Anatomy of Female Reproductive System Flashcards by Nicolas Persson

The female reproductive system is located where?

Within both the pelvic cavity and the perineum

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What parts of the female reproductive system lie in the pelvic cavity?

Ovaries
Uterine / Fallopian tubes
Uterus
Superior part of vagina

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What parts of the female reproductive system are found in the perineum?

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

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Describe the peritoneum in the female

Inferior part of parietal peritoneum - forms floor of peritoneal cavity and roof over pelvic organs

Covers the superior aspect organs

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What pouches are found in females?

Vesico-uterine pouch (utero-vesico)

Recto-uterine pouch (pouch of Douglas)

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Label these pouches found in females

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What is the broad ligament of the uterus?

Double layer of peritoneum
Extends between the uterus and the lateral walls and floor of pelvis

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What does the broad ligament of the uterus do?

Helps maintain the uterus in its correct midline position

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What does the broad ligament of the uterus contain?

The fallopian(uterine) tubes and the proximal part of the round ligament

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What is the round ligament of the uterus?

An embryological remnant
Attaches to lateral aspect of the uterus
Proximal part is contained within broad ligament

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Where does the round ligament of the uterus pass through?

The deep inguinal ring to attach to the superficial tissue of the female perineum

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

Perimetrium
Myometrium
Endometrium

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Why is the body of the uterus important?

Implantation of zygote occurs in body of uterus

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If implantation occurs anywhere but the body of the uterus, its called a ?

Ectopic pregnancy

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Fallopian tube (uterine tube)

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What is the most common position of the uterus?

Anteverted and anteflexed

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Describe what anteflxed and anteverted means in terms of the most common position of the uterus

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What is the normal variation of the position of the uterus?

The uterus is held in position by 3 levels of support, which are?

Number of strong ligaments (e.g. uterosacral ligaments) Endopelvic fascia Muscles of pelvic floor (e.g. levator ani)

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Where does fertilisation occur?

In the ampulla of the fallopian (uterine) tube Usually do not lie symmetrically

What is "salpinx" the greek word for?

tube

What is a bilateral salpingo-oophrectomy?

Removal of both Fallopian tubes and ovaries

What is a unilateral salpingectomy?

Removal of one of the fallopian tubes

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Where does the fimbriated end of the Fallopian tubes open into?

the peritoneal cavity - communication between the genital tract and the peritoneal cavity Thus, in theory, infection could pass between these two areas

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Where are ovaries located and what size are they?

Almond sized and shaped - located laterally in the pelvic cavity

Where do the ovaries develop?

On posterior abdominal wall and move onto the lateral wall of the pelvis (the round ligament of the uterus)

Ovaries secrete what hormones?

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

What is the vagina?

A muscular tube whose walls are normally in contact, except superiorly where the cervix holds them apart forming a fornix (space around the cervix)

A fornix has 4 parts which are?

Anterior Posterior 2x lateral

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The walls of the vagina are usually?

Collapsed

The clinician must be able to see what in order to perform a cervical screening procedure?

Cervix

What must be sampled in cervical screening procedure?

Squamo columnar junction (transformation zone)

How is a cervical screening procedure performed?

Brush is inserted into the external cervical os with firm pressure and rotated

During a vaginal digital examination, what can be palpated?

Position of the uterus - assessed by bimanual palpation

What does palpation of the adnexae involve?

Uterine tubes and ovaries Can detect large masses or tenderness affecting these structures

What kind of a muscle is the levator ani muscle?

Skeletal muscle (voluntary control)

What forms the majority of the pelvic diaphragm, with its fascial coverings?

Levator ani muscle

What does the levator ani muscle do?

Provides continual support for the pelvic organs Tonic contraction Reflexively contracts further during situations of increased intra-abdominal pressure

What is the levator ani muscle supplied by?

Nerve to levator ani (S3,4,5 sacral plexus) dual supply?

What is the perineum?

Shallow space between pelvic diaphragm and skin

The perineum is divided into?

Superficial and deep pouches

What are the openings in the pelvic floor?

passage of distal parts of alimentary, renal and reproductive tracts from pelvis to perineum

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What are the perineal muscles?

Superficial and deep

What nerve supplies the perineal muscles?

Pudendal nerve

What is the perineal body?

bundle of collagenous and elastic tissue into which the perineal muscles attach

Why is the perineal body important?

Important to pelvic floor strength Can be disrupted during labour

Where is the perineal body?

Located just deep to skin

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Where is the bed of breast?

from ribs 2-6 Lateral border of sternum to mid-axillary line

What does the female breast lie on?

On deep fascia covering pectorals major and serrates anterior

What space lies between fascia and breast?

Retromammary space

The female breast firmly attaches to skin via?

Suspensory ligaments

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If a lump in the breast is felt, how do we describe its position and how do we assess it?

If a lump in the breast is felt, what others areas should also be assessed?

Axilla Supraclavicular area

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Most lymph (>75%) from the breast drains into?

Ipsilateral axillary lymph nodes and then into supraclavicular nodes

Lymph from inner breast quadrants can drain to?

The parasternal lymph nodes

Lymph from lower inner breast quadrant can drain to?

Abdominal lymph nodes

Lymph from the upper limb drains to?

The axillary lymph nodes

What is contained in the axilla and what is it all embedded in?

- brachial plexus branches - axillary artery (& branches) and axillary vein (& tributaries) - axillary lymph nodes - all embedded in axillary fat

Describe level 1, II and III axillary node clearance

Level I – inferior and lateral to pectoralis minor - Level II – deep to pectoralis minor - Level III – superior and medial to pectoralis minor

What is the blood supply and drainage to the breast?