Anatomy

Question 1

1. Name the two pouches of the female peritoneum.

2. Name the two ligaments of the peritoneum which hold the uterus in place.

Answer 1

1. Rectouterine and Vesico-uterine.

2. Broad ligament and Round ligament.

Question 2

1. Name the three layers of the uterus
2. Name of implantation out-with uterus?
3. What is the most common position of the uterus? What is the most common variation?

Answer 2

1. Perimetrium, myometrium, endometrium
2. Ectopic Pregnancy
3. Anteverted and Anteflexed
   retroverted and retroflexed

Question 3

1. Identify the landmarks in the journey of an ovum from the ovaries to the uterus.
2. The infundibulum open into the _______ ____.

Answer 3

1. Ovary, fimbriae, infundibulum, ampulla, isthmus, uterus.

2. Peritoneal Cavity

Question 4

1. Name the four parts of the fornix
2. Name the main voluntary skeletal muscle that makes up the pelvic floor?
3. What nerve supplies this muscle?

Answer 4

1. Anterior, posterior and two lateral fornix
2. Levator ani
3. S2, S3, S4

Question 5

1. Name the bundle of collagenous and elastic tissue to which the perineal muscles attach.
2. Name the glands found at the lateral aspects of the vaginal orifice.
3. What is the area around the orifice known as?

Answer 5

1. Perineal Body
2. Bartholin’s glands
3. Labia

Question 6

1. Name the space that lies between the Pec. Major and the breast.
2. Where is breast milk developed and how does it reach the areola?
3. What connects the breast to the axilla?
4. To which lymph nodes does most of the breast lymph drain?

Answer 6

1. Rectomammary space
2. Lactating lobules, lactiferous tubules
3. Axillary tail of Spence
4. Ipsilateral lymph nodes

Question 7

1. Name the four muscles that make up the pelvic diaphragm.

2. What else supports the pelvis?

Answer 7

1. Puborectalis, pubococcygeus, iliococcygeus (3 Levator ani) and coccygeus
2. Endo-pelvic fascia, Pelvic ligaments.

Question 8

1. Identify the parts of the deep peroneal pouch.
2. Name the membrane superficial to the deep peroneal pouch.
3. Name the two muscles found in the superficial peroneal pouch of women
4. What is the alternative name for the Bartholin’s glands?

Answer 8

1. Urethra, bulbourethral glands in male, deep transverse peroneal muscle.
2. Perineal membrane
3. ischiocavernosus, bulbospongiosus,
4. Greater Vestibular glands

Question 9

1. What is the main purpose of the tissue in the superficial peroneal pouch?

Answer 9

1. Erectile tissue

Question 10

Define hypospadias

Answer 10

Birth defect where the opening of the urethra occurs on the ventral surface of the penis.

Question 11

1. Name the three parts of the pelvic bone
2. What do the following connect:
   i) Sacrospinous ligament
   ii) Sacrotuberous ligament
3. What does the obturator membrane cover?

Answer 11

1. Ilium, Ischium, Pubis
2. i) Sacrum and Ischial spine
   ii) Sacrum and Ischial tuberosity
3. Obturator foramen

Question 12

1. Name the only two arteries of the pelvis and perineum which do not extend from the internal iliac artery.
2. An anastamosis occurs between the ________ and ______ artery as well as the _______ and _________ artery. The _______ passes beneath the uterine arteries (water under the bridge).

Answer 12

1. Gonadal artery (either testicular or ovarian) and superior rectal artery.
2. Ovarian, uterine, uterine, vaginal, ureter.

Question 13

1. Define ‘moulding’ in reference to childbirth.

2. Define ‘station’

Answer 13

1. Refers to the movement of one foetal bone over another to allow the foetal head to pass through the pelvis during labour.
2. the distance of the foetal head from the ischial spines.

Question 14

At the pelvic inlet the foetal head should be ________. As it descends the pelvic cavity the foetal head should _______ and it should be flexed. At the pelvic outlet the foetal head should lie ______________ and extension of the head on the neck should occur.

Answer 14

transverse, rotate, occipito-anterior.

Question 15

1. If a structure is in the pelvis what innervates them?

2. If a structure is in the perineum what innervates them?

Answer 15

1. sympathetic and parasympathetic and visceral afferent neurons
2. Somatic motor and somatic sensory.

Question 16

1. Uterine ______ and uterine _______ are under hormonal (_________/_________) control.
2. The visceral afferents of the superior aspects of the pelvic organs enter the spinal cord between levels ____ and _____. The visceral afferents of the inferior aspects enter the spinal cord at levels _________.
3. The superior afferents follow the ________ back to the cord. The inferior afferents follow the _________ back to the cord.

Answer 16

1. Cramping, contractions, Oestrogen/progesterone
2. T11 and L2, S2/S3/S4
3. Sympathetics/Parasympathetics

Question 17

1. Name the nerve that carries somatic sensation from the perineum.

Answer 17

1. Pudendal nerve

Question 18

1. Where is spinal anaesthetic administered?

2. What about epidural anaesthetic?

Answer 18

1. L3-L4 region, (in the subarachnoid space)

2. Into the epidural space (fat and veins)

Question 19

1. The pudendal nerve exits pelvis via ______ _______ foramen. Passes posterior to __________ ligament. Re-enters pelvis/perineum via ______ sciatic foramen. Travels in _______ canal. Branches to supply structures of the perineum.
2. What is an episiotomy?

Answer 19

1. Greater sciatic, sacrospinous, lesser, pudendal.

2. Incision between vaginal opening and anus to aid delivery.