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88 Cards in this Set
- Front
- Back
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What three things should documentation include when noting a mass?
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1. landmarks
2. measurments 3. characteristics |
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what are two abdominal scan techniques
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transabdominal sonography (TAS)
transvaginal sonography (TVS) |
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what is the MHz of the usual curved linear array probe used for TAS
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3.5-5.0 MHz
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is the TAS or TVS probe a higher frequency
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tvs
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what is the MHz of the probe used for TVS
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5-13MHz
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what are two important things to do w/ the pt before begining a TVS exam
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explain proceedure and obtain verbal consent
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what are the adv. of a transabdominal scan
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panoramic/ wider views
displacement of bowel scan pts of all ages see mid abd. path better visualization of ant. ovaries more accurate msmt. |
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what is the purpose of the full bladder technique when doing TAS
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flattens antiflexed uterus and provides accoustic window to uterus and ovaries
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what is the standard pt. prep for TAS
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pt should drink 32 oz. of fluid before exam
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what are disadvantages of TAS
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1.adnexal struc. diff. to visualize due to gas
2. bowel/colon/rectum can mimic a mass 3.cannot see detail of mass 4. uncomfy prep 5. hard to see retroverted or retroflexed 6. large pt size can be limiting |
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what are adv. of TVS
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good resolution
more specific info no exam prep can touch pelvic organs allows use of free hand for assistance |
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what are disadvantages of TVS
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narrow or stenoic cervix
obese pts can limit probe manipulation masses >10cm may either not be visualized or only partially seen invasive exam diff. to tolerate due to primary pain limiting to pt age |
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why do a TVS scan
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gynechological survey
1st trimester sonography suspected ectopic preg fert. studies diff. getting images on TAS study intruterine path emergent situations |
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what should you do to prep probe for TVS
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soaked in gluterablehyde-based disenfec. at least 20 min btw pts.
*always wear gloves |
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what is a nebothian cyst
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benign cyst within the cervix
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what are some other names for a nabothian cyst
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inclusion or retention cyst
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what causes a nabothian cyst
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obstructed or dilated endocervical gland (nabothian gland or duct
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what is the purpose of the nabothian glands/ducts
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produce mucous and are located in the walls of the cervix
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what causes nabothian cysts
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1.retention of mucous w/in gland
2.chronic cervicitis 3.blockage of gland |
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how common are nabothian cysts
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very common; normal feature on adult cervix
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where are nabothian cysts found
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lower uterine segment
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what are the symptoms of nabothian cysts
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asymptomatic; no treatment required
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what is the sonographic appearance of nabothian cysts
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have all the characteristics of cysts; best seen trans vag.
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what are the differential dx for nabothian cysts
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can be mistaken for ovaries; can r/o by turning on it
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cervical polyps
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hyperplastic protrusion of the epithelium of the cervix. Can be broad based or preduculated
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what causes cervical polyps
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typically due to chronic inflammation
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hyperplastic
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overgrowth of tissue
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neoplasm
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condition
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what is the most common neoplasm of the cervix
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cervical polyps
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who is most likely to have cervical polyps
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multigravidas
perimenopausal or post menopausal |
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what % of women have cervical polyps
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4%
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What are the signs of cervical polyps
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bleeding and spotting sometimes bleeding after sex
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what is the sonographic appearance of cervical polyps
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hyperechoic or isoechoic
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what are the differential dx for cervical polyps
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cervical fibroid or cervical mass
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symptoms of cervical myomas
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dyspareunia-painful sex
dysurea-painful urination urgency genitourinary obstruc. cervical obstruction (cause hematometra) |
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sonographic appearance of fibroids
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more hypoechoic than normal uterine tissue
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incompetent cervix
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inability of cervix to retain an intrauterine preg. until term due to weakness in sphincter of internal os.
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what can cause a weakness in the external os
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congenital abnormalities
multiple terminations > than one D&C diff. deliveries HX of DES |
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what % of 2nd trimester abortions are due to incomp. cervix
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16-20%
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what % of incomp. cervix are caused by aquired conditions
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98%
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What is the msmt of a shortened cervix
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<2.5cm
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what is the sonographic appearance of incompetent cervix
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trans. vag normal cervical length is variable for 2.8-4.5 cm under 30 weeks of preg
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D&C
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dilitation and cuturage
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when noting funneling how should msmt be taken
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from internal to external os
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cervical stenosis
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obstruction of cervical canal at the internal or external os due to childbirth, surgery, cervical CA, radiation of the pelvis
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what are symp of cervical stenosis
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usually asymptomatic but can have lower back pain with menstral cycle
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can you see cervical stenosis on u/s
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no
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gartners duct cyst
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a remnant of the mesonephric duct from embryonic division
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how common is gartners duct cyst
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most common cystic lesion of the vagina found in long ant/ lat vag wall
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signs of gartners duct cyst
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none
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leiomyoma
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benign smooth muscle tumors
(Fibroids, fibromas and myomas) |
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what causes leiomyomas
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estrogen dependant;
> with preg < with menopause as long as u have period u have potential for fibroids 4 f's |
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what % of women have fibroids
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20-25%
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where do fibroids mostly occur
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anywhere in the uterus, broad lig, round lig. or cervix.
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characteristics of fibroids
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attenuation of sound; no enhancment; may have calcifications, distortion of uterine contour, may cause compressoin of adj. organs
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what is the most common benign tumor in the pelvis
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fibroids
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predunculated fibroid
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Fibroid arising from a stalk
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where are intramural fibroids found
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myometrium
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submucosal fibroid
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fibroid lying directly beneath the endometrium often projecting into the cavity
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intracavity fibroids
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originates from and lies entirely w/in the endo.
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which type of fibroids are the easiest to remove
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intracavity
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myomectomy
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removal of fibroid
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subserosal fibroids
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located close to the outer, peritoneal surface of the uteral wall
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what are symptoms of the subserosal fibroid
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can cause pressure and pain against adj organs (bladder and rectum)
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interligamentous fibroids
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occur with in the broad or round lig.
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what causes fibroid degeneration
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mass outgrows blood supply
necrosis takes place |
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leiomyosarcoma
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malignant degeneration of a fibroid
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endometrial hyperplasia
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excessive thickening of endometrial tissue or proliferation of endometrial tissue
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what causes endometrial hyperplasia
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unopposed estrogen
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tomoxofen therapy
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used in postmenopausal pts with breast ca. causes endo to thicken with long term therapy.
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tomoxofen can cause
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endometrial polyps
endo fibroids endo CA |
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endo hyperplasia msmts
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dx when endo msmt is > 14mm in premenopausal
endo msmt > 8mm in post menopausal endo msmt >14mm in post men on estrogen replacement |
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Is the uterus enlarged with endometrial hyperplasia
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no
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what are the clinical symptoms of endo. hyperplasia
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irregular bleeding
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what are the differential dx for endo hyperplasia
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early intrauterine preg
secretory endo HRT endo polyps or fibroids endo ca |
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what are endometrial polyps
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mass attached to the endo cavity by a stem or pedicle
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what is the peak age occurance for endo polyps
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40-49
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what do endo polyps look like on U/S
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hyperechoic areas with in endo; indistinguishable for endo hyperplasia; irregular endo contour seen after menses
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when should the endometrium be evaluated for endo polyps
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during early proliferative phase when lining is at its thinnest
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sonohysterography
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saline is infused into the endo using a catheter passed thru the cervical canal
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echogenicity of fibroids
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are more hypoechic
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echogenicity of polyps
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hyperechoic
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the most important prerequisites for TVS is:
a. emptying of the bladder b. selecting a low-freq. probe c. adequate filling of the bladder d. putting the patient in the Trendelenburg position |
A
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Where are Nebothian cysts located?
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cervix
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what is the range of tx frequencies used in TVS
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5.0-7.5 MHz
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Which of the following is not true for TVS sonography...
a. both ovaries are always seen simulateously b. an empty bladder is required before scanning c. the ovaries are identifies by the presence of follicles d. a large mass can be missed |
A
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fluid in the posterior cul-de-sac is uncommon with
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uterine Leiomyomas or fibroids
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The use of high frequency transvaginal transducers result in
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less penetration, more magnification and better resolution
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