GYN NL ANATOMY & PHYSIOLOGY

• Bony Boundaries - sacrum, coccyx, innominate bones (ilium, ischium, pubic symphysis)

• "Imaginary line from pubic symphysis to sacral prominence (top of sacrum)" - what's the term?

  Linea terminalis
• "... is deep and below the linea terminalis (at the bottom/INF). Imagine all the structures that can be seen or is in range of TV imaging. BL, small bowel, ascending and descending colon, rectum, UT, OV.s, F.T, internal iliacs, and 5 muscles."

  True pelvis
• The 5 true pelvic muscles:

  levator ani, coccygeus, obturator internus, piriformis, iliopsoas
• Pelvic diaphragm: levator ani and coccygeus

  Hammock shaped muscles that give support to pelvic organs

  (Weakening of these muscles leads to UT prolapse)

  Location: Identified scanning TRV inferiorly at level of vagina. POST to BL, vagina, and rectum
• Adnexa: "O.P.I" muscles

  Obturator internus (LAT to BL), piriformis (posterolateral), iliopsoas (anterolateral)

  Location: When scanning adnexa in TRV, appear as ovoid hypoechoic structures that elongate in SAG. Adjacent or LAT to BL/OV.s/UT
• Uterine ligaments are broad ligaments, round ligaments, and cardinal ligaments
• Broad ligaments is a double fold of peritoneum. From LAT sides of UT to walls of pelvis supporting pelvic organs. Only ligament ever visualized on sono, only when there is pelvic ascites
• Round ligaments is between folds of broad ligament. Support fundus of UT (superiorly)
• Cardinal ligaments contains vasculature of UT
• Retropubic space AKA space of Retzius ANT to BL
• ANT CDS AKA vesicouterine pouch. Between BL and UT (ANT to UT)
• POST CDS AKA rectouterine pouch/pouch of Douglas. Between UT and rectum (POST to UT)
• Uterine arteries: branches of internal iliac artery (AKA hypogastric artery)
• Arcuate arteries: periphery of myometrium
• Radial arteries: deeper into myometrium
• Straight and Spiral arteries: layers of ENDO (Straight feeds basal layer and spiral to functional)