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So we'll start with the review of the

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normal anatomy of the organs that can be

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seen via transabdominal or transvaginal

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ultrasound, and importantly,

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the relationship of the organs to one another.

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So starting in this view, in this schematic

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right here, starting from anterior, you

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have your pubic symphysis right here.

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Generally, if you're going to do a general

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transabdominal ultrasound, you're going

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to place your probe right around here on

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the pelvis. You're going to see, hopefully

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not through the symphysis, you're gonna

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have to place it slightly above to image

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here through the bladder. The bladder

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you want to be nicely distended,

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and that's for two reasons.

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It's going to push any small bowel loops

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up and out of the way because ultrasound

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can't see well through bowel loops.

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It's also going to serve as a window because

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ultrasound waves travel faster through fluid,

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so using that urine in a nicely distended

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bladder will help you to see the next organ

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right behind it, which is the uterus here.

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Back here is going to be the vagina right

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here with the fornices, anterior and posterior.

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And cervix right here.

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And then behind that, we of course

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have the rectum posteriorly back here.

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Here's a labeled one where you can get a little

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bit more detail if that's helpful to you.

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And again, this is the bladder here.

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You have your vagina here, your anterior,

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your posterior, fornix of the vagina.

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The external os of the cervix is right here.

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And then the internal os can be

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variably difficult to see but should

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be somewhere right around here.

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That's where the endometrium is going to start.

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And you have your anterior

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portion of the endometrium.

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And your posterior portion of the endometrium.

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So that's going to cover the lower uterine

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segment of the uterus, the body, and

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then the fundus of the uterus right here.

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And again, posterior to this

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is going to be the rectum.

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Again, moving to this unlabeled view right here.

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It's important to remember, too, when you're

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going to do a transvaginal approach to

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imaging, the cervix and uterus can be mobile.

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So it can look different on your

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imaging, depending on where it is

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at that particular time, at that

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particular day when you're imaging it.

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This is an example.

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The uterus can be anterior, sort of flopped

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anteriorly onto the bladder here, or it can

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be in a more posterior position as it is here.

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And remember, it's important because if

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you're doing transvaginal imaging, your

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fixed plane of imaging is going to be via

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the vagina, and you don't have a whole

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lot of wiggle room there to image this.