5) The Female Reproductive System Flashcards by Lauren Croft

How do the ovaries arise?

Develop within mesonephric ridge

Female gonads

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Describe the decent of the ovaries

Descend through abdomen, stop in pelvis
Inferior pole of ovary connected by gubernaculum to labioscrotal folds
Mesonephric ducts fuse to form uterus, stops ovaries descent

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How large are the ovaries & what is their function?

Almond shaped & sized
Oocyte development
Production of reproductive hormones

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How are the ovaries suspended?

Short ovarian ligament, tethers ovary to uterus

Lies medially within mesovarium (short peritoneal fold)

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What surrounds the ovaries?

Tunica albuginea

which is covered by a smooth layer of ovarian mesothelium

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What is the arterial supply of the ovaries?

Abdominal aorta > Ovarian artery

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What is the venous drainage of the ovaries?

Asymmetrical
Right ovarian vein > Inferior vena cava
Left ovarian vein > Left renal vein > Inferior vena cava

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What is the lymphatic drainage of the ovaries?

Para-aortic nodes

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What are the 4 main components of the uterus

Uterine tubes
Fundus
Body
Cervix

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What are the relationships of the uterus?

Uterovesical pouch anteriorly
Rectouterine (Pouch of Douglas) posteriorly
Posterior fornix of vagina

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What are the layers of the uterus?

Peritoneum - serous membrane covers the uterus
Myometrium - smooth muscle uterine wall
Endometrium - internal mucous membrane, lines the uterine cavity

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What are the differences between the two layers of endometrium in the uterine cavity?

Stratum functionalis - superficial layer, subject to cyclical growth, degeneration & shedding of dead tissues

Stratus basalis - deep layer, no cyclical changes, responsible for regeneration of upper endometrium

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What happens during the proliferative phase of the endometrium?

Oestrogen secreted during folliculogenesis stimulates growth & proliferation of endometrium

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What happens during the secretory phase of the endometrium?

After ovulation the CL secretes progesterone
Stimulates endometrial glands to secrete glycogen
Causes extensive coiling of glands, enriching vascular supply to mucous membrane

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Describe the position of the uterus

AnteVerted in relation to the Vagina

AntefleXed in relation to the cerviX

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What are the 4 main ligaments of the uterus and ovary?

Broad ligament
Round ligament of uterus
Ovarian ligament
Suspensory ligament of ovary

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What is the broad ligament of the uterus?

Double layer of peritoneum (mesentery)
Extends from sides of uterus to lateral walls & floor of pelvis
Comprised of the mesentary of the uterus, uterine tube & ovary
Assists in keeping the uterus in position

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What 3 regions can the broad ligament be divided into?

Mesometrium
Mesovarium
Mesosalpinx

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What is the round ligament of the uterus?

Embryological remnant of the gubernaculum
Attached to ovary & labium majus
Travels through inguinal canal

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What is the lymphatic drainage of the fundus of the uterus?

Aortic nodes

embryological derivation

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Name the sections of the uterine (Fallopian) tubes

Ovary
Fimbria (finger-like projections)
Infundibulum
Ampulla
Isthmus (narrow)
Uterine cavity

What is the function of the cervix?

Allow sperms to enter uterine cavity to proceed to site of fertilisation
Protect the uterus & upper genital tract from bacterial invasion

Describe the structure of the cervix

2 regions - endocervix & exocervix
Endocervix - tall columnar ep., basally placed nuclei, cytoplasm filled with mucus
Mucosa contains large glands with mucus-secreting columnar cells
Exocervix - stratified squamous non-keratinised ep.
Remainder of cervix smooth muscle & dense c.t.

What is the transformation zone in the cervix?

Abrupt change from columnar to stratified squamous non-keratinised epithelium
Majority of neoplasms form here

What is the arterial supply to the uterus?

Abdominal aorta > Common Iliac > Anterior division of Internal Iliac > Uterine artery

What does the saying "water under the bridge" refer to?

The ureter (water) passes inferiorly to the uterine artery (bridge)

What is the venous drainage of the uterus?

Uterine venous plexus > Uterine veins > Internal Iliac vein > Common Iliac vein > IVC

What is the lymphatic drainage of the uterus?

Fundus > Aortic nodes Body > External iliac nodes Cervix > External & Internal iliac nodes & sacral nodes

What are the 3 layers comprising the walls of the vagina?

Mucous membrane Muscular coat Fibrous connective tissue layer, adventitia

Describe the mucous membrane of the vagina

Stratified squamous epithelium Underlying lamina propria - dense c.t. with papillae projecting into the covering ep. Lamina propria becomes looser towards the muscular layer & has large veins here

How is the vagina lubricated?

No glands in the vagina | Mucus lubricating it originates from the cervical glands

Describe the muscular layer of the vagina?

Smooth muscle bundles arranged circularly & longitudinally | Longitudinal bundles are numerous in the outer half of the muscle layer

What are the vaginal fornices?

Anterior & posterior fornix | Recesses of vagina around the cervix

What is the arterial supply to the vagina?

Abdominal aorta > Common Iliac > Internal Iliac > Anterior division of Internal Iliac > Uterine > Vaginal artery Middle & Inferior parts of vagina: Abdominal aorta > Common Iliac > Internal Iliac > Anterior division of Internal Iliac > Pudendal artery

What is the venous drainage of the vagina?

Vaginal plexus > Vaginal vein > Uterine vein > Internal Iliac vein > Common Iliac vein > IVC

Describe the innervation of the uterus & vagina

Inferior 1/5 of vagina - somatic innervation, Pudendal nerve (S2-4) Superior 4/5 vagina & uterus - innervation from uterovaginal plexus

How do pain afferents in the uterus & vagina vary?

Depend on pelvic pain line Above line - Pain refers back up Below line - Local pain

Where do tumours of the ovary usually arise from?

Epithelial components | Germ cells

What are ovarian cysts and how do they develop?

``` Fluid-filled sacs that develop on a woman's ovary Usually derived from follicles Polycystic ovaries (>10 cysts) usually associated with infertility ```

What is salpingitis?

Inflammation of the uterine tube causes by microorganisms Fusions or adhesions of mucosa Partially/Completely block lumen - infertility May result in ectopic pregnancy

What is endometriosis?

Condition in which ectopic endometrial tissue is dispersed to various sites along peritoneal cavity & beyond (e.g. near umbilicus) Ovaries/attachments of uterus associated Dysmenorrhoea, infertility or both

What is an endometrial carcinoma and where can it take place?

``` Malignancy of the endometrium Cervix Usually postmenopausal women Junction - columnar cells of endocervix & squamous exocervix (transformation zone) Abnormal uterine bleeding ```

What happens during a cervical examination?

Use of a speculum to isolate the external os of cervix

What is a bimanual examination?

2 fingers inserted into vagina until they isolate the cervix Test of cervical motion tenderness (sign of PID) Examiner palpates uterus

What are the Bartholin glands (greater vestibular glands)?

Pea sized glands Located slightly posterior and to the left and right of the opening of the vagina Secrete mucus (slight vaginal lubrication)

What irregularites can happen to the greater vestibular glands?

Bartholinitis (infection/inflammation) | Bartholin Gland Cyst (duct of gland blocked)

What bacteria is present in the vagina & what is its function?

Lactobacillus Normal vaginal flora Utilise glycogen as a substrate for lactic acid production Maintains low pH environment

What is the technical term for inflammation of the vagina?

Vaginitis

What is vaginismus?

Condition making any sort of vaginal penetration (sex, tampons) painful or impossible Reflex of pubococcygeus muscle

Where can an ectopic pregnancy take place?

Anywhere but body of uterus

Describe the peritoneal cavity in the female

Peritoneal cavity is open via the ostium of the uterine tube | Potential route of infection