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Year 4 - Gynaecology > Anatomy of the Female Reproductive System > Flashcards

Anatomy of the Female Reproductive System Flashcards

1
Q

What happens to the ovary during development?

A

It descends in the pelvis

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2
Q

What does the descent of the ovary have implications for?

A

Venous and lymphatic drainage of the ovaries

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3
Q

Where do the gonads develop?

A

Within the mesonephric ridge, on the posterior abdominal wall

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4
Q

What is the inferior pole of the ovary attached to?

A

The gubernaculum

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5
Q

What is the inferior attachment of the gubernaculum?

A

Labia majora

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6
Q

What causes the descent of the ovary?

A

The relative shortening of the gubernaculum, which drags the ovary through the abdomen

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7
Q

Where does the ovary stop its descent?

A

In the pelvis

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8
Q

What is the arterial supply to the ovary?

A

Via direct branches of the abdominal aorta

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9
Q

What is the venous drainage of the ovary?

A
  • The right ovarian vein into the inferior vena cava
  • The left ovarian vein into the left renal vein
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10
Q

What are the parts of the uterus?

A
  • Fundus
  • Body
  • Uterine tubes
  • Cervix
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11
Q

Draw a labelled diagram of the uterus

A
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12
Q

What happens to the fundus as pregnancy proceeds?

A

It becomes palpable

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13
Q

What is the clinical importance of the fundus of the uterus?

A

It is an important clinical measurement in pregnancy

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14
Q

What is the function of the uterine tubes?

A

Duct system for the gamete

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15
Q

What does the cervix contain?

A

The endocervical canal

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16
Q

What is the endocervical canal?

A

A channel that runs through the cervix

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17
Q

What are the peritoneal pouches of the uterus?

A
  • The uterovesical pouch anteriorly
  • The rectouterine pounch posteriorly
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18
Q

Where is the uterovesical pouch?

A

Between the urinary bladder and uterus

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19
Q

What is the rectouterine pouch also known as?

A

The pouch of Douglas

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20
Q

Where is the rectouterine pouch?

A

Between the rectum and the uterus

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21
Q

How can the rectouterine pouch be accessed?

A

Through the posterior fornix of the vagina

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22
Q

What is the peritoneal pouch in a male?

A

The rectovesical pouch

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23
Q

Where is the rectovesical pouch found?

A

Between the bladder and the rectum

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24
Q

What does the uterus develop from?

A

The paramesonephric duct

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25
Q

What are the paramesonephric ducts?

A

A pair of ducts that are open cranially and caudally, and connect to the urogenital sinus

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26
Q

Why do the paramesonephric ducts need to be open?

A

To allow for the collection of gametes after ovulation

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27
Q

When do paramesonephric ducts persist in development?

A

In the absence of MIH, and therefore in the absense of testes

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28
Q

What happens to the paramesonephric ducts in female development?

A

They grow into the abdominal cavity, dragging the peritoneal membrane with it, then fuse in the midline

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29
Q

What does fusion of the paramesonephric ducts in the midline create?

A

A broad transverse fold draped by peritoneum, the broad ligament

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30
Q

What is the purpose of the broad ligament?

A

It is like a mesentery, in that it is a sheet of pertioneum that allows structures to enter and leave, including vasculature

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31
Q

What is the round ligament of the uterus embryologically derived from?

A

The gubernaculum

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32
Q

What is the round ligament of the uterus attached to?

A

The ovary and labium majus

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33
Q

Where does the round ligament of the uterus travel?

A

Through the inguinal canal

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34
Q

What does the pathway of the round ligament through the inguinal canal have consequences for?

A

Lymphatic drainage

35
Q

What is the consequence of the round ligament running through the inguinal canal on the lymphatic drainage?

A

Lymphatics run with the round ligament through the inguinal canal, so sometimes pathologies of the fundus of the uterus present as enlargement of the inguinal lymph nodes

36
Q

What position is the uterus in?

A

It is anteverted with respect to the vagina, and anteflexed with respect to the cervix.

Normally tipped anteriorly, lying on top of the bladder

37
Q

What does the uterine tube consist of?

A
  • Abdominal ostium (opening)
  • Fimbriae
  • Infundibulum
  • Ampulla
  • Isthmus
38
Q

What is the clinical relevance of the abdominal ostium of the uterine tube?

A

Means that the peritoneal cavity is open, and so there is a pathway for infection to spread from the lower reproductive tract, then into the abdominal cavity

39
Q

What is the function of the uterine tube?

A
  • Conduct oocyte into the uterine cavity
  • Normally the site of fertilisation
40
Q

Is the lining of the uterine tube endometrium, as in the uterine cavity ?

A

No

41
Q

What is the consequence of the lining of the uterine tube not being endometrium?

A

Has a consequence for ectopic implantation, as control of implantation is dependant on the presence of endometrium

42
Q

What does the cervix consist of?

A
  • Internal os (opening into vagina)
  • Endocervical canal
  • External os (to body of uterus)
43
Q

What ligaments support the pelvic viscera?

A
  • Transverse cervical ligament
  • Uterosacral ligament
  • Pubovesical ligament
44
Q

What is the tranverse cervical ligament?

A

Thickening at the base of the broad ligament

45
Q

What does the transverse cervical ligament do?

A

Provides lateral stability of the cervix

46
Q

What does the uterosacral ligament do?

A

Opposes anterior pull of the round ligament, assisting in maintaining anteversion

47
Q

What arteries supply blood to the female internal genitalia?

A
  • Ovarian artery
  • Uterine artery
  • Internal pudendal
48
Q

What is the ovarian artery a branch of?

A

The abdominal aorta

49
Q

What is the uterine artery a branch of?

A

Anterior division of internal iliac

50
Q

What does the uterine artery give branches to?

A

The vaginal artery

51
Q

What is the internal pudendal artery a branch of?

A

Anterior division of internal iliac

52
Q

What is true of the blood supply to the female internal genitalia?

A

It has lots of anastomoses

53
Q

What is the purpose of the anastomoses of the blood supply to the female internal genitalia?

A

Ensures maintainance of blood supply

54
Q

Why is the maintaince of the blood supply to the female internal genitalia of critical importance?

A

Because if pregancy should occur, there is massive growth of the myometrium which needs to be supported by blood supply

55
Q

What is the uterine artery in important anatomical relationship with?

A

The ureter

56
Q

Where does the ureter run in relation to the uterine artery?

A

The ureter runs under the artery

57
Q

When is it important to consider the close relationship between the ureter and the uterine artery?

A

During a hysterectomy

58
Q

Why is it important to consider the close relationship between the ureter and the uterine artery during a hysterectomy?

A

Because it is at risk of iatrogenic damage

59
Q

How could a surgeon differentiate between the ureter and the uterine artery?

A

The ureter has a peristaltic reflex

60
Q

Why does the uterus have a complex pattern of lymphatic drainage?

A

Reflective of its complex development

61
Q

What nodes does the uterus drain to?

A
  • Para-aortic
  • External iliac
  • Internal iliac
  • Sacral
  • Inguinal
62
Q

By what route does the uterus drain to the para-aortic nodes?

A

Along suspensory ligament

63
Q

What parts of the uterus drain into the para-aortic nodes?

A
  • Fundus
  • Body of uterus
  • Ovary
64
Q

What parts of the uterus drain into the external iliac nodes?

A
  • Body of uterus
  • Cervix
65
Q

What parts of the uterus drain into the internal iliac nodes?

A

Cervix

66
Q

What parts of the uterus drain into the sacral nodes?

A

Cervix

67
Q

What parts of the uterus drain into the inguinal nodes?

A

The fundus

68
Q

What are the parts of the female external genitalia?

A
  • Labia majora
  • Labia minora
  • Vestible
69
Q

What does the labia majora do?

A

Encloses the pudendal cleft

70
Q

What does the labia minora do?

A

Encloses the vestibule of the vagina

71
Q

What does the vestible of the vagina contain?

A

Orifaces of;

  • Urethra
  • Vagina
  • Greater and lesser vestibular glands, aka Bartholin glands
72
Q

What are the potential pathologies of the Bartholin glands?

A
  • Bartholinitis
  • Bartholin gland cyst
73
Q

What is a Bartholin gland cyst?

A

An accumulation of fluid that is not related to infection

74
Q

What does the vaginal oriface open into?

A

The vestible

75
Q

What does the vaginal oriface open into the vestible along with?

A

The external urethral oriface and the ducts of the greater and lesser vestibular glands

76
Q

What are the vaginal fornices?

A

Superior recesses of the vagina around the cervix

77
Q

What is the clinical significance of the vaginal fornices?

A

Because they are the site of culdocentesis

78
Q

What is culdocentesis?

A

Sampling of abnormal fluid from pouch of Douglas

79
Q

What innervates the vagina and uterus?

A
  • Inferior 1/5 of vagina receives somatic innervation from pudendal nerve
  • Superior 4/5 of vagina and uterus recieves innervation from uterovaginal plexus
80
Q

What does the location of pain originating from the vagina and uterus depend on?

A

The pelvic pain line

81
Q

Where does pain originating from the vagina and uterus travel back to?

A

Either;

  • Inferior thoracic lumbar spine ganglia
  • S2-4 spinal ganglia
82
Q

What innervates the perineum?

A
  • Pudendal nerve
  • Ilioinguinal nerve
83
Q

What course does the pudendal nerve take?

A
  • Exits pelvis via greater sciatic foramen
  • Enters perineum via lesser sciatic foramen
  • Travels through pudendal canal

Year 4 - Gynaecology (52 decks)

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