06 Female Pelvis Perineum

Question 1

Name the female pelvic organs

Answer 1

Ovary, uterus, fallopian tube, vagina, cervix, urethra, ureter, bladder, rectum, caecum, appendix, parts of sigmoid colon and ileum. Vessels nerves and lymphatics

Question 2

What structures is completely enveloped by peritoneum. And what is the name of this peritoneum

Answer 2

Fallopian tube

Broad ligament

Question 3

What is the broad ligament part of

Answer 3

Transverse mesentery

Question 4

What are different parts of the broad ligament

Answer 4

Mesometrium
Mesovarium
Mesosalpinx

Question 5

Name the ligaments that attach the ovary and their functions

Answer 5

Suspensory ligament: it extends towards the lateral abdominal wall. It allows the vessels and lymphatics to pass through
Ligament of the ovary: attached to the ovary inferiorly. It connects the ovary to the uterus and joins the uterus just below the origin of the fallopian tubes

Question 6

Name the 3 cervical ligament

Answer 6

1. transverse cervical (cardinal) ligament
2. uterosacral ligament
3. pubocervical ligament

Question 7

State the function of cervical ligaments

Answer 7

Anchor the cervix in position with pelvis

Question 8

State the 4 parts of the Fallopian tube from the most lateral edge

Answer 8

(Fimbriae)
Infundibulum
Ampulla
Isthmus
Uterine part
(Uterus)

Question 9

State the 3 sections of the uterus from the superior side

Answer 9

Fundus
Body
Neck/cervix of uterus

Question 10

Describe the transition of epithelial lining of the cervix

Answer 10

Cervical canal: mucus secreting simple columnar epithelial cells
Vaginal cervix: non keratinised stratified squamous epithelial cells

Question 11

Describe the anatomical position between body of uterus, vagina and cervix

Answer 11

Body of uterus is anteflexed on the cervix

Cervix is anteverted on the vagina (cervix projects into anterior vaginal wall at right angle)

Question 12

During digital examination through vagina, what structures can you feel

Answer 12

Cervix
Ischial spine
Sacral pulmontary
Uterine artery pulse (lateral fornix)
Ovary

Question 13

What are the main arterial branches supplying pelvic viscera

Answer 13

Superior vesicle
Uterine
Middle rectal

Question 14

What are the main arterial branches supplying walls of pelvis

Answer 14

Sacral, gluteal and obturator branches

Question 15

What are the main branches supplying the perineum and recto-anal region

Answer 15

Pudendal artery (via inferior rectal branch)

Question 16

What is the artery that is equivalent to inferior vesicular artery in females

Answer 16

Vaginal artery

Question 17

What is the main blood supply to the uterus

Answer 17

Uterine artery

Question 18

What are the branches of uterine artery and what do they supply

Answer 18

Ascending branch: ovary and uterine tube

Descending branch: vagina

Question 19

What is the clinical risk during hysterectomy (surgical procedure to remove the whole of the ovary)

Answer 19

Ureter can be tied off accidentally by uterine arteries

Question 20

What is the origin of the bulb of clitoris, body of clitoris

Answer 20

Corpus spongiosum

Corpus cavernosum

Question 21

What are the structures that are only present in female in deep perineal space

Answer 21

Sphincter urethrovaginalis

Compressor urethrae

Question 22

True or false: corpora cavernosae form two large vestibule bulbs around the lower vestibule and vagina

Answer 22

False. It is the corpus spongiosum which divide to form the two vestibular bulb

Question 23

Where is the pain referred to in the pelvis

Answer 23

Suprapubic region

Question 24

What nerve does anterior labial nerve derive from

Answer 24

Ilioinguinal nerve (L1)

Question 25

What nerve does S1-3 give rise to

Answer 25

Perineal branch of post cutaneous nerve of the thigh

Question 26

Describe the lymph drainage of pelvic organ, ovaries and testis and perineum (including anal canal)

Answer 26

Pelvic organs: external and internal iliac node
Ovary/testis: para-aortic node
Perineum (including anal canal): superficial inguinal node

Question 27

What does pudendal nerve supply

Answer 27

Motor to: perineal muscles, anal & urethral sphincters, lavatory ani
Sensory to: external genitalia (vestibule,labia minora, part of majora, lower vaginal, clitoris, lower anal canal)