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Reproduction > Anatomy > Flashcards

Anatomy Flashcards

1
Q

What is contained within the pelvic cavity?

A
  • ovaries
  • uterine tubes
  • uterus
  • superior part of the vagina
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2
Q

What separates the pelvic cavity and perineum?

A
  • the pelvic floor
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3
Q

What is contained within the perineum?

A
  • inferior part of the vagina
  • perineal muscles
  • bartholin’s glands
  • clitoris
  • labia
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4
Q

What is the female primary organ of reproduction?

A
  • ovaries
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5
Q

What is the peritoneum?

A
  • floor of the peritoneal cavity

- roof of the pelvic cavity

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6
Q

2 pouches formed by the peritoneum in females?

A
  • recto-uterine

- vesico-uterine

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7
Q

What are the 2 main ligaments associated with the uterus

A
  • broad ligament

- round ligament

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8
Q

Where is the round ligament found?

A
  • proximal part is contained within the broad ligament
  • passes through the pelvis
  • through inguinal canal
  • to the superficial fascial of the labia
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9
Q

Where is the broad ligament found? and what is its role

A
  • double layer of peritoneum over the uterine tube

- maintains uterus in the midline

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10
Q

3 layers of the uterus?

A
  • perimetrium
  • myometrium
  • endometrium
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11
Q

How can the position of a normal uterus be explained anatomically?

A
  • anteverted (relative to vagina)

- anteflexed (relative to cervix)

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12
Q

What holds the uterus in place?

A
  • strong ligaments
  • endopelvic fascia
  • muscles of the pelvic floor
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13
Q

During a cervical screening cell samples from where are obtained?

A
  • squamo-columnar

- transition zone

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14
Q

Where does fertilisation normally occur?

A
  • the ampulla of the uterine tubes
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15
Q

What is a hysterosalpinogram?

A
  • radiopaque dye to assess patency of the uterine tubes
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16
Q

Where do the ovaries embryologically develop?

A
  • posterior abdominal wall
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17
Q

What aids the descent of the ovaries during embryological development?

A
  • round ligament
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18
Q

What is the function of the ovaries?

A
  • secrete oesterogen (response to FSH)

- Secrete progesterone (response to LH)

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19
Q

FSH role?

A
  • oestrogen secretion from ovaries

- growth of ovarian follicles

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20
Q

LH role?

A
  • progesterone secretion from corpus callosum in ovaries

- ovulation

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21
Q

The fornix of the vagina can be divided into what?

A
  • anterior
  • posterior
  • 2xlateral
  • pouches in vagina before cervix
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22
Q

Where is the perineum located?

A
  • between skin and pelvic diaphragm
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23
Q

The perineum can be described as a diamond shape, what are the 2 divisions?

A
  • urogenital triangle

- anal triangle

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24
Q

What is the perineal body?

A
  • composed of collagenous and elastic tissue

- important for pelvic floor strength

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25
Q

Where are Bartholin’s glands located and their role?

A
  • located in the perineum

- secrete lubricating fluid

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26
Q

What is the main muscle that makes the pelvic floor?

A
  • levator ani

- composed of 3 smaller

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27
Q

Nerve supply to the levator ani?

A
  • skeletal (voluntary)
  • S3,4,5 (Sacral)
  • S2,3,4 (Puedendal)
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28
Q

What is the name of the space deep to the breast tissue?

A
  • retromammary space
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29
Q

4 quadrants of the female breast?

A
  • upper outer
  • upper inner
  • Lower inner
  • lower outer
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30
Q

Where does 75% of female breast lymph drain?

A
  • axillary nodes -> subclavian node
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31
Q

Where might the inner quadrants of the female breast also have lymph drainage to?

A
  • parasternal lymph nodes
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32
Q

Where might the lower inner quadrant of female breast also have lymph drainage to?

A
  • abdominal lymph nodes
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33
Q

What level system is used in axillary clearance?

A
  • in relation to pec minor
  • level 1 = inferior and lateral to pec minor
  • level 2 = deep to pec minor
  • level 3 = superior and medial to pec minor
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34
Q

What is the blood supply to the female breast?

A
  • internal thoracic (internal mammary) - branch of subclavian
  • thoracic artery (branch of axillary)
  • intercostal artery
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35
Q

What is the venous drainage of the female breast?

A
  • follows arterial
  • axillary vein
  • internal thoracic vein
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36
Q

What are the 3 smaller muscles that make up the levator ani?

A
  • puborectalis
  • pubococcygeal
  • ilococygeal
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37
Q

What is the pelvic floor?

A
  • separates the pelvic cavity from perineum
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38
Q

3 major layers of the pelvic floor?

A
  • pelvic diaphragm
  • muscles of perineal pouches
  • perineal membrane
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39
Q

What is the innermost layer of the pelvic floor

A
  • pelvic diaphragm
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40
Q

what makes up the pelvic diaphragm?

A
  • levator ani (puborectalis, pubococcygeus, iliococcygeus)

- coccygeus

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41
Q

How is urinary continence maintained?

A
  • external urethral sphincter
  • compressor urethrae
  • levator ani
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42
Q

How is faecal continence maintained?

A
  • puborectalis
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43
Q

What lies immediately superior to the pelvic diaphragm?

A
  • deep perineal pouch
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44
Q

What muscles are contained within the deep perineal pouch?

A
  • external urethral sphincter
  • compressor urethrae
  • deep transverse perineal muscle (males)
  • smooth muscle band (females)
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45
Q

What is the perineal membrane

A
  • between deep and superficial perineal pouch

- tough fascia

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46
Q

Where is the erectile tissue contained in the pelvic floor

A
  • superficial perineal pouch
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47
Q

What is contained in the female superficial perineal pouch?

A
  • clitoris and crura
  • bulbs of vestibule
  • bulbospongiosus
  • ischiocavernosus
  • greater vestibular gland (bartholins)
  • superficial transverse perineal muscle
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48
Q

What is contained in the males superficial perineal pouch?

A
  • bulb of penis
  • crura
  • bulbospongiosus
  • ischiocavernosus
49
Q

What is the perineal body

A
  • point of muscle convergence

- supports the pelvic floor

50
Q

Name the layers of the pelvic floor deep to superficial?

A
  • pelvic diaphragm
  • deep perineal pouch
  • perineal membrane
  • superficial perineal pouch
  • muscles of superficial perineal pouch
51
Q

Urethrocele?

A
  • herniation of the urethra
52
Q

Cystocele?

A
  • herniation of the bladder
53
Q

Enterocele

A
  • herniation of the rectouterine pouch
54
Q

rectocele?

A
  • herniation of rectum
55
Q

The round ligament of the uterus is homologous to what in males?

A
  • the vas deference
56
Q

Name the main pelvic bones in the pelvic cavity?

A
  • ilium
  • pubis
  • ischium
57
Q

What passes through the obturator membrane?

A
  • obturator neurovascular bundle
58
Q

Majority of the arterial supply to the pelvic cavity is from branches of what artery?

A
  • internal iliac artery
59
Q

Gonadal artery is a branch of what?

A
  • abdominal aorta
60
Q

The superior rectal artery is a branch of what?

A
  • inferior mesenteric
61
Q

The internal iliac artery supplies most of the pelvic cavity. It can be further divided into what?

A
  • anterior division

- posterior division

62
Q

The anterior division of the internal iliac artery mainly supplies what, compared to the posterior division

A
  • anterior mainly supplies the visceral organs (ovary, bladder, uterus, rectum)
63
Q

The posterior division of the internal iliac artery branches to what?

A
  • gluteal arteries
64
Q

The arterial supply to the perineum is mainly through what?

A
  • internal pudendal artery
65
Q

Describe the 2 important anastomosis of the female arterial pelvis supply?

A
  • uterine and ovarian

- uterine and vaginal

66
Q

Where does the majority of pelvic blood venous drain?

A
  • internal iliac vein
  • Some via superior rectal -> hepatic portal
  • some via lateral sacral -> internal vertebral venous plexus
67
Q

The obturator nerve passes through the pelvic cavity but what___

A
  • doesn’t supply the pelvis
68
Q

Majority of the nerve supply to the pelvis is from what nerve?

A
  • sacral plexus (L4-S4)
69
Q

Name the important divisions of the sacral plexus in regard to the pelvic cavity?

A
  • sciatic (L4-S3)
  • Pudendal (S2-4)
  • Nerves to levator ani
  • pelvic splanchnic (parasympathetic)
70
Q

Parasympathetic nerve supply to the pelvis?

A
  • pelvic splanchnic
71
Q

Superior pelvic viscera has lymphatic drainage where?

A
  • external iliac nodes -> common iliac -> aortic -> thoracic -> venous
72
Q

Inferior pelvic viscera and the deep perineum has lymphatic drainage where?

A
  • internal iliac nodes
73
Q

Superficial perineum has lymphatic drainage where?

A
  • superficial inguinal nodes
74
Q

The ovaries and testes have lymphatic drainage where, and why is this?

A
  • drain to the lumbar nodes

- due to their embryological development

75
Q

Functions of the bony pelvis?

A
  • supports the upper body
  • transference of weight
  • attachment of muscles
  • passage for childbirth
76
Q

What is the bony pelvis composed of?

A
  • 2 hip bones
  • sacrum
  • coccyx
77
Q

What makes up the hip bones?

A
  • ilium
  • ischium
  • pubis
78
Q

What is the pelvic cavity?

A
  • space continuous with abdominal cavity above

- lies between pelvic inlet and pelvic floor

79
Q

Where is the inguinal ligament?

A
  • between the ASIS and pubic tubercle
80
Q

Where are the ischial spines palpable?

A
  • on vaginal palpation

- at 4 and 8 o/clock

81
Q

Name the 2 important ligaments of the bony pelvis and their role?

A
  • sacrotuberous
  • sacrospinous
  • protection against weight transfer
  • creates the greater and lesser sciatic foramen
82
Q

Difference in male and female pelvis?

A
  • AP and transverse diameter of female pelvis are larger than males
  • the subpubic angle is wider in female
83
Q

What is present on the foetus skull to help during childbirth?

A
  • fontanelles

- vertex is the area formed via the fontanelles

84
Q

What is the station number?

A
  • distance between the ischial spine and the foetus head

- a negative number indicates no descent yet

85
Q

Explain the turning of the foetus head during childbirth?

A
  • pelvic inlet = foetal head transverse
  • pelvic cavity = head rotated and flexed
  • pelvic outlet = foetal head in occipitoanterior postion and in extension
86
Q

Motor supply to pelvic organs?

A
  • sympathetic or parasympathetic
87
Q

Sensory supply to pelvic organs?

A
  • visceral afferents
88
Q

Motor supply to perineum?

A
  • somatic motor
89
Q

Sensory supply to perineum?

A
  • somatic sensory
90
Q

Motor supply to the pelvic floor?

A
  • somatic motor
91
Q

Sensory supply to the vagina?

A
  • visceral afferents (pelvic)

- somatic sensory (perineum)

92
Q

Inferior hypogastric plexus is composed of what?

A
  • sympathetic and parasympathetic fibres
93
Q

Explain sensory supply to the superior aspects of the pelvic organs, touching peritoneum?

A
  • visceral afferent
  • run alongside sympathetic fibres
  • t11-l2
  • pain percieved suprapubic
94
Q

Explain sensory supply to the inferior pelvic organs, not touching peritoneum?

A
  • visceral afferents
  • run along side parasympathetic
  • s2, 3, 4
95
Q

Which nerve supplies the perineum?

96
Q

How is the level of L3/4 estimated?

A
  • line drawn at the inter-crystal plane
97
Q

Where is an epidural injected into to?

A
  • epidural space
98
Q

Name the layers a needle for a spinal anaesthetic passes?

A
  • supraspinous ligament
  • intraspinous ligament
  • ligamentum flavum
  • epidural space
  • dura mater
  • arachnoid mater
  • subarachnoid space
99
Q

Effect of a spinal anaesthetic?

A
  • injected into CSF
  • blockage of sympathetic fibres
  • loss of sympathetic tone in lower limbs
  • complication: hypotension
100
Q

General sympathetic outflow levels?

A
  • L1-T2

- For pelvis T11-L2

101
Q

Explain the route of the pudendal nerve?

A
  • exits pelvis via greater sciatic foramen
  • passes posterior to sacrospinous ligament
  • re-enters pelvis via lesser sciatic foramen
  • travels within pudendal canal
102
Q

What is a episiotomy?

A
  • planned incision to prevent tear at anal sphincter
  • posterolateral
  • sometimes (mediolateral)
103
Q

How is the location for the pudendal nerve block found?

A
  • vaginal palpation of ischial spines

- medial to this bony landmark

104
Q

What are the layers of the abdominal wall from superficial to deep?

A
  • skin
  • superficial fascia
  • anterior rectus sheath
  • rectus abdominis
  • posterior rectus sheath
  • external oblique
  • internal oblique
  • transversus abdominis
105
Q

What direction do external oblique fibres run?

A
  • run anterior inferior

- hands in pocket

106
Q

What forms the muscle aponeurosis on the anterior abdominal wall?

A
  • the external oblique
  • internal oblique
  • transversus abdominis
107
Q

Where do nerves and vessels lie in the abdominal wall?

A
  • lie between internal oblique and transversus abdomens
108
Q

What divides the rectus abdominis?

A
  • tendinous intersections
109
Q

Name of the midline fibrous line from the xiphoid process to pubic symphysis?

A
  • linea alba
110
Q

What lies immediately deep to the superficial fascia on the abdominal wall?

A
  • rectus sheath

- anterior (superior and inferiorly) and posterior (only found superiorly)

111
Q

Where does the change in sheath formation occur and what is that change?

A
  • occurs 1/3rd from the umbilicus and pubic crest
  • superiorly there is an anterior and posterior rectus sheath
  • inferiorly there is only an anterior rectus sheath
112
Q

Nerve supply to the abdominal wall?

A
  • subcostal
  • iliohypogastric
  • ilioinguinal
113
Q

Blood supply to the anterior abdominal wall»

A
  • superior epigastric arteries

- inferior epigastric arteries

114
Q

Blood supply to the lateral abdominal wall?

A
  • intercostal and subcostal arteries
115
Q

Surface anatomy of pregnancy - what value changes with gestation?

A
  • fundus-symphyseal height
116
Q

Layers incised in a LSCS?

A
  • Skin and fascia
  • anterior rectus sheath
  • rectus abdominis pulled apart
  • fascia and peritoneum
  • retract bladder
  • uterine wall
  • amniotic sac
117
Q

What is the blood supply to the uterus?

A
  • uterine arteries

- branch of anterior division of internal iliac

118
Q

Explain incisions in a laparoscopy?

A
  • sub-umbilical

- if a lateral port is required care to avoid inferior epigastric artery must be taken

119
Q

Explain the route of the inferior epigastric artery?

A
  • branch of external iliac artery
  • emerges medial to deep inguinal ring
  • passes superomedial direction
  • forms superior border of inguinal triangle

Reproduction (25 decks)

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