Anatomy Flashcards
Attachments of the ovary
Mesovarium - attaches the anterior aspect of the ovary to the posterior layer of the broad ligament
Suspensory ligament of the ovary - also referred to as the infundibulopelvic ligament. Attaches superiolaterally. Contains ovarian vessels and nerves
Ovarian ligament - attaches ovary to uterine cornua
Immediate posterior relations of the ovary
Ureter and internal iliac artery
What is the ovarian bursa
peritoneal recess between the medial aspect of the ovary and the mesosalpinx
What is the mesometrium
Part of the broad ligament which extends upwards from the pelvic floor to the ovary and ovarian ligament
Boundaries of the ovary
Above- bifurcation of the iliac vessels
Lateral - the ovarian fossa, and the obturator nerves and vessels
Medial - the fallopian tube
Behind- the ureters and internal iliac artery
Contents of the broad ligament
Fallopian tube, round ligament and ovarian ligament
Anatomy of the broad ligament
- a fold of peritoneum related to either side of the uterus
- Reaches from the lateral pelvic wall creating a septum that divides the pelvis into the anterior region (containing the bladder) and posterior region (containing the rectum)
Size of the ovary
2x3x4cm
Anatomical position of the ovary’s long axis and attachments at the upper and lower poles
Long axis is vertical
- upper pole: infundibulopelvic fold (suspensory ligament of the ovary)
- Lower pole: ovarian ligament
Base of the breast
extends from 2nd rib to 6th rib and overlies the investing fascia of pectoralis major
Lymphatic drainage of the breast
> 75% occurs via the axillary nodes, which cluster around pectoralis minor and the axillary vessels
Remaining drainage is via the para-aortic nodes
Can also occur across the midline and below the diaphragm via interconnecting lymph channels
Blood supply of the breast
Mainly: lateral thoracic artery, which is a branch of the axillary artery. Feeds into the breast through lateral mammary branches
Lateral mammary branches may also arise from lateral cutaneous branches of the posterior intercostal arteries
Medial mammary branches arise from the internal thoracic artery, which is a branch from the first part of the subclavian artery
Structure of the breast
- Divided into 20 lobules, each containing a lactiferous duct
Lactiferous ducts extend in a radial manner toward the nipple, opening onto its surface
Areolar glands also open around the nipple and secrete an oily protective lubricant
Lobules are separated by fibrous tissue that form suspensory ligaments. They extend from the deep fascia covering pec major to the dermis of the skin
Development of the breast
Ducting system is fully established during puberty
Alveolar parts of this system also appear in puberty but the increase in breast size during puberty is due to increased fat deposition
Alveoli and ducts further develop in pregnancy to produce milk
Following pregnancy, breasts return to prep regnant state due to apoptosis and macrophage action
Postmenopause: breast atrophy and decreasing tautness of suspensory ligaments due to declining oestrogen’s
Autonomic nerve supply of the uterus
Sensory fibres of the uterine body and fundus run via the inferior and superior hypogastric plexuses to T11 and T12
Autonomic nerve supply of the cervix
Run via the pelvic splanchnic nerves to S2,3 and 4. Then to the hypogastric plexuses
Autonomic supply of the vagina
The upper vagina sensory fibres run via the pelvic splanchnic nerve to S2,3,4.
The lower vagina runs through the pudendal nerve to S2,3,4
Autonomic supply of the perineum
Fibres run through the pudendal nerve to S2,3,4.
Which classes of nerves supply the genital tract
Uterine body and fundus muscle is sympathetic
Lower part of the uterus (cervix) and upper vagina are parasympathetic (pelvic splanchnic)
Lower vagina and perineum are somatic (via pudendal)
Position of the urinary bladder
Lies in lesser pelvis, but can extend up into the abdominal cavity when distended
Apex is directed toward pubis symphysis, neck lies in the pelvic floor
What is the vesicourethral or utero-vesical pouch
A pouch formed by peritoneal reflection between the superior surface of the bladder and the uterus
What is the median umbilical ligament
It is a fibrous cord covered in a peritoneal fold that represents the closure of the upper end of the vesicourethral canal during embryonic development
What are the ligaments of the bladder
At the apex - median umbilical ligament (continuous with the urachus)
Laterally - the pubovesical ligaments
What are the pubovesical ligaments and where do they run
2 thickened bands pelvic fascia that run from the bladder to the inside aspect of the pubic bone, close to the midpoint of the symphysis.