Class 1

Question 1

Uterus: Definition and Regions

Answer 1

Pear shaped muscular organ
4 regions:
Fundus
Corpus
Isthmus
Cervix

Question 2

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

Answer 2

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

Question 3

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

Answer 3

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

Question 4

What are the 3 variants in uterine position?

Answer 4

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

Question 5

ANTEFLEXED Uterine Position

Answer 5

Uterine fundus and corpus tilted forward

Question 6

RETROFLEXED Uterine Position

Answer 6

Corpus and fundus tilted posteriorly

Question 7

RETROFLEXED and RETROVERTED Uterine Position

Answer 7

Corpus, fundus and cervix are tilted posteriorly

Question 8

UTERUS MYOMETRIUM: Ultrasound Appearance

Answer 8

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

Question 9

ENDOMETRIAL CAVITY: Ultrasound Appearance

Answer 9

• Thin echogenic line

- Varies in thickness in relation to menstrual phase

Question 10

Vagina: Ultrasound Appearance

Answer 10

• Mid gray to medium level echoes

- Vaginal canal is hyperechoic line

Question 11

Fallopian Tubes: What are the 4 Portions?

Answer 11

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

Question 12

INTERSTITIAL (INTRAMURAL): Portion of the Fallopian Tubes

Answer 12

Narrowest part, nearest cornu

Question 13

ISTHMUS: Portion of the Fallopian Tubes

Answer 13

Slightly wavy and longer

Question 14

AMPULLA: Portion of the Fallopian Tubes

Answer 14

Tortuous and longest part

Question 15

INFUNDIBULUM: Portion of the Fallopian Tubes

Answer 15

Lateral, trumpet shaped,

fimbriae

Question 16

What are the 2 Adjacent Spaces?

Answer 16

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

Question 17

ANTERIOR CUL DE SAC: What is it?

Answer 17

VESICOUTERINE POUCH

Reflection of peritoneum over anterior surface of uterus and bladder

Question 18

POSTERIOR CUL DE SAC: What is it?

Answer 18

RECTOUTERINE POUCH, POUCH OF DOUGLAS

Reflection of peritoneum over posterior surface of uterus and rectum

Question 19

What are the Ligaments?

Answer 19

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

Question 20

CARDINAL LIGAMENTS

Answer 20

anchor uterine corpus and cervix to lateral pelvic wall

Question 21

UTEROSACRAL LIGAMENTS

Answer 21

anchor uterine cervix to sacrum

Question 22

ROUND LIGAMENTS

Answer 22

anchor uterine fundus anteriorly

Question 23

BROAD LIGAMENT

Answer 23

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

Question 24

What are the bones that make up the Pelvic Girdle?

Answer 24

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

Question 25

What are the Muscles of the Pelvis?

Answer 25

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

Question 26

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

Answer 26

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

Question 27

What are the Ligaments of the Ovaries?

Answer 27

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

Question 28

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

Answer 28

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

Question 29

What is produced in the ovaries?

Answer 29

Hormones and gametes

Question 30

What are the 2 parts of the ovaries?

Answer 30

CORTEX (OUTER) - contains primordial follicles

MEDULLA (INNER) - contains connective tissue, nerves, blood supply, lymphatics & smooth muscle tissue

Question 31

Ovarian Follicles

Answer 31

• 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

Question 32

Ultrasound Appearance of Ovaries

Answer 32

-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

Question 33

Pelvic Vascular Supply

Answer 33

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