Anatomy/embryology Flashcards
C-section layers (11)
Skin, campers, scarpa, external oblique, internal oblique, transverse abdominus, transversalis fascia, fat, parietal peritoneum, loose peritoneum, uterus
what developmental age does the intermediate mesoderm and genital swellings arise
4 wks postfertilization; 6wks gestational
what does the intermediate mesoderm give rise to?
ovaries, fallopian tubes, uterus, upper 2/3 vagina, urinary system components (kidneys)
what does the genital swellings give rise to?
urogenital sinus, external genitalia, lower 1/3 vagina
what is the male determinant
Y chromosome, SRY factor or testis-determining factor
what is the female determining factor
WNT4 –ovary determining factor. when wnt4 is present and SRY is absent this is female
when do the structural gonads develop?
7th wk or 9th gestational wk
when do the external genitalia develop?
12 wk, 14 gestational
when do the ovaries develop
10wks, 12 wks gestational
what is the gubernaculum
ovary attached to mesenchymal condensation that facilitates normal migration, gives rise to suspensatory ligament of the ovary
what is the ovary composed of?
oocytes from primordial germ cells and follicular cells that compose the wall of thee follicle from cortical cords derived from mesonephros
another name for mesonephric ducts
wolffian ducts
another name for the paramesonephric ducts
mullerian ducts
In the female embryo what happens to the mesonephric ducts?
they degenerate and vanish
what happens to the paramesonephric ducts in female embryos
they develop into the fallopian tubes, uterus, upper 2/3 vagina
what gives rise to the paramesonephric ducts
invaginations of the epithelium of urogenital ridges
what do the mullerian (paramesonephric) ducts do? How do they develop?
the ducts grow caudally until contacting the posterior wall of the urogenital sinus to form the vaginal plate and then the vagina. above the vaginal plate the ducts fuse to form the cervix and uterus. cranial end remain separate to form the fallopian tubes.
what do the mesonephric ducts form? (male embryo)
epididymis, ductus deferens, ejaculatory ducts.
what forms the labia majora
labiosacral swellings
what forms the labia minora
unfused urogenital folds
paramesonephric ducts form what? another name for them is what
fallopian tubes, uper 2/3 vagina, uterine corpus and cervix. mullerian ducts
what does the urogenital sinus form
lower 1/3 vagina, skenes glands, bartholin glands
why are the skene’s glands and bartholin glands clinically important
becasue they can become infected, inflamed, present with cysts. trichomonas vaginalis infection
what does the sacrum articulate on
coccyx inferiorly and the 5th lumbar superiorly
what are the pelvic viscera
uterus, vagina, bladder, fallopian tubes, ovaries, distal rectum
what does the lesser pelvis consist of and what is another name
sacrum and coccyx posteriorly, pelvic ischium bilaterally, symphysis pubis anteriorly
true pelvis
what does the greater pelvis consist of and what is another name for it>
lumbar vert posteriorly, iliac fossa bilaterally, abdominal wall anteriorly
what are the four types of female pelvis
gynecoid, anthropoid, android and platypelloid
gynecoid
round 40-50% women
anthropoid
oval-long (25% women)
android
wedge 20%
platypelloid
oval-wide (2-5%)
what does the vulva consist of
labia minora, labia majora, mons pubis, clitoris, vestibule, ducts of the vestibular glands
what is the purpose of bartholin glands
open into the vestibule and assist in vaginal lubrication during sexual arousal.
what is the blood supply to the vagina
vaginal artery off of the internal iliac (hypogastric artery)
what is the cervical fornix
the area of the vagina around the cervix; typically discussed as the posterior, anterior, left and right lateral fornices.
what lies immediately behind the posterior fornix
the floor of the pouch of douglas, of the posterior cul-de-sac.
what is dinoprostone
vaginal insert or pessary that ripens the cervix for induction of labor,. ideally placed in the posterior vaginal-cervical fornix
external os
cervical opening directed into the vagina
internal os
cervical opening directed into the uterus
what cell type makes up the outer cervical epithelium
non-keratinizing sqaumous, same as vagina
what cell type makes up the endocervix to edge of the transformation zone
columnar epithelium
what is the transformation zone
where the endocervical columnar epithelium meets the squamous epithelium of the ectocervix and vagina.
what is the squamocolumnar junction
most caudal portion of the transformation zone
infancy and early childhood squamocolumnar junction
on upper 2/3 of vaginal wall
adolescence and menstrual years squamocolumnar junction
ectocervix
squamocolumnar junction of menopause
rises up inside the cervical canal.
what is the uterine isthmus
junction of the cervix and corpus
what is the uterine cornu
junction of uterus and fallopian tube
uterine fundus
portion of corpus between the two cornu.f
what composes the uterine wall
endometrium, myometrium, serosa
endometrium describe tissue
inner mucosa, simple columnar epithelium with underlying stroma that changes during menstrual cycle
describe myometrium tissue
smooth muscle
describe the serosa tissue
thin outer layer of connective tissue distinct from the parametrium
what happens to the uterus throughout the menstrual cycle
proliferates, vascularizes and converts to secretory phase after ovulation. eventually sloughing off.
what is the broad ligament
peritoneal sheet that overlies the structures adjacent to the uterus; acts as a conduit for vessels such as the uterine artery, vaginal artery and ureters.
why is the broad ligament clinically relevant
for surgery it is must-find and important due to its vascularity.
what is the infundibulopelvic ligament
connects the ovary to the posterior abdominal wall and carries the ovarian artery and vein and lymphatics.
uterosacral ligament
connects uterus at level of cervix to sacrum
cardinal ligament
lateral attachment uterus/cervix immediately inferior to uterine artery.
uterine blood supply
primary uterine arterties with some contribution from the vaginal
venous drainage
uterine vein to pelvic venous plexus
where is the ureter compared to the uterine artery
at the point where the artery meets the uterus, ureter is deep to the uterine artery about 1.5-3cm
what arteries come off of the internal iliac to support female anatomy
uterine artery, vaginal, middle rectal and internal pudendal.
why are uterine hemorrhages complex
due to the collateral blood supply
sampson’s artery where and what
runs under the round ligament and is the anastomosis of the uterine and ovarian arteries
clinical significance of Sampson’s artery
actually is an insignificant artery that is dissected during hysterectomy. it can be a cause of bleeding, but rarely poses a hemodynamic risk for the patient. and it is easily cauterized and sutured to prevent bleeding.
where do the ureters course through the pelvis
pelvic brim, cardinal ligament, insertion into the urinary bladder
Ureter at pelvic brim
at junction between true and false pelvis, ureter is immediately below the bifurcation of the common iliac into internal and external branches. Infundibulopelvic ligament joins posterior peritoneum at this point as well
Ureter at cardinal ligament
major supporting ligament of uterus, inserts bilaterally at level of cervix, ureter courses medially and inferiorly from pelvic brim to pass through thee cardinal ligament about 1.5-3cm below the superior edge of the ligament.
cardinal ligament above ureter to superior edge
membranous portion of ligament
which way does the uterine artery course in the cardinal ligament
laterally to medially
what are the anatomical components of the fallopian tube?
fimbrae, infundibulum, ampulla, isthmus.
what are the layers of the wall of the uterus from external to internal
perimetrium, myometrium, endometrium
where is the fundus of the uterus
the apex.
what ligament is at the level of cervix
the uterosacral ligament
