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HD CC > Applied Anatomy of the Female Reproductive Tract > Flashcards

Applied Anatomy of the Female Reproductive Tract Flashcards

1
Q

Pelvic floor/diaphragm

A

Divides pelvis
Above- Main pelvic cavity
Below- Perineum

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2
Q

Pelvic floor (diaphragm) muscles

A

Levator ani muscles
Coccygeus muscles
+ their covering fascia

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3
Q

Pelvic floor function

A

Supports + maintains pelvic viscera in position

Resist intrapelvic pressure + expulsive efforts of abdominal muscles

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4
Q

Gaps in Pelvic floor

A

Urethra
Vagina (urogenital hiatus)
Rectum (anal hiatus)

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5
Q

Levator ani muscles

A

Puborectalis
Pubococcygeus
Iliococcygeus

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6
Q

Pelvic floor muscles from Anterior to Inferior

A 
Puborectalis
Pubococcygeus
Iliococcygeus
Coccygeus
Piriformis
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7
Q

Puborectalis

A

From pubic symphysis to rectum
Forms puborectal sling around anal canal
Maintains faecal continence

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8
Q

Sphincter vaginae

A

Pre-rectal fibres

Forms sling around urogenital hiatus

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9
Q

Pubococcygeus

A

From pubis to anococcygeal body (fibrous mass between tip of coccyx and anal canal)

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10
Q

Iliococcygeus

A

From ischial spines anococcygeal body and coccyx

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11
Q

Coccygeus

A

From ischial spines to coccyx/sacrum

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12
Q

Perineum

A

Area beneath pelvic diaphragm

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13
Q

Perineal membrane

A

Lies beneath anterior urogenital triangle
Offers extra support
NONE underneath anal triangle

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14
Q

Urogenital triangle location

A

Anterior portion of the perineal region

One vertex at the pubic symphysis and the two other vertices at the ischial tuberosities of the pelvic bone.

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15
Q

Anal triangle location

A

One vertex at coccyx, other two at ischial tuberosities of pelvic bone

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16
Q

Perineal body

A

Fibromuscular mass

Sits in middle of urogenital and anal hiatus

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17
Q

What is between superior and inferior pubic ramus

A

Obturator foramen

–> obturator internus and externus

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18
Q

Perineal membrane location compared to Levator Ani muscles

A

Anterior to levator ani muscles

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19
Q

DPP- deep perineal pouch

A

Between levator ani muscles (top border) and perineal membrane (lower border)
Contain urogenital diaphragm- a muscular sheet
Within urogenital diaphragm have EUS and deep muscle of perineum

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20
Q

SPP- superficial perineal pouch

A

Lower border is Colles fascia
Top border is perineal membrane
Has erectile tissue/muscles + gland
Laterally is Crus of clitoris, surrounded by ischiocavernosus muscle
Medially is Bulb of Vestibule surrounded by Bulbus Spongiosum muscle

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21
Q

Bartholin’s gland

A

In SPP in females

Corresponding male gland is in DPP

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22
Q

Urogenital diaphragm (in DPP)

A

Triangular musculofascial layer above perineal membrane
Formed by EUS, sphincter urethrovaginalis, compressor of urethrae, and deep transverse perineal muscles
Surrounded by fascia

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23
Q

Erectile tissue in SPP

A

Bulb of vestibule- attached to urogenital diaphragm, divided by vagina
Crura of clitoris (corpus cavernosum)

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24
Q

3 muscles in SPP

A

Bulbospongiosus- surrounds vaginal orifice + covers vestibular bulbs
Ischiocavernosus
Superficial transvere perineal muscle

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25
Gland in SPP
Greater Vestibular gland (Bartholin's gland)
26
Perineal body
Fibromuscular mass | Junction of UH + AH
27
Bulbospongiosus muscle
Inferior to bulb of vestibule (on top of it) | Reduces size of vaginal orifice
28
Ischiocavernosus muscle
Inferior to crus of clitoris(on top) | Assists clitoral erection
29
Bartholin gland cyst
Duct gets blocked- cyst | Bartholin's gland produces mucous secretions into vestibule area
30
Pelvic floor during birth
Supports foetal head while cervix is dilating to permit delivery
31
Injury to pelvic floor
Most medial levator ani (puborectalis and pubococcygeus) are most often torn --> encircle urethra and border of rectum, so if torn can result in incontinence
32
Pre-natal (e.g. Lamaze) classes
Provide training to reduce risk
33
Episiotomy
If labour prolonged (esp. forceps + breech) + perineal tear looks likely Done to prevent damage especially to perineal body Posterolateral incision
34
Broad ligament
Double fold of peritoneum Attaches internal genitalia to pelvis can be divided into three parts- mesosalpinx, mesovarium, mesometrium
35
Mesosalpinx
Part of Broad Ligament | Fallopian tubes
36
Mesovarium
Part of Broad Ligament | Ovaries to broad ligament
37
Mesometrium
Part of Broad Ligament | Ovaries to uterus
38
Suspensory ligament
Ovary to wall of pelvis | houses ovarian vessels
39
Ligament of ovary
Caudal gubernaculum | Ovary to lateral uterus
40
Round ligament
Caudal gubernaculum | Originates at uterine horns, exits abdominal cavity, passes through inguinal canal + ends in labium majora
41
Ovaries location
Lie in lateral wall of pelvis in Ovarian fossa | Often found in pouch of Douglas
42
Superior support of uterus
Ovarian + round ligaments
43
Vagina support
Levator ani muscles and perineal body
44
Middle Uterus aspect support
Uterosacral ligaments- cervix to sacrum Transverse cervical (cardinal) ligaments- cervix/vagina to lateral pelvic wall Pubocervical ligaments- cervix to pubis (either side of bladder)
45
Normal Uterus position
Anteverted | Anteflexed
46
Anteverted position
90 degree between axis of vagina and axis of cervix
47
Anteflexion position
170 degree between axis of uterine body and axis of cervix
48
Retroverted uterus
Directly over vagina | --> can cause vaginal prolapse
49
Prolapse of uterus
Levator ani tone + ligaments positioning cervix --> damage to these causes downwards displacement of uterus --> caused by damage during childbirth or general poor body muscular tone --> common after menopause, when pelvic viscera tend to atrophy Prolapse of uterus always accompanied by prolapse of vagina
50
Rectouterine pouch
Pouch of Douglas Accumulation of blood or pus Commonly violated by misguided instruments that pierce the post fornix
51
Vesicouterine pouch
Formed from peritoneum over uterus + bladder
52
Vagina
Thin muscular tube extending backwards from vulva to uterus Upper half above pelvic floor, lower half perineum Upper end of vagina pierced by cervix
53
Cervix fornices
Lumen divided | Anterior, posterior and 2 lateral
54
Relations of the vagina
Anterior- bladder/urethra Posterior- pouch of Douglas, ampulla of rectum, perineal body Lateral- ureters, levator ani, urogenital diaphragm and Bulb of vestibule
55
Ovarian artery
From Aorta Goes in via suspensory ligament Supplies ovaries, uterine tube
56
Uterine artery
From internal iliac | Gives off Radial arteries + arcuate artery --> uterus
57
Vaginal artery
From internal iliac
58
Autonomic nerves of Pelvis
Each organ has plexus of nerves around it- mixed para + symp | These come from Inferior hypogastric plexus (IHP), which is either side of rectum
59
Parasympathetic to IHP
From Pelvic splanchnic nerves, S2,3,4
60
Sympathetic to IHP
From Right and Left hypogastric nerves, which follow the pathway of the internal iliac artery These are from the Superior hypogastric plexus, located near bifurcation of aorta --> these nerves come from Thoracic (greater T5-9, Lesser T10-11 and Least &12) and Lumbar splanchnic nerves
61
Pudendal nerve
Somatic | S2,3,4
62
Spinal Anaesthesia
Subarachnoid space L4-5 | Complete anaesthesia below waist monitoring of uterine contractions
63
Caudal epidural block
Anaesthetic administered to catheter in sacral canal | Limbs unaffected
64
Pudendal nerve block
S2-4 Perineum + lower 1/4 vagina Mother can feel/assist contractions

HD CC (22 decks)

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