Anatomy

Question 1

what organs lie in the pelvic cavity?

Answer 1

ovaries
uterine tubes
uterus
superior part of vagina

Question 2

what organs lie in the perineum?

Answer 2

inferior vagina
perineal muscles
Bartholin's glands
clitoris
labia

Question 3

what is the peritoneum?

Answer 3

serous membrane that secretes peritoneal fluid which drapes over rectum, uterus and bladder covering their superior aspects

Question 4

what does the peritoneum form?

Answer 4

pouches

Question 5

what pouches are found in the female?

Answer 5

vesico-uterine

recto-uterine (Pouch of Douglas)

Question 6

how can fluid be drained from the recto-uterine pouch?

Answer 6

via posterior fornix of the vagina

Question 7

pouch in the male

Answer 7

recto-vesico

Question 8

two important ligaments around the female organs

Answer 8

1. broad ligaments

2. round ligament

Question 9

what is the broad ligament made from?

Answer 9

double layer of peritoneum

Question 10

position of the broad ligament

Answer 10

extends between uterus and lateral/ floor of the pelvis

Question 11

role of the broad ligament

Answer 11

maintains uterus in the midline and contains uterine tubes

Question 12

what forms the round ligament?

Answer 12

embryological remanent of gubernaculum

Question 13

position of the round ligament

Answer 13

attached to lateral aspect of the uterus and passes through the deep inguinal ring

Question 14

embryological development of the female anatomy

Answer 14

Mullerian duct (except round ligament)

Question 15

three layers of the uterus

Answer 15

1. perimetrium
2. myometrium
3. endometrium

Question 16

where should implantation occur?

Answer 16

body of the uterus

Question 17

where should fertilisation of the ovum occur?

Answer 17

ampulla of the fallopian tube

Question 18

normal position of the uterus

Answer 18

anteverted and anteflexed

Question 19

why do the fallopian tubes risk infection in the peritoneal cavity?

Answer 19

the fimbriated end opens into the peritoneal cavity which can cause peritonitis and ectopic pregnancy

Question 20

what is the peritoneal cavity?

Answer 20

opening between visceral and parietal perineum

Question 21

how does a HSG indicate patent tubes?

Answer 21

radiopaque dye should be seen spilling out

Question 22

where do the ovaries sit?

Answer 22

ovarian fossae

Question 23

where do the ovaries develop embryologically?

Answer 23

posterior abdominal wall

Question 24

where is the ovum released?

Answer 24

from the ovary into the peritoneal cavity to be picked up by the fimbriae

Question 25

vaginal digital examination landmarks

Answer 25

- Ischial spines can be palpated laterally and 4 and 8 o’clock positions - Uterus can be bimanually palpated to assess anteverted placing - Palpating the adnexae (fallopian tubes and ovaries) by placing fingers in lateral fornix and other hand on the iliac fossa to detect masses or tenderness

Question 26

what is the mons pubis?

Answer 26

skin with hair follicles overlying the subcutaneous fat pad over the pubic symphysis

Question 27

what are the labia majora?

Answer 27

rich in apocrine and sebaceous glands with smooth muscle and hair follicles

Question 28

what are the labia minora?

Answer 28

thin folds that lack fat and hair follicles with rich vasculature and sebaceous glands

Question 29

what is the clitoris?

Answer 29

two tubes of erectile vascular tissue (corpora cavernosa) covered by fibrocollagenous sheath covered by skin

Question 30

what type of muscle is levator ani?

Answer 30

skeletal muscle under voluntary control that is tonically contracted

Question 31

when does levator ani contract further?

Answer 31

when you cough or sneeze to prevent incontinence due to increased intra-abdominal pressure

Question 32

which nerve supplies levator ani?

Answer 32

nerve to levator ani S3,4,5

Question 33

what supplies the perineal muscles?

Answer 33

pudendal nerve

Question 34

what is the perineal body?

Answer 34

bundle of collagenous and elastic tissue where the perineal muscles attach

Question 35

role of Bartholin's (female) and Cowper's (male) glands?

Answer 35

secrete lubricating fluid

Question 36

position of the breast

Answer 36

extends from ribs 2-6 from lateral border of the sternum to mid-axillary line

Question 37

what lies below the breast?

Answer 37

retromammary space deep fascia pectoralis major serratus anterior

Question 38

lymphatic drainage of the breast

Answer 38

parasternal nodes axillary nodes abdominal nodes

Question 39

arterial supply to the breast

Answer 39

subclavian gives off internal and lateral thoracic arteries

Question 40

what does the pelvic floor separate?

Answer 40

pelvic cavity from perineum

Question 41

layers of the pelvic floor

Answer 41

pelvic diaphragm perineal pouches perineal membrane

Question 42

what does the pelvic diaphragm consist of?

Answer 42

levator ani and coccygeus

Question 43

three parts of levator ani

Answer 43

iliococcygeus pubococcygeus puborectalis

Question 44

what is the perineal membrane?

Answer 44

thin sheet of tough fascia with openings for urethra and vagina

Question 45

functions of the pelvic floor

Answer 45

provide support | continence

Question 46

mechanisms of injury to the pelvic floor

Answer 46

``` pregnancy childbirth chronic constipation obesity heavy lifting chronic cough/sneeze injury to pelvis/pelvic floor menopause ```

Question 47

what happens if the pelvic floor does not provide enough support?

Answer 47

incontinence | prolapse

Question 48

three bones that make up each hip

Answer 48

ilium pubis ischium all meet at the acetabulum

Question 49

what forms the greater and lesser sciatic foramen?

Answer 49

sacrotuberous and sacrospinous ligaments

Question 50

what crosses the obturator foramen

Answer 50

obturator membrane

Question 51

clinically important anastomoses in the female pelvis

Answer 51

between uterine and ovarian artery | between uterine and vaginal arteries

Question 52

relationship between ureter and uterine artery?

Answer 52

water under the bridge

Question 53

uterine artery homologous

Answer 53

artery to vas deferens

Question 54

nerves of the lateral pelvic wall

Answer 54

obturator nerve | lumbosacral trunk joins sacral plexus

Question 55

functions of the pelvis

Answer 55

``` support upper body transfer weight attachment for muscles and external genitalia protection childbirth ```

Question 56

what does the pelvis consist of?

Answer 56

2 hip bones (ilium, ischium and pubis) sacrum coccyx

Question 57

two divisions of the pelvis?

Answer 57

pelvic inlet and outlet

Question 58

differences in female pelvis

Answer 58

wider diameter wider suprapubic angle shallower pelvic cavity

Question 59

which diameter is largest at the pelvic inlet?

Answer 59

transverse

Question 60

widest part of the foetus head

Answer 60

occipitofrontal diameter

Question 61

what is the station

Answer 61

distance of the foetal head from the ischial spines negative means above and positive means below

Question 62

what position should the baby leave the pelvic cavity?

Answer 62

occipitoanterior

Question 63

position of baby's head on delivery

Answer 63

extension

Question 64

innervation of the pudendal nerve

Answer 64

S2, 3, 4 2, 3, 4 keeps the pelvis off the floor

Question 65

route of the pudendal nerve

Answer 65

passes out of the greater sciatic foramen, wraps around the sacrospinous ligament and re-enters via the lesser sciatic foramen

Question 66

where does the ovarian artery come from?

Answer 66

abdominal aorta at L2

Question 67

what is a cystocele?

Answer 67

bladder bulges into the vagina

Question 68

what is a rectocele?

Answer 68

rectum bulges into the vagina

Question 69

where is the superficial perineal pouch found?

Answer 69

between skin and perineal membrane

Question 70

what does the superficial perineal pouch hold?

Answer 70

erectile tissue

Question 71

what passes through the corpus spongiosum?

Answer 71

male urethra

Question 72

pain below the levator ani

Answer 72

somatic sensory in pudendal nerve causes pain to be felt locally in the perineum