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Chapter 39 Female Pelvis

Terms in this set (91)

coccygeus muscles
One of two muscles in the pelvic diaphragm; located on the posterior pelvic floor, where it supports the coccyx
false pelvis
Portion of the pelvis found above the brim; that portion of the abdominal cavity cradled by the iliac fossae
iliacus muscle
Paired triangular, flat muscles that cover the inner curved surface of the iliac fossae; arise from the iliac fossae, and join the psoas major muscles to form the lateral walls of the pelvis
iliopectineal line
a bony ridge on the inner surface of the ilium and pubic bones that divides the true and false pelvis
levator ani
one of two muscles of the pelvic diaphragm that stretch across the floor of the pelvic cavity like a hammock, supporting the pelvic organs and surrounding the urethra, vagina, and rectum; a broad thin muscle that consists of the pubococcygeus, iliococcygeus, and puborectalis
obturator internus muscle
a triangular sheet of muscle that arises from the anterolateral pelvic wall and surrounds the obturator foramen; passes through the lesser sciatic foramen and inserts into the medial aspect of the greater trochanter of the femur; serves to rotate and abduct the thigh
piriformis muscle
a flat, pyramidal muscle arising from the anterior sacrum, passing through the greater sciatic notch to insert into the superior aspect of the greater trochanter of the femur; serves to rotate and abduct the thigh
psoas major muscle
paired muscles that originate at the transverse process of the lumbar vertebrae and extend inferiorly through the false pelvis on the pelvic sidewall, where it unites with the iliacus muscle to form the ilioposoas muscle before inserting into the lesser trochanter of the femur; serves to flex the thigh towards the pelvis
striations
parallel longitudinal lines commonly seen in muscle tissue when imaged sonographically; appear as hyperechoic parallel lines running in the long axis of the hypoechoic muscle tissue
true pelvis
pelvic cavity found inferior to the pelvic brim; protects the bladder and some reproductive organs
anteverted
Position of the uterus when the uterus is tipped slightly forward so that the cervix forms a 90-degree angle or less with the vaginal canal; most common uterine position
anteflexed
refers to the position of the uterus when the uterine fundus bends forward toward the cervix
broad ligament
a broad fold of peritoneum draped over the fallopian tubes, uterus, and the ovaries; extends from the sides of the uterus to the sidewalls of the pelvis, dividing the pelvis from side to side and creating the vesicouterine pouch anterior to the uterus and the recto-uterine pouch posteriorly; it is divided into the mesometrium, mesosalpinx, and mesovarium
cardinal ligament
wide band of fibromuscular tissue arising from the lateral aspects of the cervix and inserting along the lateral pelvic floor; a continuation of the broad ligament that provides rigid support for the cervix
estrogen
steroidal hormone secreted by the theca interna and granulosa of female reproductive structures and secondary sexual characteristics; promotes the growth of endometrial tissue during the proliferative phase of the menstrual cycle
mesosalpinx
upper portion of the broad ligament that encloses the fallopian tubes
mesovarium
the posterior portion of the broad ligament that is drawn out to enclose and hold the ovary in place
ovarian ligament
a paired ligament that extends from the inferior/medial pole of the ovary to the uterine cornua
ovum
female egg; secondary oocyte released from the ovary at ovulation
perimetrium
a serous membrane enveloping the uterus; also called the serosa
progesterone
steroidal hormone produced by the corpus luteum that helps prepare and maintain the endometrium for arrival and implantation of an embryo
rectouterine recess (pouch)
area in the pelvic cavity between the rectum and the uterus that is likely to accumulate free fluid
retroflexed
postition of the uterus when the uterine fundus bends posteriorly upon the cervix
retroverted
position of the uterus when the entire uterus is tipped posteriorly so that the angle formed between the cervix and the vaginal canal is greater than 90 degrees
round ligament
paired ligaments that originate at uterine cornua, anterior to the fallopian tubes, and course anterolaterally within the broad ligament to insert into the fascia of labia majora; hold the uterus forward in its anteverted position.
space of Retzius
located between the anterior bladder wall and the pubic symphysis; contains extraperitoneal fat
suspensory ligament
paired ligaments that extend from the infundibulum of the fallopian tube and the lateral aspect of the ovary to the lateral pelvic wall; also called the infundibulopelvic ligament
uterosacral ligament
posterior portion of the cardinal ligament that extends from the cervix to the sacrum
vesiouterine recess (pouch)
area in the pelvic cavity between the urinary bladder and the uterus
corpus luteum
anatomical structure on the surface of the ovary, consisting of a spheroid of yellowish tissue that grows within the ruptured ovarian follicle after ovulation; acts as a short-lived endocrine organ that secretes progesterone to maintain the decidual layer of the endometrium should conception occur
amenorrhea
absence of menstruation
dysmenorrhea
pain associated with menstruation
follicle-stimulating hormone
hormone secreted by the anterior pituitary gland that stimulates the growth and maturation of graafian follicles in the ovary
gonadotropin
hormone secreted by the hypothalamus that stimulates the release of follicle-stimulating hormone and luteinizing hormone by the anterior pituitary gland
gonadotropin-releasing hormone
hormone substance that stimulates the function of the testes and the ovaries
luteinizing hormone
hormone secreted by the anterior pituitary gland that stimulates ovulation and then induces luteinization of the ruptured follicle to form the corpus luteum
menarche
refers to the onset of menstruation and the commencement of cyclic menstrual function; usually occurs between 11 and 13 years of age
menses
periodic flow of blood and cellular debris that occurs during menstruation
menorrhagia
abnormally heavy or long menstrual periods
oligomenorrhea
abnormally light menstrual periods
premenarche
time period in young girls before the onset of menstruation
vescicouterine
The anterior cul-de-sac, or _________ pouch, is located anterior to the fundus of the uterus between the urinary bladder and the uterus.
rectouterine
The posterior cul-de-sac, or _________ pouch, is located posterior to the uterus between the uterus and the rectum.
douglas
The rectouterine pouch is often referred to as the pouch of ________ and is normally the most inferior and most posterior region of the peritoneal cavity.
Retzius
An additional sonographically significan area is the retropubic space, which is also called the space of ________.
anterior
The retropubic space normally can be identified between the ________ bladder wall and the pubic symphysis.
posteriorly
The retropubic space normally contains subcutaneous fat, but a hematoma or abscess in this location may displace the urinary bladder ________.
ovulation
The greatest quantitty of free fluid in the cul-de-sac normally occurs immediately following _______ when the mature follicle ruptures.
28
The average menstrual cycle is approximately ________days in length, beginning with the first day of the menstrual bleeding.
hypothalamus
The menstrual cycle is regulated by the ________ and is dependent upon the cyclic release of estrogen and progesterone from the ovaries.
ovum
During the menarchal years, a9n) ________ is released once a month by one of the two ovaries in a process known as ovulation.
14
Ovulation normally occurs midcycle on about day ________ or a 28-day cycle.
FSH
Secretion of the ________ by the anterior pituitary gland causes the ovarian follicles to develop during the first half of the menstrual cycle.
follicular
This phase of the ovulatory cycle, known as the ________ phase, begins with the first day of menstrual bleeding and continues until ovulation on day 14.
luteinizing
The ________ hormone level will typically increase rapidly 24-36 hours before ovulation in a process known as the LH surge.
luteal
Cells in the lining of the ruptured ovarian follicle begin to multiply and create the corpus luteum, or yellow body, during the ________ phase.
proliferative
The phase of endometrial regeneration is call the ________ phase and will last until luteinization of the graafian follicle around ovulation.
secretory
The endometrial phase after ovulation is referred to as the ________ phase and extends from approximately day 15 to the onset of menses (day 28). The secretory phase of the endometrial cycle corresponds to the luteal phase of the ovarian cycle.
transabdominal
The approach that requires a full urinary bladder for us as an "acoustic window" and typically necessitates the use of a 3.5- to 5-MHz transducer for adequate penetration is the ________ approach.
transvaginal
A ________ examination is performed with an empty bladder and allows the use of a higher-frequency transducer, typically 7.5 to 10 MHz.
wider
The transabdominal scan offers a ________ field of view for a general screening of the pelvic anatomy.
distended
When a transabdominal scanning technique is used, a ________ urinary bladder is essential.
labia, majora, minora
The ________ are folds of skin at the opening of the vagina; the labia ________ is the thicker external folds, and the ________ consists of thin folds of skin between the labia majora.
innominate, sacrum, coccyx
The ________ bones make up the anterior and lateral margins of the bony pelvis; the ________ and ________ form the posterior wall.
piriformis, coccygeous
The margins of the posterolateral wall of the true pelvis are formed by the ________ and ________ muscles.
obturator internus
The anterolateral walls of the pelvi cavity are formed by the hip bones and the ________ muscles that rim the ischium and pubis.
Levitor ani, coccygeous
The lower margin of the pelvic cavity, the pelvic floor, is formed by the ________ and _______ muscles and is known as the pelvic diaphragm.
psoas, iliacus
The muscles of the false pelvis include the _______ major and _______ muscles.
perineum
The area below the pelvic floor is the ________.
puborectalis
The muscles that arise from the lower part of the pubic symphysis and surround the lower part of the rectum, forming a sling, are the ________ muscles.
vagina
A collapsed muscular tube that extends from the external genitalia to the cervix of the uterus is the ________.
posterior, anterior
The cervix lies ________ to the urinary bladder and urethra and ________ to the rectum and anus.
uterus
The largest organ in the normal female pelvis when the urinary bladder is empty is the ________.
cornua
At the lateral borders of the uterine fundus are the ________, where the fallopian tuves enter the uterine cavity.
internal, external
The cervix is constricted at its upper end by the ________ os and at its lower end by the ________ os.
isthmus
The point where the uterus bends anteriorly (anteversion) or posteriorly (retroversion) with an empty bladder is the ________.
perimetrium, myometrium, endometrium
The uterine wall consists of three histologic layers: the ________, the ________, and the ________.
fuctionalis, basalis
The endometrium consists primalriy of two layers: the superficial functional layer (zona ________) and the deep basal layer (zona ________).
broad, round, uterosacral, cardinal
The uterus is supported in its midline postition by paired ________ ligaments, ________ ligaments, ________, and ________ ligaments.
anteverted, anteflexed
The average uterine position is considered to be ________ and ________.
fallopian tubes
The ________ are contained in the upper margin of the broad ligament and extend from the uterine cornua of the uterus laterally where they curve over the ovary.
infundibulum, ampulla, isthmus, interstitial
The fallopian tubes are divided into four anatomic portions: the ________ (lateral segment), ________ (middle segment), ________ (medial segment), and ________ portions (segment that passes through the uterine cornua).
infundibulum
The ________ is often referred to as the fimbriated end of the fallopian tube because it contains fringelike extensions, called fimbriae, which move over the ovary directing the ovum into the fallopian tube after ovulation.
medial, anterior
The ovaries are usually located ________ to the external iliac vessels and ________ to the internal iliac vessels and ureter.
tunica albuginea
The cortex of the ovary consists primarily of follicles in varying stages of development and is covered by a layer of dense connective tissue, the ________.
medulla
The central ________ is composed of connective tissue containing blood, nerves, lymphatic vessels, and some smooth muscle at the region of the hilum.
estrogen, progesterone
The ovaries produce the reproductive cell, the ovum, and two know hormones: ________, secreted by the follicles, and ________, secreted by the corpus luteum.
iliac
The common ________ arteries course anterior and medial to the psoas muscles, providing blood to the pelvic cavity and lower extremities.
internal
The f________ iliac arteries extend into the pelvic cavity along the posterior wall and provide multiple branches that perfuse the pelvic structures to include the urinary bladder, uterus, vagina, and rectum.
radial
the ________ arteries extend through the myometrium to the base of the endometrium, where straight and spiral arteries branch off the radial arteries to supply the zona basalis of the endometrium
spiral
The ________arteries will lengthn dureing regeneration of the endometrium after menses to traverse the endometrium and supply the zona functionalis
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