Normal anatomy and physiology of the female pelvis workbook

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1

Vesicouterine

The anterior cul-de-sac, or _______ pouch, is located anterior to the fundus of the uterus between the urinary bladder and the uterus.

2

Rectouterine

The posterior cud-de-sac, or ______ pouch, is located posterior to the uterus between the uterus and the rectum.

3

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.

4

Retzius

An additional sonographically significant area is the retropubic space, which is also called the space of _____.

5

Anterior

The retropubic space can be identified between the ______ bladder wall and the pubic symphysis.

6

Posteriorly

The retropubic space normally contains subcutaneous fat, but a hematoma or abscess in this location may displace the urinary bladder _____.

7

Ovulation

The greatest quantity of free fluid in the cul-de-sac normally occurs immediately following _____ when the mature follicle ruptures.

8

28

The average menstrual cycle is approximately ____ days in length, beginning with the first day of menstrual bleeding.

9

Hypothalamus

The menstrual cycle is regulated by the _____ and is dependant upon the cyclic release of estrogen and progesterone from the ovaries.

10

Ovum

During the menarchal years, a(n) ____ is released once a month by one of the two ovaries in a process known as ovulation.

11

14

Ovulation normally occurs midcycle on about day ___ of a 28-day cycle.

12

Follicle stimulating hormone

Secretion of the ______ by the anterior pituitary gland causes the ovarian follicles to develop during the first half of the menstrual cycle.

13

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.

14

Luteinizing

The ____ hormone level will typically increase rapidly 24 to 36 hours before ovulation in a process known as the LH surge.

15

Luteal

Cells in the lining of the ruptured ovarian follicle begin to multiply and create the corpus luteum, or yellow body, during the ____ phase.

16

Proliferative

The phase of endometrial regeneration is called the _____ phase and will last until luteinization of the Graafian follicle around ovulation.

17

Secretory

The endometrial phase after ovulation is referred to as the _____ phase and extends from approximately day 15 to the onset or menses (day 28). The ____ phase of the endometrial cycle corresponds to the luteal phase of the ovarian cycle.

18

Transabdominal

The approach that requires a full urinary bladder for use as an "acoustic window" and typically necessitates the use of a 3.5 to 5 MHz to adequate penetration is the _____ approach.

19

Transvaginal

A ____ examination is performed with an empty bladder and allows the use of a higher-frequency transducer, typically 7.5-10 MHz.

20

Wider

The transabdominal scans offers a _____ field of view for a general screening of the pelvic anatomy.

21

Distended

When a transabdominal scanning technique is used, a _____ urinary bladder is essential.

22

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 the thin folds of skin between the labia majora.

23

Innominate; sacrum; coccyx

The ____ bones make up the anterior and lateral margins of the bony pelvis; the ___ and ____ form the posterior wall.

24

Piriformis; coccygeus

The margins of the posterolateral wall of the true pelvis are formed by the ____ and ____ muscles.

25

Obturator internus

The anterolateral walls of the pelvic cavity are formed by the hip bones and the ____ muscles that rib the ischium pubis.

26

Locator ani; coccygeus

The lower margin of the pelvic cavity, the pelvic floor, is formed by the ____ and ____ muscles and is known as the pelvic diaphragm.

27

Perineum

The area below the pelvic floor is the ____.

28

Psoas; iliacus

The muscles of the false pelvis include the ____ major and ____ muscles.

29

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.

30

Vagina

A collapsed muscular tube that extends from the external genitalia to the cervix of the uterus is the ___.

31

Posterior; anterior

The cervix lies ____ to the urinary bladder and urethra and ____ to the rectum and anus.

32

Uterus

The largest organ in the normal female pelvis when the urinary bladder is empty is the ____.

33

Cornua

At the lateral boarders of the uterine fundus are the ____, where the Fallopian tubes enter the uterine cavity.

34

Internal; external

The cervix is constricted at is upper end by the ___ os and at its lower end by the _____ os.

35

Isthmus

The point where the uterus bends anteriorly (anterversion) or posteriorly (retroversion) with an empty bladder is the _____.

36

Perimetrium; myometrium; endometrium

The uterine wall consists of three histologic layers: the ____, the ____, and the ____.

37

Functionalis; basalis

The endometrium consists primarily of two layers: the superficial functional layer (zona ____) and the feel basal layer (zona ____).

38

Broad; round; uterosacral; cardinal

The uterus is supported in its midline position by paired ____ ligaments, ____ ligaments, ____ ligaments, and ____ ligaments.

39

Anteverted; anteflexed

The average uterine position is considered to be _____ and ____.

40

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.

41

Infundibulum; ampulla; isthmus; interstitial

The Fallopian tubes are divided into four anatomic portions; the ____ (lateral segment), ____ (middle segment), ____ (medial segment), and ____ portions (segment that passed through the uterine cornua).

42

Infundibulum

The ____ is often referred to as the fimbriated end of the Fallopian tube because it contains firngelike extensions, called fiambriae, which move over the ovary directing the ovum into the fallopian tube after ovulation.

43

Medial; anterior

The ovaries are usually located ____ to the external iliac vessels and ____ to the internal iliac vessels and ureter.

44

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 _____.

45

Medulla

The central ____ is composed of connective tissue containing blood, nerves, lymphatic vessels, and some smooth muscle at the region of the hilum.

46

Estrogen; progesterone

The ovaries produce the reproductive cell, the ovum, and two known hormones: ____, secreted by the follicles, and _____, secreted by the corpus luteum.

47

Iliac

The common ____ arteries course anterior and medial to the psoas muscles, providing blood to the pelvic cavity and lower extremities.

48

Internal

The ____ 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.

49

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.

50

Spiral

The ____ arteries will lengthen during regeneration of the endometrium after menses to traverse the endometrium and supply the zona functionalis.


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