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Year 2 HD > 1. Applied female anatomy > Flashcards

1. Applied female anatomy Flashcards

1
Q

What are the branches of the internal iliac artery?

A 
Superior gluteal 
Inferior gluteal
Internal pudendal
Umbilical artery
Obturator artery
Inferior vesical artery
Uterine artery 
Vaginal artery 
Middle rectal arteries
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2
Q

What does the superior gluteal artery supply?

A

Gluteus medius and minimus

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3
Q

What does the inferior gluteal artery supply?

A

Gluteus maximus

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4
Q

What does the internal pudendal artery supply?

A

Perineum

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5
Q

Where does the ovarian artery branch off of the abdominal aorta?

A

L2/L3

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6
Q

What artery does the ovarian artery anastomose with?

A

Uterine artery

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7
Q

What artery does the external artery become and when?

A

Passes under the inguinal ligament to become the femoral artery

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8
Q

What is the most common location for an ectopic pregnancy?

A

Ampulla

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9
Q

What are the symptoms of an ectopic pregnancy?

A 
Light vaginal bleeding
Nausea and vomiting with pain
Lower abdominal pain
Sharp abdominal cramps
Pain on one side of the body
Dizziness or weakness
Pain in shoulder, neck or rectum
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10
Q

Why does an ectopic pregnancy present with pain to the shoulder, neck and rectum?

A

Blood in peritoneal cavity from ectopic pregnancy can go to and irritate the diaphragm
The pain is then referred to the dermatome for C3, 4 and 5 - shoulder, neck and rectum

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11
Q

Where does the uterine artery supply?

A

Body and fundus of the uterus

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12
Q

Where does the vaginal artery supply?

A

Cervix and the upper part of the vagina

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13
Q

Where is the vesico-uterine pouch located?

A

Between the bladder and the uterus

Shallow pouch

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14
Q

Where is the recto-uterine pouch located?

A

Between the uterus and the rectum

aka. Pouch of douglas

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15
Q

What is the round ligament of the uterus composed of?

A

The obliterated, old goobernaculum

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16
Q

What are the main supports to the uterus?

A

The levator ani muscles
Transverse cervical ligaments
Pubocervical ligaments
Sacrocervical ligaments

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17
Q

How do you recognise the transverse/cardinal ligaments?

A

Main support to the uterus

Positioned horizontally

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18
Q

How do you recognise the pubocervical ligaments

A

Main support to the uterus

2 firm bands going to the front of the pelvis: from the pubis to the cervix

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19
Q

How do you recognise the sacrocervical ligaments?

A

Main support to the uterus

Going to the back from the cervix to the sacrum

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20
Q

What passes through the obturator canal?

A

Obturator artery
Obturator vein
Obturator nerve

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21
Q

What passes through the greater sciatic foramen?

A 
Nerves:
Above piriformis: 
Superior gluteal nerve 
Below piriformis:
Sciatic nerve 
Inferior gluteal nerve
Pudendal nerve 
Posterior femoral cutaneous nerve 
Nerve to quadratus femoris 
Nerve to obturator internus

Vessels:
Superior gluteal artery and vein
Inferior gluteal artery and vein
Internal pudendal artery and vein

Muscle:
Piriformis

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22
Q

What passes through the lesser sciatic foramen?

A

Tendon of obturator internus
Nerve to obturator internus
Internal pudendal artery and vein
Pudendal nerve

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23
Q

What are splanchnic nerves?

A

Paired visceral nerves - to the internal organs
Carry fibres of autonomic nervous system (visceral efferent fibres)
Carry sensory fibres from the organs (visceral afferents)

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24
Q

What is the function of the pelvic splanchnic nerves?

A

S2, S3, S3 splanchnic nerves

Provide parasympathetic innervation to the hindgut - parasympathetic to the pelvis

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25
Q

What is the function of the sacral splanchnic nerves?

A

Sympathetic innervation to the pelvis

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26
Q

What is the inferior hypogastric plexus formed from?

A

Formed from hypogastric nerve and the pelvic splanchnic nerve

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27
Q

What is the supply of the superior hypogastric plexus?

A

Continuation of aortic plexus and L3 and L4 sympathetic ganglia
Contains sympathetic, sacral parasympathetic and visceral afferent fibres
Splits to form hypogastric nerves

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28
Q

What is the blood supply to and from the sigmoid colon?

A

To: sigmoidal branches of the inferior mesenteric artery (L3)
From: to the inferior mesenteric vein which joins the portal system

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29
Q

What is the nerve supply to the sigmoid colon?

A

From the hypogastric plexus

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30
Q

The ureter follows the same path as which artery?

A

The ureter follows the same path as the internal iliac artery

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31
Q

What is a volvulus?

A

If the sigmoid colon mesentery rotates clockwise around the sigmoid colon and the blood supply is completely shut off

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32
Q

What is the arterial supply to the rectum?

A

The superior, middle and inferior rectal arteries

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33
Q

Where do the rectal arteries stem from?

A

Superior rectal - direct continuation of the inferior mesenteric
Middle rectal - small branch from the internal iliac
Inferior rectal - branch of the pudendal

34
Q

Which arteries anastomose at the anorectal junction?

A

The inferior rectal artery and the middle rectal artery

35
Q

Where do the pelvic veins drain to?

A

Most pelvic veins follow the path of the pelvic arteries and drain into the internal iliac vein

36
Q

What is the rectovaginal septum?

A

Septum that separates the posterior wall of the vagina from the rectum

37
Q

Where is the uterus positioned?

A

Between the bladder and the rectum

Joins the vagina inferiorly

38
Q

How does the uterus expand during pregnancy?

A

Dramatically expands superiorly into the abdominal cavity

39
Q

What is the cervix?

A

This is the narrow, inferior portion of the uterus

40
Q

In which cavity is the uterus positioned and which cavity can it extend to and why?

A

The uterus is contained mainly in the pelvic cavity

Can expand into the abdominal cavity during pregnancy

41
Q

Where do the ovaries develop?

A

Develop high on the posterior abdominal wall

42
Q

Where are ovaries located at birth?

A

Ovaries descend down to the lateral wall of the pelvic cavity

43
Q

Where does the blood supply to the uterus come from?

A

From the uterine artery - an anterior branch of the internal iliac artery

44
Q

Where does the blood supply to the ovaries come from?

A

Ovarian artery from the abdominal aorta at L2/L3

45
Q

Which artery does the ovarian artery anastomose with?

A

Ovarian artery anastomoses with the terminal branches of the uterine artery

46
Q

Where do the ovarian veins drain?

A

Left - the ovarian vein drains into the renal vein, which then drains into the inferior vena cava
Right - ovarian vein drains directly into the inferior vena cava

47
Q

What is the perineum?

A

This is the region between the anus and the scrotum/vulva

48
Q

What are the boundaries of the perineum?

A

Pelvic outlet
Superiorly is the pelvic diaphragm i.e. the levator ani and coccygeus muscles
Laterally is the pelvic cavity

49
Q

What are the divisions of the perineum?

A

Anterior - urogenital triangle

Posterior - anal triangle

50
Q

What is contained in the urogenital triangle?

A

Urinary and reproductive systems

51
Q

What is contained in the anal triangle?

A

Anus and external sphincter

52
Q

What is the blood supply to the perineum?

A

Internal pudendal artery

53
Q

Which artery does the uterine artery anastomose with?

A

Terminal branches of the uterine artery anastomose with the ovarian artery

54
Q

What is the nervous innervation to the perineum?

A

Internal pudendal nerve

55
Q

What is the perineal membrane?

A

This is a fibromuscular support to the urogenital triangle

56
Q

What are the deep and superficial perineal pouches?

A

Superficial perineal pouch - located inferior to the perineal membrane
Deep perineal pouch - located superior to the perineal membrane

57
Q

Where is the deep perineal pouch located?

A

This is part of the urogenital triangle
Superior to the perineal membrane
Between the perineal membrane and the pubic arch

58
Q

What is contained within the deep perineal pouch in females?

A

Proximal part of urethra
Mass of smooth muscle
Dorsal neurovasculature of the clitoris

59
Q

Where is the superficial perineal pouch located?

A

This is inferior to the perineal membrane

Between the perineal membrane and the membranous layer of the superficial fascia

60
Q

What is contained within the superficial perineal pouch in females?

A

Contains erectile tissue and associated muscles:
Clitoris and associated muscles (ischiocavernosis)
Bulbs of vestibule and surrounding muscle (bulbospongiosis)
Greater vestibule glands
Deep perineal branch of internal pudendal vessels and nerve
Superficial transverse perineal muscle

61
Q

What are the components of the clitoris?

A

Two corpora cavernosa and the glans clitoris

62
Q

What is the bulb of vestibule?

A

This is an internal part of the clitoris - an aggregation of erectile tissue
Fill with blood during sexual arousal

63
Q

What is the nervous innervation to the clitoris?

A

Parasympathetic splanchnic nerves S2-S4

64
Q

What is the blood supply to the clitoris?

A

Branches of the internal pudendal artery

65
Q

What are the sensory nerves from the clitoris?

A

Pudendal nerves S2-S4

66
Q

What are the greater vestibule glands?

A

Aka. Bartholin’s glands
These produce secretions during sexual arousal
Located in the superior perineal pouch

67
Q

What is the purpose of a ‘pap’ smear test?

A

To test for pre-malignant cervical lesions

68
Q

What is the path of the ureter from the kidney to the bladder?

A

The ureter passes backwards to the back of the pelvis and then moves forwards to enter the bladder

69
Q

Where does the uterine artery branch from?

A

Branches from the internal iliac artery

70
Q

Where does the vaginal artery branch from?

A

Branches from the uterine artery

71
Q

What is the function of the sacrocervical ligaments

A

These are the posterior support of the uterus

72
Q

Describe the path of the ureter

A

Passes over the bifurcation of the common iliac artery, underneath the fallopian tubes and then forwards to the bladder

73
Q

What is the normal position of the uterus?

A

Antiverted and antiflexed

74
Q

What is the pelvic diaphragm/floor composed of?

A

Levator ani muscles
Coccygeus muscles
Covering fascia

75
Q

What are general visceral afferents?

A

These are visceral autonomic sensory nerves

76
Q

What are the nerve roots of the sympathetic GVAs?

A

T1-T5 for the thoracic viscera

T5-L2 for the abdomen

77
Q

What are the nerve roots for the parasympathetic GVAs?

A

S2-S4

78
Q

What is spinal anaesthesia?

A

Anaesthesia during childbirth - will also anaesthetise the legs
Inserted into the spinal cord at L3/L4 level
Complete anaesthesia below the waist
Commonly followed by headache

79
Q

What is a pudendal nerve block?

A

Peripheral nerve blood in the pudendal nerve - S2-S4

Anaesthetises the perineum and the lower 1/4 of the vagina

80
Q

What is a caudal epidural block?

A

Anaesthetic administered via catheter in the sacral canal
Anaesthetises the nerve roots S2-S4
Top ups can be given if necessary

Year 2 HD (29 decks)

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