Applied Anatomy Flashcards
What is an episiotomy?
A surgically planned incision on the perineum and posterior vaginal wall performed during the second stage of labour
When may an episiotomy be required?
During a normal delivery or a forceps delivery
What may an episiotomy result in?
Further tear
What is a caesarean section?
Delivery of the foetus through an incision in the abdominal wall and uterine wall
What is the risk of bladder injury in caesarean section?
1 in 1,000 (rare)
What is the risk of ureteric injury in caesarean section?
1 in 10,000 (rare)
Why may a hysterectomy be performed?
- Malignancy
- Post-partum haemorrhage
- Fibroids
- Endometriosis
- Other
Where is the upper half of the ureter located?
Abdomen
Where is the lower half of the ureter located?
Pelvis
What do the ureters cross as the enter the pelvis over the pelvic brim?
The bifurcation of the common iliac vessels
Where do the ureters lie?
The run retroperitoneal on the lateral pelvic wall
Where do the ureters turn medially?
At the level of the ischial spine, the turn forwards and medially (related to the posterior border of the ovary)
What artery passes above the ureters?
Uterine artery
Where does the uterine artery pass the ureters?
About 2cm lateral to the cervix and in front of the lateral border of the vagina
Where do the ureters enter the bladder?
Through the back
What change occurs to the structure of the kidney during pregnancy?
Increase in size by 1cm
What does urinary tract dilatation in pregnancy lead to?
Hydronephrosis
How long does the hydronephrosis of pregnancy last?
Throughout pregnancy and about 6 week post-partum
In pregnancy, which side is more affected by hydronephrosis?
Right
What may the enlargement of the kidney and descent into the pelvis cause?
Obstruction during labour
What is the commonest benign tumour arising from the myometrium?
Leiomyomata
What is another name for leimyomata?
Fibroids
What are fibroids mainly compose of?
Smooth muscle
How can fibroids present?
Mainly asymptomatic but can present with:
- Dysmenorrhoea
- Menorrhagia
- Pressure symptoms
- Pelvic pain
What are the management option for fibroids?
- Symptom relief
- Myomectomy
- Hysterectomy
- Uterine artery embolization
- GnRH analogues
What is endometriosis?
The presence of endometrial like tissue outside the uterine cavity
How does endometriosis occur?
The endometriotic tissues detach and bleed resulting in internal bleeding, degenerated blood and tissues shedding, inflammation of the surrounding areas, pain and possibly formation of scar tissue
What rare sites can endometriosis affect?
- Lungs
- Brain
- Muscles
- Eye
Which lymph nodes does cancer in the female reproductive system usually spread to?
Para-aortic
What surgical option can be offered for female reproductive cancer?
A radical hysterectomy is the removal of the womb, cervix, tissue around the cervix (parametrium) and upper part of the vagina. The pelvic lymph nodes are usually removed as part of this operation
Why is there risk of menopause even after a hysterectomy?
There is a risk of menopause after a hysterectomy even if the ovaries are conserved as they have a common blood supply with the uterus
Can the fallopian tube be removed without the ovary?
Yes