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Reproduction & Sexual Health > Anatomy > Flashcards

Anatomy Flashcards

1
Q

which parts of the female reproductive system lie within the pelvic cavity?

A

Ovaries
Uterine tubes
Uterus
Superior part of vagina

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2
Q

which parts of the female reproductive system lie within the perineum?

A

Inferior part of vagina
Perineal muscles
Bartholin’s glands
Clitoris
Labia

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3
Q

which part of the round ligament is contained within the broad ligament?

A

proximal

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4
Q

what are the 3 layers of the body of the uterus?

A

perimetrium
myometrium
endometrium

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5
Q

where does implantation of the zygote occur?

A

in the body of uterus

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6
Q

most common uterus position

A

Anteverted and anteflexed

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7
Q

what is a normal variation in the positioning of the uterus?

A

retroverted and retroflexed

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8
Q

what are the 3 levels of support that hold the uterus in place?

A
  • number of strong ligaments (e.g. uterosacral ligaments)
  • endopelvic fascia
  • muscles of the pelvic floor (e.g. levator ani)
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9
Q

where does fertilisation occur?

A

in the ampulla

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10
Q

what is a “bilateral salpingo-oophrectomy”

A

removal of both uterine tubes and ovaries

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11
Q

what is a “unilateral salpingectomy”

A

removal of one of the uterine tubes

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12
Q

where do the ovaries develop/move to?

A

on the posterior abdominal wall and move onto the lateral wall of the pelvis

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13
Q

what hormones do the ovaries secrete

A

oestrogen and progesterone

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14
Q

what are the 4 parts of the fornix?

A

anterior
posterior
2x lateral

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15
Q

in cervical screening, what must be sampled?

A

squamo columnar junction (transformation zone)

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16
Q

what can be palpated on a vaginal digital exam?

A
  • position of the uterus
  • the adnexae (uterine tubes and ovaries, and any massess/tenderness affecting these structures)
  • ischial spines
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17
Q

nerve supply to levator ani

A

“nerve to levator ani”
- S3,4,5 sacral plexus

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18
Q

perineal muscles innervation

A

pudendal nerve

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19
Q

what ribs does bed of breast extend from?

A

ribs 2-6

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20
Q

what space lies between fascia and breast?

A

retromammary space

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21
Q

what attaches breast firmly to skin?

A

suspensory ligaments

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22
Q

where does most lymph (>75%) from the breast drain to?

A

ipsilateral axillary lymph nodes and then to the supraclavicular nodes

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23
Q

where do the gonadal arteries (testicular/ovarian) branch off the abdominal aorta?

A

L2

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24
Q

is the inferior vesical artery present in both males and females

A

males only

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25
Q

where does the internal pudendal artery exit the pelvis

A

greater sciatic foramen

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26
Q

what does the vaginal artery supply?

A

mainly vagina, also bladder

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27
Q

what is uterine artery a branch of

A

internal iliac

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28
Q

what does the ovarian artery supply

A

ovaries, uterine tube, uterus

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29
Q

anastomoses in the female pelvis

A
  • ovarian and uterine arteries
  • uterine and vaginal arteries
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30
Q

where is the most common site of iatrogenic injury to the ureter?

A

lateral to cervix

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31
Q

what is the internal vertebral venous plexus also known as

A

epidural venous plexus

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32
Q

most of the lateral pelvic wall nerves come from the _____ plexus, apart from the _________ nerve which comes from the _____ plexus

A

sacral
obturator
lumbar

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33
Q

pelvic splanchnic nerves

A

motor innervation to viscera of the pelvis parasympathetic, S2,3,4

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34
Q

lymphatics of the pelvis - higher up in pelvis where does stuff generally drain to?

A

external iliac nodes —> common iliac

35
Q

lymphatics of the pelvis - lower in pelvis/deep perineum structures where does stuff drain to generally

A

internal iliac —> common iliac

36
Q

lymphatics of the pelvis - where do gonadal drain to

A

lumbar

37
Q

transperitoneal spread

A

disease can penetrate through the peritoneal layer and disseminate into the peritoneal cavity

38
Q

what does the bony pelvis consist of?

A

2 hip bones
sacrum
coccyx

39
Q

which muscle fills the iliac fossa?

A

iliacus

40
Q

what group of muscles attach to ischial tuberosity?

A

hamstrings

41
Q

pelvic inlet is also known as?

A

pelvic brim

42
Q

is vagina in pelvis or perineum?

A

superior part - pelvis
inferior part - perineum

43
Q

visceral afferents carrying pain from superior aspect of pelvic organs (touching the peritoneum) run alongside _____ fibres and enter spinal cord between levels ____

A

sympathetic
T11-L2

44
Q

visceral afferents carrying pain from inferior aspect of pelvic organs (NOT touching the peritoneum) run alongside _____ fibres and enter spinal cord between levels ____

A

parasympathetic
S2,3,4

45
Q

what separates pelvis and perineum

A

levator ani muscle

46
Q

what nerve does most stuff in perineum? what are the nerve routes?

A

pudendal
S2,3,4

47
Q

what spinal level does dural sac end

A

S2

48
Q

what spinal level is anaesthetic injected into in spinal and epidural anaesthetic?

A

L3-L4 (L5) region

49
Q

spinal anaesthetic vs epidural anaesthetic

A

same except for spinal you go through 2 extra layers - dura and arachnoid

50
Q

which is faster acting - epidural or spinal anaesthetic?

A

spinal (closer to spinal cord and rootlets etc)

51
Q

where does pudendal nerve exit the pelvis

A

greater sciatic foramen

52
Q

where does pudendal nerve re-enter the pelvis/perineum

A

lesser sciatic foramen

53
Q

when is pudendal nerve block used (labour)

A

painful vaginal delivery

if about to use instruments e.g. forceps

or episiotomy

or repairing perineal tears/incisions post delivery

54
Q

1st-4th degree tears

A

1st degree - skin only

2nd degree - skin and perineal muscles

3rd degree - involves external anal sphincter

4th - goes further into the lining of your anus or bowel.

55
Q

what direction is episiotomy incision made

A

posterolateral (mediolateral)

56
Q

where do external obliques attach

A

between lower ribs and iliac crest, pubic tubercle and linea alba

57
Q

which attach to thoracolumbar fascia - external or internal obliques?

A

internal

58
Q

what does linea alba mean

A

white line

59
Q

what is the rectus sheath

A

the covering lying over the rectus abdominus muscles

60
Q

do you have a posterior rectus sheath lower down

A

nope, only have anterior

61
Q

what is the transversalis fascia layer between?

A

transversus abdominis and extra peritoneal fat

62
Q

nerve supply to anterolateral abdominal wall - what direction do they enter from?

A

lateral direction

63
Q

what do the 7th-11th intercostal nerves become?

A

thoracoabdominal nerves

64
Q

blood supply to anterolateral abdominal wall

A

anterior abdominal wall:
- superior epigastric arteries
- inferior epigastric arteries

lateral abdominal wall:
- intercostal and subcostal arteries

65
Q

in a first pregnancy, when does the uterus come out of the pelvis (and can palpate)

A

12 weeks

66
Q

fundal height at 20 weeks

A

umbilicus

67
Q

fundal height at 36 weeks

A

xyphoid process

68
Q

how is fundal height measured

A

pubic symphysis up to top of fundus?

69
Q

are the rectus muscles cut in a LSCS

A

nope, they are just separated from each other is a lateral direction

70
Q

LSCS layers when opening

A
  • skin and fascia
  • (anterior) rectus sheath
  • rectus abdominis (separate not cutting)
  • fascia and peritoneum
  • retract bladder (bladder might be getting in the way)
  • uterine wall
  • amniotic sac
71
Q

Laparotomy layers when opening

A
  • skin and fascia
  • linea alba
  • peritoneum
72
Q

Laparotomy layers to stitch closed

A
  • peritoneum & linea alba
  • fascia
  • skin
73
Q

laparoscopy - If a lateral port is required, care must be taken to avoid the ______ __________ ________

A

inferior epigastric artery

74
Q

inferior epigastric artery landmarks

A
  • emerges just medial to the deep inguinal ring
  • then passes in a superomedial direction posterior to the rectus abdominis
75
Q

what is the inferior epigastric artery a branch of?

A

external iliac artery

76
Q

what are the 3 layers of the pelvic floor

A
  • pelvic diaphragm
  • muscles of perineal pouches
  • perineal membrane
77
Q

what is the deepest layer of the pelvic floor

A

pelvic diaphragm

78
Q

levator ani forms most of the pelvic _________

A

diaphragm

79
Q

what 3 muscles make up levator ani?

A

puborectalis
pubococcygeus
iliococcygeus

80
Q

levator ani innervation

A

pudendal nerve and nerve to levator ani

81
Q

bulbourethral glands (aka Cowper’s glands) function

A

produces a pre-ejaculate that cleanses and lubricates the urethra prior to the arrival of the semen.

82
Q

4th degree prolapse

A

completely outside vagina

83
Q

treatment options for uterine prolapse

A
  • sacrospinous fixation
  • incontinence surgery (controversial now because of the mesh thing)

Reproduction & Sexual Health (36 decks)

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