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Repro > Anatomy of the Female Reproductive System (Cantrell) > Flashcards

Anatomy of the Female Reproductive System (Cantrell) Flashcards

SORRY this was the longest deck ever

1
Q

term for the female external genitalia

A

vulva

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2
Q

superior pole of the ovary is the ____ end

A

tubal

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3
Q

inferior pole of the ovary is the ____ end

A

uterine

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4
Q

each ovary id suspended from the uterus by the

A

ovarian ligament

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5
Q

Which pole of the ovary does the ovarian ligament connect to?

A

inferior

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6
Q

the suspensory ligament of the ovary connects the ovary to the…

A

lateral wall of the pelvis

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7
Q

are remnants of the gubernaculum

A

ovarian ligament and round ligament

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8
Q

boundaries of the ovarian fossa:
anterior-lateral boarder?
posterior-medial?

A 
anterior-laterally = external illiac vessels
posterior-medial = ureter
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9
Q

transmits the ovarian a, v, and N supply

A

suspensory lig of ovary

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10
Q

runs within the cardinal ligmant

A

uterine a

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11
Q

when performing an oophorectomy, care must be taken to avoid damaging the ____ at the ___ boundary of the ovarian fossa

A

ureter medially (posterior-medially, specifically)

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12
Q

the ovarian a follows the _____ as it travels within the ______

A

follows suspensory ligament within the mesovarium

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13
Q

the ovaries receive their blood supply from …

A

ovarian a + anastamosies of the ovarian a with the uterine a

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14
Q

describe the venous system that drains the ovaries

A

ovarian v on the left directly connects to the IVC

ovarian v on the right connects to the left renal v

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15
Q

lateral to the ureter at the pelvic brim

A

suspensory lig of the ovary

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16
Q

how is the ovarian blood supply altered during pregnancy? how is this significant for a surgeon performing an oophorectomy?

A

the ovarian arteries enlarge and the anastomoses between the ovarian a and the uterine a become bigger(?, its 6 am and i can’t think of a better word, sorry) in order to increase the blood supply to the uterus ∴ these connections need to be ligated to avoid blood loss

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17
Q

the uterine a is a branch off of the ….

A

anterior division of the internal illiac artery

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18
Q

transport organ for the zygote

A

uterine tubes

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19
Q

aka infundibulopelvic ligament (IPL)

A

suspensory ligament of the ovary

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20
Q

trumpet end of the uterine tubes

A

infundibulum

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21
Q

most common site of conception

A

ampulla of the uterine tubes

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22
Q

all structures (a, v, N, lymphatics) directly servicing the ovary travel through the

A

suspensory ligament of the ovary

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23
Q

the margin of the infundibulum is rimmed with small finger-like projections called

A

fimbrae

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24
Q

how can the uterine tubes be examined?

A

endoscopically via a vaginal approach

laproscopically via an abdominal approach

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25
Q

projects laterally from the body of the uterus, arching superiorly and posteriorly, to open into the peritoneal cavity

A

uterine tube

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26
Q

medial to the infundibulim

A

ampulla of the uterine tubes

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27
Q

useful in trapping the ovum and sweeping it towards the opening of the uterine tube

A

movement of the fimbrae

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28
Q

sheet life fold of mesentary with anterior and posterior layers that encloses the uterus, ovary, and uterine tubes

A

broad ligament

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29
Q

ectopic pregnancy in the uterine tubes (when the tube ruptures) can causes…

A

can cause abdominopelvic hemorrage

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30
Q

the ampulla narrows to form the

A

isthmus

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31
Q

serves to keep the uterus positioned properly

A

broad ligament

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32
Q

part of the uterine tube that joins the body of the uterus

A

isthmus

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33
Q

suspended in the mesosalphinx of the broad ligmant

A

uterine tubes

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34
Q

extends from the lateral pelvic wall to the body of the uterus

A

mesometrium

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35
Q

most superior part of the broad ligamnt

A

mesosalphinx

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36
Q

the ______ suspends the ovary from its posterior aspect

A

mesovarium

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37
Q

posterior extension of the broad ligament

A

mesovarium

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38
Q

superior extension of the mesovarium

A

suspensory ligament of the ovary

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39
Q

suspends the uterine tubes in the pelvic cavity

A

mesosalphinx

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40
Q

the ovary is projected (ant or post) relative to the uterus

A

posteriorly

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41
Q

the round ligament of the uterus is enclosed in

A

the broad ligament (doesn’t say specifically what part and neither does wiki)

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42
Q

the uterus is enveloped in

A

mesometrium

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43
Q

part of the uterus that narrows inferiorly into the cervix

A

isthmus

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44
Q

part of the uterus above a line connecting the uterine tubes

A

fundus

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45
Q

connects the uterine cavity and the vagina

A

cervical canal

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46
Q

what organ/structure is anterior to the uterus? posterior?

A 
anterior = bladder
posterior = rectum
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47
Q

part of the uterus between the fundus and the cervix

A

body

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48
Q

uterine opening of the cervical canal

A

internal os

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49
Q

vaginal opening of the cervical canal

A

external os

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50
Q

neck of the uterus and is continuous with the vaginal canal

A

cervix

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51
Q

forms the anterior, posterior, and lateral fornices

A

infravaginal portion of the cervix

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52
Q

2 divisions of the cervix

A

supravaginal and infravaginal

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53
Q

the ureter is (superior or inferior) to the uterine a

A

inferior (water under the bridge)

**they are at 90ºs

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54
Q

lowest point of the abdominopelvic cavity when the pt is in the supine position?

A

rectouterine pouch aka pouch of douglas

55
Q

what forms the boundaries of the rectouterine pouch?

A

between the posterior wall of the uterus (anteriorly) and the rectum (posteriorly)
the floor is the draping of the peritoneum

56
Q

venous drainage of the uterus is via

A

pelvic plexus of veins

57
Q

the ______ passes the pelvic floor from lateral to medial in the transverse cervical (aka cardinal) ligament (which is at the base of the broad ligament)

A

uterine a

58
Q

describe the blood supply of the uterus

A 
uterine a (branch of internal iliac)
ovarian a (branch of abd aorta) 
 2 or 3 vaginal aa (branches of internal iliac)
59
Q

at risk for perforation during cystoscopic procedures that use a vaginal approach?

A

rectouterine pouch

60
Q

Pfannensteil’s incision

A

transverse suprapubic incision to remove the uterus thru the ant abd wall

61
Q

the inferior end of the uterus projects towards the

A

posterior wall of the vagina

62
Q

the uterine passes the pelvic floor from lateral to medial in the _______ which is at the base of ______

A

transverse cervical (aka cardinal) ligament which is at the base of the broad ligament

63
Q

2 approaches for a hysterectomy

A

removal through the ant abd wall or the vagina

64
Q

angle of enteflexion is the

A

angulation between the wall of the cervix and the axis of the body of the uterus

65
Q

angle of anteversion is the

A

anglulation between the axis of the cervix and the axis of the vaginal canal
~100-110

66
Q

in an anterverted and ante flexed position, the anterior surface of the uterus rests on

A

the superior surface of the bladder

67
Q

in an anterverted and ante flexed position, the posterior surface of the uterus rests on

A

loops of small intesine

68
Q

improper positioning of the uterus may contribute to…

A

▪︎ infertility
▪︎ complications during pregnancy and delivery
▪︎ inc tendency towards uterine prolapse

69
Q

What are the cuases of uterine prolapse?

A

▪︎ trauma during childbirth
▪︎ improperly postioned uterus
▪︎ aging

70
Q

how is uterine prolapse treated?

A

surgery or pessary (mesh-like prosthetic device)

71
Q

What are the supporting structures of the female internal genitalia?

A

▪︎ bladder and rectum
▪︎ pelvic and UG diaphragms
▪︎ perineal body
▪︎ ligaments: transverse cervical (cardinal), pubovesical, uterosacral, and round

if any of these are damaged or atrophy you can get prolapse

72
Q

the anterior wall of the vagina is posterior to the

A

base of the bladder and urethra

73
Q

the posterior wall of the vagina is anterior/related to

A

the ampulla of the rectum, perineal bodym and the rectouterine pouch

74
Q

describe the blood supply to the vagina

A

vaginal arteries which are branches off of the internal iliac artery
**there are also some anastomoses with the uterine a

75
Q

describe the venous drainage of the vagina

A

pelvic plexus

76
Q

culdoscopy is

A

a medical diagnostic procedure performed to examine the rectouterine pouch and pelvic viscera by the introduction of a culdoscope through the posterior vaginal wall

77
Q

…. may impinge upon the walls of the vagina

A

herniations of the bladder (cystocle), rectum (rectocele), and bowel (enterocele)

78
Q

may result in leakage of urine or feces from the vaginal orifice

A

fistulae formation

79
Q

female homologs of the scrotum

A

labia majora and mons pubis

80
Q

female homolog of the penis

A

clitoris

81
Q

the hair bearing elevation of skin anterior to the pubis

A

mons pubis

82
Q

encloses the clitoris

A

labia minora: foms the prepuce and the frenulum

83
Q

what is the labia major filled with

A

CANDY! jk, fat and fibrous tissue

84
Q

fourchette

A

the sharp fold fromed from the united posterior ends of the labia minora

85
Q

describe the blood supply to the labia minora

A

internal pudental artery and external pudental branches of the femoral artery

86
Q

describe the innervation of the labia minora

A

ilioinguinal N
genital branch of the genitofemoral N
posterior labial N (from perineal N)
posterior cutaneous N of the thigh

damn, that a lot of different places, our evolutionary ancestors really didn’t want us to lose feeling down there

87
Q

the smooth area bounded by the labia minora

A

vestibule

88
Q

how is the structure of the body of the clitoris different than the body of the penis

A

clitoris is formed by 2 (rather than 3) cylindrical bodies (corporus caveronsa)

89
Q

small mass of erectile tissue that caps the body of the clitoris

A

glans

90
Q

the root structure serves to support an anchor the clitoris to the

A

perineal membrane

91
Q

the left and right crura of the clitoris are continuous with the

A

corpora cavernosa and the bulb of the vestibule

92
Q

the bulb of the vestibule is firmly attached to the

A

UG diaphragm

93
Q

what gives rise the the clitoris

A

bulb of the vestibule

94
Q

extends from the perineal body to surround the orifice of the vagina and cover the vestibular bulbs

A

bulbospongiosus muscle

95
Q

where does the ischiocavernosus muscle arise

A

ischiopubic rami

96
Q

located just posterior to each half of the bulb of the vestibule

A

greater vestibular gland (aka Bartholin’s)

97
Q

function is to decrease the size of the vaginal opening

A

bulbospongiosus muscle

98
Q

innervation of the ischiocavernosus and bulbospongiosus muscles

A

perineal branch of the pudental N

99
Q

where do the ducts of the greater vestibular glands open?

A

vestibule

100
Q

function is to compress the deep dorsal vein of the clitoris to maintain erection

A

bulbospongiosus muscle

101
Q

function is to secrete clear mucus to lubricate the vulva during sexual excitation

A

greater vestibular gland (aka Bartholin’s)

102
Q

arteries that are responsible for erection of the clitoris

A

deep arteries of the clitoris

103
Q

describe the venous drainage of the clitoris

A

superficial and deep dorsal veins → internal pudental v

104
Q

function is to compress the crus of the clitoris to assist in erection

A

ischiocavernosus muscle

105
Q

what provides the blood supply to the corporus cavernosa?

A

deep arteries of the clitoris

106
Q

what provides the sensory innervation to the clitoris

A

dorsal N of the clitoris

107
Q

erection is a vascular event generated by ____ innervation from spinal cord levels..

A

generated by parasympathetics (pelvic splanchnics) from S2-S4

SAME IN MEN AND WOMEN

108
Q

describe the specifics of the innvervation of the clitoris

A

pregang para N fibers exit ventral rami S2-S4 via pelvic splanchnics and enter the inferior hypogastric plexus → postgang para N fibers derived from hypoglastic plexus innervate the clitoris via the cavernous N in the vesicular plexus

109
Q

muscles of the pelvic diaphragm

A

levator ani and coccygeus muscles

110
Q

what is the origin and insertion of levator ani?

A

O: pubis, tendinous arch, and ischial spine
I: midline connective tissue raphe

111
Q

innvervation of levator ani

A

inferior rectal N and direct branches from S4

112
Q

action of the levator ani

A

support of pelvic viscera and to keep the rectum and vagina closed

113
Q

UG diaphragm stretches between

A

the ischiopubic rami

114
Q

why is there a gap in the anterior fibers of the UG diaphragm?

A

small communication with the perineum and the pelvis

115
Q

covers the inferior surface of the UG diaphragm

A

dense fibrous layer called the “inferior fascia of the UG diaphragm” or the “perineal membrane”

116
Q

specialization just posterior to the free posterior margin of the UG diaphragm

A

perineal body

**provides additional support

117
Q

what structures are at the greatest risk of tearing during childbirth?

A

perineum, levator ani, ligaments of the pelvic fascia

118
Q

why is an episiomety performed?

A

to enlarge the birth canal and prevent tearing or excessive trauma

119
Q

what is cut in an episiomety

A

perineum and inferoposterior vaginal wall (just typing that made me cringe)

120
Q

What are the 3 options for regional anesthesia during childbirth?

A
  1. spinal nerve block
  2. caudal nerve block
  3. pudental nerve block
121
Q

diff between spinal N block, caudal epidural block, and pudental N block

A

spinal: anesthesia introduced in SUBARACHNOID space at L3/L4 and causes complete paralysis from the waist down
epidural: anesthesia introduced in EPIDURAL space and bathes S2-S4 roots and does not affect the lower limbs
pudental: anesthetizes the S2-S4 DERMATOME

122
Q

where is the pudental N block injected?

A

medial aspect of the ischial spine around the sacrospinous ligament

123
Q

is the mother able to still feel the contractions with a pudental N block

A

yes

124
Q

what nerve would have to be blocked to abolish sensation from the anterior portion of the perineum?

A

ilioonguinal N

125
Q

where is the pudental N block injected?

A

medial aspect of the ischial spine around the sacrospinous ligament

126
Q

is the mother able to still feel the contractions with a pudental N block

A

yes

127
Q

what nerve would have to be blocked to abolish sensation from the anterior portion of the perineum?

A

ilioonguinal N

128
Q

narrowest part of the pelvic canal from side to side

A

interspinous distance (between ischial spines)

129
Q

What is the minimum distance for the estimated true conjugate to be in order to ensure a safe delivery

A

≥ 11 cm

130
Q

How is the true obstetrical conjugate measured?

A

determine the diagonal conjugate (palpate the sacral prominence with the tip of the middle finger while using the other hand to make the levels of the inferior margin of the pubic symphysis on the examining hand)

the true obstetrical conjugate is estimated to be the tip of the INDEX finger (not middle) to the marked level of the pubic symphysis

131
Q

narrowest fixed distance that the baby’s head must fit thru during a vaginal delivery

A

obstetrical conjugate

132
Q

What is the minimum distance for the estimated true conjugate to be in order to ensure a safe delivery

A

≥ 11 cm

133
Q

how is the interspinous distance determined to be wide enough for delivery

A

can fit 3 fingers wide

***this may get wider as the pregnancy continues due to hormones inducing relaxation of ligaments binding the pelvis

134
Q

narrowest fixed distance that the baby’s head must fit thru during a vaginal delivery

A

obstetrical conjugate

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