Sonographic appearance of female pelvis Cheat Sheet (DRAFT) by Alyssabruestle1

Muscles	Hypoechoic
Ligaments	Not seen unless there is free fluid; echogenic
Posterior cul de sac	Not uncommon to see small amount of fluid
Anterior cul de sac	usually empty
Fallopian tubes	Not seen unless if there is fluid or pathology
Vagina	Medium level echos, homoge­neous with smooth contours
Endome­trium	Changes based on menses
Superf­icial layer of endome­trium	Typically hypoechoic depends on cycle.
Basal layer of endome­trium	hypere­choic
Uterus	Dependent on myomet­rium. Isosonic to vaginal wall.
Internal os	Hard to see unless pregnant
External os	Echogenic line
Cervix	Homoge­neous, mid level echoes, isosonic to uterus
Endome­trial canal	Thin echogenic line
Ovary	Homoge­neous unless if there is a cyst
Mature Graafian or follicles	Anechoic

Menstrual phase (1-5 days)	Thin echogenic line
Prolif­erative phase (day 5-9)	Hypere­choic, 4-8mm, "3 line sign"
Prolif­erative phase (day 10-14)	isoechoic with myomet­rium, 6-10mm
Secretory phase (day 15-28)	thick echogenic line, 7-14mm

True pelvis	1. Piriformis 2. Obturator internus 3. pelvic diaphragm
False pelvis	1. Psoas major 2. iliacus 3. iliopsoas

Broad ligaments	Extend from uterine cornua to the lateral pelvic walls.
Round ligaments	Holds uterus in place
Cardinal and Utero Sacral	Provides support to the CERVIX
Infund­ibu­lop­elvic and ovarian	Support the ovaries
Pubove­sical and lateral	Holds the urinary bladder

Anterior cul de sac	Area between uterus and pelvic bone
Posterior cul de sac (pouch of Douglas)	Area between rectum and uterus

Vagina	Between urethra and rectum; posterior to urethra and bladder.
Cervix:	Between body of uterus and vagina
- External os	Muscle that connects the cervix to vagina
- Internal os	Muscle that connect the body of uterus to cervix
Uterus	Between bladder and rectum
Fallopian tubes (salpingo)	Emerges from cornua of uterus (later­ally)
Ovaries	Anterior to internal iliac arteries

Anteverted	Fundus is anteriorly at a 90 degree angle, most common.
Anteflexed	Fundus is pointing inferiorly and resting on cervix
Retrov­erted	Fundus is poster­iorly at an angle
Retrof­lexed	Fundus is superiorly and resting on cervix

UTERUS:
- Fundus	Widest and most superior portion (at level of cornua)
- Corpus (body)	Largest part
- isthmus (internal os)	Connects body and cervix
- Cervix	Lowest uterine segment
FALLOPIAN TUBES (salpi­ngo):
- Inters­titial (intra­mural)	Portion closest to uterus; narrowest
- Isthmus	Short straight narrow portion; adjacent to uterus
- Ampulla	Longest and most coiled portion; most common place for ectopic pregnancy
- Infund­ibulum	Funnel shape at end of the tube
OVARIES:
- Peripheral cortex	Site of oogensis (produ­ction of eggs, outer portion; contains follicles
- Central medulla	Made up of ovarian vascul­ature, homoge­neous.