ANATOMY OF FEMALE REPRODUCTION SYSTEM

Question 1

Female reproductive system lies within both the ______ and the _______

Answer 1

Pelvic cavity and perineum

Question 2

What lies in the pelvic cavity?

Answer 2

Ovaries
Uterine tubes
Uterus
Superior part of vagina

Question 3

What lies in the perineum?

Answer 3

Inferior part of vagina 
Perineal muscles 
Bartholin's glands 
Clitoris 
Labia

Question 4

What are the true reproductive organs?

Answer 4

Ovaries - everything else is secondary/accessory

Question 5

What is the peritoneum?

Answer 5

A thin, transparent serous membrane that secretes a small amount of peritoneal fluid.
Lines the walls of the abdominal cavity and wraps the organs of the abdominal cavity

Question 6

What does the inferior part of parietal peritoneum form?

Answer 6

The floor of the peritoneal cavity

The roof over the pelvic organs

Question 7

What two pouches does the it form when covering the superior aspect of organs?

Answer 7

Vesico-uterine (utero-vesico)

Recto-uterine (Pouch of Douglas) - one of the lowest points of the peritoneal cavity in the upright female patient

Question 8

What forms the broad ligament of the uterus?

Answer 8

When the anterior and posterior layers of the peritoneum fuse together under the uterine tubes

Question 9

What does the broad ligament of the uterus contain?

Answer 9

Contains within it the uterine tubes and (the proximal part of) the round ligament
- Helps maintain the uterus in its correct midline position

Question 10

How does the round ligament of the uterus form?

Answer 10

It is an embryological remnant - left over from the gubernaculum (a fibrous cord that helps guide the ovaries into their final position)

Question 11

What are the 3 layers of the body of the uterus?

Answer 11

Perimetrium
Myometrium - thick muscular layer
Endometrium - what is shed as menstruation

Question 12

What holds the uterus in place?

Answer 12

A number of strong ligaments e.g. uterosacral ligaments - attach to neck of uterus
Endopelvic fascia - a ‘connective tissue packaging’ that fills in any spaces
Muscles of the pelvic floor e.g. elevator ani

Question 13

Weakness in uterine support can result in what?

Answer 13

Uterine prolapse - movement of the uterus inferiorly

Question 14

What is the most common uterus position in the pelvic cavity?

Answer 14

Anteverted and ante flexed

Question 15

What does anteverted mean?

Answer 15

Cervix is tipped anteriorly relative to the axis of the vagina

Question 16

What does anteflexed mean?

Answer 16

Uterus tipped anteriorly relative to the axis of the cervic (the mass of the uterus lies over the bladder

Question 17

What is a normal variation in cervix position?

Answer 17

Retroverted and retroflexed

Question 18

What does retroverted mean?

Answer 18

Cervix tipped posteriorly relative to the axis of the vagina

Question 19

What does retroflexed mean?

Answer 19

Uterus tipped posteriorly relative to the axis of the cervix

Question 20

Where does fertilisation occur?

Answer 20

The ampulla of the uterine tubes

Question 21

What is a bilateral sapling-oophrectomy?

Answer 21

Removal of both uterine tubes and ovaries

Question 22

What is a unilateral salpingectomy?

Answer 22

Removal of one uterine tube

Question 23

Describe the location of the ovaries

Answer 23

Almond sized and shaped located laterally in the pelvic cavity - they sit in the ovarian fossa (a dip in the lateral walls of the pelvis)

Question 24

Where do the ovaries develop?

Answer 24

On the posterior abdominal wall and move onto the lateral wall of the pelvis
Guided into place by the gubernaculum which leaves the round ligament of the uterus as a remnant

Question 25

What hormones do the ovaries secrete?

Answer 25

Oestrogen and progesterone in response to anterior pituitary hormones FSH and LH

Question 26

What is the vagina?

Answer 26

A muscular tube who's walls are usually in contact - apart from the superior part which is held apart by the cervix forming a fornix

Question 27

What are the parts to the fornix?

Answer 27

1. Anterior 2. Posterior 3. 2x lateral - can be used for palpation

Question 28

What is the adnexae?

Answer 28

Joint term for the uterine tubes and ovaries together

Question 29

How do you palpate the uterus?

Answer 29

Place examining fingers into the lateral fornix Press deeply with the hand in the iliac fossa of the same side Repeat on opposite side

Question 30

Where can the ischial spines be palpated?

Answer 30

Laterally at 4 and 8 o'clock positions

Question 31

What is the perineum?

Answer 31

Shallow space between the pelvic diaphragm and the skin

Question 32

What shape is the perineum?

Answer 32

Diamond shaped - divided into 2 triangles (urogenital anteriorly and anal posteriorly)

Question 33

What does the lavatory ani muscle do?

Answer 33

Provides support for the pelvic organs

Question 34

What nerve supplies the elevator ani?

Answer 34

Nerve to levator ani | S3,4,5 sacral plexus

Question 35

What nerve supplies the perineal muscles?

Answer 35

Pudendal nerve

Question 36

What is the perineal body?

Answer 36

A bundle of collagenous and elastic tissue into which the perineal muscle attach Found between posterior aspect of the vestibule of the vagina and rectum

Question 37

Why is the perineal body important?

Answer 37

Important to pelvic floor strength | Can be disrupted during labour as located just deep to skin

Question 38

What do Bartholin's glands do?

Answer 38

A.k.a great vestibular gland - secretes a small amount of lubricating fluid for the opening of the vagina

Question 39

Where does the bed of the breast extend?

Answer 39

From ribs 2-6 | Lateral border of the sternum medially to mid-axillary line (due to axillary tail)

Question 40

Where do the breasts lie?

Answer 40

On the deep fascia covering the pec major and serrates anterior

Question 41

What is the retromammary space?

Answer 41

The space between the fascia and breast. Allows the breast to move relative to the pec major and serratus anterior i.e. the breast can move on the chest wall

Question 42

How is the breast tissue attached to the skin?

Answer 42

Via suspensory ligaments

Question 43

Where does most lymph from the breast drain?

Answer 43

Into the ipsilateral axillary lymph nodes and then to the supraclavicular nodes

Question 44

Where can lymph from the inner breast quadrants drain?

Answer 44

Into the parasternal lymph nodes

Question 45

Where can lymph from the lower inner breast quadrants drain?

Answer 45

To the abdominal lymph nodes

Question 46

Lymph from where else drains into the axillary lymph nodes?

Answer 46

The upper limb

Question 47

What is the blood supply and drainage to the breast?

Answer 47

The subclavian artery passes under the clavicle and becomes axillary, then lateral thoracic and internal thoracic (mammary) supply blood to the breast Same name for veins except venous instead of artery