Anatomy and Physiology Flashcards
Describe the surface anatomy of the Breasts
- Lateral Sternal Border to Mid Axillary Line
- Superficial to Pectoralis Major and Serratus Anterior
- Nipple surrounded by areolea (containing sebaceous glands)
What are Mammary Glands?
Modified sweat glands
Series of 15-20 ducts/secretory lobules
What is the role of Cooper’s Ligaments of the Breast?
Attaches and secures to dermis/pectoral fascia
Separates secretory lobules
State the blood supply of the Breast
Internal Thoracic Artery
Lateral Thoracic
Thoracoacromial
State three roles of the vulva
Sensory tissue during Sexual Intercourse
Assists in Micturition
Protects internal female organs from infection
What is the Mons Pubis
Anterior fat pad (to pubic symphysis) formed by fusion of labia majora
What are the Labia Majora?
Hair bearing external skin folds
Cover perineal body
Embryologically derived from labioscrotal swellings
What are the Labia Minora?
Hairless folds lying within the Labia Majora
Fuse anteriorly to form clitoral hood, and posteriorly to form fourchette
Derived from Urethral Folds
What is the Vestibule?
Area containing openings of urethra and vagina
What are Bartholin’s Glands?
Secrete lubricating mucous from small ducts either side of vaginal orifice in sexual intercourse
What is the Clitoris?
Formed of Erectile Corpus Cavernosa Tissue
Becomes engorged in stimulation
Derived from Genital Tubercle
Describe the arterial supply and lymphatic drainage of the Vulva
Pudendal Artery
Superficial Inguinal
Describe the sensory innervation of the Vulva
Anterior - Ilioinguinal, Genital Branch of Genitofemoral
Posterior - Pudendal, Posterior Cutaneous Nerve of Thigh
Describe the anatomical structure of the Vagina
Fibromuscular tube, normally collapsed with walls in contact with one and other
At upper end surrounds cervix, forming anterior and posterior fornix
Describe two clinical relevances of the Posterior Fornix
- Where a high vaginal swab should be taken from
- A reservoir for sperm, allowing it to liquify for easier cervical penetration
Describe the four histological layers of Vagina
Stratified Squamous Epithelium
Elastic Lamina Propria
Fibromuscular Layer (Inner Circular, Outer Longitudinal)
Adventitia
Describe the arterial supply of Vagina
Internal Iliac
Describe the lymphatic drainage of Vagina
Superior - External Iliac Nodes
Middle - Internal Iliac Nodes
Inferior - Superficial Inguinal Nodes
What is the Ectocervix?
Portion of the cervix extending into the Vagina
Opening is called External Os
Histologically Stratified Squamous Non Keratinised
What is the Endocervix?
AKA Endocervical Canal
Mucous Secreting Simple Columnar
Enters Uterine Cavity via Internal Os
Give two roles of the Cervix
Allows passage of Sperm
Maintains sterility of Upper Genital Tract (Narrow Os, Frequent Shedding, Thick Mucous)
Describe the normal position of the Uterus
Normally Antiverted and Antiflexed
Varies with bladder distension
What is the relevance of a Retroverted Uterus?
More vertical above Vagina therefore more likely to prolapse
State the three Histological layers of the Uterus
Perimetrium (continuous with abdominal peritoneum)
Myometrium
Endometrium
Describe the two endometrial sub layers
Deep Stratum Basalis - Doesn’t really change throughout menstrual cycle and isn’t shed
Superficial Stratum Functionalis - Proliferates in response to Oestrogen and becomes secretory in response to Progesterone. Regenerates from Stratum Basalis
What is the Broad Ligament?
Double layer of peritoneum attaching Uterus to Pelvis, helping maintain position
Made up of Mesometrium, Mesosalpinx, Mesovarium
What is the Round Ligament?
Remnants of the Gubernaculum
From Uterus to Labia Majora via Inguinal Canal (Maintains Antiversion)
What is the Ovarian Ligament?
Connects Ovaries to Uterus
What is the Cardinal Ligament?
The base of the broad ligament
Cervix to lateral pelvic walls
Contains Uterine Artery and Vein
What is the Pubocervical Ligament?
Attaches Cervix to Pubic Symphysis
What is the Uterosacral Ligament?
Attaches Uterus to Sacrum, providing support
How are the Fallopian Tubes adapted to assist ovum transport?
Inner Mucosa - Ciliated, Peg Cells (secretory, supply with nutrients)
Smooth Muscle - Contracts, Sensitive to Oestrogen
Name the four parts of the Fallopian Tube
Fimbriae
Infundibulum
Ampulla
Isthmus
Describe the Histology of the Ovaries
Surface - Simple Cuboidal Epithelium
Cortex - Stroma and Follicles
Medulla - Loose connective tissue and rich vasculature
Name the two ligaments associated with the Ovaries
Suspension (from mesovarium to pelvic wall)
Ovarian (to Fundus)
Where do the Ovarian Lymphatics drain to?
Para Aortic Nodes
Name three functions of the Pelvic Floor
Continence
Supporting Viscera
Resisting increased Intra abdo/ Pelvic Pressure
Name the three muscles of Levator Ani and their midpoint attachment
Puborectalis
Pubococcygeus
Iliococcygeus
Perineal Body
What is the Urogenital Diaphragm?
Anterior triangular fibrous structure
Name the three Perineal Muscles
Bulbospongiosus
Ischiocavernosus
Transverse Perineal
What is the role of FSH and LH respectively?
FSH stimulates Oestrogen production and Oogenesis
LH stimulates Progesterone production
Describe the order of pubertal changes in girls
Thelarche Pubarche Growth Spurt Menarche Adult Pubic Hair Breast Development
Describe Pubarche in Girls
Initially sparse, light and straight
Through it becomes thicker and darker
Axillary hair growth begins two years later
Describe Menarche
Normally occurs 1.5-3 years after Thelarche
Average age for Caucasians is 12.8 years, and 4-8m later for African American
Describe Growth Spurts during Puberty
Rises from increased stimulation from Testosterone/Oestrodiol
GH increases IGF1 and causes somatic growth by metabolic actions
The Ovarian Cycle can last between 20 and 35 days. Describe the follicular phase.
FSH stimulates Granulosa to convert androgens to oestrogen
LH stimulates Theca to produce Androgens
Follicle prepared for Ovulation
Oestrogen initially rises and exerts negative feedback until reaches positive
Inhibin released, inhibiting FSH and allowing LH surge
The Ovarian Cycle can last between 20 and 35 days. Describe the luteal phase.
Granulosa and Theca cells become vascularised today form Corpus Luteum
Corpus Luteum produces Inhibin and Progesterone
If fertilised, bHCG from Syncytiotrophoblast maintains Corpus Luteum
Describe the Proliferative Phase of the Uterine Cycle
Corresponds with follicular phase
Functional layer doubles in size in response to Oestrogen
Straight glands become coiled
Describe the Secretory phase of the Uterine Cycle
Glands become Secretory due to Progesterone
Functional Layer Sheds
Describe the hormonal changes in Menopause
Reduced Oestrogen, Progesterone and Inhibin
Increased FSH and LH
When does Fertility end graphically?
When decreasing follicle number intersects increasing proportion of poor quality
Describe the ‘Pre Menopause’ stage
Shortened follicular phase and more frequent LH Surges
Ovulation is early or absent
Describe the Perimenopause stage
Transition when Women begin to notice changes
Mood swings, Hot flushes
Describe the Post Menopausal risks
Osteoporosis (Type 1)
Atherosclerosis
Alzheimer’s
