Anatomy Flashcards
at what lumbar vertebrae is the iliac crest?
L4
what nerve runs along the ischial spines and is useful for anesthetising the perineum?
pudendal nerve
what bony prominences are palpable on vaginal examination at 4 and 8 oclock positions?
ischial spines
what ligaments separate the greater and lesser sciatic foramen?
sacrotuberous ligaments
sacrospinous ligaments
what does the sacrotuberous ligament run between?
sacrum and ischial tuberosity
what does the sacrospinous ligament run between?
sacrum and ischial spine
why is there more strain on the sacrospinous and sacrotuberous ligaments in pregnancy?
centre of weight is shifted anteriorly
what happens to ligaments during pregnancy and why?
they relax due to relaxin hormone
describe the course of the pudendal nerve?
leaves the pelvis out of the greater sciatic foramen, wraps around the sacrospinous ligament and goes back into the pelvis through the lesser sciatic foramen
what separates the false and true pelvis?
pelvic inlet
what makes up the pelvic inlet?
sacral promontory
ilium
superior pubic ramus
pubic symphysis
what makes up the pelvic outlet?
pubic symphysis ischiopubic ramus ischial tuberosities sacrotuberous ligaments coccyx
at what level does the abdominal aorta branch into the common iliac artery?
L4
do the superior/inferior gluteal arteries come from the external or internal iliac arteries?
internal iliac artery
compare the anterior-posterior and transverse diameter of the female and male pelvis?
female diameters are both larger
compare the subpubic angle of the female and male pelvis?
females is wider
compare the depth of the female and male pelvic cavity?
females pelvic cavity is shallower
what are fontanelles?
soft spots on the fetal skull
what parts of the fetal skull allows moulding during childbirth?
fontanelles
sutures
what suture is between the frontal and parietal bones of the fetal skull?
coronal suture
what suture is between parietal bones of the fetal skull?
sagittal suture
what suture is between the occipital and parietal bones?
lambdoid suture
what outlines the vertex of the fetal skull?
anterior and posterior fontanelles
parietal eminences
compare the occipitofrontal diameter to the biparietal diameter of the fetal skull?
occipitofrontal diameter is longer than the biparietal diameter
at the pelvic inlet of a womens pelvis, which is wider- transverse diameter or AP diameter?
transverse diametter
at the pelvic outlet of a womens pelvis, which is wider- transverse diameter or AP diameter?
AP diameter
what is the ‘station’? (a term used during childbirth)
the ischial spines
negative number station = superior to the ischial spines
during delivery, should the foetal head be in flexion or extension?
extension
while descending through the pelvic cavity, should the foetal head be in flexion or extension?
flexion (chin on chest)
visceral afferents from the superior aspect of the pelvic organs (ie touching the peritoneum) runs alongside what nerve fibres? at what levels do they enter the spinal cord?
sympathetic fibres
T11-L2
pain from inferior aspects of pelvic organs (ie not touching the peritoneum) runs alongside what nerve fibres? at what levels do they enter the spinal cord?
parasympathetic fibres
S2,3,4
what nerve supplies somatic sensory fibres to organs/structures within the perineum?
pudendal nerve
what are the 3 methods of anesthetising the female reproductive tract?
spinal anaesthetic
epidural anaesthetic
pudendal nerve block
at what levels does the spinal cord become the cauda equina?
L2
at what level does the subarchnoid spae end?
S2
for a spinal/epidural anaesthetic procedure, at what lefvel is anaesthetic injected into?
L3-L4
for spinal anaesthetic, what 7 layers does the needle pass through?
supraspinous liament interspinous ligament ligamentum flavum epidural space (fat/veins) dura mater arachnoid mater subarachnoid space (CSF)
for epidural anaesthetic, what 4 layers does the needle pass through?
supraspinous ligament
interspinous ligament
ligamentum flavum
epidural space (fat/veins)
what happens to the lower limbs during spinal anaesthetic and why?
skin looks flushed
warm
reduced sweating
(loss of sympathetic supply)
what is the name of the surgical cut in the area between the vagina and the anus during delivery?
episiotomy
what fossa is an episiotomy made in?
ischioanal fossa
how can the pouch of Douglas be drained?
needle aspiration through the posterior fornix of the vagina (culdocentesis)
what are the 2 ligaments of the uterus?
- broad ligament
- round ligament
what is the broad ligament of the uterus actually made of?
double layer of peritoneum
what does the broad ligament of the uterus extend between?
uterus and lateral walls/floor of pelvis
what is the function of the broad ligament of the uterus?
helps maintain uterus in correct position
what is the round ligament of the uterus actually made of?
embryological remnant
what does the round ligament of the uterus extend between?
lateral aspect of uterus and superficial tissue of the female perineum
what inguinal ring does the round ligament of the uterus pass through?
deep inguinal ring
describe the most common position of the cervix?
anteverted
describe the most common position of the uterus?
anteflexed
whats the difference between a retroverted and retroflexed vagina?
retroverted- uterus tipped posteriorly relative to axis of vagina
retroflexed-uterus tipped posteriorly relative to axis of cervix
what area of the cervix must be sampled in a cervical smear?
squamo-columnar junction (Transformation zone)
what is a salpingo-oophrectomy?
removal of uterine tube and ovary
what is a salpingectomy?
removal of uterine tube
where do ovaries develop?
on the posterior abdominal wall
what are the 4 parts of the fornix of the vagina?
anterior fornix
posterior fornix
2 lateral fornices
what nerves supply the levator ani muscle?
nerve to levator ani muscle
pudendal nerve
what is the perineal body?
bundle of collagenous and elastic tissue where perineal muscles attach
what nerve supplies the perineal muscles?
pudendal nerve
what glands are near the labia of the vagina and secrete fluids associated with sexual arousal?
bartholins glands
from what ribs does the bed of the breast extend?
ribs 2-6
to what line does the lateral border of the breast extend to?
mid-axillary line
what spaces lies between deep fascia and the breast?
retromammary space
what ligaments firmly attach the breast tissue to skin?
suspensory ligaments
what hormone causes lactation?
prolactin
what hormone causes descent of lactating milk to areola?
oxytocin
what are the 5 main areas of the female breast?
upper inner lower inner lower outer upper outer axillary tail
where does greater than 75% of lymph from the breast drain to?
ipsilateral axillary lymph nodes