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71 Cards in this Set
- Front
- Back
OSSEOUS LIGAMENTS
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Connect Pelvic Bones
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SUSPENSORY LIGAMENTS
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Support Uterus and Ovaries
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Female Pelvis Function
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a. weight bearing
b. pathway of fetal head c. Protect reproduction organs |
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Linea Terminalis
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imaginary line dividing pelvis
a. False(greater)- above b. True(lesser)- UT, ovaries, and adnx |
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Mullerian Ducts Form
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UT, Fallopian Tubes, Vagina
(Does not include ovaries) |
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DES
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T Shaped Uterus
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SIS
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Introduce saline in Endocavity
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Ovarian Torsion
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a. Large Uterus
b. Absent Color and Spectral Doppler c. Possible Arterial w/out Venous Flow d. Possible Adnx Mass |
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Polycystic Ovarain Syndrome
Clinical Signs |
(Stein-Leventhal Syndrome)
a. infertility b. obesity c. amenorrhea d. hirsuitism |
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PCOS Sonographic Findings
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a. ALWAYS bilateral
b. string of pearls c. normal ovarian size |
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RECTUS ABD MUSCLES
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ghosting artifact
anterior body wall |
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PELVIC DIAPHRAGM MUSCLES
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A. Perineal
B. Coccygeus C. levantor ani muscles |
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PELVIC DIAPHRAGM FUNCTIONS
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a. resist gravity
b. reist prolapse |
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VAGINAL FORNIX
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a. anterior
b. posterior c. Lateral |
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Parts of Uterus
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a. Fundus or Dome
b. Body or Corpus c. Isthmus or LUS d. Cervix |
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Cervix Functions
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a. alkaline secretion for sperm penetration
b. acts as a sphincter during pregnancy |
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Cervical Parts
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a. Internal OS- Cx to Uterus
b. External OS- Cx to Vaginal |
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Layers of Uterus
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a. Perimetrium- serosal (outer)
b. Myometrium- mid muscular c. Endo- inner mucous layer |
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Calcutate Ovarian Volume
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Length X Width X A/P X.523
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Parts of Fallopian Tubes
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(Oviducts)
a. Interstitial/Intramural- w/in cornua of Uterus b. Istmus- medial portian c. Ampulla- Longest portion *site of fertilization d. Infundibulum- trumpet end e. Fimbria- finger like projections |
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Vesicouterine Space
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anterior cul-de-sac
Anterior to Uterus Posterior to Bladder |
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Rectouterine Space
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Posterior Cul-de-sac
or Pouch of Douglas Posterior to Uterus and Cervix and Anterior to Rectum |
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Ovarian Arteries
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Gonadal Arteries
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Uterine Artery Doppler
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High Resistance Flow
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Gonadal Veins (RT and LT)
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Rt drains into IVC
Lt drains into LT Renal Venal then into IVC |
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Estradiol Levels Falls
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Hypothalamus produces Gonadotropic Releasing Hormone( GnRH)
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GnRH
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from Hypothalamus, signals anterior pituary gland to secrete gonadotropins (FSH and LH)
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FSH
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stimulate follicle growth
Theca cells(inside follicles) produce estrogen |
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Estrogen
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from Theca Cells inside Ovarian Follicles; stimulate endometrial growth
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LH
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muturation of follicle; Progesterone peaks after ovulation
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Corpus Luteal
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hCG secrets progesterone to prevent endo shedding; w/out inplantation-progesterine decreases and sloughing of uterus lining
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Follicular Phase
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FSH
estrogen >11mm follicle |
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Ovulation
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Day 14
LH Progesterone surges after Possible free fluid in post cul de sac |
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Luteal Phase
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Corpus Luteal- crater left by expulsion of ovum, becomes filled with yellowish fatty cell
(secretes progesterone- prepares endo for inplantaion) Day 15-18 |
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Luteal Phase Sonographic Findings
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a. irregular cystic mass with thick borders
b. Doppler findings hypervascular c. Echogenic structure representing thrombus |
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Ovarian Phases
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a. Follicular- 1-14
b. Ovulation - 14 c. Luteal- 15-28 |
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Uterine Phase
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a. Menstrual- 1-5
b. Proliferative- 6-14 c. Secretory- 15-28 |
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Menstrual Phase
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a. 1-5
b. thick, echogenic endo c. Thin endo @ menses d. Max diam- 2mm |
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Proliferative Phase
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a. 6-14
b. Theca Cells- Estrogen secreted X follicles (FSH) c. Hypoechoic area around endo (early) d. Thick, isoechoic (late) |
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Secretory Phase
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a. 15-28
b. Progesterone surges after ovulation c. endo becomes edematous and spongy c. no fertilization- autolysis(dies n ruptures) sloughing of endo d. Max Diam- 18mm |
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Menorrhagia
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heavy bleeding
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Metrorrhagia
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irregular, heavy bleeding
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Dysmenorrhea
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Painful bleeding
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Amenorrhea
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No mestrual
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- Colpos
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Vagina
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- Metro
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Uterus
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Post Menopausal
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a. myometrium may have calcified arcuate arteries
b. decrease estrogen- thin endo c. Max endo- 4-5mm |
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Hormone Replacement Therapy
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a. endo up to 8mm
b. Estrogen phase- 10-12mm Progesterone Phase- decrease endo |
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Causes of Post Menopausal Bleeding
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a. Exogenous Estrogen Admin
b. Endo Atropthy(most common reason w/o hormones c. Endo carcinoma d. Cervical CA |
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Tamoxifen
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T Shaped Uterus
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Failure of Formation
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Complete Agenesis- absence of vag, ut, cx, and tubes
Partial- Unicornuate Uterus and single tube |
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Failure of Fusion
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UT Didelphys- Duplication of UT, CX, and VAG
***Bicurnuate UT- single vag, one or two cervix, duplicate uterus(Most common anomaly) |
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Failure of Dissolution
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median septum fails to dissolve
Single vav, cx, and UT with and intrauterine septum |
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Failure of Dissappearance
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Gartners Duct Cyst- arises from caudal remnants of the Mesonephric(Wolfian) Duct
ant, lat wall of Vagina |
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Congenital Vaginal Anomalies
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a. Vaginal Atresia- no vag
b. Vaginal Septa- Septations w/in vag c. Duplication- two vaginas |
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Leiomyoma Locations
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a. Submucous- beneath endo
b. Intramural/Interstitial- w/in endo c. Pedunculation |
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Myoma Symptoms
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a. Menometrorrhagia
b. Freq urination c. Enlarge UT d. Pelvic Pain e. Infertility |
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Myoma Sono Findings
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a. well circumscribed hypoechoic mass
b. Lobulated w/increased attenuation c. Whirled internal |
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Adenomyosis
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a. Venetian Blind Shadow
b. Lg UT c. Myometrial Cysts d. Inhomogenous |
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Endo Carcinoma
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a. Postmenopausal Bleeding
b. Pain c. Increase UT size d. Fluid in endo e. Endo echoes |
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Endo Hyperplasia
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a. abn uterine bleeding
Caused X estogen hormone replacement, PCOD, obesity |
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Endo Hyperplasia Sono Findings
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smooth borders
Premenopausal- Endo>14mm Postmenopausal- Endo>5mm |
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Acute Hemorrhage Ovarian Cyst
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a. Posterior Acoustic Enhancement
b. Solid Hyperechoic Mass |
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Benign Serous Tumors(Ovarian)
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a. Unilateral Mostly
b. sharp marginals c. anechoic d. thin septations |
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Malignany Serous Tumors(Ovarian)
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a. Bilateral (50%)
b. Multilocular c. echogenic material d. ascites |
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Benign Mucinous Tumors
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a. Thick and numerous septations
b. Up to 50 cms c. Uni-lateral |
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Malignanct Mucinous Tumors
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a. papillary
b. up to 30 cm c, unilateral d. echogenic material |
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Transitional Cell Tumors
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Brenner Tumor
a. benign b. unilateral c. hypoechoic solid mass d. small cystic spaces e. calcs present f. greater than 2cm |
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Clear Cell Tumor
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a. always malignant
b. unilateral c. up to 30 cms d. complex solid mass |
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Germ Cell Tumors
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mostly benign
derived from germ cells of embryonic gonads |
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Benign Cystic Teratoma
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Germ Cell Tumor
unilateral asymtomatic, incidental finding cystic adnx mass with calcs diffuse echogenic |