Anatomy of the Male and Female Pelvic Organs Flashcards
Label the Female Reproductive System.
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Ovaries: Function:
- oocyte development
- folliculogenesis
Fallopian Tube: Function:
- transit of ovum
- fertilisation of ovaum into
zygote - transit of zygote
Uterus: Function:
- implantation of zygote
- development and nutrition
of the embryo/foetus
Layers of the Uterus:
- composed of myometrium =
smooth muscle - outer = connective tissue
and
peritoneum/perimetrium - inner = endometrium =
vascular mucous layer
In which layer of the uterus does the embryo implant?
Endometrial Layer
Also the layer lost during menstruation
Describe uterine walls and shape of organ.
- thick walled
- pear-shaped organ
What is the normal position of the uterus?
- anteverted
- anteflexed
What does Version desccribe?
the position of the cervix in relation to the vagina
eg anterversion in anatomical plane
What does flexion describe?
the position of the fundus and uterine body in relation to the cervix
eg anteflexed in anatomical position
Uterus:
insert diagram
cervix is thick and narrow area
What are the fallopian tubes?
a pair of hollow, muscular ducts located between the ovaries and the uterus
What does the fallopian tube consist of?
A thin mucous membrane and muscular layers
Fallopian Tubes:
- fimbrae are finger like projections
- the ovary is not in contact with the
fallopian tube - the fimbrae help bring the egg into
the fallopian tube - infundibulum = funnel shape
- ampulla = outpouching
- isthmus = connects to the uterus
In anatomical position where is the ovaries in relation to the uterus and fallopian tubes?
- posterior to the fallopian tubes
- lateral and superior to the uterus
What is the position of the uterus shown below?
retroverted and anteflexed
What is the position of the uterus shown below?
retroverted and retroflexed
Variation in position of uterus generally results in pathology.
True or False?
False
normal variation
some tightness in ligaments
very few result in pathology
Ectopic pregnancies (abdominal) occur when
the fimbrae of the fallopian tube fail to bring the egg into the fallopian tube and hence the egg is sitting elsewhere in the abdomen
Where does fertilisation occur in the fallopian tube?
Ampulla of fallopian tube
Ovaries:
- how many
- shape
- attached to the posterior surface
of the
- paired
- oval shaped organs
- attached to the posterior surface
of the broad ligament
What is X?
broad ligament is connective tissue, peritoneal layer that covers ovaries and fallopian tube and fans out
white projection next to the bladder is the ureters
structure running to ovaries on right hand side?
What are the three main histological features of the ovaries?
- outer surface
- cortex with developing follicles
- medulla with blood vessels
Label the three main histological features of the ovaries.
insert diagram
Which two arteries are the main arteries from branches arise to supply the female reproductive system?
- internal iliac artery gives off the
uterine artery - abdominal aorta gives off the ovarian
artery
Why does the abdominal aorta supply the female reproductive system despite the ovaries residing in the pelvis?
due to the descent of the gonads
blood supply from the gonads is also drawn down
Label.
- abdominal aorta
- gonadal arteries
- common iliac arteries
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Label the arteries.
uterine artery branches off into the vaginal artery
ureter
Where does anastomoses of the ovarian artery and uterine artery occur?
the fallopian tube
Blood supply to the falllopian tube from the
uterine and ovarian artery
Label views and arteries.
insert diagrams
sagittal view
During hysterectomies what is at risk of damage?
ureter which passes under the uterine artery
Bony landmark between abdomen and pelvis?
None
What is the broad ligament?
- the periotneum passes superiorly over
the pelvic organs - as the peritoneum folds over the body
of the uterus it creates a broad sheet
of peritoneum enclosing the uterus - which is the broad ligament
What is the name of the peritoneal pouch anterior to the uterus formed by the folding of the broad ligament?
vesicouterine pouch
What is the name of the peritoneal pouch posterior to the uterus formed by the folding of the broad ligament?
rectouterine pouch (of douglas)
Draw the broad ligament.
Intraperitoneal organs are enclosed in peritoneum hence
*fully or almost fully enclosed
*are mobile organs
Which of the pelvic organs are intraperitoneal?
uterus
during pregnancy uterus grows hence needs to be mobile
What is the lowest point in the peritoneal cavity?
the rectouterine pouch
Label the ligaments.
The ovaries descend down and are held in place by
the suspensory ligament of the ovary
What vessels run within the suspensory ligament of the ovary?
the ovarian artery and vein
Ovarian ligament:
- runs between
- length
- function
- ovary and uterus
- short
- holds the ovary in close proximity to
the uterus
Round Ligament of the Uterus:
- runs between
- function
- runs from uterus and attaches to the
front of the abdomen - when gonads descends they are
pulled down by the gubernaculum - the gubernaculum differentiates into
the round ligament of the uterus in
females
What are the three divisions of the broad ligament?
- Mesometrium: covers the uterus
(metrium) and runs to the side of the
pelvis - Mesovarium: in sagittal view, runs
between the ovary and mesometrium
and mesosaplinx -> very small - Mesosalpinx: runs between the ovary
and the fallopian tube
Broad Ligament Divisions:
insert diagram
The round ligament is the embryonic remnant of the
gubernaculum
Gubernaculum:
- structure brings the gonads down
during development - becomes the ovarian ligament
- continues round to form the
suspensory ligament which
attaches to the anterior abdominal
wall - also attaches to the labia majora
Cervix:
- location
- composition
- function
- histology (2):
- part of the uterus which projects
inferiorly into the vagina - highly muscular
- keeps bacteria out of the uterus
- abrupt change of epithelium at the
external os of the cervix - changes from simple columnar to
stratified squamous epithelium at the
squamocolumnar junction =
transformation zone
Where do most cervical cancers start?
- transformation zone
- squamocolumnar junction
- simple columner epithelial lining in
internal os changes to stratified
squamous epithelial lining at external
os
why?
Cervix:
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Vagina:
- composition
- extends
- between
- vagina is posterior to
- vagina is anterior to
- distensible fibromuscular tube
- extends posterosuperiorly
- from the external vaginal orifice to the
cervix - vagina is posterior to the bladder
- vagina is anterior to the rectum
Vagina:
the anterior and posterior fornix are the spaces in the vagina anterior and posterior to the cervix
Male Reproductive System:
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Male Gonadal Descent:
- develop in the abdomen
- during foetal development descend
into the scrotum - external gonads
Testes:
- location
- function
- paired oval organ
- within the scrotum
- produce sperm, testosterone and
other androgens - tunica vaginalis is space filled with
fluid. Outpouching of peritoneum.
Epididymis:
- location
- function
- situated on the posterolateral aspect
of each testicle within the scrotum - suspended from the abdomen by the
spermatic cord - transport sperm from the testes to the
vas deferens
Label
- tunica vaginalis is fluid filled
- seminiferous tubules connect to rete
testis which connects to the
epididymis - superior pole of epididymis = head
- body is less coiled
- tail straightens out and continues
upwards toward the prostate and
ejaculatory ducts as the ductus
deferens
Ductus Deferens:
- is
- content of
- function
- muscular tube
- content of the spermatocord
- propels spermatozoa from the
epididymis through the spermatic
cord, inguinal canal towards the back
of the bladder where it joins the
seminal vesicles
Draw the pathway of the ductus deferens.
Seminal Vesicles:
- location
- function
- long tubular glands
- located between the fundus of the
bladder (posterior) and the rectum - connect with the ductus deferens in
the prostate where it forms the
ejaculatory duct - produces and stores semen to the
spermatozoa
Prostate Gland:
- location
- relation to urethra
- function
- directly inferior to the male bladder
- urethra transverses the prostate and
so any enlargement of the gland can
impinge on the urethra - produces seminal fluid to protect
spermatazoa during transport
The prostatic utricle is an embryological remnant of
- Mullerian tube
- gives rise to the uterus, fallopian tubes
and cervix
Prostate Gland:
- histological divisions
- three zones:
- transitional zone: surrounds urethra,
BPH - peripheral zone: posterior aspect of
the prostate, most prostatic cancers - central zone:
Prostate Gland:
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Bulbourethral Glands:
- are
- location
- function
- pea-shaped exocrine glands
- posterolateral to membranous
urethra - found in the deep perineal pouch (part
of the perineum) - secrete fluid
Bulbourethral Glands:
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Penis:
- anatomical divisions
- three anatomical divisions: root, body
and glans - root and body and glans are spanned
by three masses of erectile tissue - corpus cavernosum x2 = deep penile
arteries - corpus spongiosum = urethra runs
through
Penis:
label root, body and glans (end)
Male Urethra Divisions (4):
- pre-prostatic: bladder forms urethra
- prostatic: in prostate
- membranous: small, passes through
perineal floor - spongy: within the erectile tissue
Male Reproductive System: Blood Supply:
- abdominal aorta -> testicular artery
- internal iliac artery gives off inferior
vesicular artery (inferior part of
bladder) gives off branch -> prostatic
artery - internal iliac artery gives off internal
pudenal branch gives off the dorsal
artery
internal pudenal supplies the perineum (both male and female)
Males and Females both have a superior vesicular artery
Blood Supply:
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Male Peritoneal Folds:
- peritoneum passes superiorly over the
pelvic organs - rectovesicle pouch formed between
bladder and rectum - lowest point of pelvic cavity =
infection, extra-fluid
A = testicle
B = process vaginalis
C = head of epidydimus
A = fallopian tubes
B = fundus of uterus (anterior)
C = round ligament of uterus (anteriorly running)
A = ductus deferens
B = prostate gland
C = bladder
D = cervix
Muscles of the Abdominal Wall:
Muscles of the Abdominal Wall:
Anterior Spine:
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Inguinal ligament
the inferior border of the external oblique’s aponeurosis rolls under itself to create the inguinal ligament
Inguinal Ligament:
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label inguinal canal
from the anterior superior iliac spine to pubic tubercle
grey = aponeurosis rolled onto itself forms the ligament
Layers of the Abdomen:
- skin
- subcutaneous fatty tissue
- external oblique
- internal oblique
- transversus abdominis
- transversalis fascia
- peritoneum
The inguinal canal is created by
part of the inguinal ligament
What neurovasculature passes underneath the inguinal ligament?
- femoral artery
- femoral vein
- femoral nerve
Inguinal Canal: Contents:
- testicular artery and vein
- ductus deferens passes back up
- in females the rounf ligament of the
uterus passes through the inguinal
canal
Spermatic Cord: Contents:
- testicular artery
- ductus deferens
- pampiniform venous plexus: comes
from the testicular vein, encircles the
testicular artery - genital branch of the geniotofemoral
nerve - ilioinguinal nerve (runs with the cord)
on the most superficial layer of the
spermatocord = NOT DEEP!!!
TDPGI
Spermatic Cord:
Purpose of pampiniform venous plexus encircling testicular artery?
thermoregulation within the scrotum to keep the sperm viable
Inguinal Canal:
*skin
*external spermatic fascia
*cremaster muscle/fascia
*internal spermatic fascia
The deep inguinal ring is the point at which
the contents of the spermatic cord enter the abdominal wall
Excluding skin, how many layers to the spermatocord?
3 layers
Superficial inguinal ring is the point at which the spermatocord
emerges from the abdominal wall
Inguinal Rings
anterior-superior view
- all layers of abdomen
- external iliac vessels passes under
inguinal ligament and emerges as
femoral vessels - testicular artery/plexus
- deep inguinal ring -> spermatic cord
enters abdominal wall - superficial inguinal ring -> spermatic
cord emerges from abdominal wall
Inguinal Canal and Abdominal Muscles:
only external and internal oblique contribute to spermatic cord
Cremaster muscle function:
- cremaster reflex
- draws scrotum closer to abdomen
- thermoregulation
*stroke inner thigh
Genitofemoral nerve L1 and 2
Spermatocord Development:
- gonad initially sits high in peritoneum
- testes descend in peritoneum to the
deep inguinal ring (midpoint of
inguinal ligament) - peritoneum attaches to gonad and
starts to form processus vaginalis
eventually forming tunica vaginalis - further descends through
transversalis fascia forming the
internal spermatic fascia once passes
through the superficial ring - passes through transversus abdominis
which does not contribute to the
spermatocord - pulls internal oblique downward
- forming the cremaster muscle
- external oblique is also pulled down
- forming the external spermatic fascia
- throughout the process the processus
vaginalis is pulled down - contents may herniate
- peritoneum is generally pinched off
- hence forming tunica vaginalis
Label
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Label
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what is the midpoint of the inguinal ligament?
the deep inguinal ring
hence the midpoint between anterior iliac spine and pubic tubercule
Formation of the Round Ligament of the Uterus:
gubernaculum pulls ovaries down
round ligament passes through deep and superficial ring and attaches to the labia majora
Inguinal Hernias:
- protrusion of peritoneum or viscera
through opening or weakness - inguinal hernias = 75%
- usually harmless
- risk of blood supply strangulation
- if blood supply cut off at opening in
abdominal wall then surgery
Direct vs Indirect Hernias:
landmark differentiation are the inferior epigastric vessels which arise from the external iliac vessels
Label vessels and hernia type
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Hasselbach’s Triangle:
- inferior epigastric vessels
- inguinal ligament
- lateral border of rectus abdominis
- direct hernias occur due to a
weakness in hasselbach’s triangle in
the anterior abdominal wall
Hasselbach’s Triangle:
looking at posterior part of abdominal wall
Hydrocoele:
- persistent processus vaginalis
- peritoneal fluid
Varicocoele:
- varicosity of pampiniform plexus
- valve dysfunction
- renal pathology
- L side venous damage….left because
of the position of the abdominal aorta
and IVC…left gonadal vein drains at a
perpendicular angle hence more
restricted than the right
Label
insert diagram
Testicular Torition
spermatocord twists
contents are compressed
