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SF4 - Test 3 > 1 - Pelvic Viscera II (Female) > Flashcards

1 - Pelvic Viscera II (Female) Flashcards

1
Q

What is the anterior-inferior border of uterus?

Posterior?

A

Bladder

Rectum

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2
Q

What are the internal os and extern os of the uterine cervical canal?

A

Internal leads to uterine cavity

External leads to lumen of vagina

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3
Q

What is the normal position of the uterus?

A

Horizontal, fundus pointing anterior

Anterversion - long axis of cervix bent anterior to long acis of vagina and 90 degrees

Anteflexion - Log axis of body of uterus bent anterior relative to long axis of cervix

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4
Q

What can be associated with abnormal position of uterus?

Retroverted Uterus

Retroflexed Uterus

A

Dyspareunia (pain during intercourse)

Dysmenorrhea (pain during menstruation)

Retroverted = Long axis of cervix in line with long axis of vagina (vertical w/vagina)

Retroflexed = Posterior bend, lies in rectouterine pouch

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5
Q

What is the anterior peritoneal covering of the uterus?

What is the Vesicouterine Pouch?

A

Covers w/exception of cervix (reflected onto bladder)

Part of peritoneal cavity

Floor of the peritoneal refelction from the cervix to the bladder

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6
Q

What is the posterior peritoneal covering of the uterus?

A

Peritoneal reflection from rectum to upper part of vagina and uterus forms floor of Rectouterine Pouch (of Douglas) of peritoneal cavity

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7
Q

What are the four parts of the Broad Ligament of Uterus (lateral peritoneum)

A

Mesometrium - Majority of ligament lateral to uterus and inferior to mesovarium

Mesovarium - From posterior layer of broad ligament associated with ovary

Mesoalpinx - Inferior to uterine tube

Suspensory Ligament of Ovary - Upper lateral part of broad ligament; suspends ovary from lateral pelvic wall; contains neurovascular supply to ovary

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8
Q

What are the contents of the broad ligament?

What make up the Distal Part of Gubernaculum? (remnants)

What makes up the Proximal Part of the Gubernaculum? (remnants)

A

Uterine Tube - free upper border of ligament

Round Ligament of Uterus - Remnant of distal part of gubernaculum attached to lateral side of uterus; passes through inguinal canal to labium majora (UTERUS TO INGUINAL CANAL - LABIUM MAJORA)

Round Ligament of Ovary (Ligament of Ovary) - Remnant of proximal gubernaculum attached to lateral uterus; attached to ovary (UTERUS TO OVARY)

Uteran Artery and Vein and Ovarian Artery and Vein, lymphatics, nerves; all anastomose

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9
Q

What level does the uterine artery pass superior to the ureter?

Clnical: Hyserectomy?

What branch comes off this?

A

Cervix

During hysterectomy (removal of uterus) Ligate the arter, NOT ureter

Has vaginal branch

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10
Q

What is the lymphatic drainage from the fundus?

What is the lymphatic drainage from body/cervix?

A

Lumbar (para aortic) Lymph nodes (UPPER = LUMBAR)

Iliac Lymph Nodes (LOWER = ILIAC)

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11
Q

What can contribute to the prolaps of uterus into vagina or protruding of urinary bladder or rectum against vaginal wall?

What are the named structures and locations for the above?

A

Stretching of ligaments of Cervix of Uterus

  1. Cardinal Ligaments - Lateral Vagina/Cervix to Lateral Pelvis; located at base of broad ligament
  2. Vesicouterine Ligament - Bladder to Uterus
  3. Uterosacral Ligament - Sacrum to Cervix (beneath pouch of douglas); CAN BE PALPATED during rectal exam
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12
Q

Cystocele?

Rectocele?

A

Bladder bulges against anterior wall of vagina

Rectum bulges against posterior wall of vagina

Childbirth can cause weakening of pelvic diaphragm by stretching pelvic diaphragm and ligaments of uterus

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13
Q

Uterine Tube parts

Infundibulum

Ampulla

Isthmus

Uterine Part

A

Infundibulum - Location of fimbria

Ampulla - Fertilization

Isthmus - Short narrow, medial to ampulla

Uterine - short intramural sgement entering within wall of uterus

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14
Q

What is blood supply and lymphatics of uterine tube?

A

Blood = Uterine and Ovarian Arteries

Lymph - Lumbar, Internal Iliac nodes

(Fundus = Lumbar, Body/Cervix = Internal Iliac)

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15
Q

What peritoneal covers the uterine tubes?

A

Mesosalpinx

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16
Q

What can lead to spread of infection form uterus/vagina to peritoneal cavity?

What can a blockage of uterine tube cause?

What is a Hysterosalpingography?

What is a second form of ectopic pregnancy?

A

Opening of uterine tube to peritoneal cavity

Blockage of Uterine Tube can cause infertility; result of adhesions from healed infections; can result in Ectopic Tubal Pregnancy; leading to rupture and hemorrage

Hysterosalpingography - Radiography of uterus and uterine tubes following injection of radiopaque material to determine patency of tubes

Opening of uterine tube to peritoneal cavity can result in oocytes passing into cavity and impanting in peritoneum

17
Q

What is the fibrous capsul of the ovary?

Normal location of ovary? Boundaries?

Why can ovary disease cause thigh pain?

A

Tunica Albuginea

Ovarian Fossa on lateral wall of pelvis

Superior - External Iliac Vessels

Inferior - Internal Iliac Vessels and Ureter

Passes righ over Obturator Nerve

18
Q

What two ligaments contain ovarian neurovascular bundles?

A

Suspensory Ligment

Mesovarium

19
Q

Where doe Ovarian Arteries arise form?

What do they cross over and enter?

Anastomose with?

A

Aorta at L2

Cross over External Iliac Vessels to enter Suspensory Ligament of Ovary

Anastomose with Uterine Artery

20
Q

What is an Ovariectomy?

A

Ovarian Vessels ligated as they cross pelvis brim and external iliac vessels; do not ligate ureter at this location

21
Q

What is the venous drainage of the ovaries?

What are the lymphatics of the ovary?

A

Right - IVC

Left - Left renal vein

W/Fundus to Lumbar Lymph Nodes

22
Q

Where does the superior half of the vagina lie?

Inferior?

What is the inferior end of vagina originally covered by?

A

Superior = Above Pelvic Diaphragm

Inferior = Below Pelvic Diaphragm

Hymen

23
Q

What can be examined during manual vaginal exam:

Anterior

Posterior

Lateral

A

Anterior: Cervix, Posterior Bladder, Urethra

Posterior: Rectouterine Pouch, Amulla of Rectum, Perineal body

Lateral: Uterine Artery, Ureter, levator Ani, Ovary (if abnormal), urogenital diaphragm, bulbs of vestibule

24
Q

What is important about the Posterior Fornix in relation ot the Rectouterine Pouch?

A

Access for drainage of infected peritoneal fluid, Culdocentesis is removal of fluid from rectouterine pouch by intentional puncture

Bad abortion can easily puncture the posterior vaginal wall w/sharp instrument

25
Q

What is the blood supply to the vagina?

Lymphatics?

A

Vaginal Artery forms vagina venous plexus and vaginal branch of uterine artery

Upper 1/3 = External/internal Iliac Nodes

Middle 1/3 = Internal Iliac Nodes

Lower 1/3 = Superficial Inguinal Nodes

26
Q
A

SF4 - Test 3 (12 decks)

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