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Reproduction Week 2 2018/19 > 8: Anatomy - female reproductive tract and breast > Flashcards

8: Anatomy - female reproductive tract and breast Flashcards

1
Q

In which cavity does the female reproductive system lie?

A

Pelvic cavity

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2
Q

Which space is found inferior to the levator ani muscle?

A

Perineum

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3
Q

What separates the pelvic cavity and the perineum?

A

Pelvic floor

levator ani, perineal muscles etc.

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4
Q

What type of peritoneum forms the floor of the peritoneal cavity and the roof of the pelvic cavity?

A

Parietal peritoneum

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5
Q

From anterior to posterior, which organs are found in the female pelvic cavity?

A

Bladder

Uterus

Rectum

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6
Q

In the female peritoneal cavity, which pouches are formed by the

a) bladder and uterus
b) uterus and rectum?

A

a) Vesico-uterine pouch

b) Recto-uterine pouch (of Douglas)

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7
Q

Which two pouches are found in the female peritoneal cavity?

A

Vesico-uterine pouch

Recto-uterine pouch

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8
Q

What is the most inferior part of the female peritoneal cavity?

A

Recto-uterine pouch

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9
Q

Which ligament connects the uterus to the walls and floor of the pelvis?

A

Broad ligament

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10
Q

What parts of the pelvic cavity are connected by the broad ligament?

A

Uterus

Pelvis walls and floor

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11
Q

What structures are contained within the broad ligament?

A

Uterine tubes

Proximal part of the round ligament

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12
Q

Which ligament, connecting the uterus to the walls and floor of the pelvis, contains the uterine tubes?

A

Broad ligament

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13
Q

What is the purpose of the broad ligament?

A

Keeps uterus in the midline

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14
Q

Which ligament’s proximal part is contained within the broad ligament?

A

Round ligament

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15
Q

Which structures are connected by the round ligament?

A

Uterus

Superficial perineum

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16
Q

Which structures does the round ligament pass through to connect the uterus and the superficial perineum?

A

Broad ligament

Deep inguinal ring

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17
Q

The (proximal / lateral) part of the round ligament is found in the broad ligament.

A

proximal part

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18
Q

What are the three layers of the uterus, from superficial to deep?

A

Endometrium

Myometrium

Perimetrium

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19
Q

What are the three layers of the uterus from deep to superficial?

A

Perimetrium

Myometrium

Endometrium

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20
Q

Which layer of the uterus is sloughed off during menstruation?

A

Endometrium

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21
Q

What are the two areas of the uterus?

A

Body

Cervix

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22
Q

The cervix is the space between which parts of the uterus?

A

Internal and external os

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23
Q

What area is found between the uterus and the perineum?

A

Vagina

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24
Q

Where in the uterus does implantation occur?

A

Body of uterus

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25
Q

Which ligaments attach the uterus to the sacrum?

A

Uterosacral ligaments

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26
Q

Which muscles form the floor of the pelvis?

A

Pelvic floor muscles

e.g levator ani

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27
Q

Inferior movement of the uterus is called uterine ___.

A

uterine prolapse

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28
Q

In which two positions can the uterus sit?

A

Anteversion

Retroversion

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29
Q

(Anteversion / Retroversion) is the most common uterine position in women.

A

Anteversion

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30
Q

What are the three important axes when determining whether the uterus is anterverted or retroverted?

A

Axis of the vagina

Axis of the cervix

Axis of the uterus

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31
Q

Is uterine retroversion normal?

A

Yes - normal variant

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32
Q

The walls of the vagina are usually (straight / collapsed).

A

collapsed

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33
Q

What device is used to hold the walls of the vagina apart during a gynae exam?

A

Speculum

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34
Q

What type of epithelium lines the vagina?

A

Squamous epithelium

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35
Q

What type of epithelium lines the cervix?

A

Columnar epithelium

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36
Q

At which point does the squamous epithelium of the vagina transition to the columnar epithelium of the cervix?

A

Squamocolumnar junction

Or ‘transformation zone’

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37
Q

At which structure is a smear inserted to sample the squamocolumnar junction?

A

External os of uterus

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38
Q

What is another name for the uterine tubes?

A

Fallopian tubes

Oviduct

39
Q

What is another name for the Fallopian tubes?

A

Uterine tubes

Oviduct

40
Q

Where in the uterine tubes does fertilisation occur?

A

Ampulla

41
Q

Are the uterine tubes symmetrical?

A

No - length and curvature are different

42
Q

What are the hairs of the uterine tube which collect the eggs from the ovaries?

A

Fimbriae

43
Q

The fimbriae of the uterine tubes push the egg into which area?

A

Infundibulum (“funnel” - leads to the ampulla)

44
Q

At their distal ends (nearest to the ovaries), what are the uterine tubes continuous with?

A

Peritoneal cavity

45
Q

Why can infection pass between the female genital tract and the peritoneal cavity?

A

Uterine tubes are open-ended

46
Q

What size are ovaries?

A

About the size of an almond

47
Q

Similarly to the testes, where do the ovaries develop?

A

Posterior abdominal wall

48
Q

Which ligaments are formed as the ovaries descend through the abdominal cavity to the pelvis?

A

Round ligaments

49
Q

The walls of the vagina are made of ___ ___.

A

smooth muscle

50
Q

At the superior end of the vagina, the cervix holds the vaginal walls apart in four places. What are these areas called?

A

Anterior, posterior and 2 lateral fornixes

51
Q

What are the four parts of the vaginal fornix?

A

Anterior

Posterior

Left and right lateral

52
Q

What bony features can be palpated on internal examination?

A

Ischial spines

53
Q

What areas of the uterine tubes are closest to the uterus?

A

Adnexae

54
Q

The adnexae are found at the (proximal / distal) ends of the uterine tubes.

A

proximal

55
Q

The levator ani is a ___ muscle.

A

skeletal muscle

under voluntary control

56
Q

Which muscle forms the majority of the pelvic floor?

A

Levator ani

57
Q

Which specific nerves supply the

a) superior
b) inferior

aspects of levator ani? What are their nerve roots?

A

a) Superior - nerve to levator ani (S3-5)

b) Inferior - pudendal nerve (S2-4)

58
Q

What does the levator ani do?

A

Relaxes in defaecation

Reflex contraction when intra-abdominal pressure increases

Physical barrier

59
Q

The levator ani prevents ___ of the pelvic organs.

A

prolapse

60
Q

Apart from the levator ani, which other muscles make up the pelvic floor?

A

Perineal muscles

61
Q

Which nerve supplies the perineal muscles?

A

Pudendal nerve (S2,3,4)

62
Q

Where do all the perineal muscles originate from?

A

Perineal body

63
Q

The perineal body acts as the origin of which muscles?

A

Perineal muscles

64
Q

When can the perineal body be damaged?

What happens as a result?

A

Childbirth

Incontinence / prolapse

65
Q

Which glands are found in the perineum, just inferior and lateral to the vaginal orifice?

A

Bartholins glands

66
Q

What is the other name for the Bartholins glands?

A

Greater vestibular glands

67
Q

What is the function of the Bartholins glands?

A

Produce lubrication

68
Q

What is the difference between the vestibule and vaginal orifice?

A

Vaginal orifice surrounds vagina only

Vestibule surrounds vaginal orifice and external urethral orifice

69
Q

Which ribs do the breasts cover?

A

Ribs 2 - 6

70
Q

Which space exists between the breast and the pectoralis muscles?

A

Retromammary space

71
Q

Where does 75% of lymph from the breast drain to?

A

Axillary nodes on the same side

72
Q

Where does lymph from the inner breast quadrants (upper inner and lower inner) drain?

A

Parasternal nodes on the same or contralateral sides

73
Q

Where can lymph from the lower inner breast drain?

A

Parasternal nodes

OR

Abdnominal nodes

74
Q

Where does lymph from the axillary and parasternal nodes drain to?

A

Supraclavicular nodes

75
Q

Axillary lymph nodes supply both the breasts and upper limbs. They are surgically cleared out for some types of breast cancer.

What muscle are the different levels of axillary nodes described in relation to?

A

Pectoralis minor

76
Q

Which branches of the subclavian artery supply the breast?

A

Axillary artery

Internal thoracic/mammary artery

77
Q

Which specific branches of the subclavian artery supply the breast?

A

Axillary artery

Internal thoracic artery

78
Q

Which branches of the subclavian artery supply the

a) upper and lower INNER
b) upper and lower OUTER

quadrants of the breast?

A

a) Internal thoracic artery supplies inner quadrants

b) Axillary artery supplies outer quadrants

79
Q

Via which vaginal structure can fluid be drained from the rectouterine pouch?

What is this procedure called?

A

Posterior fornix

Culdocentesis

80
Q

The broad ligament is made of which material?

A

Peritoneum

81
Q

The broad ligament can be divided into different sections depending on the structures it envelops.

What are these three sections?

A

Mesosalpinx - surrounding uterine tubes

Mesovarium - surrounding ovary

Mesometrium - surrounding uterus

82
Q

The broad ligament (is / isn’t) a peritoneal formation.

A

IS a peritoneal formation

83
Q

The round ligament (is / isn’t) a peritoneal formation.

A

ISN’T a peritoneal formation

Embryological remnant (of the gubernaculum, which the ovaries descended through from the posterio abdominal wall)

84
Q

Which embryological structure allows the testes and ovaries to descend from the posterior abdominal wall to the pelvis?

A

Gubernaculum

85
Q

Which ligament is thought to contribute to the anterverted, anteflexed position of the uterus in most women?

A

Round ligament

86
Q

Which infection can be mimicked by infection tracking through the right uterine tube?

A

Appendicitis

87
Q

Which part of the vagina is culdocentesis performed via?

A

Posterior fornix

88
Q

Which triangle is made by the right and left ischial spines and the pubic symphysis?

A

Urogenital triangle

89
Q

What is the central focus of most of the pelvic floor muscles called?

A

Perineal body

90
Q

The vaginal and external urethral orifices are found in which area of the perineum?

A

Vestibule

91
Q

Which breast quadrant is the axillary tail found in?

A

Upper outer quadrant

92
Q

Which hormones are responsible for

a) production of breast milk
b) ejection of breast milk?

A

a) Prolactin

b) Oxytocin

93
Q

If pathology is found in one breast, what should you do first?

A

Examine the other breast

As parasternal lymph node pathology can track to contralateral breast

Check both axillae for lumps (axillary node invasion)

94
Q

What is the clinically significant venous drainage of the breast?

Why?

A

Intercostal veins

Drain posteriorly, allowing breast cancer to spread to the thoracic spine

Reproduction Week 2 2018/19 (9 decks)

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