2. Female repro

Question 1

Label.

Answer 1

Question 2

Name and describe the 2 ligaments attaching to the ovary.

Answer 2

1. Suspensory ligament of the ovary
   - fold of peritoneum extending from ovary to pelvic wall
   - contains ovarian artery, ovarian vein, lymph vessels and nerves
2. Ovarian ligament
   - extends from ovary to fundus of uterus (then continues from uterus to labium majus as round ligament of uterus)

Question 3

Where does lymph from ovaries drain to?

Answer 3

Para-aortic nodes

Question 4

Label.

Answer 4

Question 5

How do the fallopian tubes assist transport of the ovum from ovaries to uterus?

Answer 5

1. Inner mucosa lined with ciliated columnar epithelial cells and peg cells (non-ciliated secretory cells) - waft ovum towards uterus and supply it with nutrients.
2. Smooth muscle layer in wall - peristaltic contraction

Question 6

Why can infection spread from female repro. tract to peritoneum?

Answer 6

Fimbriae open into peritoneal cavity.

Question 7

Where in the repro. tract is the site of fertilisation?

Answer 7

fallopian tube ampulla

Question 8

Describe the layers of the uterine wall.

Answer 8

1. Endometrium: inner mucous membrane consisting of functional layer (hormone-responsive, contains secretory glands and is shed during menses) and basal layer (source from which new functional layer is developed)
2. Myometrium: thick smooth muscle layer that is hormone-responsive but not shed

Question 9

Label.

Answer 9

Question 10

What epithelial transition is marked by the external os?

Answer 10

Ectocervix (opening onto vagina) = stratified squamous

Endocervical canal = mucus-secreting simple columnar

Question 11

Name the 2 angles that can be used to describe the position of the uterus.

Answer 11

Angle of anteversion (<180º) between cervix and vagina (retroverted if abnormal).

Angle of anteflexion (<180º) between uterine body and cervix (retroflexed if abnormal).

Question 12

Descrive the vasculature to the uterus.

Answer 12

Located in broad ligament:

• uterine artery (branch of internal iliac a.)
• uterine plexus drains into uterine vein

Question 13

Which structure may be at risk during hysterectomy?

Answer 13

Ureters can be damaged during clamping of uterine arteries as these run under arteries approx. 1cm laterally to internal os (“water under bridge”).

Question 14

Name the most common location for an ectopic pregnancy.

Answer 14

Fallopian ampulla

Question 15

Label.

Answer 15

Question 16

Why is vaginal candidiasis more common in post-menopausal women?

Answer 16

Oestrogen stimulates the stratified squamous epithelial cells of the vagina to secrete glycogen - digested by natural flora of vagina to produce lactic acid and maintain low vaginal pH (4.5).

Question 17

What is the broad ligament? Describe the different parts.

Answer 17

Broad sheet of peritoneum that extends from lateral pelvic walls on both sides and folds over internal female genitalia.

3 divisions:

• mesometrium - surrounds uterus
• mesovarium - projects from posterior surface of broad ligamebt to attach to hilum of ovary
• mesosalpinx - encloses fallopian tubes

Question 18

Other than the broad ligament, which ligament is associated with the superior uterus?

Answer 18

Round ligament (remnant of embryonic gubernaculum) - connects uterine horns and labia majora, passing through inguinal canal.

Question 19

Name 3 ligaments associated with the cervix.

Answer 19

1. Cardinal ligaments - lateral cervix and vaginal fornices to lateral pelvic wall (contain uterine a. and vv.)
2. Uterosacral ligaments - cervix to sacrum
3. Pubocervical ligaments - cervix to pubic symphysis

Question 20

Label the nerves that innervate these areas.

Answer 20