Anatomy Flashcards
The female external genitalia (vulva) consist of what?
mons pubis labia majora labia minora vestibule clitoris distal portion of vaginal canal greater vestibular glands (Bartholin's glands)
the greater vestibular glands are also known as what?
bartholin’s glands
what are the components of the female internal genitalia?
true pelvis including ovaries, uterine tubes, uterus and proximal portion of vaginal canal
the suspensory ligament of ovary is also known as what?
infundibulopelvic ligament
what does the suspensory ligament of ovary (IPL) transmit?
ovarian artery & vein
nerve supply
lymphatics
what structure connects the inferior pole of the ovary to the lateral apsect of the uterus?
ovarian ligament
how would you describe the anatomic position of the ovaries in relation to the true pelvis?
they are on the lateral wall of the true pelvis
how would you describe the anatomic position of the ovaries in relation to the uterus?
they are posterior to the uterus
if you are performing an oophorectomy you need to be careful not to damage what structure postero-medial to the ovarian fossa?
ureter
if you are performing an oophorectomy you need to be careful not to damage what structure antero-lateral to the ovarian fossa?
external iliac vessels
the ovarian arteries are direct branches of what?
abdominal aorta
there is a collateral source of oxygenated blood from the anastomosis of the ovarian arteries with the terminal parts of what arteries?
uterine arteries (branches of the internal iliac artery)
the uterine artery is a branch of what artery?
internal iliac artery
the right ovarian vein drains directly into what?
inferior vena cava
the left ovarian vein drain directly into what?
left renal vein
when you do an oophorectomy what two arteries do you need to ligate to avoid blood loss?
ovarian artery & uterine artery
the uterine artery runs within what anatomical structure?
cardinal ligament
the ________ligament is situated just at the base of the broad ligament?
cardinal ligament
what artery characteristically crosses over the ureter?
the uterine artery
the mesovarium is a _____________ extension of the broad ligament which attaches to the ovary
posterior
during a hysterectomy the surgeon needs to be careful not to damage what structure right below the uterine artery?
ureter
what structure is formed b/w the posterior wall of the uterus & rectum by the draping of the inferior extent of the parietal peritoneum?
rectouterine pouch (pouch of douglas)
what is the lowest point in the abdominopelvic cavity when the pt is in the supine position?
Pouch of douglas
what are the 3 main arteries that supply the uterus?
- uterine artery (branch of internal iliac)
- vaginal artery (branch of internal iliac)
- ovarian artery (descending abd. aorta)
what set of veins drains the uterus?
pelvic plexus of veins?
the uterine artery crosses the pelvic floor from lateral to medial in what structure?
transverse cervical (aka cardinal ligament) in the base of the broad ligament
what is right under the uterine artery at the pelvic floor?
the ureter (water under the bridge)
___________refers to the angulation b/w the axis of the cervix and the axis of the body of the uterus.
anteflexion
___________refers to the angulation b/w the axis of the cervix and teh axis of the vaginal canal.
anteversion
what can go wrong with improper positioning of the uterus?
can contribute to: infertility, complications during pregnancy, delivery, and an increased tendency towards uterine prolapse
what are 3 things that could cause uterine prolapse?
- trauma during childbirth
- improperly positioned uterus
- normal process of aging
which is longer the anterior or posterior wall of the vagina?
posterior
what structures are nearby the posterior wall of the vagina?
ampulla of the rectum, perineal body, Pouch of Douglas
what artery supplies blood to the vagina?
vaginal arteries (branches of anterior div. of internal iliac)
term for the part of the vagina that is the smooth area bounded by the labia minora.
vestibule
describe the blood supply to the labia minora?
supplied by branches of internal pudendal artery & external pudendal branches of the femoral artery
describe the sensory innervation of the labia?
ilioinguinal nerve
genital branch of the genitofemoral nerve
posterior labial nerve (from the perineal nerve)
posterior cutaneous nerve of the thigh
what structure gives rise to the glans of the clitoris?
bulb of the vestibule
what muscle extends from the perineal body to surround the orifice of the vagina and cover the vestibular bulbs?
bulbospongiosus
what is the function of the bulbospongiosus muscle?
reduce the size of the vaginal orifice & compress the deep dorsal vein of the clitoris assisting in maintaining erection
name the muscle that arises from the ischiopubic ramus and covers the crus clitoris on each side.
ischiocavernosus
what is the action of the ischiocavernosus?
to compress the crus clitoris and assist in erection
what structure forms the body of the clitoris?
the crura of the clitoris
what is the purpose of the greater vestibular glands?
to secrete clear mucus to lubricate the vulva during sexual excitation
what are the name of the paired accessory reproductive glands just posterior to each half of the bulb of the vestibule?
greater vestibular gland (bartholin’s glands)
what nerve innervates both the bulbospongiosus muscle and the ischiocavernosus muscle?
perineal branch of the pudendal nerve
which arteries supply the corpora cavernosa?
the deep arteries of the clitoris
which arteries are responsible for erection of the clitoris in the female?
deep arteries of the clitoris
which 2 sets of veins drain the blood from the clitoris to the internal pudendal vein?
superficial & deep dorsal veins
what provides sensory innervation to the clitoris?
dorsal nerve of the clitoris (branch of pudendal nerve)
explain the autonomic innervation to the clitoris regarding erection?
parasympathetics via pelvic splanchnics from S2-S4
preganglionics from S2-S4–>inferior hypogastric plexus
Postganglionics–>from plexuses innervate the erectile tissues of the clitoris via the cavernous nerves from the vesicular plexuses
what is the action of the levator ani?
support the pelvic viscera and keeping teh rectum and vagina closed
what is the innervation to the levator ani?
inferior rectal nerve & direct branches from S4
the inferior fascia of the UG diaphragm is more commonly known as what?
perineal membrane
name the structure that is just posterior margin of the UG diaphragm?
perineal body
describe a spinal nerve block for childbirth
anesthesia is introduced via a needle into the subarachnoid space at L3/L4, produces complete anesthesia from about the waist down
describe a caudal epidural block
anesthesia is administered into the epidural space via an indwelling catheter in the sacral canal to bath the S2-S4 spinal roots.
-has the advantage that the lower limbs are not usually affected
describe a pudendal nerve block
provides local anesthesia of the S2-S4 dermatomes
-does not block pain from the superior birth canal, so the mother is still able to feel uterine contractions
if you had already done a pudendal nerve block and wanted to abolish sensation from the anterior part of the perineum, what additional nerve would you need to block?
ilioinguinal
term for the minimum anterior to posterior diameter of the lesser pelvis as measured b/w the sacral promontory and the pubic symphysis
true obstretrical conjugate
term that describes the narrowest fixed distance that the baby’s head must pass through during a vaginal delivery?
true obstretrical conjugate
term for the distance measured by palpating the sacral promontory with the tip of the middle finger while using the other hand to mark the level of the inferior margin of the pubic symphysis on the examining hand.
diagonal conjugate
what distance does the true conjugate distance need to be to have a safe delivery?
11 cm
term for the narrowest part of the pelvic canal from side to side as measured b/w the right and left ischial spines
interspinous distance
during the pelvic exam, if the ischial spines are far enough apart to allow ______ fingers to enter the vagina side by side, it is considered safe to have delivery.
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