Anatomy Flashcards
what organs lie in the pelvic cavity?
ovaries
uterine tubes
uterus
superior part of vagina
what organs lie in the perineum?
inferior vagina perineal muscles Bartholin's glands clitoris labia
what is the peritoneum?
serous membrane that secretes peritoneal fluid which drapes over rectum, uterus and bladder covering their superior aspects
what does the peritoneum form?
pouches
what pouches are found in the female?
vesico-uterine
recto-uterine (Pouch of Douglas)
how can fluid be drained from the recto-uterine pouch?
via posterior fornix of the vagina
pouch in the male
recto-vesico
two important ligaments around the female organs
- broad ligaments
2. round ligament
what is the broad ligament made from?
double layer of peritoneum
position of the broad ligament
extends between uterus and lateral/ floor of the pelvis
role of the broad ligament
maintains uterus in the midline and contains uterine tubes
what forms the round ligament?
embryological remanent of gubernaculum
position of the round ligament
attached to lateral aspect of the uterus and passes through the deep inguinal ring
embryological development of the female anatomy
Mullerian duct (except round ligament)
three layers of the uterus
- perimetrium
- myometrium
- endometrium
where should implantation occur?
body of the uterus
where should fertilisation of the ovum occur?
ampulla of the fallopian tube
normal position of the uterus
anteverted and anteflexed
why do the fallopian tubes risk infection in the peritoneal cavity?
the fimbriated end opens into the peritoneal cavity which can cause peritonitis and ectopic pregnancy
what is the peritoneal cavity?
opening between visceral and parietal perineum
how does a HSG indicate patent tubes?
radiopaque dye should be seen spilling out
where do the ovaries sit?
ovarian fossae
where do the ovaries develop embryologically?
posterior abdominal wall
where is the ovum released?
from the ovary into the peritoneal cavity to be picked up by the fimbriae
vaginal digital examination landmarks
- 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
what is the mons pubis?
skin with hair follicles overlying the subcutaneous fat pad over the pubic symphysis
what are the labia majora?
rich in apocrine and sebaceous glands with smooth muscle and hair follicles
what are the labia minora?
thin folds that lack fat and hair follicles with rich vasculature and sebaceous glands
what is the clitoris?
two tubes of erectile vascular tissue (corpora cavernosa) covered by fibrocollagenous sheath covered by skin
what type of muscle is levator ani?
skeletal muscle under voluntary control that is tonically contracted
when does levator ani contract further?
when you cough or sneeze to prevent incontinence due to increased intra-abdominal pressure
which nerve supplies levator ani?
nerve to levator ani S3,4,5
what supplies the perineal muscles?
pudendal nerve
what is the perineal body?
bundle of collagenous and elastic tissue where the perineal muscles attach
role of Bartholin’s (female) and Cowper’s (male) glands?
secrete lubricating fluid
position of the breast
extends from ribs 2-6 from lateral border of the sternum to mid-axillary line
what lies below the breast?
retromammary space
deep fascia
pectoralis major
serratus anterior
lymphatic drainage of the breast
parasternal nodes
axillary nodes
abdominal nodes
arterial supply to the breast
subclavian gives off internal and lateral thoracic arteries
what does the pelvic floor separate?
pelvic cavity from perineum
layers of the pelvic floor
pelvic diaphragm
perineal pouches
perineal membrane
what does the pelvic diaphragm consist of?
levator ani and coccygeus
three parts of levator ani
iliococcygeus
pubococcygeus
puborectalis
what is the perineal membrane?
thin sheet of tough fascia with openings for urethra and vagina
functions of the pelvic floor
provide support
continence
mechanisms of injury to the pelvic floor
pregnancy childbirth chronic constipation obesity heavy lifting chronic cough/sneeze injury to pelvis/pelvic floor menopause
what happens if the pelvic floor does not provide enough support?
incontinence
prolapse
three bones that make up each hip
ilium
pubis
ischium
all meet at the acetabulum
what forms the greater and lesser sciatic foramen?
sacrotuberous and sacrospinous ligaments
what crosses the obturator foramen
obturator membrane
clinically important anastomoses in the female pelvis
between uterine and ovarian artery
between uterine and vaginal arteries
relationship between ureter and uterine artery?
water under the bridge
uterine artery homologous
artery to vas deferens
nerves of the lateral pelvic wall
obturator nerve
lumbosacral trunk joins sacral plexus
functions of the pelvis
support upper body transfer weight attachment for muscles and external genitalia protection childbirth
what does the pelvis consist of?
2 hip bones (ilium, ischium and pubis)
sacrum
coccyx
two divisions of the pelvis?
pelvic inlet and outlet
differences in female pelvis
wider diameter
wider suprapubic angle
shallower pelvic cavity
which diameter is largest at the pelvic inlet?
transverse
widest part of the foetus head
occipitofrontal diameter
what is the station
distance of the foetal head from the ischial spines
negative means above and positive means below
what position should the baby leave the pelvic cavity?
occipitoanterior
position of baby’s head on delivery
extension
innervation of the pudendal nerve
S2, 3, 4
2, 3, 4 keeps the pelvis off the floor
route of the pudendal nerve
passes out of the greater sciatic foramen, wraps around the sacrospinous ligament and re-enters via the lesser sciatic foramen
where does the ovarian artery come from?
abdominal aorta at L2
what is a cystocele?
bladder bulges into the vagina
what is a rectocele?
rectum bulges into the vagina
where is the superficial perineal pouch found?
between skin and perineal membrane
what does the superficial perineal pouch hold?
erectile tissue
what passes through the corpus spongiosum?
male urethra
pain below the levator ani
somatic sensory in pudendal nerve causes pain to be felt locally in the perineum
