Female Pelvis Breakdown And Vascularity

Question 0

What is S/D ratio?

Answer 0

Peak systole/end diastole ratio

Question 1

How do you distinguish between a vessel and a cyst when scanning?

Answer 1

Use color Doppler or pulsed Doppler display

Question 2

What is RI?

Answer 2

Resistive Index

      Peak systole

Question 3

What is PI?

Answer 3

Pulsatility Index

           Mean

Question 4

How are arteries and veins positioned in the body?

Answer 4

Arteries are usually anterior to veins

Question 5

Where are the iliac vessels located?

Answer 5

In the lateral pelvis

Question 6

Where are the uterine vessels located?

Answer 6

Lateral to cervix

LUS at level of internal so

Question 7

What is the RI of the uterine vessels in a non pregnant uterus?

Answer 7

RI .88

Question 8

The vagina has how many sources of blood?

Answer 8

2

Question 9

When dealing with the vagina, what does a branch of the uterine artery supply?

Answer 9

Anterior surface of the vagina and the cervix

Question 10

When dealing with the vagina, what does a branch of the internal iliac vessel supply?

Answer 10

Posterior surface of the vagina

Question 11

The RI of the ovaries ________ throughout the menstrual cycle.

Answer 11

Varies

Question 12

Describe resistance and velocity during the follicular phase.

Answer 12

High resistance

Low velocity

Question 13

During ovulation, describe velocity and RI. What is RI of corpus luteum?

Answer 13

Max velocity higher
RI decreases
.44 or lower impedance in corpus luteum

Question 14

What is the RI of a post menopausal ovarian artery? Describe diastole flow.

Answer 14

.94

No diastole flow evident after 5 years into menopause = RI 1.0

Question 15

What are the layers of the uterus?

Answer 15

Serosa
Myometrium
Endometrium

Question 16

Describe uterus serosa.

Answer 16

Not visualized sonographically

Outer layer

Question 17

Describe uterus myometrium.

Answer 17

Middle muscle layer
Homogeneous smooth walled borders
Arcuate arteries may have calcification

Question 18

Describe uterus endometrium.

Answer 18

Inner layer
Thin hypovascular
Contains spiral arteries

Question 19

Describe the location of the internal os of the cervix.

Answer 19

Body of uterus separated from cervix by isthmus

Question 20

Describe the cervical canal.

Answer 20

Homogenous
Echogenic central line
May contain cysts

Question 21

What type of cysts are found in the cervix and what are their sizes?

Answer 21

Nebothian cysts

1-2 cm

Question 22

How can the true lie of the uterus be visualized?

Answer 22

Endovaginally

Question 23

How will an anteverted uterus seen on the screen?

Answer 23

Fundus to left of screen

Cervix to right of screen

Question 24

How is a retroverted uterus seen on the screen?

Answer 24

Cervix to left of screen | Uterus to right of screen

Question 25

How is the endometrium seen best?

Answer 25

Endovaginally

Question 26

Menstruation days and endo size?

Answer 26

Days 1-4 | Hypoechoic line 4-8 mm

Question 27

Early proliferative phase days and endo size?

Answer 27

Days 5-9 | 6 mm

Question 28

Late proliferative phase days and endo size?

Answer 28

Days 10-14 | 10 mm when ovulation occurs

Question 29

Secretory (luteal) phase days and endo size?

Answer 29

Days 15-28 | 7-14 mm

Question 30

What doesn't get included even measuring the endometrium?

Answer 30

Fluid

Question 31

Endometrium size during childbearing years is what?

Answer 31

4-14 mm normal

Question 32

Post menopausal endo size?

Answer 32

Less than 8 mm

Question 33

Post menopausal with HRT endo size?

Answer 33

Up to 14 mm

Question 34

At what size should the endo have additional evaluations?

Answer 34

If greater than 5 mm

Question 35

Can you see the Fallopian tubes?

Answer 35

Usually no

Question 36

What is the size of the Fallopian tubes?

Answer 36

8-10 mm

Question 37

How can you find the Fallopian tubes when scanning?

Answer 37

Follow laterally from cornua to ovaries

Question 38

What does an abnormal Fallopian tube look like?

Answer 38

Tortuous tubular structure

Question 39

How do the ovaries normally lie within the pelvis?

Answer 39

Laterally to uterus and anteromedial to iliac vessels

Question 40

Describe the ovoid medium level.

Answer 40

Echogenic structure with follicles

Question 41

Describe a Graafian follicle.

Answer 41

Day 14 dominant follicle | 2 - 2.5 cm

Question 42

What happens after ovulation?

Answer 42

Corpus luteum develops

Question 43

What is the normal ovary volume during premenarch?

Answer 43

3-8 cm cubed

Question 44

What is the normal ovary volume during menarch?

Answer 44

9.8-21.9 cm cubed

Question 45

What is the normal ovary volume during postmenopausal?

Answer 45

5.8-8 cm cubed

Question 46

What is the measurement of normal follicles?

Answer 46

Less than 3 cm

Question 47

Describe postmenopausal cysts.

Answer 47

Greater than 5 cm with septations or nodules should be removed

Question 48

Describe inclusion cysts.

Answer 48

Echogenic nonshadowing foci 1-3 mm Normal cysts

Question 49

Describe focal calcifications.

Answer 49

Stromal reaction Previous hemorrhage or infection Need f/u or r/o early neoplasm

Question 50

What is another name for the posterior cul de sac?

Answer 50

Pouch of Douglas

Question 51

Are small amounts of fluid in the cul de sac normal?

Answer 51

Yes

Question 52

When should fluid in the cul de sac be a concern?

Answer 52

Large amounts of fluid | Debris or septated fluid

Question 53

How is bowel seen while scanning?

Answer 53

Dirty shadow | Fluid filled with peristalsis

Question 54

Other names for a sonohysterography...

Answer 54

Saline infused sonography | Hysterosonograghy

Question 55

What does a sonohysterography evaluate?

Answer 55

Thickness of endometrium to r/o a polyp or mass

Question 56

How is a sonohysterography done?

Answer 56

``` Insert sterile speculum Catheter is inserted Speculum is removed TV probe is inserted 10-15 cc sterile saline is inserted ```

Question 57

What is 3 dimensional imaging called?

Answer 57

Volume imaging

Question 58

What does volume imaging evaluate?

Answer 58

Endometrium

Question 59

What kind of imaging is demonstrated with 3D?

Answer 59

Coronal imaging

Question 60

How is a volume image taken?

Answer 60

Press 3D/4D button Will automatically sweep to image Sonographer manipulates image to visualize endometrium canal Line up dots with endo line in 3 different planes