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OBGYN > 2: PRINCIPLES OF APPLIED ANATOMY/PHYSIOLOGY > Flashcards

2: PRINCIPLES OF APPLIED ANATOMY/PHYSIOLOGY Flashcards

1
Q

Origin of inferior epigastric vessels

A

External iliac

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2
Q

Medial umbilical ligament AKA

A

Obliterated umbilical artery

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3
Q

What is the termination of the internal iliac artery

A

Medial umbilical ligament AKA obliterated umbilical artery

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4
Q

Visualization of what structure confirms intrauterine location?

A

Tubal ostia

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5
Q

What scope degree should be used on HSC?

A

30 degrees

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6
Q

Borders of vesicovaginal space

A

Anterior: Bladder
Posterior: Vagina/endopelvic fascia
Lateral: Uterine arteries/bladder pillars

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7
Q

Borders of rectovaginal space

A

Anterior: Vagina
Posterior: Rectum
Lateral: Uterosacral ligaments

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8
Q

Borders of paravesical space

A

Caudad: Uterine artery
Medially: Bladder
Laterally: Medial umbilical ligament

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8
Q

Borders of pararectal space

A

Cephalad: Uterine artery
Medial: Ureter
Lateral: Internal iliac artery

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9
Q

Borders of retropubic space

A

Anterior: Pubic symphysis
Posterior: Bladder
Lateral: Pubic rami and obturator internus

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10
Q

Retropubic space AKA

A

Space of retzius

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11
Q

Presacral space AKA

A

Pouch of Douglas

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12
Q

Borders of presacral space

A

Anterior: Rectum
Posterior: Sacrum
Lateral: Common iliac vessels and ureters

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13
Q

Structures in presacral space

A

Middle sacral artery
Left common iliac vein (generally midline)
Inferior mesenteric artery (above L common iliac vein)
Right internal iliac is lateral aspect of the dissection

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14
Q

% of ureteral injuries attributable to GYN surgery

A

75%

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15
Q

Ureteral injury rate

A

0.03-1.5%

16
Q

Abdominal ureter pathway

A

Renal pelvis > courses inferiorly along psoas muscle > enters pelvis/crosses pelvic brim at bifurcation of iliac > medial/deep to IP > medial leaf of broad ligament

17
Q

Pelvic ureter pathway

A

Medial leaf of broad ligament > Passes within 1cm lateral to uterosacrals > into cardinal ligament complex > inferior to uterine vessels > medial along anterior vaginal to enter bladder at trigone

18
Q

Distance of ureter from internal os

A

1-1.5cm

19
Q

Fascial structures/ligaments of the pelvic floor

A

Endopelvic fascia
Cardinal ligaments
Uterosacral ligaments
Arcus tendineus of pelvic fascia

20
Q

Role of endopelvic fascia

A

Connects bladder, urethra, cervix, and lower portion of uterus to pelvic sidewall
Support for uterus and upper portion of vagina

21
Q

Role of cardinal ligaments

A

Fibromuscular condensation of pelvic fascia that directly attaches to cervix

22
Q

Role of arcus tendineus pelvic fascia/location

A

Attaches endopelvic fascia to pelvic sidewall
Can be found at interface of obturator internus and ischial spine
Formed by fascial attachments of the levator ani mm

23
Q

Female perineum: Perineal membrane layer

A

Deep transverse perineal mm
Compressor urethrae mm
Sphincter urethrae mm

24
Q

Female perineum: Superficial muscular layer

A

Superficial transverse perineal muscle
Bulbospongiosus
Ischiocavernosus

25
Q

Female perineum: Urogenital triangle

A

Spans entire anterior pelvic outlet
Occupies area between pubic symphysis and ischial tuberosities
Insertion of UG triangle forms perineal body

26
Q

Female perineum: Anal triangle

A

Includes external and internal anal sphincters

27
Q

Female perineum: Pelvic diaphragm AKA levator ani mm

A

Puborectalis
Pubococcygeus
Pubovaginalis??
Iliococcygeus
*Contiguous with piriformis and obturator mm

28
Q

Level 1 pelvic support + Defects

A

APICAL SUPPORT
Uterosacral/Cardinal ligament complex
Defects: Uterus or vaginal vault prolapse

29
Q

Level 2 support and defects

A

LATERAL ATTACHMENTS
Arcus tendineus fascia
Pubocervical and rectovaginal fascia
Defects: A/P vaginal wall prolapse

30
Q

Level 3 support and defects

A

LOWER SUPPORT
Perineal body / Levator ani mm
Defects: Rectal prolapse and anal incontinence

31
Q

Follicular cyst: Origin and US findings

A

Arises from ovarian follicle
US: Thin-walled, anechoic/fluid filled

32
Q

Corpus luteal cyst: Origin and US findings

A

Arises from corpus luteum
Thick walled and yellow
US: Internal echoes, central lucency, thickened walls

33
Q

Management of pre-menopausal ovarian cyst based on size

A

Asymptomatic, </=5cm: Expectant
Asymptomatic, >5cm: US 6-12w

34
Q

When to consider removal ovarian cyst, pre-menopausal

A

Persistent, enlarging, symptomatic
Torsion
Concern for underlying malignancy

35
Q

Risk of recurrence with cyst aspiration

A

30%

OBGYN (16 decks)

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