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Obstetrics and Gynaecology > Anatomy > Flashcards

Anatomy Flashcards

1
Q

Blood Supply to the Uterus (and origin of vessel(s))

A 
Uterine artery (origin:internal iliac artery-common iliac artery-abdominal aorta)
Collateral supply from ovarian arteries (origin:abdominal aorta)
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2
Q

Venous Drainage of the Uterus

A

Uterine veins (from internal iliac vein-common iliac vein-inferior vena cava)

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3
Q

Which bones form the bony pelvis?

A

2 hip bones, sacrum and coccyx

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4
Q

Bones of the Pelvic Inlet

A

Sacral promontory, ilium, superior pubic ramus, pubic symphysis

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5
Q

Bones of the Pelvic Outlet

A

Pubic symphysis, ischiopubic ramus, ischial tuberosities, sacrotuberous ligaments, coccyx

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6
Q

Where is the False Pelvis?

A

Above Pelvic inlet

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7
Q

Where is the True Pelvis?

A

Below Pelvic inlet

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8
Q

Where is the Pelvic Cavity?

A

The space betweem the pelvic inlet and the levator ani muscle

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9
Q

5 Functions of the Bony Pelvis

A

1) Support of he upper body when sitting and standing
2) Transference of weight from vertebral column to femurs allowing standing and walking
3) Attachment for muscles of locomotion and abdominal wall
4) Protection of pelvic organs, their blood and nerve supply, their venous and lymphatic drainage
5) Passage for childbirth

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10
Q

Bones that make up the hip bone

A

ilium, ischium, pubic bone

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11
Q

Bony features of the Ilium

A 
Iliac crest
Anterior superior iliac spine
Posterior superior iliac spine
Iliac fossa
Anterior inferior iliac spine
Posterior inferior iliac spine
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12
Q

Bony features of the ischium

A

Ischiopubic ramus
Ischial tuberosity
Ischial spine

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13
Q

Pubic Bone

A 
Superior pubic ramus
Pubic tubercle
Ischiopubic ramus
Pubic arch
Subpubic angle
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14
Q

Joints of the Bony Pelvis

A 
Sacroiliac joints
Hip joints (femur and acetabulum)
Pubic symphysis
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15
Q

Palpable Surface Landmarks of the Bony Pelvis

A 
Iliac crest
ASIS
Pubic Symphisis
Pubic Tubercle
PSIS
Ischial Tuberosity
Sacrum
Coccyx
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16
Q

Ligaments of the Bony Pelvis

A

Sacrospinous ligament: Sacrum to ischial spine

Sacrotuberous ligament: Sacrum to ischial tuberosity

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17
Q

Foraminae of the Bony Pelvis

A 
Obturator foraminae (obturator artery, vein and nerve)
Greater and lesser sciatic foraminae
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18
Q

Blood vessels in the pelvis at risk of haemorrhage

A

common iliac artery and common iliac vein

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19
Q

Sutures and fontanelles of the foetal skull

A

Midline sagittal suture
Coronal suture
Lambdoid suture
Anterior and posterior fontanelles

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20
Q

Moulding

A

Movement of one bone over another to allow the foetal head to pass through the pelvis during labour

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21
Q

Vertex of the foetal skull

A

An area of the foetal skull outlined by the anterior and posterior fontanelles and parietal eminences

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22
Q

Which diameter of the foetal skull is longer?

A

The occipitofrontal diameter is longer than the biparietal diameter

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23
Q

Position of foetal head at the pelvic inlet during labour.

A

Transverse

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24
Q

Position of foetal head whilst descending through the pelvic cavity.

A

Rotated and in a flexed position

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25
Q

Position of the foetal head at the pelvic outlet?

A

Occipitoanterior position and in extension

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26
Q

Differences between male and female pelvis

A

The AP and transverse diameters of the female pelvis are larger than the male at both the pelvic inlet and outlet
The subpubic angle (and pubic arch) in the female is wider than the male
The pelvic cavity is shallower in the female

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27
Q

Which parts of the female reproductive system are in the pelvic cavity?

A

Ovaries, uterine tubes, uterus and most of the vagina

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28
Q

Which parts of the female reproductive system are in the perineum

A

Inferior part of the vagina, perineal muscles, bartholins glands, clitoris, labia

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29
Q

What does the parietal peritoneum form

A

It forms the floor of the peritoneal cavity and a roof over the pelvic organs.

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30
Q

Where is the pouch of douglas?

A

The rectouterine pouch, the most inferior part of the peritoneal cavity

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31
Q

Where is the broad ligament?

A

Suspends the uterus, uterine tube and ovary from the lateral wall of the pelvic cavity

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32
Q

Where is the round ligament?

A

Attaches the uterus to the perineum

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33
Q

What are the 3 layers of the wall of the body of the uterus?

A

Perimetrium,myometrium, endometrium

34
Q

Which layer of the uterus is shed during menstruation?

A

The endometrium

35
Q

Where should implantation of the fertilised ovum occur?

A

The body of the uterus

36
Q

Which layers hold the uterus in place?

A

1) Strong ligaments (e.g.uterosacral ligaments)
2) (endo)pelvic fascia
3) Muscles of the pelvic floor e.g. levator ani

37
Q

What is the most common position of the uterus?

A

Anteverted and anteflexed
Uterus tipped anteriorly relative to the axis of the vagina and the uterus is tipped anteriorly relative to the axis of the cervix.

38
Q

Where is sampled in a cervical smear?

A

The squamo columnar junction

39
Q

Where is the widest part of the uterine tube?

A

The ampulla

40
Q

What is a salpingectomy?

A

Removal of a uterine tube

41
Q

How is there a communication between the genital tract and the peritoneal cavity?

A

The fimbriae at the end of the uterine tubes open into the peritoneal cavity

42
Q

What do the ovaries secrete? In response to what?

A

They secrete oestrogen and progesterone in response to anterior pituiary hormones (FSH and LH)

43
Q

How do the ovaries move during foetal development?

A

They move from the posterior abdominal wall into the pelvis. A structural remnant of this embryology is the round ligament of the uterus

44
Q

What are the parts of the vaginal fornix?

A

Anterior, posterior and 2 lateral

45
Q

Where is the perineum located?

A

Inferior to the levator ani muscle

46
Q

What is the nerve supply to levator ani?

A

“Nerve to levator ani”: a branch of the sacral plexus

47
Q

What is the role of the levator ani?

A

Provides support for pelvic organs by being tonically contracted most of the time
It reflexively contracts further during sitations of increased intra-abdominal pressure

48
Q

What is the perineal body?

A

A bundle of collagenous and elastic tissue into which the perineal muscles attach

49
Q

What nerve supplies the perineal muscles?

A

pudendal nerve

50
Q

What are the Bartholins glands?

A

2 pea-sized glands located slightly posterior and to the left and right of the vagina. They secrete mucus for vaginal lubrication

51
Q

What is the vestibule?

A

The area within the labia minora containing the external urethral origace and the vaginal orifice

52
Q

What are the borders of the female breast?

A

Ribs 2 and 6

53
Q

What lies beneath the female breast?

A

Retromammary space ad pectoralis major

54
Q

What do the suspensory ligaments of the breast do?

A

Attach breast tissue to overlying dermis of skin

55
Q

Blood supply of the female breast

A

Lateral thoracic artery (from axillary- from subclavian artery)
Internal thoracic artery (from axillary- from subclavian artery)

56
Q

Venous drainage of female breast

A

Internal thoracic vein (to brachiocephalic vein)

57
Q

What is the axilla?

A

The pyramidal space between the arm and chest

58
Q

Superior border of the axilla

A

Outer border of first rib, superior border of scapula, posterior border of scapula

59
Q

Anterior border of axilla

A

Pectoralis major, pectoralis minor and subclavius

60
Q

Posterior Border of axilla

A

Subscapularis, teres major and latissimus dorsi

61
Q

Medial Border of axilla

A

Serratus anterior and ribcage

62
Q

Lateral border of axilla

A

Intertubercular sulcus

63
Q

Contents of the axilla

A

Branches of brachial plexus
Axillary artery and its branches
Axillary vein and tributaries
Axillary lymph nodes

64
Q

Which lymph nodes can lymph from the breast drain into?

A

75% drains into the ipsilateral axillary lymph nodes
Can also drain to the supraclavicular and parasternal lymphnodes
Lymph from the lower inner breast can drain to the abdominal lymph nodes.

65
Q

Describe the levels of axillary lymph nodes.

A

Level 1: Inferior and lateral to pectoralis minor
Level 2: Deep to pectoralis minor
Level 3: Superior and medial to pectoralis minor

66
Q

Blood supply of ovary

A 
Ovarian artery (abdominal artery)
Uterine artery (internal iliac artery, common iliac artery, aorta)
67
Q

Venous drainage of ovary

A

Ovarian vein (inferior vena cava [left renal vein])

68
Q

Blood supply of vagina

A 
Uterine artery (internal iliac artery)
Vaginal artery (internal iliac artery or uterine artery)
69
Q

Venous drainage of the vagina

A

Vaginal venous plexus (internal iliac veins)

70
Q

What are the common surgical incisions in Obs and Gynae? (2)

A

Vertical midline incision: laparotomy

Suprapubic/Pfannenstiel/bikini-line incision: LSCS, abdominal hysterectomy,

71
Q

What is the Rectus Sheath?

A

The combined aponeuroses of the external oblique, internal oblique and transversus abdominis muscles that surround the rectus abdominis muscles

72
Q

What is the Linea Alba?

A

Formed by the interweaving of the muscle aponeuroses that form the anterior and posterior rectus sheath. It runs from the xiphoid process to the pubic symphysis

73
Q

What is the fibre direction of the external oblique?

A

Anteromedial and inferiorly

74
Q

What is the fibre direction of the internal oblique

A

Posterolateral and inferiorly

75
Q

What is the fibre direction of the transversus abdominis?

A

Horizontal

76
Q

What is the nerve supply to the anterolateral abdominal wall?

A 
7th-11th intercostal nerves
Subcostal nerve (T12 anterior ramus)
Iliohypogastric nerve (half of L1 anterior ramus)
Ilioinguinal nerve (other half of L1 anterior ramus)
77
Q

What is the blood supply to the anterolateral abdominal wall?

A

Superior epigastric artery (continuation of internal thoracic artery [from axillary artery])
Intercostal and subcostal arteries
Inferior Epigastric Artery (branch of external iliac artery)

78
Q

What layers need to be opened in an LSCS?

A

Skin, fascia, anterior rectus sheath, rectus abdominis, fascia and peritoneum, uterine wall, amniotic sac

79
Q

What layers need to be opened for a laparotomy?

A

Skin, fascia, linea alba, peritoneum

80
Q

What is the path of the inferior epigastric artery?

A

Emerges as a branch of the external iliac artery, just medial to the deep inguinal ring. It then passes superomedial direction posterior to the rectus abdominis.

81
Q

How do you differentiate between the uterine artery and the ureter?

A

The ureter passes inferior to the uterine artery and vermiculates when touched.

Obstetrics and Gynaecology (7 decks)

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