Anatomy 2 - Female Reproductive Anatomy Flashcards
What structures are in the pelvic cavity? (4)
Ovaries
Uterine tubes
Uterus
Superior part of vagina (vagina goes through the pelvic floor)
What structures are in the perineum? (5)
Inferior part of vagina Perineal muscles Bartholin's glands Clitoris Labia
What pouches do the female peritoneum form?
Vesico-uterine
Recto-uterine (pouch of douglas)
What is superior to the female perineum?
Levator ani
Where does excess fluid in peritoneal cavity tend to collect and why?
Pouch of Douglas (recto-uterine pouch) because it is most inferior part of peritoneal cavity
How can fluid in pouch of douglas be drained?
Via a needle passed through the posterior fornix of vagina
What are the ligaments of the uterus?
Round ligament
Broad ligament
Although not true ligaments
Where does the broad ligament extend from?
Uterus to lateral walls and floor of pelvis
What is the function of broad ligament?
Maintain uterus in midline position
What does the broad ligament contain?
Uterine tubes
Proximal part of round ligament
What makes up the broad ligament?
Double layer of peritoneum
What makes up the round ligament?
Embryological remnant
What does round ligament attach to and from?
From lateral aspect of uterus
Passes through deep inguinal ring
To superficial tissue of perineum
Connects to broad ligament
What are the 3 subcomponents of the broad ligament?
Mesometrium (mesentery of uterus)
Mesoslapinx
Mesovarium
What are the 3 layers of body of uterus?
Perimetrium
Myometrium
Endometrium
What structures support the uterus?
Uterosacral ligaments
Endopelvic fascia
Muscles of pelvic floor (esp. levator ani)
What can occur if the structures that support the uterus become weak?
Uterine prolapse
What is the most common positioning of uterus?
Anteverted and anteflexed
What does anteverted anteflexed uterus mean?
Certix tipped anteriorly to vagina (anteverted)
Uterus tipped anteriorly to cervix (anteflexed)
What does retroverted retroflexed mean?
Uterus tipped posterior to vagina
Uterus tipped posterior to cervix
How is an anteverted anteflexed uterus palpated?
Via vagina
How is a retroverted retroflexed uterus palpated?
Via rectum
What is sampled in a smear test?
Transition zone
Squamo-columnar junction
Where does fertilisation usually occur?
Ampulla
Where does fimbriae at the end of uterine tube open into?
The peritoneal cavity
Why is there a possibility of infection transfer from genitals to peritoneal cavity?
Because the fimbrae have an open communication into the peritoneal cavity
What hormones do ovaries secrete?
Oestrogen and progesterone
What causes ovaries to secrete hormones?
Response to LH and FSH
Where is the ovum released by ovary?
Directly into the peritoneal cavity to be picked up by the fimbriae of uterine tube
What is the fornix of vagina?
Superior part of vagina where the walls are held apart by the cervix
What are the 4 parts of the fornix?
Anterior
Posterior
2 x lateral
What can be palpated on vaginal digital examination?
Ischial spines (to find pudendal nerve)
Position of uterus
Adnexae
How can the adnexae be palpated?
Place fingers into lateral fornix
Press deeply with other hand into iliac fossa of same side
Can detect large masses or tenderness
What is the perineum?
Shallow space between pelvic diaphragm and skin
What are the 2 pouches of perineum?
Superficial
Deep
What are the 2 triangles of perineum?
Urogenital
Anal
What nerve supplies perineal muscles?
Pudendal nerve
What muscle forms the majority of the pelvic diaphragm?
Levator ani
What nerve supplies the pelvic diaphragm?
S3, S4, S5
Functions of levator ani (3)
- Support abdominopelvic organs through their tonic contraction
- Resist any increases in intrapelvic or abdominal pressure during e.g. coughing
- Urinary and fecal continence
What is the perineal body?
Bundle of collagenous and elastic tissue
What attaches to perineal body?
Perineal muscles
Why is perineal body important?
Pelvic floor strength
Where is perineal body located?
Just deep to skin
What does perineal body contain?
Bartholin’s glands (greater vestibular glands)
What do Bartholin’s glands secrete?
Lubricant for sexual arousal
What is anterior to pubic bone?
Mons pubis
Name key components of surface area of vagina
Mons pubis Labium majus Labium minus Clitoris External uretral orifice Vestibule Vaginal orifice Anus
Where does bed of breast attach?
Rib 2 - 6
Lateral border of sterum
To mid-axillary line
What does bed of breast lie on?
Deep fasica
What muscles does bed of breast cover?
Pec major and serratus anterior
Where does retromammary space lie?
Between fascia and breast
How does breast attach to skin?
Via suspensory ligaments
How is the breast divided for examination?
Quadrants Upper outer Upper inner Lower outer Lower innter
How do you get the patient to stand during breast examination?
Hands on hips
To contract the pectoral muscles
What is also assessed during a breast examination?
Axilla
Supraclavicular area
Where does 75% of lymph from breast drain to?
Ipsilateral lymph nodes
Then supraclavicular nodes
Where can lymph from inner quadrant drain?
Ipsilateral OR CONTRALATERAL lymph nodes
Then supraclavicular nodes
Where does lymph from upper limb drain?
Axillary nodes
What can occur in axillary node clearance?
Lymphedema
What is the axilla?
Pyramidal passageway between arm and chest
What does the axilla contain?
Brachial plexus branches
Axillary artery and vein
Lymph nodes
Embedded in axillary fat
What does the ‘level’ of axillary node clearance related to?
Pectoralis major
What is level 1 axillary clearance?
Inferior and lateral to pectoralis major
What is level 2 axillary clearance?
Deep (central) to pectoralis major
What is level 3 axillary clearance?
Superior and medial to pectoralis major (in supraclavilar area near the venous angle)
What artery supplies the breast?
Internal thoracic (branch of subclavian artery)
Where does blood from breast drain?
Into axillary and internal thoracic veins
