Anatomy And Physiology

Question 1

How long is a female urethra?

Answer 1

3-4cm

Question 2

Tissues involved in second degree perineal tear

Answer 2

Perineal skin
Vaginal epithelium
Perineal body

Question 3

Tissues involved in 3rd degree perineal tears

Answer 3

External and internal anal sphincters

Question 4

Tissues involved in 4th degree perineal tears

Answer 4

Extends into anal mucosa

Question 5

How are perineal tears managed

Answer 5

Sutured
>1st and 2nd degree = in the ward
>3rd and 4th degree = in theatre

Question 6

What is the length of a vagina?

Answer 6

Posterior wall = 9-10cm
Anterior wall = 7,5cm

Question 7

What lubricates the vagina?

Answer 7

There are no glands in the vagina. It is lubricated by secretions from the cervix and the bartholins glands, and vaginal transudate from capillaries

Question 8

What are the normal dimensions of a uterus?

Answer 8

Length 6-8,5cm
Width 3-6cm (in transverse plane)
Depth 2-6cm

+-50g

Question 9

What epithelium lines the endometrium?

Answer 9

Columnar epithelium (single layer)

Question 10

What are the components of the broad ligament?

Answer 10

Mesosalpinx
Mesometrium
Mesovarium

Question 11

What’s the most common position of the uterus?

Answer 11

Anteversion and anteflexion

Question 12

What is the lymphatic drainage of the cervix?

Answer 12

Drains to the iliac LN situated on the external iliac vessels and in the obturator foramen

Question 13

What are the phases of the menstrual cycle?

Answer 13

1)Follicular phase
2)Ovulatory phase
3)Luteal phase (always 14 days)
4)Mentruation

Question 14

What is oogenesis?

Answer 14

The process of maturation of a primary oocyte into a mature oocyte

Question 15

What phase of mitosis does the oogonia freeze in inutero? When do they continue their mitosis?

Answer 15

Prophase 1 (primary oocyte)

Meiosis continue at the start of menstruation and finish just before ovulation (starts at puberty)
The second meiotic division occurs at the time of sperm penetration

2 meiotic divisions x 1oocyte = 1 mature ovum + 3 polar bodies

Question 16

Describe the follicular phase of the menstrual cycle.

Answer 16

At the beginning of the follicular phase, FSH stimulates a bunch of oocytes to mature. The maturing oocytes produce oestrodiol and the granulosa of the oocytes produce Inhibin A. Both oestrodiol and Inhibin A cause a negative feedback on the pituitary resulting in decreased FSH. The dominant follicle is selected as it has the most FSH receptors and higher oestrodiol levels allowing it to survive the low FSH environment.
FSH withdrawal causes a surge in LH, and the FSH then functions to up-regulate the LH receptors.

Question 17

Describe the events in the Ovulatory phase of menstrual cycle

Answer 17

There is a surge in LH which causes the release of the ovum from the mature oocyte. (Within 36hours of onset of surge, and 10-12hours after peak) There is a increase in prostaglandins (stimulating follicular wall degeneration) and progesterone (terminates LH surge by negative feedback)

Question 18

What are the normal parameters of the menstrual cycle?

Answer 18

Length of cycle = 24-36days
Volume = 5-80ml
Duration = <8days
Regularity = variation <7-9days

Question 19

When is the window of fertility?

Answer 19

Ovum lasts 12-24hours after ovulation in tubes
Sperm survive +-5days in tubes

Therefore window = 5days before ovulation

Question 20

When is the window of implantation?

Answer 20

The fertilised ovum is in the tubes for 6-10 days before enters uterus.

Window = 6days after LH surge for +-4days

Question 21

Define puberty

Answer 21

The process in which secondary sexual characteristics and reproductive capability develop in adolescence, resulting in the ability of human to reproduce.

Question 22

What hormones spike in puberty?

Answer 22

LH and FSH =

Oestrodiol
Testosterone
Progesterone

Question 23

What are the effects of increased oestrodiol at puberty?

Answer 23

Breast development
Growth acceleration
Ovulation
Menstruation

Question 24

What factors influence timing of puberty?

Answer 24

Ethnic
Genetic
Physical health/exercise
Diet
Mental health

Question 25

What staging is used for breast and pubic hair development in puberty?

Answer 25

Tanners staging

Question 26

What is precocious puberty?

Answer 26

The onset of pubertal development at an age that is 2-2,5 standard deviations earlier than the population norm defined by onset of menstruation and secondary sexual characteristics before the age of 8years old

Question 27

Thelarche?

Answer 27

Breast development

Question 28

During which stage in the Tanner staging does the first menstrual period occur?

Answer 28

Stage 4-5

Question 29

How do you determine bone age in a child?

Answer 29

X-ray of let wrist

Question 30

What medical treatments can be used to treat precocious puberty?

Answer 30

GnRH analogues (downregulates endogenous secretion by applying constant stimulation to pituitary) = FIRST LINE

Question 31

Define delayed puberty?

Answer 31

The failure to develop secondary sexual characteristics by age 13
OR
Absence of menarche by age 16
OR
When menarche does not occur five or more years after the onset of pubertal development

Question 32

Anechoic?

Answer 32

No u/s waves are reflected back = black

Question 33

Hyperechoic?

Answer 33

Lots of u/s waves are reflected back = white

Question 34

Haematometria?

Answer 34

Collection of blood in the uterus mostly due to imperforate hymen