A and P/Development Flashcards
bones of bony pelvis (4)
ilium
ischium
sacrum
coccyx
(4) joints of pelvis
cartilaginous symphyseal joints (sacrococcygeal and symphysis pubis)
synovial joints (sacroiliac joint and lumbar sacral joint)
major severe that innervates the external genetalia + originates
pudendal nerve
S2, S3, S4 segments
pudendal nerve function
sensory innervation to EXTERNAL genitals
striated urethral and anal sphincters
perineal muscles
lymphatic drainage of internal genetalia
uterus and upper 2/3 of vagina = obturator and internal/external
drainage of ovaries = paraaortic
venous drainage of uterus
venous plexus thru uterine vein
venous drainage of ovaries
R ovarian vein (to IVC)
L ovarian vein (to L renal)
arteries of female reproductive
aorta –> common iliac –> internal iliac artery
uterine artery
vaginal artery
internal pudendal artery
ovarian vascular supply
ovarian artery off the aorta
vestibular glands
Bartholin’s and Skene’s
provide lubrication during sexual stimulation
rarely noted during exam unless abscessed
squamocolumnar junction
stratified squamous epithelium and mucus secreting columnar epithelium of CERVIX meet here
culdocentesis
posterior to the cervix thru vaginal wall into peritoneal cavity
samples fluid in pouch of douglas
4 parts of Fallopian tubes
- interstitial (narrowest, next to uterine)
- isthmus
- Ampulla
- Fimbria (infundibulum)
uterus is held into position by
round ligament
uterosacral ligaments
cardinal ligaments
menorrhagia
excessive menstrual flow
> 30 mL
risk of IDA
GnRH fxn
stimulates anterior pituitary to release FSH and LH
when does the menstrual cycle begin?
first day of menses
follicular phase (general)
onset of menses - LH surge
proliferative phase of endometrium
luteal phase
begins with LH surge ends with menses onset
secretory phase
menstrual cycle in teens
35 days
shortens with maturation
adult menstrual cycle
28 days (women 20-40)
10 yrs prior to menopause there is variability
early follicular phase
ovary is not hormonally active
uterus is quiet
estradiol and progesterone levels fall
hormone action in the early follicular phase
hypothalamus releases GnRH
GnRH releases FSH and LH
what do FSH and LH do? (follicular phase)
cause follicles in the ovary to mature
mid follicular phase
estradiol levels rise significantly by day 7 and multiple follicles are recruited for maturation, one becomes dominant
endometrium proliferates under influence of estrogen
granulose cells
found in the developing follicles to produce estrogen
estrogen decreases FSH release and strongest follicle emerges
late follicular phase
single dominant follicle is selected
estrogen stimulates thickening of endometrium
high estrogen levels increase amount and stringiness of cervical mucus
LH surge
occurs during ovulation
serum estradiol levels elevate one day before ovulation causing a rise in LH
36 hrs after = ovulation
most reliable indicator of ovulation
LH surge
luteal phase
follicle cells transform to corpus luteum = progesterone release
dominant hormone of luteal phase
progesterone
mid to late luteal phase
IF fertilized
early embryo makes HcG which maintains corpus luteum
continued corpus luteum = progesterone production continues until steroidogeneis is well established
mid to late luteal phase
NOT fertilized
LH levels fall and progesteorn/estradiol = decreased blood flow to endometrium
tissue sloughing and necrosis
GnRH secretion increases
menstruation
prostaglandins produced due to falling progesterone
causes contraction of endometrial blood vessels and uterine muscles
lasts 3-7 days
two layers of endometrium
funtionalis
basalis
continues to proliferate each cycle
three phases of functionalis endometrium
menstrual (sloughing)
proliferative (growth)
secretory (organization)
what causes irregular spotting/bleeding?
progesterone withdrawal doesn’t cause sloughing,
continued estrogenic stimulation causes endometrium to outstrip blood supply at irregular intervals
