18. Female Reproductive System Flashcards
What are the component of the Upper Genital Tract?
- Ovaries
- Fallopian Tubes
- Uterus
- Cervix
- Upper 2/3 Vagina
Which Embryological structure gives rise to the
Female Genital Tract?
Paramesonephric/Mullerian Duct
What happens to the Mullerian Duct?
It initially forms in Both Males and Females, but then Degenerates in Males.
Which structures develop from the Paramesonephric Duct?
- Upper 1/3 of Vagina
- Cervix
- Uterus
- Fallopian Tubes
What are the Remnants of the Paramesonephric Duct?
- Epoophoron
- Skeneโs Glands
- Gartnerโs Duct/Cyst
Where is the Epoophoron found?
Found next to the Ovary and Fallopian Tube
What is the Epoophoron?
Contains Ducts that might lead to Gartnerโs Ducts.
Where are the Skeneโs Glands found?
Located on Anterior Walls of Vagina
Where is the Gartnerโs Duct/Cyst found?
Located on the Broad Ligament,
Parallel to the lateral Uterine Tubes.
How can a Gartnerโs Cyst form?
The Cyst can form if Mucous is trapped in the Ducts remnant.
What does the Gartnerโs Duct/Cyst arise from?
Paramesonephric/Mullerian Duct
Which Embryo Germ Layer does the Genital Tract arise from?
Mesoderm
What is the Genital Tract closely related to?
The Development of the the Genital Tract is closely related to the Development of the Urinary Tract.
What is the Female equivalent of the Testes?
Ovary
What are the Female equivalents of the Prostatic Utricle?
Uterus
Cervix
Vagina
What is the Female equivalent of the Scrotum?
Labia Majora
What is the Female equivalent of the Penile Skin?
Labia Minora
What is the Female equivalent of the Penis?
How do the Crura of the Clitoris form the Body?
What is the Female equivalent of the Glands Penis?
Glans Clitoris
What is the Female equivalent of the Prepuce?
Clitoral Hood
What are the Female equivalents of the Gubernaculum?
Round Ligament
Ovarian Ligament
What is the Female equivalent of the Epididymus?
Gartnerโs Duct
What is the Female equivalent of the Prostate Gland?
Skeneโs Gland
What is the Female equivalent of the Bulbourethral Gland?
Bartholinโs Gland
Why are Pelvic Organs not Palpable Abdominally?
Normal sized Pelvic Organs are situated in the True Pelvis.
Below the Pelvic Inlet which is too low to be palpated Abdominally.
When can certain Pelvic Organs be Palpated?
The Bladder can be palpated Abdominally when Full,
Uterus can be palpated per Abdomen when 12 weeks Pregnant.
How can Pelvic Organs be Palpated?
Vaginally
Rectally
What are the 3 Sytems that pass through the Female Pelvis?
Posterior to Anterior:
- Gastrointestinal
- Urinary
- Genital Tracts
What is the Genital Septum?
The Genital Septum is a Ridge between the Inferior Uterus and Rectum.
What is the Function of the Genital Septum?
Separates the Gastrointestinal from the Genitourintary Tracts
Which Pouch is Anterior to Genital Septum?
Vesico - Uterine Pouch
Which Pouch is Posterior to Genital Septum?
Rectouterine Pouch (of Douglas)
What issues can arise during Pelvic Surgery?
The structures in close Proximity may get Damaged.
One structure may Join to another e.g. Enterovaginal Fistula
What are Adhesions?
Deposits of Fibrous Strands/Scar Tissue,
Which can connect Organs together.
How can Adhesions cause symptoms?
Organs in pelvic cavity normally slide freely against each other
Adhesions can hinder this Movement leading to:
- Pain
- Infertility
- Bowel Obstruction.
Which conditions can cause Adhesions in the Pelvis?
- Inflammation
- Endometriosis
- Infection (e.g. Gonorrhoea)
- Pelvic Surgery
Give examples of Inflammation that causes Adhesions?
- Pelvic Inflammatory Disease: Infection of Female Upper GI Tract.
- Crohnโs Disease: Part of GI is Inflamed.
- Ulcerative Colitis: Colon and Rectum are inflamed.
What Clinical Complications can Adhesions cause?
- Atopic Pregnancy: The egg attaches outside the Uterus
- Reduced Fertility
- Increased Risk of Miscarriage
What is the Function of the Uterus?
Receives the developing Embryo in the Morula Stage.
Allows Implantation of the Embryo when as it enters the Uterine Wall in the Blastocyst Stage.
Provides the environment for development before expelling the Foetus through the Lower Genital Tract.
What is the Size and Shape of the Uterus?
It is the Size and Shape of a Pear
What is Flexion of the Uterus?
Angle between the Axes of the Uterus and Cervix
The Normal Angle is 90 degrees.
What is Version of the Uterus?
Angle between the Axes of the Uterus with the Vagina.
The Normal is 170 degrees.
What is the Clinical Significance of a Retroverted Uterus?
A retroverted Uterus is positioned directly above the Vagina.
In instances of increased Abdominal Pressure,
The Uterus is more likely to Prolapse into the Vagina.
Who is more susceptible to Uterine Prolapse?
Uterine Prolapse is particularly prevalent in those with a history of Pelvic Floor Damage.
Retroverted and Retroflexed also increases the risk of Prolapse.
How else can the positioning of the Uterus be Clinically relevant?
The Uterus may also be positioned in a way that does not allow for conception/ birth.
You can test for infertility or the need for Caesarean Section.
What are the 2 Sub - Divisions of the Uterus?
- Fundus
2. Body
Which structure deliniates the Fundus & Body?
The position of the Uterine Tubes.
Specifically the Isthmus.
What is the Fundus of the Uterus?
The top of the Uterus,
Above the entry point of the Uterine Tube.
It has a Rounded Shape.
Which structures arise at the junction of the Fundus & Uterine Tubes?
Anteriorly: Round Ligament
Posteriorly: Ovarian Suspensory Ligament
What are the 3 Component Tissues of the Uterus?
- Endometrium
- Myometrium
- Peritoneum/Perimetrium
What is the Endometrium?
Inner Mucous membrane Lining
Sheds in Menstruation
Site of Implantation of the Fertilised Zygote
What is the Myometrium?
Middle Thick Smooth Muscle Layer
Allows for Uterine Contractions
What is the Perimetrium?
Outer Double Layered Membrane that is continuous with the Abdominal Peritoneum
Which covers the Uterus
What are the Important relations of the Uterus?
Anterior:
- Bladder
Posterior:
- Rectum
Inferior:
- Cervix
- Vagina
- Vulva
Lateral:
- Ovarian Tubes
- Ovaries
What happens to the Uterus when the Bladder fills?
When the Bladder Fills,
The Uterus moves more Posterior.
What is the Blood Supply of the Uterus?
Uterine Artery
Where does the Uterine Artery arise from?
Anterior Branch of the Internal Iliac Artery
Which important structure is closely related to the Uterine Artery?
Ureter:
- The Uterine Artery crosses Anterior to the Ureter.
- Water under the Bridge.
What is the Clinical Significance of Water under the Bridge?
During a Hysterectomy the Uterus and Uterine Artery are removed,
Here the Ureter is in danger of being accidentally damaged,
Especially when Clamping Down the Uterine Artery during the procedure.
What is the Venous Drainage of the Uterus?
Plexus in the Broad Ligament
Which drains into the Uterine Vein
Where does the Uterine Vein drain into?
Internal Iliac Veins
What is the Sympathetic Nerve Supply of the Uterus?
Sympathetic Nerve Fibres of the Uterus arise from the Uterovaginal Plexus.
What does the Uterovaginal Plexus mainly consist of?
This consists of 2 Parts of the the Inferior Hypogastric Plexus:
- Anterior Part
- Intermediate Part
What Type of Plexus is the Inferior Hypogastric Plexus?
Pelvic Plexus
What are the Nerve Roots of the Inferior Hypogastric Plexus?
T10/T11
What is the Parasympathetic Nerve Supply of the Uterus?
Pelvic Splanchnic Nerves
What are the Nerve Roots of the Pelvic Splanchnic Nerves?
S2 - S4
Where are the Pelvic Splanchnic Nerves derived from?
From the Sacral Spinal Nerves
At which Spinal Level do the Afferent Nerves enter?
Enter the CNS at T10/T11
What is the Clinical Significance of the Afferent Nerves?
Labour Pains refer to Areas of Skin supplied by these Nerves
e.g. the Lumbo - Sacral Region and Lower Abdomen
At what Gestation does the Uterus become Palpable Abdominally?
After 12 Weeks of Pregnancy the Fundus of the Uterus is Palpable above the Pubic Symphysis.
At what Gestation does the Uterus reach the Umbilicus?
20 - 22 Weeks
What Clinical Conditions are associated with the Uterus?
- Menstrual Disorders
- Uterine Prolapse
- Uterine Fibroids/Polyps
- Endometriosis
- Endometrial Carcinoma
What are the Menstrual Disorders associated with the Uterus?
- Menorrhagia
- Metrorrhagia
- Dysmenorrhoea
- Oligomenorrhoea
What is Menorrhagia?
Period is Abnormally Heavy or Prolonged.
What is Metrorrhagia?
Periods occur with Irregular Intervals,
Between expected times.
What is Dysmenorrhoea?
Painful Periods.
What is Oligomenorrhoea?
Infrequent Menstrual Periods.
What is Uterine Prolapse?
When the Pelvic Floor Muscles and Ligaments Stretch and Weaken,
And no longer provide enough Support for the Uterus,