Anatomy: Female Reproductive Tract Flashcards
What contains the neurovascular supply of the ovary?
Suspensory ligament
What is another name for the suspensory ligament?
Infundibulopelvic Ligament
What space does the ovary lie in?
Lateral pelvic ovarian fossa:
What are the boundaries of the ovarian fosa?
External iliac vessels
Ureter (Do not cut!)
What is the blood supply of the ovary?
Ovarian artery from aorta through suspensory ligament
Uterine artery in cardinal ligament can also be in ovarian ligament… smaller percent
If ovarian artery is ligated and bleeding is occuring, look at what?
Uterine artery in cardinal ligament through ovarian ligament from uterus
What is the most common places for ectopic implantation site?
- Uterine tube itself
2. Rectouterine pouch of douglas
What ways can women stop fetility?
Get tubes ligated/cauterized
E coil blocks
What are the three parts fo the broad ligament?
Mesometrium (bulk)
Mesoavarium
Mesosalpinx
What does the mesometrium contain? mesosalpinx? mesovarium?
Metrium: uterine artery
Ovarium: Ovary
Salpinx: tube
What is the relationship between the uterer and the uterine artery/vein?
“Water under the bridge”
Ureter takes a 90* turn under the vessels
Uterer is under the uterine vessels
What is the blood supply of the uterus?
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)
What arteries can anasthemose?
Uterine and ovarian
What is the position of the uterus in the pelvis?
Anteverted
Anteflexed
Why lies on top of the uterus, mostly?
Small intestine
What lies under the uterus, mostly?
Bladder (vesiclar surface)
What two angles are in the uterus?
Uterus
Cervix
What is first degree prolapse?
Into cervical canal
What is second degree prolapse?
Into vaginal canal
What is third degree prolapse?
External eversion of uterus
Why do you get prolapse?
You lose normal supportive structures
What is one of the main supoorting strucutres of the uterus?
Anteflexion
Anteversion
(normal position)
When does prolapse normally occur?
Late in life, 80’s/90’s
Who else can prolapse happen in?
Traumatic births… tearing of structures
What fornices are in vagina?
Posterior
Anterior
Laterals
What can be plapated via the vaginal walls?
Posterior: rectum
Anterior: bladder
What is the term for using the posterior fornix to enter or visualize the peritoneal space?
Colposcopy “Colpy”
this is a sterile space, be cautious!
What is a rectocele?
A herniation of the rectum into the posterior vaginal wall
Cycstocele?
Herniation of bladder into anterior vaginal wall
What is a enterocele?
Herniation of colon into posterior vaginal wall
What fistulas were mentioned?
Urethrovaginal
Vesicovaginal
Vaginoperineal
Rectovaginal
What pouch are external genitalia found in?
Superficial pounch
What provides sexual lubrication in female?
Vestibular (bartholin’s) glands
What is the function of the ischiocavernossus muscles?
Compress crus to erect clitoris with blood
What two ways is the bulbospongious functional in females?
- compress deep dorsal vein by wrapping around clitoris to engorge erection
- sphincter of vaginal oraface
What is the blood supply of the clitoris?
Dorsal artery to clitoris
Deep artery to clitoris
-from the
Dorsal nerve
What is the innervation of the clitoris?
Dorsal nerve of the clitoris
-from internal pudendal artery
What clitoral artery is for erection?
deep artery (dorsal artery supplies more superficial structures)
What artery does the blood supply of the clitoris come from?
Internal pudendal artery
What parasympathetic
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
What are the 2 muscles of the floor of the pelvis?
Levator ani
Coccygeus
What is cutting the UG diaphragm in labor called?
Episiotomy
-Posterior or
What types of episiotomy are done?
lateral
mediolateral
What are the muscles of the UG diaphragm?
Ischio
Bulbo
deep transverse perineal
Supergicial transverse perineal
What are the options for regional anesthesia in childbirth??
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)
What is the obstentrical conjugate?
Pubic symphysis to sacral promitory distance
What is a good estimate of the obstentrical conjugate?
Finger tip on sacral promontory to distance to pubic symphysis on palm
What is the interspinous diameter?
Spine to spine
Changes during labor
