Anatomy of the Female Reproductive Tract Flashcards
where does excess fluid in the peritoneal cavity collect
pouch of douglas
what procedure can be performed to drain the pouch of douglas
culdocentesis - needle passed through pos fornix of vagina
what is the broad ligament formed from
double layer of peritoneum
what does the broad ligament attach to
the uterus, fallopian tubes and ovary
what is the function of the broad ligament
to maintain the uterus in the correct midline position
name the 3 parts of the broad ligament adn what they enclose
- mesometrium - largest section, surrounds uterus
- mesovarium - attaches to hilum of ovary, doesnt cover ovary surface
- mesosalpinx - encloses the fallopian tubes
what structure are the round, ovarian and suspensory ligament all enclosed in
broad ligament
what does the ovarian ligamenet run between
ovary and side of uterus - joint the uterus just below th eorigin of the fallopian tubes
what is the ovarian ligament formed from structurally
fibrous band of tissue that lies wtihin the broad ligament
what does the suspensory ligament of the ovary connect
ovary to lateral abdominal wall
what does the suspensory ligament of the ovary contain
ovarian vessels and nerves
whichb embryological structure is the round ligament a remnant of
gubernaculum
outline the passage of the round ligament
originates at uterine horns
passes through inguinal canal
attaches to labia majora
where is the fundus of the uterus
where does implantation of the zygote normally occur in the uterus
body
what structures hold hte uterus in position
ligaments - eg uterosacral ligaments
endopelvic fascia
muscles of pelvic floor
what can cause uterine prolapse
weakness of the supporting structures of the uterus - eg damage to pelvic floor
which angles do anteversion and anteflexion relate to in the position of the uterus
anteverted - the cervix is tipped anteriorly relative to the axis of the vagina
anteflexed - the uterus is tipped anteriorly relative to the axis of the cervix
name abnormal positions of the uterus
retroverted or retroflexed
what does abnormal positioning of the uterus predispose one to
uterine prolapse when there is inc intraabdominal pressure
what epithelium is present in teh cervix
columnar epithelium
are there glands in the vagina and cervix?
there are glands in the cervix - these secrete either a watery or thick secretion depending on menstrual time. secretion flows down and lubricates vagina (no glands here)
what are the 4 histological layers of the vagina
non keratinized stratified squamous
lamina propria
fibromuscular layer
adventitia
which layer of the vagina secretes glycogen, and what is the reason for this
the stratified squamous epithelium
it is metabolized by commensal bacteria (Lactobacillus spp) to form lactic acid - this maintain the low vaginal pH and inhibits the growth of pathogenic bacteria
do the fimbriae touch the ovary
only one does - the great fimbriae
the egg is released into the peritoneal cavity and then gathered up by the fimbriae
what is found in the medulla and cortex of the ovaries
neurovascular structures in the medulla and developing follicles in the cortex
what is the name of he dense connective tissue layer that surrounds the ovaries
tunica albuginea - covered by germinal epithelium (layer of cuboidal cells)
at what positions can the ischial spines be palpated on bimanual examinatio
4 and 8 o clock positions
what are the fornix of the uterus
what 2 triangles can the perineum be divided up into
what is the perineum separated from the pelvic cavity by
superiorly by the pelvic floor
whta are the anatomical boundaries of the perineum
what are the surface borders of the perineum
is the levator ani one muscle?
no, it is made up of a number of smaller muscles
which nerves supply the levator ani
nerve to levator ani (S345 of sacral plexus) and pudendeal nerve
it is under skeletal control
what is the perineal body made of
irregular fibromuscular mass - point of attachment of muscle fibres from pelvic floor and perineum
where is the perineal body located in relation to the UG and anal triangles
at the junction
how deep does the perineal body lie
just deep to the skin
what function does the perineal body serve
point of attahcment of muscles - maintain pelvic floor strength and prevent prolapse
wha structures is the perineal body located between in male and female
women - vagina and external anal sphincter
male - bulb of penis and anus
what is the function of Bartholin’s gland
produces lubrication - erectile tissue
what is the mons pubis formed from
skin with hair follicles overlying subcutaneous fat pad
whichb bony structure does the mons pubic overly
pubic symphysis
which sweat glands are present in the perineum
apocrine and sebaceous
compare the structure of the labia majora and minora
majora is an extension of the mons pubis, has glands, some smooth muscle, skinm subcut fat etc
minora has no subcutaenous fat or hair follicles - rich in vasculature and sebaceous glands
what is the erectile vascular tissue in teh clitoris called
corpora cavernosa
what two openings are found in the vaginal vestibular
vaginal orifice and external urethral meatus
describe the surface anatomy of the breast - where does it extend to and from horizontally, which muscles is it superficial to
located on ant thoracic wall
extend horizontally from lateral border of sternum to mid axillary line
superficail to pec major and serratus anterior
what are nipples made of
mainly smooth muscle fibres
what are the mammary glands and what are they drained by
ducts and secretory lobules (in pregnancy)
drained by lactiferous ducts
which ribs does the breast extend between
2 and 6
name the 4 quadrants of the bresat
upper/lower outer/inner
which position should a female stand in when examinig breast
inspect:
- arms by sides
- hands on hips - tense pec major
- arms above head and then lean forward
palpate with pt at 45 degree angle and arms above head
outline the lymphatic drainage of the breast
75% axillary, 20% parasternal and 5% pos intercostal nodes
where does lymph from the parasternal nodes drain
supraclavicular nodes
can lymph from the breast drain to the abdominal lymph nodes?
yes
why can axillary node clearance result in lymphoedema
upper limb lymph also drains to axillary nodes
what are the 3 levels of axillary node clearance
1 - inferior and lateral to pec minor
2 - under pec minor
3 - superior and medial to pec minor
what is the significance of the uterine tubes oepning into the peritoneal cavity
spread of infection
eg PID can cause peritonitis
ectopic pregnancy could develop in peritoneal cavity
where does the ovarian artery arise from
abdominal aorta at L2
where do the ovarian (gonadal) veins drain to
right - IVC
left - left renal vein - IVC
