1
Q
almond-shaped slightly flattened structures that are attached to uterus by ovarian ligaments
A
ovaries
2
Q
long narrow tube located between the ovaries and the uterus that serve as the tunnel of the ova that travels from the ovaries to the uterus
A
uterine or Fallopian tubes (oviducts or salphinges)
2
Q
size of ovaries
A
2.5 - 5 cm long
1 cm wide
1 cm thick
3
Q
size of uterine
A
10 - 12 cm in length
1 - 4 mm in diameter
4
Q
where does fertilization of ovum generally occurs?
A
oviducts
5
Q
- a thick-walled muscular organ lying within the pelvis.
- Its position changes with the degree of fullness of the bladder and rectum.
A
uterus
6
Q
4 parts of uterus
A
- fundus
- body
- isthmus
- cervix
6
Q
rounded superior portion of the uterus. It is found above the line joining the entrance of the uterine tubes.
A
fundus
7
Q
small triangular area between the uterine walls, extend downward toward the isthmus.
It is the MAIN portion of the uterus.
A
body
7
Q
narrow constricted area located between the cervix and body of uterus measuring about 1 cm in length.
A
isthmus
8
Q
lower end portion of the uterus, located at the top of the vagina, 1 inch long.
A
cervix
9
Q
muscular tube that forms lower portion of the birth canal.
A
vagina
10
Q
size of vagina
A
7.5 cm or 3 inches long
10
Q
3 layers of vagina
A
mucosal layer
muscular layer
fibrous layer
11
Q
space into which the vagina and urethra open
A
vestibule
11
Q
a thin mucous membrane that covers the vaginal opening.
can completely close the vaginal orifice, in which case it must be removed to allow menstrual flow
A
hymen
12
Q
a small erectile structure located in the anterior margin of the vestibule.
consists of a shaft and distal glands
A
clitoris
12
Q
The clitoris is well supplied with ____ receptor, and it is made up of erectile tissue.
A
sensory
12
Q
The region between the vagina and the anus
A
clinical perineum
12
Q
are two prominent, rounded folds of skin located lateral to labia minora.
A
labia majora
13
Q
what type of incision is conducted to prevent tearing of the skin and muscle of clinical perineum during childbirth?
A
episiotomy
13
Q
functions of vagina
A
- receptacle for the penis during sexual intercourse
- outlet for blood during menstruation
- Passageway for the baby to pass through at birth
14
Q
narrow, tightly coiled tube connecting the ductus deferentes from the rear to its vas deferens.
consists of head, body, tail
A
epididymis
15
Q
where is epididymis attached?
A
superior and lateroposterior aspect of testis
16
thickness of epididymis
5 - 10 mm
16
an ovoid-shaped structure, divided into 200 – 300 compartments, with tubules that enter the head of the epididymis.
testis
17
size of testis
1.5 inches (3.7 cm) length
1 inch (2.5 cm) width
1 inch depth
18
These are excretory channels, one leading from each testis and through which the spermatozoa pass from gonads to the prostatic portion of the urethral canal
ductus deferentes (vas deferens)
19
size of vas deferens
16 - 18 inches (40 - 46 cm) length
20
a walnut-sized gland located in the pelvic area, just below the outlet of the bladder and in front of the rectum
prostate gland (PG)
21
functions of prostate gland
* To produce, maintain, and transport sperm and semen
* To discharge sperm
* To produce and secrete male sex hormones
21
examination procedures for males
* For Seminal ducts
1. Vesiculography
2. Epididymography
3. Epididymovesiculography
* For Prostate
1. Prostatography
(ung may number ha baka kung ano pa anohin mo letse ka)
22
examination procedures for females
1. Vaginography
2. Hysterosalpingography
23
Radiographic examination of the EPIDIDYMIS using positive contrast media.
EPIDIDYMOGRAPHY
24
Radiographic examination of the SEMINAL VESICLE, VAS DEFERENS, and EJACULATORY DUCTS using positive contrast media.
VESICULOGRAPHY
24
Radiographic examination of the PROSTATE GLAND using positive contrast media.
PROSTATOGRAPHY
25
Radiographic examination of the VAGINA to investigate congenital malformations or any pathology by introducing positive contrast media.
VAGINOGRAPHY
26
Radiographic examination of the UTERUS and FALLOPIAN TUBES using iodinated c.m.
HYSTEROSALPINGOGRAPHY
hyster/o = uterus
salping/o = fallopian tubes
26
ok sa mga laman na ng bawat examination
next
27
VESICULOGRAPHY
Pathologic indications
* Cysts
* Abscesses
* Sterility
* Tumors
* Inflammation
* Epididymitis
* Orchitis
* Obstruction
27
VESICULOGRAPHY
Patient Prepation
* Take two dulcolax tablet after lunch prior to examination (oral)
* Light supper evening
* Cleansing enema or 30 cc of castor oil before bedtime if not contraindicated
* NPO post-midnight
* The patient is partially dehydrated by withholding the intake of fluid for 9-12 hours
* No breakfast
* Report to x-ray department immediately
28
Two Methods of Performing VESICULOGRAPHY
1. Catheterization of the ejaculatory ducts is done with a special catheter inserted through the urethra.
2. Scrotal incision
29
VESICULOGRAPHY
Series film
ito for all projection
- CR & RP - ⊥ to superior border of the symphysis pubis
- IR size - 8 x 10 or 10 x 12
1. AP PROJECTION
- Radiograph should have a short scale of contrast to optimally demonstrate the seminal ducts
2. RAO & LAO
- Iliac crest should not superimpose the seminal ducts
- Uppermost thigh should not overlap the region of the prostate and urethra
29
VESICULOGRAPHY
Preliminary film
AP PROJECTION
- CR & RP - ⊥ to superior border of the symphysis pubis
29
PROSTATOGRAPHY
Pathologic Indications
* Prostate stones
* Tumor
* Benign prostatic hyperplasia (BPH)
* Prostitis
* Prostate cancer
30
PROSTATOGRAPHY
Patient preparation
* Take two dulcolax tablet after lunch prior to examination
* Light supper evening
* Cleansing enema or 30 cc of castor oil before bedtime if not contraindicated
* NPO post-midnight
* No breakfast
* Report to x-ray department immediately
(pinagkaiba lang sa vesiculography ay meron vesic na no fluid intake for 9-12 hours, dito kasi sa prostato ay wala)
30
PROSTATOGRAPHY
preliminary film
AP PROJECTION
- CR - ⊥ to the IR
- RP - at the level of symphysis pubis
30
PROSTATOGRAPHY
series film
PA AXIAL PROJECTION
- Head is in lateral position for patient’s comfort
- Both hands are placed at sides of patient’s head
- RP - at the level of symphysis pubis
- CR - directed at an angle of 20 – 25 degrees cranially to the RP
- Take exposure at the end of exhalation
30
VAGINOGRAPHY
Pathologic indications
* Fistula
* Tumor
* Vaginal warts
* Vaginismus
* Vaginitis
30
VAGINOGRAPHY
Preliminary film
AP PROJECTION
- CR & RP - ⊥ to RP, at the level of superior border of symphysis pubis
- IR size - 10 x 12 (all exam)
31
what is the advantage of PA position?
it places the prostate gland CLOSER to the film or IR, allowing coccyx and sacrum to be projected above region of the PG by angulating CR
31
VAGINOGRAPHY
Series film
- CR & RP - ⊥ to RP, level of superior border of symphysis pubis (sa lahat)
1. AP PROJECTION
2. LATERAL PROJECTION
3. RAO PROJECTION
4. LAO PROJECTION
32
HYSTEROSALPINGOGRAPHY
Purposes
* procedure best demonstrates the uterine cavity and the patency of the uterine tubes.
* The uterine cavity is outlined by injection of contrast media throughout the cervix.
* The shape and contour of the uterine cavity are assessed to detect any uterine pathologic process.
* Tumor or mass
* Tubal ligation
* Pre and Post operative evaluation of the genital organs
* Location of ectopic or lost contraceptive devices
* Re-opening of the fallopian tubes following a sterilization or disease-related blockage
33
HYSTEROSALPINGOGRAPHY
Contraindications
* Acute or sub-acute pelvic inflammation
* Vaginal infections
* Active uterine bleeding
* Pregnancy
33
HYSTEROSALPINGOGRAPHY
Imaging equipment
* The major equipment required for HSG is CONVENTIONAL or DIGITAL FLUOROSCOPY. Ideally, the table should have the capability to tilt the patient to a Trendelenburg position if needed.
* If available, GYNECOLOGIC STIRRUPS should be attached to the table to assist the patient in the lithotomy position.
33
HYSTEROSALPINGOGRAPHY
Patient preparation
* Departmental protocol should determine the requirements for patient preparation.
* Preparation may include a MILD LAXATIVE, SUPPOSITORIES, or a CLEANSING ENEMA, or some combination of these, before the procedure. In addition, the patient may be instructed to take a MILD PAIN RELIEVER.
* To prevent displacement of the uterus and uterine tubes, the patient should be instructed to EMPTY HER BLADDER immediately before the examination.
33
an instrument with an instrument with a hooked clamp for gathering and holding tissues and structures in place
tenaculum
33
HYSTEROSALPINGOGRAPHY
Cannula or catheter placement and injection process:
* At the beginning of the procedure, the patient lies SUPINE on the table in the LITHOTOMY position. If gynecologic stirrups are unavailable, the patient bends her knees and places her feet at the end of the table.
* The patient is draped with sterile towels; with sterile technique, a VAGINAL SPECULUM is inserted into the vagina. The vaginal walls and cervix are cleansed with an antiseptic solution.
* A CANNULA or BALLON CATHETER is inserted into the cervical canal. Dilation with a balloon catheter helps to occlude the cervix, preventing contrast media from flowing out of the uterine cavity during the injection phase.
* A tenaculum may be necessary to aid in insertion and fixation of the cannula or catheter.
* When cervical placement of the cannula or catheter has been obtained, the physician may remove the speculum and place the patient in a slight TRENDELENBURG position.
* This position facilitates the flow of contrast media into the uterine cavity. A syringe filled with contrast media is attached to the cannula or balloon catheter.
* Using FLUOROSCOPY, the physician slowly injects contrast media into the uterine cavity. If the uterine tubes are patent (open), contrast media flows from the distal ends of the tubes into the peritoneal cavity.
(translate mo sa tagalog kung d mo gets leste tamo ka ifflag mo lang din to wag na lang ipaggawa letse)
33
HYSTEROSALPINGOGRAPHY
Additional and optional equipment
* Routinely, a sterile, DISPOSABLE HSG TRAY is used.
* An additional instrument that may be requested by the physician is a TENACULUM
33
HYSTEROSALPINGOGRAPHY preliminary film and series film (same lang sila ng projection)
AP PROJECTION
- CR & RP - ⊥ to the RP, 2” above the symphysis pubis
- IR size - 10 x 12
RCE
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