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ETA 4: REPRODUCTION > 2: Female Reproductive System & Pelvic Floor > Flashcards

2: Female Reproductive System & Pelvic Floor Flashcards

1
Q

What are the main anatomical structures of the female pelvis? (5 things)

A
  1. Ovary
  2. Uterus
  3. Uterine tubes
  4. Vagina + external gentalia
  5. Pelvic bones, lig, musc, nerves and vessels
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2
Q

Where is the uterus located?

A

Between bladder and rectum

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3
Q

How is the uterus anchored to the pelvis

A

series of ligaments

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4
Q

What is the top muscle of the uterus called?

A

Fundus

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5
Q

What is anterior to the uterus?

A

Uterovesical pouch

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6
Q

What is posterior to the uterus?

A

Recto-uterine pouch (aka pouch of Douglas)

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7
Q

What is the lowest point in the peritoneal cavity?

A

Recto-uterine pouch (aka pouch of Douglas)

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8
Q

Where are the ovaries located? (2 points)

A
  1. Laterally and behind uterus
  2. Inferior to pelvic inlet
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9
Q

What is the purpose of the ovaries? (2 things)

A
  1. Produce mature ova for fertilisation
  2. Generate steroid hormones
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10
Q

What is the arterial supply of the ovaries?

A

Ovarian arteries (directly branch off from abdominal aorta)

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11
Q

What is the venous return from the ovaries?

A

R ovarian vein –> IVC
L ovarian vein –> L renal vein

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12
Q

What is the lymphatic drainage of the ovaries?

A

Via lumbar lymph nodes

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13
Q

What makes up the bulk of ovarian tissue?

A

Primordial follicles

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14
Q

What do primordial follicles consist of?

A

Large primary ooctye with nucleus surrounded by a single layer of follicular cells

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15
Q

How is the uterus divided functionally?

A

2 Main regions:

  1. Muscular body (upper 2/3rds)
  2. Fibrous Cervix (lower 1/3rd)
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16
Q

What are the 4 major uterine ligaments?

A
  1. Broad Ligament
  2. Round Ligament
  3. Cardinal (Transverse cervical) ligament
  4. Uterosacral Ligament
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17
Q

What are the 3 minor uterine ligaments?

A
  1. Pubocervical ligament
  2. Suspensory Ligament of Ovary
  3. Ligament of Ovary
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18
Q

Which is the largest ligament?

A

Broad ligament

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19
Q

What is the broad ligament?

A

Double layer of peritoneum that provides support to uterus

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20
Q

Where does the broad ligament extend do?

A

Laterally on each side of uterus onto the lateral pelvic walls

(Like a sheet of tissue draped over the uterus)

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21
Q

What are the 3 divisions of the broad ligament?

A
  1. Mesovarium
  2. Mesosalpinx
  3. Mesometrium
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22
Q

What is the mesovarium?

A

Broad ligament mesentry covering ovary

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23
Q

What is the mesosalpinx?

A

Broad ligament mesentry covering uterine tubes

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24
Q

What is the mesometrium?

A

Broad ligament mesentry covering uterus body itself
It is the largest part of ligament

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25
Q

Where does the round ligament of uterus extend to?

A

From ovary –> through inguinal canal –> labia majora

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26
Q

Where does the cardinal (transverse cervical) ligament extend to?

And what does it contain? (2 things)

A

From circular cervix –> lateral pelvic walls

Contains:

  1. Uterine artery
  2. Uterine veins
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27
Q

Where does the uterosacral ligament extend to?

A

From circular cervix –> posterior pelvic walls

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28
Q

What does the uterosacral ligament assist with?

A

Maintaining anteversion of uterus

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29
Q

What is the role of the minor uterine ligaments? (2 things)

A
  1. Provide support to pelvic viscera
  2. House vascular structures
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30
Q

Where does the pubocervical ligament extend to?

A

From cervix –> anterior pelvic wall

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31
Q

What is the role of the pubocervical ligament?

A

Supports uterus

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32
Q

Where does the suspensory ligament of the ovary extend to?

And what does it contain? (4 things)

A

Ovary –> lateral pelvic wall

Contains:

  1. Ovarian artery
  2. Ovarian vein
  3. Ovarian nerve plexus
  4. Lymphatic vessels
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33
Q

Where does the ligament of the ovary extend to?

A

Ovary –> uterus

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34
Q

Are the fallopian tubes open or closed ended tubes?

A

Open

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35
Q

Where do the fallopian tubes extend from?

A

From each side of superior end of uterus body?

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36
Q

Where are the fallopian tubes enclosed in?

A

Within mesosalpinx (broad ligament)

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37
Q

What are the functions of the fallopian tubes? (2 things)

A
  1. Conduct oocyte into uterine cavity
  2. Site of fertilisation
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38
Q

Where in the fallopian tube is the egg fertilized?

A

Ampulla (middle part of tube)

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39
Q

What are the layers of the fallopian tube? (3 layers)

A
  1. Mucous membrane
  2. Muscular layer
  3. Serous coat
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40
Q

What cells does the mucous membrane of the fallopian tube have?

A
  1. Ciliated simple columnar epithelium
  2. Non-ciliated (secretory) cells
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41
Q

What is the role of the ciliated cells in the fallopian tube?

A

Help transfer ovum from ovary surface –> fallopian tube

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42
Q

What is the purpose of the non-ciliated (secretory) cells in the fallopian tube?

A

Provide nutrients to early conceptus after fertilisation

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43
Q

What does contraction of the SMC in the muscular layer of the fallopian tubes transport? (2 things)

A
  1. Sperm –> fertilisation site
  2. Conceptus –> uterus
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44
Q

What is the cervix?

A

Fibromuscular neck of uterus

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45
Q

What are the functions of the cervix? (2 things)

A
  1. Allows sperm from vagina to enter uterine cavity –> site of fertilisaton
  2. Protect uterus + upper genital tract from bacteria
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46
Q

What are the 2 regions of the cervix?

A
  1. Endocervix
  2. Exocervix
47
Q

What cells are in the endocervix?

A

Tall columnar epithelium (basally placed nuclei)

(most of cytoplasm filled w. mucus)

48
Q

What are the 2 openings of the endocervical canal?

A
  1. External opening: opening from vagina to cervix
  2. Internal opening: opening from cervix to uterus
49
Q

What cells are in the exocervix?

A

Stratified squamous non-K ciliated epithelia

50
Q

What is the rest of the cervix composed of?

A

Circular arranged SM fibres in dense connective tissue

51
Q

What is the vagina?

A

Distensible muscular tube (6-7.5cm) from middle cervix –> vaginal orifice

52
Q

What are the functions of the vagina? (5 things)

A
  1. Canal for menstrual fluid
  2. Inferior portion of birth canal
  3. Receives penis and ejaculate
  4. Communicate w. cervical canal above
  5. Communicate w. vestibule (opening) of vagina below
53
Q

What is the arterial supply of the superior portion of the vagina?

A

Uterine arteries

54
Q

What is the arterial supply of the middle / inferior portion of the vagina?

A

Vaginal + Internal pudendal arteries

55
Q

What is the innervation of the inferior 1/5th of the vagina?

A

Somatic (from pudendal nerve branch)

56
Q

What is the innervation of the superior 4/5th of the vagina?

A

Visceral (from uterovaginal nerve plexus)

57
Q

What are the 3 layers of the vaginal wall?

A
  1. Mucous membrane
  2. Muscular coat
  3. Adventitia (fibrous connective tissue layer)
58
Q

What cells are in the mucous membrane of the vaginal wall?

A

Stratified squamous non-K epithelium

59
Q

What is underneath the stratified squamous epithelium in the mucous membrane of the vaginal wall?

A

Lamina propria - Looser towards muscular layer + has large veins

60
Q

Are there glands in the vagina? (why / why not)

A

No, the mucus lubricating the vagina comes from the cervical glands

61
Q

What is the muscular coat of the vaginal wall composed of?

A

SM bundles arranged circularly and longitudinally

(lots of longitudinal in outer half of the layer)

62
Q

What is endometriosis?

A

Ectopic endometrial tissue dispersed to different sites in peritoneal cavity

63
Q

What are some signs / symptoms of endometriosis? (2 things)

A
  1. Dysmenorhoea (painful period)
  2. Infertility
64
Q

What is endometrial carcinoma?

A

Uterus cancer mainly in post menopausal women

65
Q

What sign/symptom is associated with endometrial carcinoma?

A

Abnormal uterine bleeding

66
Q

What are ovarian cysts derived from?

A

Follicles

67
Q

What are polycystic ovaries and what are the associated with?

A

10+ cysts
Associated with infertility

68
Q

What can fallopian tube infection lead to?

A

Occlusion of fimbrial (ovary) end of tube

69
Q

What can inflammation of fallopian tube (salpingitis) lead to?

A

Blockage of tube

70
Q

What can clinical problems of the fallopian tube in general cause?

A

Infertility / ectopic pregnancy

(Cah the egg can’t get to where it needs to be)

71
Q

How is a low pH environment maintained in the vagina?

A

Bacteria in the vagina use glycogen as substrate for lactic acid production

72
Q

What is the normal pH of the vagina?

A

3.8 - 4.5

73
Q

What is the pelvic floor?

A

Muscular layers that support pelvic viscera

74
Q

What are the functions of the pelvic floor? (3 things)

A
  1. Exerts sphincteric action on rectum, urethra and vagina
  2. Resists increase in intra-abd pressure
  3. Helps in child birth, urinary and faecal continence
75
Q

What causes an increase in intra-abdominal pressure? (3 things)

A
  1. Coughing
  2. Defecation
  3. Heavy lifting
76
Q

What is the perineal body? (2 things)

A
  1. Fibromuscular junction @ intersection of anterior and posterior perineum
  2. Central fulcrum for pelvic support
77
Q

What attaches at the perineal body?

A

Muscles of the pelvic floor and perineum

78
Q

What muscle fibres (from pelvic floor –> perineum) attach at the perineal body? (5 muscles / muscle groups)

A
  1. Bulbospongiosus muscle
  2. External anal sphincter
  3. Levator ani (part of pelvic floor)
  4. Transverse perineal muscles (superficial and deep)
  5. Sphincter urethrae

BELTS for support

79
Q

What does the perineal body act as in women?

A

Tear resistant body between vagina and external anal sphincter

(Supports posterior part of vaginal wall against prolapse)

80
Q

What are the two main layers of the Pelvic Floor?

A
  1. Pelvic diaphragm (bowl shaped)
  2. Perineum
81
Q

What is the pelvic diaphragm divided into? (2 things)

A
  1. Coccygeus
  2. Levator Ani (I,P,P)

(Could I Please Peek) (PD = pedo)

82
Q

What are the 3 muscles of the Levator Ani?

A
  1. Iliococcygeus
  2. Pubococcygeus
  3. Puborectalis

(I Please Peek)

83
Q

What is the perineum divided into? (2 things)

A
  1. Anterior (urogenital) Triangle (2 layers)
  2. Posterior (anal) Triangle

PeRineum like PyRamid so triangles

84
Q

What are the 2 layers of the anterior (urogenital) triangle?

A
  1. Urogenital Diaphragm (2 layers)
  2. Superficial Perineal Pouch
85
Q

What are the 2 layers of the urogenital diaphragm?

A
  1. Deep perineal pouch
  2. Perineal membrane
86
Q

What is the posterial (anal) triangle composed of? (3 things)

A
  1. Anal aperture
  2. Levator ani parts
  3. Ischioanal fossa

Ali likes anal

87
Q

What causes prolapse of the pelvic viscera (bladder and vagina)? (2 things)

A
  1. Trauma to pelvic floor
  2. Poor muscle fibre tone
88
Q

What causes prolapse of the vagina?

A

Damage to the perineal body @ childbirth

89
Q

What problems are causes by pelvic floor dysfunction?

A

Urinary and renal incontinence

90
Q

What are the risk factors for pelvic floor dysfunction? (6 things)

A
  1. Age
  2. No. of vaginal deliveries
  3. Family history
  4. Weight
  5. Chronic coughing (from lung disorders)
  6. Menopause (atrophy of tissues after oestrogen withdrawal)
91
Q

What are the treatments of pelvic floor dysfunction? (3 things)

A
  1. Surgically repaired
  2. Strengthen muscle w. pelvic floor exercises
  3. Do episiotomy @ childbirth
92
Q

What is episiotomy?

A

Surgical incision of perineum and posterior vaginal wall @ 2nd stage of labour to enlarge opening and stop uncontrollable tearing

93
Q

What are the differences between the female and male bony pelvis? (5 things)

A
  1. F: Circular pelvic inlet // M: Heart shaped
  2. F: Wide pubic arch angle // M: Narrow
  3. F: Less distinct sacral promontory (inward projecting ant. part of sacral vertabra) // M: More distinct
  4. F: Ischial spine project less medially into pelvic cavity // M: Project more medially
  5. F: Thinner bone // M: Thicker
94
Q

Circular pelvic inlet… male or female?

A

Female

95
Q

Heart shaped pelvic inlet… male or female?

A

Male (men don’t love but snm heart shape)

96
Q

Wide pubic arch angle… male or female?

A

Female

97
Q

Narrow pubic arch angle… male or female?

A

Male

98
Q

Distinct sacral promontory (inward projecting ant. part of sacral vertabra) … male or female?

A

Male

99
Q

Ischial spine project more medially into pelvic cavity… male or female?

A

Male

100
Q

Thinner bone of bony pelvis… male or female?

A

Female

101
Q

Thicker bone of bony pelvis… male or female?

A

Male

102
Q

What is the pelvic inlet?

A

Junction between greater and lesser pelvis

103
Q

What are the posterior borders of the pelvic inlet? (2 things)

A
  1. Sacral promontory (inward projecting ant. part of sacral vertabra)
  2. Sacral wings
104
Q

What are the lateral borders of the pelvic inlet? (2 things)

A
  1. Arcuate line on inner surface of ilium
  2. Pectineal line on superior pubic ramus
105
Q

What is the anterior border of the pelvic inlet?

A

Pubic symphysis

106
Q

What is the posterior border of the pelvic outlet?

A

Tip of coccyx

107
Q

What are the lateral borders of the pelvic outlet? (2 things)

A
  1. Ischial tuberosities
  2. Inferior margin of sacrotuberous ligament
108
Q

What is the anterior border of the pelvic outlet?

A

Pubic arch (inferior border of ischiopubic rami)

109
Q

What is the pelvic region divided into? (2 things)

A
  1. Greater (false) pelvis
  2. Lesser (true) pelvis
110
Q

Where is the greater (false) pelvis located?

A

Superiorly

111
Q

What is the greater (false) pelvis?

A

Space surrounded by upper portions of iliac bones and upper part of sacrum posteriorly

112
Q

Where is the lesser (true) pelvis located?

A

Inferiorly

113
Q

What is the lesser (true) pelvis?

A

Space surrounded by margins of obturator foramen, ischial spines, and lower portion of sacrum

ETA 4: REPRODUCTION (10 decks)

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