5. Female Reproductive Tract Flashcards
What is the inferior pole of the ovary connected to
Labioscrotal folds via gubernaculum
What fuses to form the uterus
Mesonephric ducts (Stops ovary descent)
What are the ovaries suspended by
What is contained within
Short peritoneal fold / mesentery: mesovarium
Within mesovarium, short ovarian uterus tethers ovary to uterus
What is the ovarian ligament a remnant of
Superior part of ovarian gubernaculum
Uterus:
Arterial supply
Venous drainage
Lymphatic drainage
Uterine artery (anterior division of internal iliac) Ureter passes inferiorly, under uterine artery (water under the bridge)
Uterine venous plexus
Merges to form uterine veins
Tributaries of internal iliac
Fundus: aortic nodes
Body: external iliac nodes
Cervix: external & internal iliac nodes, sacral nodes
Describe the positioning of the uterus
In relation to vagina
In relation to cervix
Anteverted
Antiflexed
What are the 3 layers of the uterus
Endometrium:
Mucous membrane
Tubular glands extend from surface to CT (stroma)
Myometrium:
Mass of smooth muscle
Hyper trophy/hyperplasia in pregnancy
Peritoneum:
Serous membrane
Open via ostium of uterine tube
What are the 2 sub layers within the endometrium
stratum functionalis:
cyclical growth & shedding
stratus basalis:
regenerates upper endometrium)
What are the 2 main ligaments of the uterus
Broad ligament:
Double layer of peritoneum (mesentery)
From sides of uterus to lateral walls & floor of pelvis
Helps keep uterus in position
Round ligament:
Embryological remnant of gubernaculum
Attached to ovary & labium majus
Travels thru inguinal canal
What are the parts of the uterine tubes
Abdominal ostium Infundibulum Fimbra (extensions of infundibulum) Ampulla Isthmus
What are the 2 regions of the cervix
Describe the epithelial coverings
Endocervix:
Columnar, mucus-secreting
Mucosa contains large glands, also lined wing mucus-secreting columnar epithelia
Exocervix: Stratified squamous (as of vagina)
Abrupt transformation zone
Remainder of cervix comprised of circular smooth muscle in abundant CT
Describe the in innervation of:
Uterus & Vagina
Perineum
Inferior 1/5th vagina:
somatic innervation, pudendal nerve (S2-4)
Superior 4/5th vagina & uterus:
Uterovaginal plexus
Perineum:
Somatic innervation: pudendal & ilioinguinal nerves
Describe the different pain sensations in the uterus & vagina
Pain afferents depend on pelvic pain line:
Above line: refers back up
Below line: local pain
Describe the 3 layers of the vagina
Mucous membrane:
Stratified squamous epithelium
Lamina propria - dense CT & projections (papillae)
Muscular coat:
Smooth musc bundles arranged circularly & longitudinally
Adventitia:
Fibrous CT
Vagina:
Arterial supply
Venous drainage
Superior vagina: uterine arteries
Middle & Inferior vagina: vaginal & internal pudendal arteries (anterior division of internal iliac)
Vaginal veins from vaginal venous plexuses
Merge to form vaginal vein
Drains into uterine then internal iliac
What are the 2 ligaments that support the pelvic viscera
Transverse cervical ligament:
Thickening @ base of broad ligament
Lateral stability of cervix
Uterosacral ligament:
Opposes anterior pull of round ligament
Assists in maintaining anteversion
Describe ovarian cysts & polycystic ovaries
Usually derived from follicles
PCO: usually >10 cysts & assoc with infertility
What is the usual origin of tumours of the ovary
Epithelial components or germ cells
What is salpingitis
Inflammation of uterine tube caused by microorganisms
Causes fusions / adhesions of mucosa
What is endometriosis
Ectopic endometrial tissue dispersed to various sites along peritoneal cavity & beyond
Severe period pain &/or infertility
Describe endometrial carcinoma
Major symptom
At risk group
Malignancy of endometrium; mostly @ transformation zone
Abnormal uterine bleeding
Postmenopausal women
Describe 2 conditions of the Greater Vestibular / Bartholin Glands
Bartholinitis: infection/inflammation
Bartholin Gland Cyst: duct of gland blocked
What is vaginitis
Inflammation of the vagina
What is vaginismus
Condition making any penetration painful/impossible
A reflex of pubococcgeus muscle
Describe the role of Lactobacillus
Normal vaginal flora
Maintains low pH
Use glycogen as substrate for lactic acid production
Ovary:
Arterial supply
Venous drainage
Lymphatic drainage
Ovarian arteries (directly off abdominal aorta, below renal arteries)
Right ovarian vein -> IVC
Left ovarian vein -> L renal vein -> IVC
Para-aortic nodes
