2.4 - Female Reproductive System Flashcards
What are the female internal reproductive organs? (4)
Uterus
Fallopian tubes
Vagina
Ovaries
Which 3 structures constitute the birth canal?
Uterus
Vagina
Cervix
What are the 3 layers of the uterus?
Peritoneum
Myometrium
Endometrium
As pregnancy advances, the uterus phsyiologically has an ‘upper’ segment and a ‘lower’ segment, what constitutes each of these and what are their functions for birth?
Upper = fundus = contraction Lower = cervix and isthmus = dilation and distension
Which part of the uterus is opened in a C-section?
Lower part
What is the normal positioning of a uterus described as?
Anteverted and anteflexed
What could happen if the uterus is very retroverted and retroflexed? (particularly in early pregnancy)
- Pregnancy - uterus can become incarcerated, meaning it gets wedged in the pelvis during growth (however this is rare)
- Other - increased incontinence/difficulty urinating, back pain, prone to uterine prolapse
At any surgical management of miscarriage why might it be important to know prior to instrumentation of the uterine cavity whether the uterus is anteverted or retroverted?
To minimise risk of perforation of the uterus with instrumentation
What are the names of the 2 peritoneal spaces on either side of the uterus?
Rectouterine pouch
Uterovesical pouch
What are the fornices of the vagina?
Posterior and anterior
They are superior portions of the vagina extending into the recesses created by the vaginal portion of the cervix
Through which vaginal fornix can you access the rectouterine pouch? What is the clinical significance of this?
Posterior fornix
Peritoneal dialysis for ESRF
Rectovaginal fistulae can also occur if the walls are weak
Name 4 ligamentous attachments which firmly anchor the uterus and cervix into position in the pelvis
Ligament of ovary
Suspensory ligament of ovary
Round ligament of uterus
Broad ligament
Which ligament (part of the pelvic fascia, which is one of the main supports of the uterus) is called the cardinal ligament of the uterus? (also pubocervical. uterosacral and sacrocervical (fascial) ligaments)
Lateral cervical ligament
Apart from pelvic fascia, what other structure in the pelvis is also an important support of the uterus?
Bladder
Name the 4 parts of the uterine tube
Infundibulum
Ampulla
Isthmus
Intramural/uterine part
Which part of the uterine tube is the longest and widest?
Ampulla
Fertilisation most commonly occurs in which part of the uterine tube?
Ampulla
What is meant by a tubal/ectopic pregnancy?
Fertilised egg implants itself outside of the womb (usually in tube)
What might a cornual ectopic be?
Pregnancy in part of the tube that penetrates muscular layer of the uterus
What might repeated pregnancies do to the ovary?
Displace the position
What happens to the ovary following menopause?
They become atrophied and fibrous
What are the 2 ligaments associated with the ovary? What structures are they connected to?
Ligament of ovary/ovarian ligament - from uterus to ovary
Suspensory ligament - from ovary to lateral pelvic wall
Which 2 major branches from the aorta provide blood supply to the gonads and genitalia?
Gonadal and internal iliac arteries
At what vertebral level do the gonadal arteries originate?
L2
Describe the pathway of the ovarian artery
Descends within the suspensory ligament to supply the ovaries via the broad ligament
Which vessel does the ovarian artery freely anastomose with?
Uterine artery (and may in fact be replaced by it)
Where does the left gonadal vein drain (this is the left testicular vein in men and the left ovarian vein in women)?
Left renal vein
Where does the right gonadal vein drain?
IVC
Where specifically does the uterine artery cross over the ureter? Hence which expression is used to remind us of an important anatomical relation during the ligation of uterine artery?
At the level of the ischial spine at the junction of cervix and lateral part of fornix of vagina
‘Water under the bridge’
Lymphatic drainage of the internal pelvic organs largely follows the arterial supply and venous drainage by passing backwards through the nodes around the branches of which arteries?
Iliac arteries and abdominal aorta
Lymph from the labia and distal part of the vagina drain into which group of lymph nodes?
Sacral and superficial inguinal
Which group of lymph nodes receives lymph from the ovary?
Right and left lumbar via common iliac
Which lymph nodes drain the fundus and upper body of the uterus?
Pre-aortic group
Which lymph nodes drain the major part of the uterine body?
External iliac
Which lymph nodes drain the uterine cervix and upper vagina?
Internal iliac and sacral
Which lymph nodes drain the lower vagina?
Superficial inguinal
