The safest, most accessible and precise method research in our time is ultrasound (ultrasound). This method examinations are used for almost all diseases of internal organs, systems, blood vessels and tissues. Examination of certain organs requires special preparation.
Ultrasound of the pelvic organs can be prescribed to men and women for diagnostic examination various reasons. When pathological changes appear on early stages this method allows them to be identified and carried out timely treatment. The accuracy of the diagnostic examination is more than 90%.
What is a pelvic examination?
Ultrasound examination, or scanning (also called ultrasonography), is performed using high-frequency sound waves to produce images on a monitor of body structures and internal organs.
The principle of the examination is to use a sonar system: a sound wave collides with an obstacle and is reflected from it, creating an echo. Computer processing of such data visualizes them on the monitor screen and shows the final appearance of the object being examined (density, amount of liquid, contours, shape, dimensions).
The sensor of the ultrasonic device sends sound signals and simultaneously receives them, a reflected echo and records the data in the computer.
Modern equipment makes it possible to take color photographs of the condition for some types of studies. internal systems organs.
The ultrasound examination process does not use ionizing radiation, as in X-ray examinations. By obtaining images of organs in real time, the study allows you to see the state of internal organs, tissue structure, movement and condition of organ walls, filling blood vessels, blood flow quality and valve condition.
Ultrasound examination is non-invasive (without penetrating tissue) and helps determine accurate diagnosis, making patient care and treatment more effective.
When performing an ultrasound of the pelvic organs, you can easily examine (take an image and save on media) the organs and adjacent tissues of the lower sections in abdominal cavity, small pelvis. Ultrasound examinations of pelvic organs and systems are performed abdominally, vaginally, rectally.
In some cases, simultaneously with the main examination, Doppler sonography is performed, which makes it possible to assess the condition of the vessels (veins or arteries) and the filling of organs with blood (whether a sufficient amount enters the organ or whether there is a small flow of blood and why). Impaired blood supply to organs can also cause their pathological condition.
Indications for pelvic ultrasound
Organs examined
An examination of the pelvic organs can be prescribed routinely, in the event of painful conditions, after various injuries for diagnostic assessment or extent of damage.
By using this study you can examine: the uterus, ovaries, appendages, fallopian tubes, vagina, urethra, bladder, prostate gland, tissues between these organs.
In women, ultrasound of the pelvic organs is recommended for the following conditions:
- preventative medical examinations during puberty or menopause;
- examination of patients of reproductive age before pregnancy;
- if there are complaints of pain in the abdomen, perineum, pelvis;
- deviations menstrual cycle, bleeding or spotting between cycles or menopause;
- having problems with urination of various origins(difficult, painful, bloody, other);
- to monitor the condition of the contraceptive device;
- after gynecological examination when the doctor detects a change in the condition of the genital organs (thickening, enlargement, change in the contour of the organs) or detects tumor processes;
- to check for pregnancy;
- routine scanning during pregnancy;
- for control healing process in the treatment of infertility or determining the most necessary period for conception;
- various injuries of the abdominal cavity or pelvic organs.
For men, there are the following indications for examination:
- pain in the pelvic area, including when urinating;
- infertility;
- problems with potency;
- urethral discharge and urinary disturbances;
- identification of various types of changes in the pelvis after examination by a urologist;
- injuries of the perineum, lower abdomen and abdominal cavity.
Examination of the pelvic organs can be performed by three methods: transabdominal, transvaginal, transrectal. For individual species examinations must be prepared on certain days, which is described in detail by the doctor who refers patients for an ultrasound examination of the pelvic organs.
How is the procedure done?
Ultrasound of the pelvic organs is simple and fairly quick. The patient's position is supine. Transabdominal ultrasound is mainly performed; other methods are used less frequently depending on the patient's condition.
A special conductive gel is applied to the area under study and distributed evenly over the surface of the skin. It does not cause allergies, is easy to wash and does not leave marks on clothes (in case of incomplete removal from the skin).
This type of examination is convenient because it is not invasive, i.e. during examination, the sensor does not penetrate into natural environments body
Then the research begins. Using a special ultrasonic sensor, the doctor gently presses the skin to ensure tight contact with the surface and proper signal transmission. If you press a little harder, you may feel the urge to empty your bladder (when it is completely full). Others discomfort does not appear during the study. The exception is injuries; pain may occur when changing position or examination.
Transvaginal or transrectal ultrasound of the pelvic organs is an uncomfortable procedure for patients, as they have to undress to the waist and leave intimate areas exposed. The diagnostician tells you what position you should be in during the examination.
Transvaginal examination allows you to study the condition of the cervix in more detail, however, this method is used quite rarely due to the complexity of the procedure in the postpartum period
If necessary, the patient may need to turn on his side or hold his breath - all this will be clarified by the specialist conducting the examination. If desired and accessible, the patient can observe everything on the monitor of an ultrasound machine or on a large special screen.
Depending on the research method, additional manipulations may be necessary. After completing the examination, the gel must be wiped off because it will leave a flaky feeling on the skin once it dries. If possible, it is better to wash off the gel from the skin.
Routine examinations for women are carried out on certain days, for pregnant women - at appropriate times. IN emergency situations diagnosis is carried out regardless of these indicators, that is, according to vital indications.
The procedure time ranges from 3-5 minutes to 15-20 minutes, depending on the complexity of the health condition and the identified abnormalities.
When and how can I get the test result?
After completing an ultrasound examination on an outpatient basis, you can receive the results almost immediately. The doctor describes the examination data and records them in the computer. Also, information about the condition of internal organs can be saved on a floppy disk, special photographs can be taken and a conclusion can be obtained on paper. 
When undergoing a procedure while in hospital, the data is transferred to the attending physician. All inspection results can be clarified and discussed with him individually.
Sometimes required additional consultations related specialists and other types diagnostic examinations body. Also, after a course of treatment, a repeat examination or a clarifying examination after some manipulations is prescribed.
The following indicators are considered normal results in studies of women:: the shape of the uterus is pear-shaped with clear, even contours, size 5 centimeters in length, homogeneous echogenicity. The cervix is 2-3 centimeters in length and width, with smooth contours and uniform echogenicity.
Endometrium ( inner layer uterus) in different days the cycle normally has different thicknesses, making up three normal values: 1–4, 4–8, 8–16 mm. Healthy ovaries normally also measure no more than three centimeters in length and no more than two in width.
Normal indicators for men The dimensions of the prostate gland are considered to be 25–35 mm in length, 25–40 in width, thickness no more than 2 mm, volume no more than 2.5–3 cubic cm. The echogenicity is homogeneous, the seminal vesicles are unchanged.
The bladder and ureters must have smooth contour, clear boundaries with the same wall thickness along the entire perimeter. Women have a slightly thinner bladder, and men have slightly thinner ureters, so the normal values are different. Also, no additional inclusions or neoplasms should be detected anywhere.
What can be revealed during research?
Ultrasound of the pelvic organs allows you to determine the presence of diseases, the onset pathological conditions, degree of illness or the following conditions:
- stones Bladder and lower parts of the ureters;
- inflammatory diseases of the genitourinary system;
- vascular pathologies in the pelvic organs;
- congenital developmental or structural abnormalities
- various types of formations (tumors, cysts, seals, nodes, abscesses, ectopic pregnancy);
- state of blood flow in prostate gland, its structure, as well as the state of the seminal vesicles;
- gestational age or fetal condition;
- find out the residual amount of urine in the bladder to determine the correct functioning of the system;
- condition of the lymph nodes;
- monitor the condition of uterine fibroids (whether there is an increase or active growth or not);
- cervical polyposis;
- polycystic ovary syndrome;
- the presence of fluid behind the uterus (indicates internal bleeding due to rupture of the ovary or tube, or other painful conditions);
- the condition of endometriosis, determine its degree.
Contraindications for the procedure
There are no specific contraindications for ultrasound.
Relative contraindications are: improper preparation of the patient (presence of a large amount of gases in the intestines, small amount of urine in the bladder), pregnancy (too frequent examinations), minor childhood(the procedure is carried out with a special apparatus for diagnosing children), a large layer of fatty tissue (the result may be incomplete, another type of diagnosis is recommended), inappropriate behavior of patients.
No complications were identified after the ultrasound procedure.
The main feature of ultrasound is that it does not use harmful ionizing radiation, as is the case with x-rays. In addition, ultrasound does not show a static picture, but an image, so to speak, online. This allows specialists to evaluate the movement of organs and blood flow in the vessels.
Indications for pelvic ultrasound
So, the doctor may prescribe a pelvic ultrasound in one of the following cases:
Using ultrasound, you can determine pregnancy literally in the first days after conception.
The doctor prescribes an ultrasound for women for any malfunctions and irregularities in the menstrual cycle, be it a delay in the onset of menstruation or too early menstruation, bleeding in the middle of the cycle, and so on. Ultrasound is also prescribed for excessively strong or weak menstruation, for unclear vaginal discharge, for discharge after menopause and, of course, if there is no menstruation at all.
Ultrasound of the uterus is prescribed if a disease that is difficult to treat is suspected - uterine fibroids.
Ultrasound can also identify all formations on the uterus and ovary (both malignant and benign).
Various inflammations of the pelvic organs are also indications for ultrasound diagnostics.
The gynecologist may prescribe a study to monitor the intrauterine contraceptive device (IUD), as well as in case of complaints about side effects on the part of such a contraceptive.
A pelvic ultrasound is performed for both sexes if there are any problems with genitourinary system.
Obstetricians prescribe ultrasound for early detection everyone pathological disorders fetus, checking the condition and tone of the uterus during pregnancy and simply to monitor the development of the child.
Also ultrasound - mandatory procedure when searching for the cause of infertility in men and women.
An ultrasound is always prescribed for possible obstruction of the fallopian tubes in women.
It is important to note that ultrasound is prescribed for men if any pathology of the prostate gland (prostate) and seminal vesicles is suspected.
Children are also sometimes prescribed a pelvic ultrasound when severe pain in the pelvic area.
What can a pelvic ultrasound reveal?
In addition to monitoring pregnancy and the process of fetal development, pelvic ultrasound in women can promptly detect a number of serious illnesses. First of all, these are, of course, neoplasms, such as cysts, polyps and fibroids. An ultrasound can also show whether a woman has ovarian or uterine cancer. Ultrasound can detect almost all uterine abnormalities, including scars on the uterus.
In both men and women, pelvic ultrasound reveals diseases of the bladder, including a tumor (cancer) of the bladder, as well as the presence of stones and sand in the kidneys. As for children, ultrasound reveals various neoplasms and anomalies in the pelvic area, heterogeneity of the genital organs. U little girls Ultrasound can show too early or too late puberty.
A special type of ultrasound, Doppler ultrasound, shows such nuances as congenital vascular malformation, blockages and blood clots in the bloodstream, narrowing in the vessels, and the appearance of blockages in the vessels.
Preventive ultrasound of the pelvic organs
They do not always send for an ultrasound only if there are any diseases. The purpose of ultrasound is early diagnosis illnesses, because in the earliest stages any disease is much more treatable. So it is very necessary to undergo an ultrasound for preventive purposes, this is especially important for women.
How often should this be done? Healthy young women need to undergo such an ultrasound for preventive purposes at least once every two years. Women over forty need to do this ultrasound more often - once a year.
For the most reliable result, it is important to undergo a preventive ultrasound at the beginning of the menstrual cycle - on the fifth to seventh day after the start of menstruation.
Hello my dear readers. I recently read in one popular newspaper that with complaints about gynecological problems Millions of girls and women visit doctors every day.
In this article, I decided to touch upon the topic of pelvic ultrasound.
Barely noticeable ailments may indicate the development of pathology reproductive system, which is why it is so important to regularly carry out ultrasound examinations.
The internal organs of the female pelvis include:
- the uterus, in which the formation and development of the fetus occurs;
- ovaries, which produce eggs and hormones;
- fallopian tubes, in which mature eggs are fertilized;
These organs are responsible for the ability to reproduce offspring, and also affect the state of the body system as a whole, since they produce important hormones.
The action of estrogens, progesterones and androgens produced by the ovaries is closely related to such health indicators as: general emotional background and metabolism, the development of adipose tissue, the condition of the mammary glands, bones and epidermis.
Regular visits to the gynecologist and exercise functional diagnostics The condition of the pelvic organs is necessary for every woman, regardless of the presence or absence of complaints - this is precisely what the prevention of the development of diseases consists of.
However, more often the study is used for medical reasons - in the presence of confirmed ailments or suspicious symptoms that require a diagnosis.
- Menstrual irregularities.
- Pain during menstruation, excessive or scanty bleeding.
- Unexplained pain.
- Suspicion of infertility.
- Inflammatory diseases female organs.
- Inflammatory diseases of the urinary system (cystitis, pyelonephritis, etc.).
- Suspicions of the presence of neoplasms (cysts, polyps, tumors).
- Observation after surgery.
- Monitoring the position of the intrauterine device after its installation.
- Suspicion of ectopic pregnancy.
- Monitoring pregnancy and diagnosing fetal development.
There are three types of ultrasound of the pelvic organs in women, differing in the ways of accessing the organ being examined:
Transabdominal - through abdominal wall using an external sensor. This method was once very common, but today, with medical institutions equipped with modern equipment, it has almost ceased to be used.
Transvaginal - access is carried out using a sensor-probe inserted through the vagina upward to the cervix. Its obvious advantage is the accuracy of observation results due to the maximum proximity of the sensor to the uterus.
Transrectal - a special sensor is inserted through the rectum. Used in cases where examination through the vagina is impossible: in virgins, if it is necessary to clarify the results of a transabdominal ultrasound.
WITH detailed description These methods can be found in the next section.
When a gynecologist prescribes an ultrasound, you need to take into account the method of performing it, because This is what determines the specifics of preparation for the procedure.
Preparing for an ultrasound of the pelvic organs
Typically, gynecologists prescribe transvaginal ultrasound, special training which is not required. There are no restrictions related to fluid or food intake. Of course, a woman should take care of personal hygiene, given the method of examination.
The sterility of transvaginal ultrasound is ensured using disposable means - the sensor-probe is protected by a special medical condom. Sometimes the patient is asked to purchase a condom themselves. It should not be confused with a standard means of contraception - condoms for ultrasound with the same name are sold in every pharmacy.
Note: if the doctor prescribed a transvaginal ultrasound in combination with laboratory tests(smear on hidden infections, microflora or cytology), ultrasound should only be done after collection of smears, because The gel that generously covers the sensor gets on the vaginal mucosa and distorts the test results.
Transrectal examination requires preliminary bowel preparation. A few hours before the appointment, the patient should do a small enema (300-350 ml of water) to cleanse the rectum.
Transabdominal ultrasound differs in more thorough preparation for the examination.
During the day before the appointment, you should not eat food that increases gas formation in the intestines (vegetables, fruits, carbonated drinks, brown bread, sweets, etc.) - accumulations of gases can distort the observation picture.
The procedure must be carried out with full bladder– otherwise it will be difficult for the doctor to “examine” the uterus and ovaries. An hour to an hour and a half before the test, you need to drink a liter of still water and not have a bowel movement until it’s over.
In what phase of the menstrual cycle should a pelvic ultrasound be performed?
Taking into account the characteristics of the female reproductive system, the study should be carried out on certain days of the menstrual cycle. Usually, gynecologists recommend doing an ultrasound immediately after the end of menstruation - on the 5th–7th day of the new cycle.
The fact is that the functional state of the female pelvic organs continuously changes throughout monthly cycle.
So, having done an ultrasound in the last phase of the cycle, you can mistakenly mistake epithelial growths for a pathology, which will completely naturally “disappear” during menstruation. Therefore, doctors give clear recommendations regarding the period of the study.
However, sometimes observation is required functional state reproductive system. In these cases, ultrasound can be performed several times during one cycle in order to track the dynamics of development dominant follicle, the onset of ovulation and other processes.
You can do an ultrasound during menstruation. The duration of menstruation in some women reaches 7–8 days, which means that the period recommended for examination occurs before their end.
In addition, if there is sharp pain or acute conditions specialists perform ultrasound examinations promptly and urgently. Sterility procedures and measures personal protection the patient eliminates the risk of infection.
Ultrasound during pregnancy is absolutely harmless and cannot cause any harm to the developing fetus. Questions related to conducting Ultrasound in pregnant women deserve special attention and are highlighted in a separate article.
How is an ultrasound examination of the pelvic organs performed?
The examination procedure is absolutely painless. The patient, having undressed from the waist down, lies on the couch with her back down.
If ultrasound is performed externally, the doctor generously lubricates the procedure site special gel to ensure better contact of the sensor with the surface of the skin and, with slight pressure, slowly moves the device within the pelvic area.
If a transvaginal ultrasound is performed, a probe with a diameter of 1.5–2 cm, covered with a disposable condom, is inserted deep into the vagina.
As a rule, a woman feels quite comfortable during this procedure. For optimal penetration, it is necessary, lying on your back, to slightly spread your legs slightly bent at the knees.
The sensor is connected to an ultrasound machine, the monitor of which displays an accurate dynamic image of the observed organs, tissues and their structure (with magnification).
Such accuracy is achieved due to the ability of ultrasound, passing through the boundaries of organs and tissues of various structures, to respond with changes in the magnitude of the acoustic response.
What does pelvic ultrasound reveal in women?
During the diagnosis, which lasts about 20 minutes, the specialist has time to study:
- position and size of the uterus;
- cervical condition;
- thickness and features of the endometrium (the inner layer lining the uterine cavity);
- the presence of pathological inclusions and neoplasms;
- size and position of the ovaries;
- condition and patency of the fallopian tubes (presence of adhesions);
- number and condition of follicles;
- congenital anomalies of the structure of MT organs;
- the presence of free fluid in the pelvis.
In most cases, the data obtained as a result of ultrasound is a reliable conclusion about the health of the patient’s reproductive system.
Based on the results of ultrasound, the following diseases can be identified:
- neoplasms of the uterus or ovaries (fibroids, polyps, cysts, etc.);
- polycystic ovary syndrome;
- inflammatory diseases of the pelvic organs (salpiginitis, oophoritis, acute inflammatory disease of the uterus, pelvic peritonitis, etc.);
- endometriosis;
- malignant tumors;
- functional disorders of the reproductive system;
- congenital pathologies of organ structure.
Since deviations from the average values of healthy indicators are present to one degree or another in every person, the patient should be able to correctly “read” the results of his studies in order to have a correct idea of the state of his body.
For this purpose, you can familiarize yourself with and decipher the results of the conclusion obtained.
OK it's all over Now. If you have any questions or comments, ask them in the comments to the article.
I would like to say finally - take care of your health and the health of your loved ones. You can't buy it for any money. All the best!
Men are tested if they have the following symptoms:
- erectile disfunction;
- atypical discharge from the urethra;
- pain in the lower abdomen, lower back;
- blood in ejaculate or urine;
- disturbances in the urination process (changes in the frequency of urination and the amount of urine, pain).
Women need to undergo the following signs:
- atypical bleeding;
- pain in the lower abdomen;
- disruptions of the menstrual cycle.
Ultrasound methods
Surveys can be carried out in three ways:
- transabdominal - through the wall of the abdominal cavity;
- transvaginal - through the vagina;
- transrectal - through the rectum.
If necessary, methods can be combined.
Transrectal and transvaginal ultrasound provide more information than transabdominal ultrasound. However, the first two methods have contraindications. For some patients, only transabdominal ultrasound is indicated.
Contraindications
Ultrasound itself has no contraindications. Ultrasound does not harm children, pregnant women or elderly patients. However, the research method must be taken into account.
Transabdominal ultrasound has no contraindications, except that the patient's obesity makes the examination difficult. Fat layer significantly reduces image clarity.
Transvaginal ultrasound of the pelvic organs is not performed in the second and third trimester of pregnancy. In the first trimester, transvaginal examination can be performed.
Transrectal studies are contraindicated:
- with intestinal obstruction;
- after surgical operations on the rectum;
- for hemorrhoids;
- in the presence of chronic sphincter fissures.
Virgins undergo either transrectal or transabdominal ultrasound.
Ultrasound is not recommended after X-ray examination with contrast. The contrast agent may affect the reliability of the results. It is better to go for an x-ray after an ultrasound.
Also, an ultrasound examination of the pelvic organs may be uninformative after colonoscopy and gastroscopy. These procedures help increase gas formation in the intestines.
Preparation
Preparation for the study depends on the type of procedure. However, there are also general measures: before all types of ultrasound, it is necessary to clear the intestines of gases. To do this, 3 days before the examination you need to give up gas-forming products:
- flour;
- sweet;
- raw vegetables and fruits;
- legumes;
- dishes with cabbage;
- whole milk and dairy products;
- carbonated, caffeinated and alcoholic drinks.
You can eat boiled lean meat (turkey, chicken fillet, beef), porridge, hard-boiled eggs (one per day).
Also during these 3 days, with increased gas formation, enterosorbents are welcome. However, do not “assign” them to yourself arbitrarily. Let your doctor determine the need for such a measure.
Features of preparation for different types procedures:
- Transabdominal ultrasound is performed with a full bladder. An hour before the procedure, drink 1-1.5 liters of pure still water and do not empty the bladder.
- On the eve of the transrectal ultrasound, the intestines are emptied using an enema or glycerin suppositories. Cleansing actions are repeated in the morning, before the examination.
Diagnosis of pathologies using ultrasound
For women, the procedure is carried out to identify:
- inflammation;
- dysfunction of the reproductive system organs;
- neoplasms;
- diseases of the ovaries and uterus.
Men are examined to diagnose prostate diseases.
Ultrasound is used for both women and men in diagnosing:
- tumors;
- diseases of the bladder and urinary tract;
- pathologies of other internal organs.
When is the best time to do a pelvic ultrasound?
For men, the study can be performed at any time period according to indications.
But the question is, when is it better to do an ultrasound of the pelvic organs in women? - not idle, since the phase of the cycle significantly affects many indicators, for example, the thickness of the endometrium.
On what day of the cycle is it better to do an ultrasound of the pelvic organs? , depends on the diagnostic task.
Most often, scanning is carried out for a period up to the 10th day of the cycle. However, there are other schemes for its purpose.
When diagnosing the causes of infertility, three ultrasound examinations V different phases monthly cycle:
- From 8 to 10 days. The optimal and dominant follicle is selected.
- From 14 to 16 days. Its volume is measured.
- From 22 to 24 days. Availability is determined corpus luteum and the presence or absence of ovulation.
Before planning IVF, the procedure is performed in the first 2 days of the cycle to determine the number of follicles, regardless of the abundance of menstruation.
In menopausal women, the test is performed at any time.
Decoding the research results
Conclusion Ultrasound is performed according to the following characteristics of the organ being studied: size, volume, uniformity of its structure, echogenicity, clarity of contours. There are many parameters for assessing the results of ultrasound of the pelvic organs; here are some of them.
Uterus.The shape is pear-shaped or oval. Average echogenicity of the myometrium. The endometrium with clearly defined contours, uniform thickness, with high echogenicity, is located in the center of the uterus. Standard indicators The size of the organ depends on such factors - the day of the monthly cycle, the number of pregnancies and births in the anamnesis, the age factor (menopause).
Norms for uterine size
The size of the cervix and its ratio to the body of the uterus are measured separately.
Ovaries. Their size varies greatly depending on the day of the monthly cycle, the woman’s age, use hormonal drugs, including contraceptives.
Shape, length, width and thickness are measured. For the ovaries, the volume and number of follicles are determined.
Norms for ovarian size
What does an ultrasound of the pelvic organs show in women?
Here are some examples of pathological changes:
- A pathological increase in the size of the uterus, combined with the presence of rounded areas with heterogeneous echogenicity, indicates fibroids.
- Sarcoma is similar to fibroids, but the tumors have reduced echogenicity and internal cystic inclusions.
- Uneven wall thickness, increased size of the uterus, and increased echogenicity of the myometrium indicate endometriosis.
- A shrinking uterus while simultaneously enlarging the ovaries may indicate polycystic ovary syndrome (PCOS).
- The inflammatory process in the ovaries - oophoritis, can be diagnosed with a decrease in echogenicity and a spherical shape of the organs.
Some diagnoses must be clarified using additional research. For example, the diagnosis of “uterine sarcoma” can only be made based on the result of a histological examination.
Ultrasound can be used to detect indirect signs erosive processes of the cervix, but colposcopy is necessary to confirm the diagnosis. This study will also be needed to diagnose dysplasia and cervical cancer - ultrasound does not detect them.
How is an ultrasound of the pelvic organs performed?
All types of pelvic ultrasound are performed approximately the same:
- The patient lies on his back (during transrectal examination - on his side).
- During transabdominal ultrasound, a gel is applied to the areas being examined and then a transducer is moved across the body. To conduct transvaginal and transrectal examinations, a sensor placed in a condom is treated with gel and then inserted into the vagina or rectum.
Ultrasound waves, reflected from the tissues being examined, make it possible to study the image of organs on the monitor in real time. This is very important if it is necessary to evaluate the movements of internal organs and the characteristics of blood circulation.
