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Spring 2014 - OB TEST 4 - S & D EVAL OF FEMALE PELVIS ✔️ > Female Pelvis & TA's/TV's > Flashcards

Female Pelvis & TA's/TV's Flashcards

0
Q

What is PATIENT PREP for a TRANS-VAGINAL scan?

A

NO PREP

Have patient urinate, getting out as much fluid as possible; bladder should be as empty as possible

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1
Q

What is PATIENT PREP for a TRANS-ABDOMINAL scan?

A

Full bladder - 4 to 6 glasses of water; finish 1 hour prior to exam
Do not void (urinate) prior to exam

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2
Q

What are the 6 reasons for having a full bladder during a TRANS-ABDOMINAL scan?

A

Displaces bowel/colon out of true pelvis
Better acoustic window - “overview” of organs
Anatomic & “cystic” reference point
Decreases mobility of organs/masses - full vs. empty
Contour reflects size/shape of surrounding organs
Causes physiologic retroversion of uterus

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3
Q

What are 3 different ways a bladder can be described based on fullness?

A

Not full, adequate, overdistended

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4
Q

What PATIENT HISTORY needs to be asked before a pelvic exam?

12 items

A

First day of last period. How was flow?
Gravid/Parity/Abortions. Menstrual status
Symptoms. Personal/family history of cancer
Previous surgeries. Previous pap/biopsy results
Lab tests. Findings on pelvic exam
Latex allergies? Previous US or other imaging

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5
Q

What is gravid?

A

Number of pregnancies

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6
Q

What is parity?

A

Number of live births

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7
Q

When talking about Menstural status, what is premenarch?

A

Prepuberty; prior to onset of menses

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8
Q

When talking about Menstural status, what is menarche?

A

Reaching puberty; menses every 21-28 days

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9
Q

When talking about Menstural status, what is peri/premenopausal?

A

2-10 years prior to cessation of menses

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10
Q

When talking about Menstural status, what is menopause?

A

Menses ceases permanently; AT LEAST one year without menses

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11
Q

BE ABLE TO EXPLAIN PROCEDURES:

  • Transabdominal (TA)
  • Transvaginal (TV)/Endovaginal (EV)
A

TA - done on belly, use of gel, take images, need a full bladder, can empty when done on top

TV/EV - use of condom & gel, empty bladder, insert into vagina, take images

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12
Q

What 4 organizations control performance standards in Pelvic US?

A

SDMS, AIUM, ACOG, ACR

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13
Q

What is SDMS?

A

Society of Diagnostic Medical Sonography

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14
Q

What is AIUM?

A

American Institute of Ultrasound in Medicine

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15
Q

What is ACOG?

A

American College of Obstetrics & Gynecology

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16
Q

What is ACR?

A

American College of Radiology

Mainly used for Pelvic US guidelines

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17
Q

What are some ACR guidelines for Pelvic US?

A

Valid reason for medical exam
Lowest possible dose - 100 mW/cm squared (AIUM bioeffects range)
Must identify & document ALL anatomy & pathology
Transperineal scan for PROM or prolapsed uterus
Must be accredited through ARDMS, follow protocols, up to date equipment, QA, quality improvement

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18
Q

What is PROM?

A

Premature rupture of membranes

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19
Q

What transducer would be used for a TA?

A

Curvilinear or sector/vector up to 5 MHz - “overview”

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20
Q

What transducer would be used for a TV?

A

TV transducer 7.5 MHz or higher - detail & characterization

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21
Q

When identifying pathology in a structure, what guidelines should be followed?

A

Identify anatomy and pathology in 2 planes - long & transverse

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22
Q

What should be remembered when setting up equipment for a scan?

A

Built in presets
Should tweak to improve
Harmonics
Highest frequency to penetrate; decrease if need more penetration

23
Q

When describing anatomy and pathology, what 5 details need to be included?

A 
Identity sonographic characteristics 
Location
Size
External contours
Internal consistency
24
Q

What is the normal size of a follicle?

A

Under 2.0-2.5 cm

25
Q

What measurement size is labeled as possible cyst?

A

Above 2.5 cm

26
Q

What is a limitation of the TA scan?

A

Obese patients or unable to fill bladder

27
Q

2 important things to remember about TA & TV scans…

A

Take images in long and transverse

Be methodical and routine; follow SAME imaging protocol

28
Q

List LONGITUDINAL TA & TV protocol…

A

Long ML UT w/ & w/o measure (fundus to cervix & AP)
Long Endometrium w/ & w/o measure (wall to wall; exclude fluid)
Long RT UT
Long RT edge of UT
Long RT ADX (between unsterile edge & iliac vessels)
Long ML UT
Long LT UT
Long LT edge of UT
Long ADX

29
Q

List TRANSVERSE TA & TV protocol…

A 
Trans Vagina
Trans Cervix
Trans LUS
Trans UT w/ & w/o measure
Trans Fundus
Trans RT ADX
Trans LT ADX
30
Q

How do you scan an OVARY Transabdominally & Transvaginally?

A 
Find ovaries transversely - follow ligament
Take multiple images of ovary
Measure ovary side to side
Turn 90° for longitudinal scan
Sweep through ovary
Measure ovary - long & AP
31
Q

What should you always be evaluating the pelvis for?

A

Masses or cysts

32
Q

What are the steps for a TV scan?

A 
Explain procedure
Prep probe
Have patient empty bladder & remove clothes from waist down
Position patient on bed
Have patient "guide" probe into vagina
Follow protocol for TA & TV
33
Q

For TV scanning, the LEFT side of the screen is showing what?

A

Cranial/right side of patient

34
Q

For TV scanning, the RIGHT side of the screen is showing what?

A

Caudal/left side of patient

35
Q

For TV scanning, the TOP is describing what scanning plane?

A

Caudal

36
Q

For TV scanning, the BOTTOM is describing what scanning plane?

A

Cranial

37
Q

For TV scanning, the RIGHT is describing what scanning plane?

A

Anterior

38
Q

For TV scanning, the LEFT is describing what scanning plane?

A

Posterior

39
Q

Direction of the TV transducer is based on the movement of the ______ of the transducer and not the ______ of the transducer.

A

Face; handle

40
Q

When doing a TV scan longitudinally, the notch of the transducer is pointed which direction?

A

Notch of transducer is up

41
Q

When doing a TV scan transversely, the notch of the transducer is pointed which direction?

A

Notch is pointed toward the sonographer

42
Q

When doing a TV scan, tilting the transducer anteriorly will bring what into view?

A

The fundus

43
Q

When doing a TV scan, tilting the transducer posteriorly will bring what into view?

A

Cul-de-sac

44
Q

Be sure to ALWAYS do what when finished with a TV scan?

A

Clean the probe

45
Q

When is a TRANSLABIAL scan done?

A

When a patient has PROM, cervical incompetence, or prolapsed uterus/cervix

46
Q

How is a TRANSLABIAL scan done and what transducer is used?

A

Considered a transperineal
Use a 3.5-5.0 MHz or TV probe
Cover probe & place in perineal area towards vagina

47
Q

When scanning, how do you know you’re imaging a muscle?

A

It will be hypoechoic structures with echogenic striations

48
Q

How are muscles seen when imaging? What type of transducer is used?

A

With a full bladder

Sector/vector or Linear transducer

49
Q

What is the Obturator Internus muscle?

A

Posterior lateral corners of bladder at vagina/cervix level

50
Q

What is the Pelvic Floor muscles?

A

Transverse inferior aspect of bladder

51
Q

What is the Piriformis muscles?

A

Posterior lateral to upper half of uterine body/fundus

52
Q

What muscles are scanned with a sector or vector transducer?

A

Obturator Internus muscles
Pelvic floor muscles
Piriformis muscles

53
Q

What is the Rectus Abdominus muscles?

A

Anterior abdominal wall

54
Q

What muscles are scanned with a linear transducer?

A

Rectus Abdominus muscles

Iliopsoas muscles

Spring 2014 - OB TEST 4 - S & D EVAL OF FEMALE PELVIS ✔️ (2 decks)

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