL LIGAMENTS - anchor uterine cervix to sacrum
ROUND LIGAMENTS - anchor uterine fundus anteriorly
BROAD LIGAMENT - part of peritoneum that divides true pelvis into anterior & posterior portions

CARDINAL LIGAMENTS

anchor uterine corpus and cervix to lateral pelvic wall

UTEROSACRAL LIGAMENTS

anchor uterine cervix to sacrum

ROUND LIGAMENTS

anchor uterine fundus anteriorly

BROAD LIGAMENT

part of peritoneum that divides true pelvis into anterior and posterior portions

What are the bones that make up the Pelvic Girdle?

FOUR BONES
SACRUM
COCCYX
2 INNOMINATE BONES (ILIUM, ISCHIUM, & PUBIS)

What are the Muscles of the Pelvis?

RECTUS ABDOMINUS - form anterior abdomino - pelvic wall PSOAS and ILIACUS - large muscles laterally, located in false pelvis ILEOPSOAS MUSCLE - seen laterally in TRV OBTERATOR INTERNUS - laterally in true pelvis PIRIFORMIS -posterior in true pelvis MUSCLES OF PELVIC FLOOR - levator ani and coccygeus

The Ovaries: Where are they located and how big are they?

``` LOCATION: Lateral to the uterus in the adnexa In posterior fold of broad ligament May be superior or posterior to uterine fundus, May be in posterior cul de sac ``` SIZE: SAG = 2.5-5.0 cm TRV= 1.5-3.0 cm AP = .6-2.2 cm

What are the Ligaments of the Ovaries?

Mesovarian - anchors ovary to posterior surface of broad ligament Ovarian ligament - anchors ovary to uterine cornu Infundibulopelvic ligament - anchors ovary to pelvic brim

What is the only abdominal organ not covered by the peritoneum?

the Ovaries are the only abdominal organ not covered by the peritoneum?

What is produced in the ovaries?

Hormones and gametes

What are the 2 parts of the ovaries?

CORTEX (OUTER) - contains primordial follicles | MEDULLA (INNER) - contains connective tissue, nerves, blood supply, lymphatics & smooth muscle tissue

Ovarian Follicles

- Born with millions of primordial follicles - 300-400 mature in lifetime - Graafian Follicle - the follicle that matures each month - Graafian Follicle ruptures with ovulation at approximately 1.8 TO 2.5 cm - After rupture, follicular cavity becomes the corpus luteum of menstruation - If ovum fertilized, corpus luteum remains, if not it resolves

Ultrasound Appearance of Ovaries

-SIMILAR TO MYOMETRIUM IN ECHOGENICITY -FOLLICLES GIVE “SWISS CHEESE APPEARANCE” -POST MENOPAUSAL OVARIES DIFFICULT TO VISUALIZE -TIPS FOR VISUALIZATION: Turn down gains, Look for posterior enhancement, Ovary may be anterior to internal iliac vessel

Pelvic Vascular Supply

- HYPOGASTRIC ARTERY (INTERNAL ILIAC) - UTERINE ARTERY - OVARIAN ARTERY - VEINS HAVE SIMILAR PATTERN - VEINS ARE DISTENSIBLE & VARY IN SIZE WITH CERTAIN CONDITIONS