2 - Female Reproductive System Flashcards

1
Q

Label the parts of the female reproductive system.

A
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2
Q

What is the blood supply to the female reproductive system?

A
  • Ovarian artery from abdominal aorta below renal artery.
  • Anastomoses between uterine and vaginal so could be issues with bleeding in hysterectomy
  • Also internal pudendal artery
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3
Q

Why are nuns more likely to get ovarian cancer?

A
  • Capsule of peritoneum that is damaged at ovulation by rupturing follicle
  • Scarring and causes chance for mutation as proliferating
  • Nuns don’t take OC pill so have more ovulations
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4
Q

How might someone with an ovarian cyst present?

A
  • Discomfort on intercourse
  • Pain
  • Bloating
  • More likely to lead to torsion and occlusion of blood supply
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5
Q

Label the different parts of the uterus and the uterine tubes?

A
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6
Q

What can you feel in the fornices when doing a vaginal exam?

A

Lateral: levator ani

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7
Q

What does a cervix look like if you were to put a camera up the vagina?

A
  • Looks like glans penis, external os is like the wee hole. Os bigger if had a child.
  • Os may be inside out due to pregnancy and OC pill
  • Cervical cancer will look red and nasty on cervix
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8
Q

Why might a pregnant woman feel pain in her labia majora?

A

Round ligament (remnant of gubernaculum) is being stretched and this attaches from the uterine horns to the labia majora

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9
Q

What is the issue with the uterine tubes being open into the peritoneal cavity?

A

Bacteria can track up the vagina and uterine tubes and end up with peritonitis

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10
Q

Explain the attachments of the main ligaments of the female reproductive system?

A

- Broad: Flat sheet of peritoneum, from lateral walls and folds over the internal female genitalia, covering their surface anteriorly and posteriorly. Split into three

- Round: Uterine horns to labia majora. Remnant of gubernaculum

- Suspensory: from ovary to wall. Neurovascular pathway and tents peritoneum

- Ligament of ovary: ovary to uterus

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11
Q

How is the broad ligament split into three?

A

Mesometrium: mesentry of uterus

Mesovarium: mesentry of ovaries

Mesosalpinx: mesentry of tubes

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12
Q

How can the bladder move up if it is constricted by the peritoneum?

A

Peritoneum does not cover the anterior bladder so it can move up

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13
Q

What is the normal angle of the cervix with the vagina and the uterus?

A
  • Anteverted, Anteflexed
  • Round ligament pulls fundus forward
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14
Q

When giving birth and a mother has a tear, what part of the vagina is tearing?

A

Fourchette

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15
Q

What are the four types of femal genital mutilation?

A

Type 4 is things like piercings

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16
Q

What are the health risks with FGM?

A
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17
Q

Complete the following table.

A
18
Q

What is the general pathogenesis behind polycystic ovaries?

A

Ovarian cysts derived from follicles form. Can be asymptomatic or can cause torsion/rupture. To be polycystic have to have over 10 - common cause of infertility

19
Q

What is the common origin of tumours of the ovary?

A

From germinal epithelium (modified mesothelium cuboidal)

20
Q

How does the ova travel down the uterine tube and what are some causes of infertility due to dysfunction of this?

A

- Cilia and mucus secreting Peg cells

  • Scarring from ectopic pregnancy or a chronic infection like chlamydia
  • Adhesions from endometriosis
21
Q

What are some risk factors for an ectopic pregnancy?

A
  • IUD
  • Endometriosis
  • PID
  • Blocked fallopian tube
  • Immotile cilia
22
Q

What is the clinical significance of the vesicouterine and the rectouterine pouch?

A

Fluid collection can occur here, e.g in haemorraghe or infection

23
Q

What are the layers of the uterus?

A

Endometrium is simple columnar, same as the cervix

24
Q

What is endometriosis?

A

Ectopic endometrial tissue is dispersed to different sites in peritoneal cavity. Can attach to ovaries and uterus and associated with severe dysmennorhea and infertility

25
Q

What do the epithelia in the cervix do?

A
  • Simple columnar
  • Secrete cervical mucus, changes in consistency and pH depending on menstraul cycle to help or hinder entry of sperm
26
Q

What is the purpose of the epithelia in the vagina?

A

- Stratified squamous containing lots of glycogen

  • Lactobacilli regulate pH and keep environment acidic so no thrush
  • Adapted to expand and resist friction but cannot lubricate so depends on cervix
27
Q

What are the common sites of ectopic implantation, with most common first?

A
  • Ampulla
  • Isthmus
  • Fimbrae
  • Cornual
28
Q

Where would you mainly feel pain with ectopic pregnancy in ampulla?

A

- Iliac fossa - compression of structures

- Shoulder tip (on rupture): irritation of phrenic nerve, referred pain

29
Q

Why is ectopic pregnancy a gynaelogical emergency?

A

Lots of anastomoses between vaginal and uterine arteries

30
Q

Why are the ureters at risk during a hysterectomy?

A

Ureters cross the uterine arteries which need to be ligated so may clamp them

31
Q

How might a retroverted retroflexed uterus present?

A

Painful sex or asymptomatic

32
Q

What is the innervation of the different parts of the female genitalia?

A
33
Q

What would the histology of the vagina be like?

A
  • Mucosa, submucosa and muscular layer
  • Non-keratinised stratified squamous
  • Lots of glycogen (bright pink) for metabolism by lactobaccili to maintain acid pH
  • No glands as lubrication from cervix
34
Q

What would the histology of the cervix be like?

A
  • Simple columanr with sharp change to vaginal epithelium at entrance to external os
  • Lots of mucosal glands
  • Transformation zone changes location in life
35
Q

What is the histology of the uterus?

A

Simple columnar

36
Q

How can the endometrium be split up into different areas?

A

- Stratum Basalis

- Stratum Functionalis: outer compact and deeper spongy layers

  • Functional layer stripped away in menstruation and replaced by basal layer (cells next to the glands)
37
Q

Identify where in the menstrual cycle each of these histological slides are (endometrium).

A

1 - Proliferative stage under influence of oestrogen. Stratum functionalis ncrease in length as cells grown from the glands in basalis

2 - Secretory phase where glands grow bigger and more coiled into the lamina propria. Saw tooth appearance. Empty spaces due to stromal oedema. Decidual cells where can only see nucleus

3 - Menstraul phase where progesterone levels drop so endometrium breaks down. Spasm of coiled arteries in stratum functionalis so lack of nutrients so these cells die. Coiled arteries don;t go into the basalis

38
Q

What is the histology of the fallopian tubes?

A
  • Inner mucosa and a serosal layer. Folding in the lumen
  • Ampulla has two muscle layers, isthmus has three and is bigger
  • Ampulla has lots of cilliated cells, increase in peg cells towards uterus
39
Q

What is a peg cell?

A
  • Non-ciliated epithelial cell within the uterine tube.
  • Capacitate sperm
  • Give nutrients to the oocyte
  • Inhibits microorgansms getting into peritoneum
40
Q

What are the layers of the urogenital triangle?

A