18. Female Reproductive System Flashcards
1
Q
What are the component of the Upper Genital Tract?
A
- Ovaries
- Fallopian Tubes
- Uterus
- Cervix
- Upper 2/3 Vagina
2
Q
Which Embryological structure gives rise to the
Female Genital Tract?
A
Paramesonephric/Mullerian Duct
3
Q
What happens to the Mullerian Duct?
A
It initially forms in Both Males and Females, but then Degenerates in Males.
4
Q
Which structures develop from the Paramesonephric Duct?
A
- Upper 1/3 of Vagina
- Cervix
- Uterus
- Fallopian Tubes
5
Q
What are the Remnants of the Paramesonephric Duct?
A
- Epoophoron
- Skeneโs Glands
- Gartnerโs Duct/Cyst
6
Q
Where is the Epoophoron found?
A
Found next to the Ovary and Fallopian Tube
7
Q
What is the Epoophoron?
A
Contains Ducts that might lead to Gartnerโs Ducts.
8
Q
Where are the Skeneโs Glands found?
A
Located on Anterior Walls of Vagina
9
Q
Where is the Gartnerโs Duct/Cyst found?
A
Located on the Broad Ligament,
Parallel to the lateral Uterine Tubes.
10
Q
How can a Gartnerโs Cyst form?
A
The Cyst can form if Mucous is trapped in the Ducts remnant.
11
Q
What does the Gartnerโs Duct/Cyst arise from?
A
Paramesonephric/Mullerian Duct
12
Q
Which Embryo Germ Layer does the Genital Tract arise from?
A
Mesoderm
13
Q
What is the Genital Tract closely related to?
A
The Development of the the Genital Tract is closely related to the Development of the Urinary Tract.
14
Q
What is the Female equivalent of the Testes?
A
Ovary
15
Q
What are the Female equivalents of the Prostatic Utricle?
A
Uterus
Cervix
Vagina
16
Q
What is the Female equivalent of the Scrotum?
A
Labia Majora
17
Q
What is the Female equivalent of the Penile Skin?
A
Labia Minora
18
Q
What is the Female equivalent of the Penis?
A
How do the Crura of the Clitoris form the Body?
19
Q
What is the Female equivalent of the Glands Penis?
A
Glans Clitoris
20
Q
What is the Female equivalent of the Prepuce?
A
Clitoral Hood
21
Q
What are the Female equivalents of the Gubernaculum?
A
Round Ligament
Ovarian Ligament
22
Q
What is the Female equivalent of the Epididymus?
A
Gartnerโs Duct
23
Q
What is the Female equivalent of the Prostate Gland?
A
Skeneโs Gland
24
Q
What is the Female equivalent of the Bulbourethral Gland?
A
Bartholinโs Gland
25
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.
26
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.
27
How can Pelvic Organs be Palpated?
Vaginally
| Rectally
28
What are the 3 Sytems that pass through the Female Pelvis?
Posterior to Anterior:
1. Gastrointestinal
2. Urinary
3. Genital Tracts
29
What is the Genital Septum?
The Genital Septum is a Ridge between the Inferior Uterus and Rectum.
30
What is the Function of the Genital Septum?
Separates the Gastrointestinal from the Genitourintary Tracts
31
Which Pouch is Anterior to Genital Septum?
Vesico - Uterine Pouch
32
Which Pouch is Posterior to Genital Septum?
Rectouterine Pouch (of Douglas)
33
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
34
What are Adhesions?
Deposits of Fibrous Strands/Scar Tissue,
| Which can connect Organs together.
35
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.
36
Which conditions can cause Adhesions in the Pelvis?
1. Inflammation
2. Endometriosis
3. Infection (e.g. Gonorrhoea)
4. Pelvic Surgery
37
Give examples of Inflammation that causes Adhesions?
1. Pelvic Inflammatory Disease: Infection of Female Upper GI Tract.
2. Crohnโs Disease: Part of GI is Inflamed.
3. Ulcerative Colitis: Colon and Rectum are inflamed.
38
What Clinical Complications can Adhesions cause?
1. Atopic Pregnancy: The egg attaches outside the Uterus
2. Reduced Fertility
3. Increased Risk of Miscarriage
39
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.
40
What is the Size and Shape of the Uterus?
It is the Size and Shape of a Pear
41
What is Flexion of the Uterus?
Angle between the Axes of the Uterus and Cervix
| The Normal Angle is 90 degrees.
42
What is Version of the Uterus?
Angle between the Axes of the Uterus with the Vagina.
| The Normal is 170 degrees.
43
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.
44
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.
45
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.
46
What are the 2 Sub - Divisions of the Uterus?
1. Fundus
| 2. Body
47
Which structure deliniates the Fundus & Body?
The position of the Uterine Tubes.
| Specifically the Isthmus.
48
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.
49
Which structures arise at the junction of the Fundus & Uterine Tubes?
Anteriorly: Round Ligament
Posteriorly: Ovarian Suspensory Ligament
50
What are the 3 Component Tissues of the Uterus?
1. Endometrium
2. Myometrium
3. Peritoneum/Perimetrium
51
What is the Endometrium?
Inner Mucous membrane Lining
Sheds in Menstruation
Site of Implantation of the Fertilised Zygote
52
What is the Myometrium?
Middle Thick Smooth Muscle Layer
| Allows for Uterine Contractions
53
What is the Perimetrium?
Outer Double Layered Membrane that is continuous with the Abdominal Peritoneum
Which covers the Uterus
54
What are the Important relations of the Uterus?
Anterior:
- Bladder
Posterior:
- Rectum
Inferior:
- Cervix
- Vagina
- Vulva
Lateral:
- Ovarian Tubes
- Ovaries
55
What happens to the Uterus when the Bladder fills?
When the Bladder Fills,
| The Uterus moves more Posterior.
56
What is the Blood Supply of the Uterus?
Uterine Artery
57
Where does the Uterine Artery arise from?
Anterior Branch of the Internal Iliac Artery
58
Which important structure is closely related to the Uterine Artery?
Ureter:
- The Uterine Artery crosses Anterior to the Ureter.
- Water under the Bridge.
59
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.
60
What is the Venous Drainage of the Uterus?
Plexus in the Broad Ligament
| Which drains into the Uterine Vein
61
Where does the Uterine Vein drain into?
Internal Iliac Veins
62
What is the Sympathetic Nerve Supply of the Uterus?
Sympathetic Nerve Fibres of the Uterus arise from the Uterovaginal Plexus.
63
What does the Uterovaginal Plexus mainly consist of?
This consists of 2 Parts of the the Inferior Hypogastric Plexus:
1. Anterior Part
2. Intermediate Part
64
What Type of Plexus is the Inferior Hypogastric Plexus?
Pelvic Plexus
65
What are the Nerve Roots of the Inferior Hypogastric Plexus?
T10/T11
66
What is the Parasympathetic Nerve Supply of the Uterus?
Pelvic Splanchnic Nerves
67
What are the Nerve Roots of the Pelvic Splanchnic Nerves?
S2 - S4
68
Where are the Pelvic Splanchnic Nerves derived from?
From the Sacral Spinal Nerves
69
At which Spinal Level do the Afferent Nerves enter?
Enter the CNS at T10/T11
70
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
71
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.
72
At what Gestation does the Uterus reach the Umbilicus?
20 - 22 Weeks
73
What Clinical Conditions are associated with the Uterus?
1. Menstrual Disorders
2. Uterine Prolapse
3. Uterine Fibroids/Polyps
4. Endometriosis
5. Endometrial Carcinoma
74
What are the Menstrual Disorders associated with the Uterus?
1. Menorrhagia
2. Metrorrhagia
3. Dysmenorrhoea
4. Oligomenorrhoea
75
What is Menorrhagia?
Period is Abnormally Heavy or Prolonged.
76
What is Metrorrhagia?
Periods occur with Irregular Intervals,
| Between expected times.
77
What is Dysmenorrhoea?
Painful Periods.
78
What is Oligomenorrhoea?
Infrequent Menstrual Periods.
79
What is Uterine Prolapse?
When the Pelvic Floor Muscles and Ligaments Stretch and Weaken,
And no longer provide enough Support for the Uterus,
80
What are the causes of Uterine Prolapse?
1. Pregnancy
2. Being Overweight
3. Difficult Labour
4. Retroverted & Retroflexed Uterus
81
What are the Grades of Uterine Prolapse?
```
Grade 0: Normal Position.
Grade 1: Descent into Vagina, but not reaching Introitus.
Grade 2: Descent up to Introitus.
Grade 3: Descent outside Introitus.
Grade 4: Procidentia (Severe Prolapse).
```
82
What are Uterine Fibroids/Polyps?
Non - Cancerous Growths of the Uterine Wall.
83
What are the symptoms of Uterine Fibroids/Polyps?
Excessive Uterine Bleeding
Painful and Prolonged Periods
Difficulty with Urination
Can lead to Infertility
84
What is Endometriosis?
When Endometrial Tissue grows outside the Uterus.
85
What are the Symptoms of Endometriosis?
Abnormal Bleeding
| Pain during Urination
86
Why is the Incidence of Endometrial Cancer increasing?
Increased use of Hormone Based Contraceptives
Increased Obesity Levels
More people not having Children.
87
What are the Ligaments of the Internal Female Reproductive Organs?
1. Broad Ligament
2. Round Ligament
3. Cardinal Ligament
4. Uterosacral Ligament
5. Ovarian Ligament
6. Ovarian Suspensory Ligament/Infundibulo - Pelvic Ligament
7. Pubocervical Ligament
88
Broad Ligament:
A Double Layer of Peritoneum that Attaches the Sides of the Uterus to the Pelvis,
In order to maintain its Position.
89
What are the 3 Portions of the Broad Ligament?
1. Mesometrium
2. Mesosalpinx
3. Mesovarium
90
What is the Mesometrium?
Constitutes the majority of the Broad Ligament of the Uterus.
The Ureter is found within this portion.
91
What is the Mesosalpinx?
Mesentery of the Uterine/Fallopian Tubes.
92
What is the Mesovarium?
Connects the Ovaries to the Broad Ligament.
93
What is the Round Ligament?
Extends from the Uterus to the Labia Majora via the Inguinal Canal,
And acts to maintain the Uterusโ Anteverted Position.
94
Describe the Course of the Round Ligament?
1. Originates at the Uterine Horns in the Fundus of the Uterus,
2. Exits the Pelvis via the Deep Inguinal Ring,
3. Passes through the Inguinal Canal,
4. Continues out of the Superficial Inguinal Ring and onto the Labia Majora.
95
Where does the Round Ligament terminate?
At the Labia Majora/Mons Pubis.
96
What is the Cardinal Ligament?
Extends from the Cervix to the Lateral Pelvic Walls from the Base of the Broad Ligament,
And acts to support the Uterus,
As well as contains the Uterine Artery and Vein.
97
What is the Uterosacral Ligament?
Extends from the Cervix to the Sacrum and acts to provide support to the Uterus.
98
What is the Ovarian Ligament?
Joins the Ovaries to the Uterus.
99
What is the Ovarian Suspensory Ligament/Infundibulo - Pelvic Ligament?
Attaches the Ovary to the walls of the Pelvis.
Fold of Peritoneum extending from the Mesovarium to the Pelvic Wall.
Contains the Neurovascular Structures.
100
What is the Pubocervical Ligament?
Attach the Cervix to the Posterior Surface of the Pubic Symphysis.
They function to support the Uterus within the Pelvic Cavity.
101
What are the 2 Parts of the Cervix?
1. Endocervix: Supra โ Vaginal Part
| 2. Ectocervix: Intra โ Vaginal Part
102
What structures surround the Endocervix?
Anterior Fornix
Posterior Fornix
Lateral Fornices: Right & Left
103
What are the Cervical Openings?
External Orifice: Opening from Vagina into Cervix
| Internal Orifice: Opening from Cervix into Uterus
104
What is the Clinical Utility of the External Orifice?
Seen in the Speculum Examination
| And when taking the Cervical Smear Test to test for Cervical Cancer/ HPV.
105
What are Adnexa?
Structures between the Uterus and Pelvic Side Walls:
| Tubes and Ovaries
106
How can Adnexal Masses be Examined?
1. Bimanual Examination can examine Adnexal Masses:
- 2 fingers in Vagina
- 1 on Abdomen
2. Transvaginal Ultrasonography
107
How long is each Uterine Tube?
10cm
108
What are the 4 Parts of the Uterine Tubes?
1. Fimbriae
2. Infundibulum
3. Ampulla
4. Isthmus
109
What are the Fimbriae?
Finger - Like, Ciliated Projections which capture the Ovum from the Surface of the Ovary.
110
What is the Infundibulum?
Funnel - Shaped opening near the Ovary to which Fimbriae are attached.
111
What is the Ampulla?
Widest section of the Uterine Tubes.
| Fertilization usually occurs here.
112
What is the Isthmus?
Narrow section of the Uterine Tubes connecting the Ampulla to the Uterine Cavity.
113
Which part of the Uterine Tubes is the Narrowest?
Isthmus
114
Where in the Uterine Tubes does Fertilisation take place?
Ampulla
115
What happens in Ectopic Pregnancies?
Fertilisation does not occur at the Ampulla.
116
How does an Ectopic Pregnancy occur?
1. If the Lumen of the Uterine Tube is Partially Occluded,
2. Sperm may be able to pass through and Fertilise the Ovum.
3. However, the Fertilised Egg may not be able to pass into the Uterus,
4. And can Implant in the Uterine Tube.
117
What are the consequences of Ectopic Pregnancy?
An Ectopic Pregnancy is a Medical Emergency if not diagnosed early,
The Implanted Blastocyst can cause Rupture and Haemorrhage of the affected Tube.
118
What type of Cells line the Uterine Tubes?
Ciliated Simple Columnar Epithelium:
- The Cilia on the Cells waft the Ova through the Ovarian Tube,
- Towards the Endometrium of the Uterus.
119
What is the Blood Supply of the Uterine Tubes?
1. Ovarian Artery:
- Arises from the Abdominal Aorta.
- At the Level of L1/L2.
- Makes up 1/3 of the Blood Supply.
2. Uterine Artery:
- Internal Iliac Artery.
- Makes up 2/3 of the Blood Supply.
120
What is Salpingitis?
Inflammation of the Fallopian Tubes
121
What is the most common cause of Salpingitis?
Chlamydia
122
What are the consequences of Salpingitis?
Infertility.
| Ectopic Pregnancy by forming Adhesions that block the Lumen of the Uterine Tube.
123
What is a Hydro - Salpinx?
Condition that occurs when the Fallopian Tube is Blocked,
| Fills with Serous or Clear Fluid near the Ovary.
124
What is a Pyo - Salpinx?
Condition in which the Fallopian Tube fills up and Swells with Pus.
125
What is Cervical Excitation?
Cervical Motion Tenderness,
Sign found on a Gynaecological Pelvic Examination,
Suggestive of Pelvic Pathology.
126
What Pathologies is Cervical Excitation suggestive of?
Pelvic Inflammatory Disease (PID)
| Ectopic Pregnancy
127
How would you Test for Cervical Excitation?
Assessed via a Bimanual Digital Exam.
| Speculum: Would cause intense pain if Cervical Excitation is present.
128
What is Cervical Excitation also known as?
Chandelierโs Sign
129
What are the Anatomical changes during the Menstrual Cycle?
Mucus Thinning
Cilia Waft
Endometrium Builds Up
130
Which Germ Cell Layer of the Embryo do the Ovaries arise from?
Mesoderm
131
How many Oocytes are there and how much do these decrease?
20 Weeks Gestation: 5 Million Oocytes
At Birth: 500,000 Oocytes
Puberty: 50,000 Oocytes
Ovulated: Fewer than 500 Oocytes
132
Where do the Ovaries begin and Where do they Descend?
Begin high on the Posterior Abdominal Wall.
| Descend only to the Pelvic Brim.
133
Where do the Ovarian Arteries arise?
Arise from the Abdominal Aorta
134
At which Vertebreal Level do the Ovarian Arteries arise?
L2
135
Describe the Course of the Ovarian Arteries?
1. Ovarian Arteries arise from Abdominal Aorta,
2. Descend along the Posterior Abdominal Wall,
3. Cross over the External Iliac Vessels at the Pelvic Brim,
4. Enter the Suspensory Ligaments,
5. Ovarian (and Ascending Uterine Arteries) Terminate by Bifurcating into Ovarium and Tubal branches,
6. Which supply the Ovaries and Tubes from Opposite Ends and Anastomose with each other.
136
Which Structure is at risk of Injury when Ligating the Ovarian Vessels?
Ureter
137
Where does the Ovarian Vein drain into?
Left Ovarian Vein:
- Left Renal Vein
- Inferior Vena Cava
Right Ovarian Vein:
- Inferior Vena Cava
138
Where do the Lymphatics of the Ovaries drain to?
Paraortic Lymph Nodes
139
How can Lymphatics facilitate Cancer?
Cancers can Metastasise to other Organs through their shared Lymphatic Drainage.
140
What are the Anatomical differences in Pre and Post - Menopausal Women?
The Ovaries Shrink and Artophy after Menopause.
141
Why may Ovarian Pathology cause symptoms in Medial Thigh?
The Obturator Nerve runs over the Ovary.
Damage to the Ovary can damage the Obturator Nerve,
Causing Thigh Pain or Loss of Function.
142
Which 3 Types of Cell are found in the Ovary?
1. Surface Epithelium:
- The Surface of the Ovaries is covered with Membrane,
- Consisting of a Lining of Simple Cuboidal-to-Columnar Shaped Mesothelium,
- Called the Germinal Epithelium.
2. Germ Cells:
- The Cells that will develop into Follicles (Eggs).
3. Stromal Cells:
- Connective Tissue Cells that are abundantly supplied by Blood Vessels.
143
Which Ovarian Cell Type most commonly leads to Malignancy?
Most Common Cancers arise from Epithelial Cells or Germ Cells.
90% of Ovarian Cancers are derived from Epithelium, called Ovarian Adenocarcinomas.
144
What is a Teratoma?
Most Germ Cell Tumours are Teratomas.
A Tumour composed of Tissues not normally present at the site,
Which comprise Cells from all 3 Germ Cell Layers and are usually benign.
145
Why does Ovarian Cancer have such a Poor Prognosis?
Lacks any clear early Detection or Screening Test,
Most cases are not Diagnosed until they have reached Advanced Stages.
Metastasizes Early in its development, often before it has been Diagnosed.
High - Grade Tumours metastasize more readily than Low - Grade Tumours.
146
What are the Symptoms of Ovarian Cysts?
1. Bowel Obstructions
2. Abdominal Distension
3. Nausea
4. Pain on Defacation
147
What are the 3 Cyst Complications that can arise causing Acute Pain?
1. Rupture
2. Haemorrhage
3. Torsion
148
What are the Components of the Lower Genital Tract?
1. Vulva
2. Vagina
3. Cervix
149
How long is the Vagina?
3 - 4 inches.
But can expand to 6 - 10 inches when Sexually Aroused.
The Posterior Wall is Longer than the Anterior Wall.
150
How is the Vagina Lubricated?
By Plasma Secreted from the Cervix.
151
What does the Cervix form at the Upper End of the Vagina?
Cervix Protrudes into the Upper End of the Vagina creating a Sulcus,
As well as 4 Fornices.
152
What is the Relation of the Vagina to the Cervix?
```
At the Upper Ending, the Vagina surrounds the Cervix.
Creating Two Domes (Fornices/Vaults):
1. Anterior Fornix
2. Posterior Fornix:
- This is Deeper
- Anterior to the Genital Septum
```
153
What is the Clinical Significance of the Posterior Fornix?
Acts like a Natural Reservoir for Semen after Intravaginal Ejaculation.
The Semen retained in the Fornix Liquefies in the next 20 - 30 mins,
Allowing for Easier Permeation through the Cervical Canal.
154
Which important structure is related to the Lateral Fornix?
The Ureter
155
When might the Ureter be Injured during Surgery?
Clamping during a:
- Hysterectomy
- Oophorectomy
- Salpingectomy
156
Where is the Vaginal Opening located?
The Vaginal Opening is at the Posterior end of the Vulval Vestibule,
Behind the Urethral opening.
The Opening to the Vagina is normally obscured by the Labia Minora.
157
What Angle does the Vaginal Canal make with the Horizontal Plane?
60 Degrees
158
What separated the Vagina from the Rectum?
Perineal body (Genital Septum)
159
What are the Anatomical Relations of the Vagina?
1. Anterior:
- Bladder
- Urethra
2. Posterior:
- Rectouterine Pouch
- Rectum
- Anal Canal
3. Lateral:
- Ureters
- Levator Ani Muscle
160
What is the Blood Supply of the Vagina?
1. Vaginal Artery:
| - Arises from the Internal Iliac Artery.
161
How does Pelvic Organ Prolapse occur?
The Muscles and Tissues supporting the Pelvic Organs become Weak or Loose.
Pelvic Organs such as the Uterus, Bladder or Rectum.
This allows one or more of the Pelvic Organs to Drop or Press into or out of the Vagina.
162
What is the Hymen?
The Hymen is a Membrane covering the External Vaginal Opening.
A remnant of Urogenital Sinus.
163
What is the function of the Hymen?
Keeps Germs out of the Vagina.
164
How is the Hymen formed?
At 5 Months Gestation the Vaginal Canalization is complete.
And the Foetal Hymen is formed from the Proliferation of the Sinovaginal Bulbs.
Where Mullerian Ducts meet the Urogenital Sinus.
165
Where do the Glands Open in relation to the Hymen?
- Bartholinโs Glands Open Above
| - Skeneโs Glands Open Below
166
What is the Vulva?
All the External Female Genitalia
167
What are the Components of the Vulva?
1. Mons Pubis
2. Vestibular Fossa
3. Labia Majora
4. Labia Minora
5. Vulval Vestibule
6. Hymen
7. Introitus
8. Urethral Meatus
9. Clitoris
10. Opening Of Greater Vestibular (Bartholinโs) Gland
11. Opening Of Lesser Vestibular (Skeneโs) Gland
168
What is the Mons Pubis?
Pad of Fatty Tissue that covers the Pubic Bone.
| Secretes Pheromones responsible for Sexual Attraction.
169
What is the Vestibular Fossa?
Depression between the Vagina/Hymen and the Frenulum.
170
What is the Labia Majora?
Outer Lips protecting the Vagina.
171
What is the Sensory Innervation of the Anterior 1/3 Labia Majora?
Ilioinguinal Nerve
172
What is the Vertebral Root for the Ilioinguinal Nerve?
L1
173
What is the Sensory Innervation of the Posterior 2/3 Labia Majora?
Perineal Branch of the Pudendal Nerve
174
What is the Vertebral Root for the Perineal Branch of the Pudendal Nerve?
S3
175
What is the Labia Minora?
Inner Lips protecting the Vagina.
176
What are the 2 Commissures of the Labia Majora?
- Anterior Commissure
| - Posterior Commissure
177
What is the Vulval Vestibule and Which structures open into it?
Vulval Vestibule/Vestibule of Vagina:
- Part of the Vulva between the Labia Minora
- Into which the Urinary Meatus (urethral opening) and the Vaginal Opening (Introitus) open.
178
What is the Introitus?
The Opening that leads to the Vaginal Canal.
179
What is the Urethral Meatus?
Opening of the Female Urethra.
180
Where is the Urethral Meatus located?
Located about 2.5 cm behind the Clitoris,
| And immediately In Front of the Vagina in the Vulval Vestibule.
181
What are the 3 Components of the Clitoris?
1. Prepuce
2. Glans
3. Frenulum
182
Where is the Erectile Tissue of the Clitoris?
The Crura and Body of the Clitoris are formed of Erectile Tissue.
183
How do the Crura of the Clitoris form the Body?
The Clitoris consists of Two Crura,
| Which unite to form the Body.
184
How is the Body of the Clitoris related to the Glans?
The Body of the Clitoris is Curved, and Points Downwards.
It ends at the Glans,
Just in front of the point where the Labia Minora come together.
185
Why is the Glans a Sensitive Area?
The Glans of the Clitoris is richly endowed with Sensory Nerve endings.
186
What is the Blood Supply of the Vulva?
External Pudendal Artery
187
How is the Sensory Innervation of the Vulva Split?
The Vulva gets Sensory Innervation Split into:
- Anterior Section
- Posterior Section
188
What is the Anterior Section of Sensory Innervation of the Vulva?
Anterior Section:
- Ilioinguinal Nerve
- Arising from the Genital Branch Of The Genitofemoral Nerve
189
What is the Vertebral Root for the Genital Branch Of Genitofemoral Nerve?
L1
190
What is the Posterior Section of Sensory Innervation of the Vulva?
Posterior Section:
- Pudendal Nerve
- Arising from the Posterior Cutaneous Nerve Of The Thigh.
191
What is the Vertebral Root for the Posterior Cutaneous Nerve Of Thigh?
S2 - S4
192
What is a Caudal Block?
Caudal Nerve Epidural Block:
- Occurs by inserting a Needle through the Sacral Hiatus,
- To gain entrance into the Sacral Epidural Space or the Caudal Nerves.
193
Why will a Caudal Block not completely Anesthetise the Vulva?
The nerves at a Higher Vertebral Level,
Such as the Nerves of the Anterior Section,
Wonโt be Affected.
194
What is the Lymphatic Drainage of the Vulva?
Superficial Inguinal Lymph Nodes
195
What is the Gartner's Duct?
Vestigial remnant of the Mesonephric Duct (Wolffian Duct) in Females.
196
What is a Gartner's Duct Cyst?
A Gartner's Duct Cyst is a Benign Vaginal Cyst that originates from the Gartner's Duct,
They are typically Small Asymptomatic Cysts that occur along the Lateral Walls of the Vagina,
Following the course of the Duct.
197
How does a Gartner's Duct Cyst present?
They can present in Adolescence with Dysmenorrhea (Painful Menstruation)
Or Difficulty Inserting a Tampon.
198
What is the Parasympathetic Control of Sexual Arousal?
Pelvic Splanchnic Nerve
199
What is the Sympathetic Control of Sexual Arousal?
Hypogastric Nerve
