Anatomy - Female Reproductive System and the Breast Flashcards
What components of the female reproductive system lie in the pelvic cavity?
Ovaries
Uterine tubes
Uterus
Superior part of vagina
What components of the female reproductive system make up the perineum?
Inferior part of vagina
Perineal muscles
Bartholin’s glands
Clitoris
labia
What is the clinical significance of the pouch of douglas? (rectouterine pouch)
Excess abnormal fluid within the peritoneal cavity tends to collect here (most inferior part of the peritoneal cavity in anatomical position)
What are the two pouches the peritoneum forms?
vesico-uterine
recto-uterine (pouch of douglas)
What forms the floor of the peritnoeal cavity and the roof over pelvic organs?
the inferior part of parietal peritoneum
How can fluid collection in the pouch of douglas be drained?
A needle passed through the posterior fornix of the vagina
Label the 2 pouches.
What is the broad ligament of the uterus?
double layer of peritoneum
What does the broad ligament of the uterus do?
helps maintain the uterus in its correct midline position
What does the broad ligament of the uterus contain in it?
the uterine tubes and the proximal part of the round ligament
Label this diagram
What is the round ligament of the uterus?
An embryological remnant
Where is the broad ligament of the uterus?
It extends between the uterus and the lateral walls and floor of the pelvis
Where does the round ligament attach? Where does it pass through?
To the lateral aspect of the uterus
Passes through the deep inguinal ring to attach to the superficial tissue of female perineum
What are the 3 parts of the broad ligament of the uterus?
mesometrium - uterus
mesosalpinx - tubes
mesovarium - ovary
How is the uterus held in position?
Levels of support:
number of strong ligaments (e.g. uterosacral ligaments)
endopelvic fascia
muscles of pelvis floor (e.g. levator ani)
What happens with weakness of the uterine supports?
Uterine prolapse - movement of the uterus inferiorly
What are the 3 layers of the body of the uterus?
perimetrium
myometrium
endometrium
What layer of the uterus is shed during the menstrual cycle?
endometrium
Where does implantation of the zygote occur?
Body of uterus
Label this diagram.
What is the most common position of the uterus?
Anteverted and anteflexed
What is normal variation for the position of the uterus?
retroverted and retroflexed
What must be sampled in a cervical smear?
the squamocolumnar junction (transformation zone)
Where does fertilisation occur?
the ampulla
Label this diagram of a fallopian tube.
Where is there comminucation between the genital tract and the peritoneal cavity?
The fimbirated end of the uterine tubes - they open into the peritoneal cavity
Where do the ovaries develop?
On the posterior abdominal wall and move onto lateral wall of the pelvis
What are the 4 parts of the fornix?
anterior
posterior
2 lateral
What is a fornix?
The space around the cervix where the cervix holds the vagina walls apart
Where can ischial spines be palpated on vaginal examination?
4 and 8 oclock
What is the perineum?
Shallow space between pelvic diaphragm and the skin
What forms the majority of the pelvix diaphragm?
levator ani muscle
What does the levator ani muscle do?
provides continual support for the pelvic organs
- tonic contraction
What is the innervation of levator ani?
S2,3,4 sacral plexus
What nerve supplies the perineal muscles?
pudendal nerve
What is the perineal body?
A bundle of collagenous and elastic tissue
attachment of: external anal sphnicter, external urethral sphincter, bulbospongious, superficial and deep transverse perineal muscles, levator ani
Located just deep to skin
What could an enlarged Bartholin’s gland indicate?
infection
Where does the bed of breast extend?
from ribs 2-6
lateral border of sternum to mid axillary line
Where is the retromammary space?
Lies between fascia and breast
Where do the breasts lie?
On deep fascia covering pec major and serratus anterior
Where does lymph from the breast drain to?
Most to ipsilateral axillary lymph nodes then to supraclavicular nodes
inner breast quadrants: can drain to parasternal
lower inner breast quadrants: can drain to abdominal
Where does lymph from the upper limb drain to? What is the clinical significance of this?
Axillary lymph nodes
If axillary nodes are removed (axillary node clearance) in treatment for breast cancer, can result in lymphedema
How is the extent of axillary clearance desrcibed?
‘levels’
the position of each can be described in relation to pectoralis minor
1 - inferior and lateral to
2 - deep to
3 - superior and medial to
What does the pyramidal passageway between arm and chest contain?
brachial plexus branches
axillary artery and vein (and branches and tributaries)
axillary lymph nodes
What is the blood supply to the female breast? What is the venous drainage?
medial breast - internal thoracic artery (From subclavian)
lateral breast - axillary artery
venous drainage - axillary and thoracic veins
Label this diagram.
What makes up the pelvic diaphragm?
levator ani and coccygeus
levator ani: pubococcygeus + iliococcygeus
Where are the bulbourethral glands in the male? What glands are homologous in females? Where are they?
deep pouch
Batholin’s glands - in superficial pouch
What are the spinal nerve roots of the pudendal nerve?
S2, S3, S4
keeps the poo off the floor
Label the colours in this diagram.
