Anatomy: Female Reproductive Tract

Question 1

What contains the neurovascular supply of the ovary?

Answer 1

Suspensory ligament

Question 2

What is another name for the suspensory ligament?

Answer 2

Infundibulopelvic Ligament

Question 3

What space does the ovary lie in?

Answer 3

Lateral pelvic ovarian fossa:

Question 4

What are the boundaries of the ovarian fosa?

Answer 4

External iliac vessels

Ureter (Do not cut!)

Question 5

What is the blood supply of the ovary?

Answer 5

Ovarian artery from aorta through suspensory ligament

Uterine artery in cardinal ligament can also be in ovarian ligament… smaller percent

Question 6

If ovarian artery is ligated and bleeding is occuring, look at what?

Answer 6

Uterine artery in cardinal ligament through ovarian ligament from uterus

Question 7

What is the most common places for ectopic implantation site?

Answer 7

1. Uterine tube itself

2. Rectouterine pouch of douglas

Question 8

What ways can women stop fetility?

Answer 8

Get tubes ligated/cauterized

E coil blocks

Question 9

What are the three parts fo the broad ligament?

Answer 9

Mesometrium (bulk)
Mesoavarium
Mesosalpinx

Question 10

What does the mesometrium contain? mesosalpinx? mesovarium?

Answer 10

Metrium: uterine artery
Ovarium: Ovary
Salpinx: tube

Question 11

What is the relationship between the uterer and the uterine artery/vein?

Answer 11

“Water under the bridge”
Ureter takes a 90* turn under the vessels
Uterer is under the uterine vessels

Question 12

What is the blood supply of the uterus?

Answer 12

Ovarian (in suspensory ligament)
Uterine (within cardinal ligament situated just at base of broad ligament, crosses under ureter)
Vaginal (branch from inferior vesicle supplies upper portion of vagina)

Question 13

What arteries can anasthemose?

Answer 13

Uterine and ovarian

Question 14

What is the position of the uterus in the pelvis?

Answer 14

Anteverted

Anteflexed

Question 15

Why lies on top of the uterus, mostly?

Answer 15

Small intestine

Question 16

What lies under the uterus, mostly?

Answer 16

Bladder (vesiclar surface)

Question 17

What two angles are in the uterus?

Answer 17

Uterus

Cervix

Question 18

What is first degree prolapse?

Answer 18

Into cervical canal

Question 19

What is second degree prolapse?

Answer 19

Into vaginal canal

Question 20

What is third degree prolapse?

Answer 20

External eversion of uterus

Question 21

Why do you get prolapse?

Answer 21

You lose normal supportive structures

Question 22

What is one of the main supoorting strucutres of the uterus?

Answer 22

Anteflexion
Anteversion
(normal position)

Question 23

When does prolapse normally occur?

Answer 23

Late in life, 80’s/90’s

Question 24

Who else can prolapse happen in?

Answer 24

Traumatic births… tearing of structures

Question 25

What fornices are in vagina?

Answer 25

Posterior Anterior Laterals

Question 26

What can be plapated via the vaginal walls?

Answer 26

Posterior: rectum Anterior: bladder

Question 27

What is the term for using the posterior fornix to enter or visualize the peritoneal space?

Answer 27

Colposcopy "Colpy" | this is a sterile space, be cautious!

Question 28

What is a rectocele?

Answer 28

A herniation of the rectum into the posterior vaginal wall

Question 29

Cycstocele?

Answer 29

Herniation of bladder into anterior vaginal wall

Question 30

What is a enterocele?

Answer 30

Herniation of colon into posterior vaginal wall

Question 31

What fistulas were mentioned?

Answer 31

Urethrovaginal Vesicovaginal Vaginoperineal Rectovaginal

Question 32

What pouch are external genitalia found in?

Answer 32

Superficial pounch

Question 33

What provides sexual lubrication in female?

Answer 33

Vestibular (bartholin's) glands

Question 34

What is the function of the ischiocavernossus muscles?

Answer 34

Compress crus to erect clitoris with blood

Question 35

What two ways is the bulbospongious functional in females?

Answer 35

1. compress deep dorsal vein by wrapping around clitoris to engorge erection 2. sphincter of vaginal oraface

Question 36

What is the blood supply of the clitoris?

Answer 36

Dorsal artery to clitoris Deep artery to clitoris -from the Dorsal nerve

Question 37

What is the innervation of the clitoris?

Answer 37

Dorsal nerve of the clitoris | -from internal pudendal artery

Question 38

What clitoral artery is for erection?

Answer 38

``` deep artery (dorsal artery supplies more superficial structures) ```

Question 39

What artery does the blood supply of the clitoris come from?

Answer 39

Internal pudendal artery

Question 40

What parasympathetic

Answer 40

Preganglionic PNS cells bodies in S2/S4 Goes to inferior hypogastric plexus lining the floor of the pelvis Synapse with postganglionics Postganglionics travel with cavernous nerves to facilitate deep artery dilation and allow erection

Question 41

What are the 2 muscles of the floor of the pelvis?

Answer 41

Levator ani | Coccygeus

Question 42

What is cutting the UG diaphragm in labor called?

Answer 42

Episiotomy | -Posterior or

Question 43

What types of episiotomy are done?

Answer 43

lateral | mediolateral

Question 44

What are the muscles of the UG diaphragm?

Answer 44

Ischio Bulbo deep transverse perineal Supergicial transverse perineal

Question 45

What are the options for regional anesthesia in childbirth??

Answer 45

Spinal nerve block at L3/L4 (cant move legs or utuerus ) Caudal epidural (still move legs and euterus to push ) Pudendal (ischial spine target, cant feel perineum, good for episiotomy)

Question 46

What is the obstentrical conjugate?

Answer 46

Pubic symphysis to sacral promitory distance

Question 47

What is a good estimate of the obstentrical conjugate?

Answer 47

Finger tip on sacral promontory to distance to pubic symphysis on palm

Question 48

What is the interspinous diameter?

Answer 48

Spine to spine | Changes during labor