The sonographic and Doppler evaluation of the female pelvis

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1

Displaces; flattens

The full bladder _____ the bowel and its contained gas from the field of view and ____ the anteflexed uterus slightly so that it is more perpendicular to the transducer angle.

2

Triangular

The bladder shape may be helpful because a well distended bladder typically has a ____ or elongated shape on midline scans.

3

Iliac

The ___ vessels can be used as a landmark to identify the lateral adnexal borders.

4

Right upper quadrant; renal

If pathology is present, documentation of the ____ (morison's pouch and subphrenic area) and bilateral ____ areas must be obtained.

5

Anterior; posterior

In transvaginal scanning, it is necessary to advance the transducer slightly, angling ___ to visualize the fundus, and to withdraw slightly, away from the external os, while angling ____ to see the cervix and the rectouterine recess.

6

Lenth; width; axial

These measurements of the uterus and ovaries should be documented: _____, ____, and ______.

7

Sagittal

The thickness of the endometrium should be measured in the ____ plane.

8

Symmetrical

Pelvic muscles may be mistaken for ovaries, fluid collections, or masses. A ____ bilateral arrangement indicates that they are muscles

9

Obtuator internus

Sonographically, sections of the ____ muscle are seen at the posterior lateral corners of the bladder at the level of the vagina and cervix.

10

Levator ani

The muscle that is best visualized sonographically in a transverse plane with caudal angulation at the most inferior aspect of the bladder is the ____ muscle.

11

Piriformis

The muscles that are located on either side of the midline posterior to the upper half of the uterine body and fundus are the ____ muscles.

12

Lateral

To asses the uterine vessels, the sonographer interrogates just ___ to the cervix and lower uterine segment of the level of the internal os.

13

Low-velocity

A ____, highly resistive flow pattern in the ovary is show during the follicular phase of the menstrual cycle.

14

Decreases

At ovulation, the maximum velocity increases and the RI _____.

15

Myometrium

The middle uterine layer is the ____ of the uterus; this layer should have a homogenous echotexture with smooth-walled borders.

16

Endometrium

The ____ of the uterus is hypoechoic and surrounds the relatively echogenic endometrial stripe, creating a subendometrial halo.

17

Arcuate

Calcifications may be seen in the ____ arteries in post-menopausal women and appear as peripheral linear echoes with shadowing.

18

Internal os

The body of the uterus is separated from the cervix by the isthmus at the level of the ____ and is identified by narrowing of the canal.

19

Flexion; version

The axis of the uterine body relative to the cervix is referred to as the ____, whereas ______ refers to the axis of the cervix relative to the vagina.

20

Transabdominal

The best way to measure the cervical fundal dimension of the uterus in the longitudinal plane is the _____ technique.

21

Endometrial

During menstruation (days 1-4) the ____ canal appears as a hypoechoic central line representing blood and tissue reaching 4-8 mm, including the basal layer in this measurement.

22

Hyperechoic

As menses progress (days 3-7), the hypoechoic echo that represented blood disappears, and the endometrial stripe is a discrete thin _____ line that is usually only 2-3 mm long.

23

Single thin

In the early proliferative phase (days 5-9), the endometrial canal appears as a ____ stripe.

24

Functionalis

The layer that is seen as a hyperechoic halo encompassing the stripe is the ____ layer.

25

Basalis

The layer of the endometrium that represents the thin surrounding hyperechoic outermost echo is the ____ layer.

26

Secretory

During the ____ (luteal) phase (days 15-28), the endometrium is at its greatest thickness and echogenicity with posterior enhancement.

27

Echogenic

Sonographically, the post-menopausal endometrial complex is seen as thin ____ line measuring less than 8 mm, unless a hormone regimen is being followed.

28

Fluid

If the tubes are distended with or surrounded by a sufficient amount of _____, they can be easily outlined by the contrasting fluid.

29

Lateral; anteromedial

Typically, the ovary is located just ___ to the uterus and ____ to the internal iliac vessels, which can be used as a landmark to localize the ovary.

30

Follicular cyst

The best sonographic marker for the ovary is identification of a ____, which has the classic appearance of being thin walled and anechoic with through-transmission posteriorly.

31

Rectouterine recess

The posterior cul-de-sac, or _____, is the most posterior and inferior reflection of the peritoneal cavity. It is located between the rectum and vagina and is also known as the pouch of Douglas.

32

Sonohysterography

_____ involves the instillation of sterile saline solution into the endometrial cavity.


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