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2 RA > 5 Anatomy of the Female Pelvis and Partuition > Flashcards

5 Anatomy of the Female Pelvis and Partuition Flashcards

1
Q

What makes up the pelvic inlet?

A

sacral promontory
margin of ala
linea terminalis
superior pubic symphysis

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2
Q

What comprises the pelvic outlet?

A 
pubic symphysis
ischiopubic rami
ischial tuberosity
sacrotuberous ligament
coccyx
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3
Q

Which of the pelvic inlet or outlet is bigger?

A

the pelvic outlet is smaller

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4
Q

how can the parietal bone move?

A

they can move on top of each other, elongating the skull

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5
Q

What can be measured on MRI pelvimetry?

A

sagittal pelvic inlet diameter
transverse inlet diameter
bispinous outlet
sagittal pelvic outlet

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6
Q

What is the smallest diameter in the pelvis, what is the significance of this?

A

bispinous outlet (10.5)

child can arrest here

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7
Q

What is the shape of the pelvic inlet?

A

wide transverse and narrower AP diameter

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8
Q

What is the shape of the pelvic outlet?

A

narrow transverse and wide AP diameter

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9
Q

What are the front and back of the foetal skull referred to as?

A

occiput

sinciput

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10
Q

What is the widest part of the foetal skull?

A

biparietal diameter at 9.5cm

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11
Q

What are the 3 layers to the uterine wall?

A

endometrium
myometrium
perimetrium

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12
Q

What are the layers of the myometrium?

A 
internal muscle
middle muscle (thick, spiral arrangement)
external muscle (longitudinal)
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13
Q

Going down, what are the parts of the uterus?

A 
fundus
corpus
anatomical internal os
isthmus
histological internal os
cervix
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14
Q

What is the difference in composition of the fundus compared to the cervix?

A

fundus is 90% muscle

cervix is 10% and hence much more collagenous

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15
Q

What happens to the uterine wall over pregnancy?

A

first 20 weeks - hypertrophy of muscle wall

next 20 weeks - distension, decrease in thickness

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16
Q

How does the weight of the uterus change over pregnancy?

A

50g to 950g

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17
Q

What is the height of the uterus at 12 weeks?

A

pubic symphysis

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18
Q

What is the height of the uterus at 20 weeks?

A

umbilicus

19
Q

What is the height of the uterus at 36 weeks?

A

xiphisternum

20
Q

What is significant about uterus size at 24 weeks?

A

from this point onwards, the accurate gestational age estimate can be taken

21
Q

What is aortocaval compression?

how can this be avoided?

A

reduction in venous return to the heart

women are advised to sleep on their left to avoid this

22
Q

What is Potters’ syndrome?

A

in some chemical kidey diseases causing impaired urine production, the uterus can be smaller

23
Q

What arteries are associated with female genitalia?

A

ovarian artery, which anasotmoses with the uterine artery

vaginal artery

24
Q

What is significant about the structure of the uterine artery?

A

tortuous path to allow for expansion

25
Q

What are the 3 main phases of childbirth?

A

dilation of cervix
expulsion of foetus
afterbirth of placenta

26
Q

What facilitates dilation of the cervix?

A

relaxin

27
Q

What is the cranial position when the cervix dilates?

A

normally right or left occipitotransverse

28
Q

What is the state of the histological internal os at 36 weeks?

A

full of mucous

29
Q

What are the phases of foetus expulsion?

A 
engagement
descent
flexion
medial rotation
extension
lateral rotation
expulsion
30
Q

What happens in engagement?

A

biparietal diameter enters pelvic inlet

31
Q

What happens in descent?

A

head goes through pelvic cavity

32
Q

What happens in flexion?

A

neck flexes

head forced anteriorly under force of contraction

33
Q

What happens in medial rotation?

A

the baby changes from lateral facing to occipitoanterior position, via a wave of uterine contraction

34
Q

What happens in extension?

A

head extends around the pubic symphysis

35
Q

What happens in lateral rotation?

A

face turns laterally, so the anterior shoulder can expel and then the posterior shoulder

36
Q

When does labour technically start?

A

when the mucous of the histological internal os is no more

37
Q

How is haemorrhage avoided in placenta delivery?

A

rapid involusion of the fetus disrupts the plaenta ad tears the blood vessels, fibres the pinch off the arterioles

38
Q

What is a 3rd degree pelvic tear?

A

tearing the rectal sphincter

39
Q

What is a 4th degree pelvic tear?

A

tearing of the rectal sphincter with rectal mucosa involvement

40
Q

What nerve can be damaged during childbirth?

A

the pudendal nerve

41
Q

What is the function of an episotomy?

A

prevention of tears progressing to 3rd or 4th degree and vaginal prolapse

42
Q

Name 2 types of episotomy

A

midline episotomy

mediolateral episotomy

43
Q

What do you have to do if a woman presents with abdominal pain?

A

if they are of childbearing age, you have to rule out ectopic pregnancy

2 RA (12 decks)

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