Anatomy & Histology

Question 1

Where does the inguinal ligament attach between?

Answer 1

ASIS and pubic tubercle

Question 2

which anatomical landmark is your ‘sit bones’?

Answer 2

ischial tuberosities

Question 3

What are the 3 main joints associated with the pelvis?

Answer 3

sacroiliac joint
hip joint
pubic symphysis

Question 4

Which joint(s) assoc. with the pelvis is synovial?

Answer 4

sacroiliac (mostly synovial, posterior part = syndesmosis)

hip joint

Question 5

What type of joint is the pubic symphysis?

Answer 5

secondary cartilaginous

Question 6

which ligaments strengthen the joints of the bony pelvis? where do they attach between?

Answer 6

sacrospinous (sacrum & ischial spine) and sacrotuberous (sacrum & ischial tuberosity)

Question 7

What foramina are formed by the 2 pelvic ligaments?

Answer 7

greater & lesser sciatic foramen

Question 8

What is the function of the 2 ligaments which strengthen the pelvis?

Answer 8

ensures the inferior part of the sacrum isn’t pushed superiorly when weight is suddenly transferred vertically through the vertebral column
e.g. when jumping / in late pregnancy.

Question 9

describe a straddle injury of the pelvis.

Answer 9

fracture of all 4 pubic rami

Question 10

Describe the difference between the male and female pelvis.

Answer 10

AP and transverse diameters are > than male pelvis.

The subpubic angle & pubic arch is wider in female than male.

Question 11

What is “moulding” in regards to foetal skulls? What anatomical feature allows this to happen?

Answer 11

the movement of one bone over another to allow the foetal head to pass through the pelvis during labour.
the sutures and fontanelles (soft spots) allow the bones to do this.

Question 12

Which area is the vertex of the foetal skull?

Answer 12

the area outlined by the anterior and posterior fontanelles and the parietal eminences

Question 13

Which diameter of the foetal skull is longer than the other?

Answer 13

occipitofrontal diamter > biparietal

foetal head is longer than it is wide

Question 14

Name for the dense connective tissue layer in the outer shell of the ovarian cortex.

Answer 14

tunica albuginea

Question 15

What is the germinal epithelium?

Answer 15

a single layer of cuboidal cells which covers the tunica albuginea

Question 16

What is the name of the dominant follicle?

Answer 16

Graafian

Question 17

Describe the formation of oogonia.

Answer 17

During early embryonic development, germ cells from the yolk sac invade the ovaries and proliferate by mitosis to form oogonia.

Question 18

Describe the formation of oocytes.

Answer 18

Oogonia undergo development and division via meiosis to form mature oocytes (aka. ova)

Question 19

What is folliculogenesis?

Answer 19

growth of the follicle (consists of the oocyte and any associated support cells)

Question 20

What is atresia?

Answer 20

loss of oogonia and oocytes via an apoptosis-based process

Question 21

What makes up the primordial follicle?

Answer 21

primary oocyte + squamous cells

Question 22

When the follicle enters growth phase, the pre-granulosa cells turn from squamous to what?

Answer 22

cuboidal cells.

Question 23

Name the layer that forms in between the growing oocyte and its granulosa cells.

Answer 23

zona pellucida

Question 24

What space forms within the granola layer? What does this form?

Answer 24

the antrum begins to form and enlarge in the granulosa layer - it contains follicular fluid and forms a secondary follicle.

Question 25

what structure attaches the oocyte to the wall in a mature graafian follicle?

Answer 25

cumulus oophorus

Question 26

Imminent rupture of a follicle is preceded by visualisation of?

Answer 26

the follicular stigma

Question 27

What is the term for the oocyte and granolas cells once it has been released (ovulation)?

Answer 27

corona radiata

Question 28

What happens to the corpus luteum if no implantation occurs?

Answer 28

it will become white coloured connective tissue = corpus albicans (basically scar tissue)

Question 29

What happens to the corpus luteum when implantation occurs?

Answer 29

placenta secretes HCG which prevents degeneration of the corpus luteum for a time and so maintains progesterone levels (maintains the pregnancy).

Question 30

Describe the epithelium in the uterine tubes.

Answer 30

simple columnar epithelium ciliated cells secretory cells highly folded mucosa in ampulla smooth muscle in ampulla

Question 31

What are the layers of the uterine wall?

Answer 31

``` Endometrium = inner secretory mucosa (shed during periods) Myometrium = 3 SM layers + collagen + elastic tissue. Perimetrium = outer visceral covering of loose CT covered by mesothelium ```

Question 32

What is mesothelium?

Answer 32

flattened squamous-type epithelium

Question 33

What is the endometrium divided into?

Answer 33

stratum functionalis | stratum basalis

Question 34

Which layer of endometrium is shed monthly?

Answer 34

stratum functionalis - basalis regenerates it each month.

Question 35

when does the proliferative phase end?

Answer 35

around 1 day after ovulation

Question 36

Describe the appearance of glands during the secretory phase.

Answer 36

coiled with a corkscrew appearance and secrete glycogen

Question 37

Describe the stratum functionalis during the menstrual phase.

Answer 37

arterioles constrict --> ischaemia of tissue --> breakdown, blood leakage and sloughing.

Question 38

Describe the epithelium in the cervix.

Answer 38

mostly fibrous CT covered by stratified squamous epithelium on its vaginal surface. transitions to mucous secreting simple columns epithelium

Question 39

Describe the secretions of the endocervical glands during the different phases of the menstrual cycle.

Answer 39

proliferative phase - thin & watery | post-ovulation - thick and viscous

Question 40

What happens when the outlets of the endocervical glands become blocked?

Answer 40

results in expansion and formation of Nabothian cysts.

Question 41

Describe the 4 layers of the vagina.

Answer 41

Non-keratinised stratified squamous epithelium. Lamia propria Fibromuscular layer Adventitia

Question 42

Describe the lamina propria.

Answer 42

connective tissue rich in elastic fibres and thin-walled blood vessels.

Question 43

Describe the appearance of the outermost layer of the vagina during reproductive years.

Answer 43

non-keratinised stratified squamous epithelium - thicker and cells are enlarged due to glycogen accumulation (gives clear appearance).

Question 44

There are no glands in the wall of the vagina. How does it stay lubricated?

Answer 44

mucous from cervical glands and fluid from the thin walled blood vessels of the lamina propria

Question 45

How is the glycogen present within the walls of the vagina involved in host defence?

Answer 45

commensal bacteria metabolise the glycogen to lactic acid which inhibits growth of pathogenic bacteria.

Question 46

Skin containing highly oblique hair follicles, overlying a substantial subcutaneous fat pad which itself overlies the pubic symphysis.

Answer 46

mons pubis

Question 47

which sweat glands are abundant in the labia majora??

Answer 47

apocrine sweat glands and sebaceous glands

Question 48

Hair follicles are present all over the labia majora. | T/F?

Answer 48

False - only on outer surface

Question 49

Where in the body would you find apocrine sweat glands?

Answer 49

axilla, groin and labia majora

Question 50

Thin skin folds that lack subcutaneous fat and hair follicles but are rich in vasculature and sebaceous glands.

Answer 50

labia minora

Question 51

Describe the secretion of sebum from the sebaceous glands in the external genitalia.

Answer 51

sebum secreted directly onto surface of skin (unusual)

Question 52

From which artery do the major arteries of the pelvis and perineum arise from?

Answer 52

internal iliac artery

Question 53

There are 2 lateral pelvic wall arteries that are exceptions to normal rule of their origin.Which arteries are these and where do they arise from?

Answer 53

gonadal artery - L2 abdominal aorta | superior rectal artery - continuation of IMA (L3)

Question 54

The arteries supplying the pelvis have a posterior and anterior division. What are the main branches of the posterior division?

Answer 54

gluteal arteries

Question 55

What is the remnant of the umbilical artery called?

Answer 55

median umbilical ligament

Question 56

Which artery is part of the anterior division of pelvic arteries and exits the pelvis via greater sciatic foramen and re-enters perineum via lesser sciatic foramen?

Answer 56

internal pudendal artery

Question 57

List the anterior division pelvic arteries in males.

Answer 57

``` obturator artery superior and inferior vesical arteries prismatic branch of inferior vesicle artery middle rectal artery internal pudendal artery median umbilical ligament ```

Question 58

Which artery supplies the corpus spongiosum and glans penis?

Answer 58

dorsal artery

Question 59

Which artery supplies the corpus cavernosum?

Answer 59

deep artery (branch of internal pudendal)

Question 60

Which artery in the male perineum is the exception to rule of origins? Where does it come from?

Answer 60

anterior scrotal artery is branch of external iliac artery

Question 61

Which artery needs to ligated during hysterectomy? What do surgeons need to watch out for?

Answer 61

uterine artery ureter is in very close proximity to artery water under bridge

Question 62

What is the difference that is seen in male and female pelvic arterial supplies?

Answer 62

males have superior and inferior vesical arteries females only have superior vesical arteries vaginal artery (branch of uterine artery) is said to be the equivalent of the male inferior veiscal artery

Question 63

What are the main anastomoses in the female pelvis?

Answer 63

uterine & ovarian artery | uterine & vaginal artery

Question 64

List the main branches of the internal pudendal artery.

Answer 64

inferior rectal perineal labial arteries dorsal artery of clitoris

Question 65

Which vein do most venous plexuses of the pelvis drain to?

Answer 65

internal iliac vein

Question 66

Which veins drain to the hepatic portal system?

Answer 66

superior rectal veins --> splenic vein --> hepatic portal system

Question 67

Where do the lateral sacral veins drain to?

Answer 67

lateral sacral veins --> internal vertebral venous plexuses --> within vertebral canal

Question 68

describe the route of the gonadal veins

Answer 68

right gonadal vein --> IVC | left gonadal vein --> left renal vein --> IVC

Question 69

Which nerves of the lateral wall are parasympathetic?

Answer 69

pelvic splanchnic nerves

Question 70

Name all the lymphatics of the pelvis.

Answer 70

``` para-rectal sacral superficial inguinal deep inguinal external iliac internal iliac common iliac inferior mesenteric lumbar ```

Question 71

Describe the route of lymph from superior pelvic viscera.

Answer 71

External iliac nodes --> common iliac --> aortic --> thoracic duct --> venous system

Question 72

Describe the route of lymph from inferior pelvic viscera.

Answer 72

Deep perineum --> internal iliac nodes --> common iliac --> aortic --> thoracic duct --> venous system

Question 73

Describe the route of lymph from superficial perineum.

Answer 73

Superficial inguinal nodes --> external iliac --> common iliac --> aortic --> thoracic duct --> venous system

Question 74

Which structures of the superficial perineum are exceptions for lymph drainage and go to the deep inguinal nodes first?

Answer 74

clitoris and glans penis

Question 75

what is trans-peritoneal spread?

Answer 75

disease can penetrate through the peritoneal layer and disseminate into the peritoneal cavity