Anatomy- female reproductive system and breast Flashcards
Define what is meant by the perineum
Area below levator ani
What are the two pouches of the female peritoneum?
Recto-uterine pouch (of Douglas)
Vesico-uterine pouch
What is the clinical significance of the pouch of Douglas?
Most inferior part of the peritoneal cavity- this is where abnormal fluid will collect in the anatomical position
How can abnormal fluid collection in the pouch of douglas be drained?
Needle passed through the posterior fornix of the vagina
Double layer of peritoneum extending between the uterus and lateral walls/floor of the pelvis, maintaining the midline position of the uterus
Broad ligament
Round ligament
Extends from the lateral uterus (within the broad ligament) to the superficial tissue of the female perneum
What structure does the round ligament pass through?
Deep inguinal ring
Three structures which help maintain the position of the uterus and prevent prolapse
Pelvic floor muscles
Uterosacral ligaments
Endopelvic fascia
Typical position of the uterus within the pelvis
Anterverted and anteflexed (over the bladder)
Which area of the cervix is sampled during a smear test?
The squamocolumnar junction
Where does fertilisation usually occur?
The ampulla (widest part) of the fallopian tubes
How can tubal patency be tested during hysterosalpingogram?
Radio-opaque dye should spill out into the peritoneal cavity
Which structures suspend the ovary in the pelvis?
The ovarian ligament
The ovarian suspensory ligament
At its deepest part what does the vagina form?
Four fornices around the cervix
What can be palpated during bimanual vaginal examination?
The ischial spines (laterally at 4 and 8 oclock)
Position of the uterus
The adnexae (for any mass/tenderness)
What nerve supplies the pelvic diaphragm?
Nerve to levator ani from sacral plexus
Which nerve roots form the sacral plexus?
S3, 4, 5
Which nerve supplies the perineal muscles?
Pudendal nerve branches
Bundle of collagennous and elastic tissue between the lower part of the vagina and anus
Perineal body
Alternative name for Bartholins gland
Greater vestibular gland
Describe the position of the breast bed
From ribs 2-6, lying on deep fascia above the pec. major and serratus anterior muscles
Space lying between fascia and breast
Retromammary space
Extension of the breast into the axilla
Axillary tail of Spence
How is the position of a breast lump described?
By clock face position, or quadrant e.g. upper inner
What feature of any breast lump should be assessed by asking the patient to stand with hands firmly on hip?
Fixation of lump to underlying tissues
Where does 75% of lymph from the breast drain to?
The ipsilateral axillary nodes, and from there to the supraclavicular
What might be the consequence of axillary node clearance?
Upper limb lymphoedema
How are the “levels” of axillary lymph nodes described?
By their relationship to pectoralis minor:
Level 1- lateral and inferior
Level 2- deep
Level 3- medial and superior
Blood supply to the breast
Laterally- branches of the axillary
Medially- branches of the internal thoracic
(similar pattern for venous drainage)
