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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
Q

Gland in SPP

A

Greater Vestibular gland (Bartholin’s gland)

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26
Q

Perineal body

A

Fibromuscular mass

Junction of UH + AH

27
Q

Bulbospongiosus muscle

A

Inferior to bulb of vestibule (on top of it)

Reduces size of vaginal orifice

28
Q

Ischiocavernosus muscle

A

Inferior to crus of clitoris(on top)

Assists clitoral erection

29
Q

Bartholin gland cyst

A

Duct gets blocked- cyst

Bartholin’s gland produces mucous secretions into vestibule area

30
Q

Pelvic floor during birth

A

Supports foetal head while cervix is dilating to permit delivery

31
Q

Injury to pelvic floor

A

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
Q

Pre-natal (e.g. Lamaze) classes

A

Provide training to reduce risk

33
Q

Episiotomy

A

If labour prolonged (esp. forceps + breech) + perineal tear looks likely
Done to prevent damage especially to perineal body
Posterolateral incision

34
Q

Broad ligament

A

Double fold of peritoneum
Attaches internal genitalia to pelvis
can be divided into three parts- mesosalpinx, mesovarium, mesometrium

35
Q

Mesosalpinx

A

Part of Broad Ligament

Fallopian tubes

36
Q

Mesovarium

A

Part of Broad Ligament

Ovaries to broad ligament

37
Q

Mesometrium

A

Part of Broad Ligament

Ovaries to uterus

38
Q

Suspensory ligament

A

Ovary to wall of pelvis

houses ovarian vessels

39
Q

Ligament of ovary

A

Caudal gubernaculum

Ovary to lateral uterus

40
Q

Round ligament

A

Caudal gubernaculum

Originates at uterine horns, exits abdominal cavity, passes through inguinal canal + ends in labium majora

41
Q

Ovaries location

A

Lie in lateral wall of pelvis in Ovarian fossa

Often found in pouch of Douglas

42
Q

Superior support of uterus

A

Ovarian + round ligaments

43
Q

Vagina support

A

Levator ani muscles and perineal body

44
Q

Middle Uterus aspect support

A

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
Q

Normal Uterus position

A

Anteverted

Anteflexed

46
Q

Anteverted position

A

90 degree between axis of vagina and axis of cervix

47
Q

Anteflexion position

A

170 degree between axis of uterine body and axis of cervix

48
Q

Retroverted uterus

A

Directly over vagina

–> can cause vaginal prolapse

49
Q

Prolapse of uterus

A

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
Q

Rectouterine pouch

A

Pouch of Douglas
Accumulation of blood or pus
Commonly violated by misguided instruments that pierce the post fornix

51
Q

Vesicouterine pouch

A

Formed from peritoneum over uterus + bladder

52
Q

Vagina

A

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
Q

Cervix fornices

A

Lumen divided

Anterior, posterior and 2 lateral

54
Q

Relations of the vagina

A

Anterior- bladder/urethra
Posterior- pouch of Douglas, ampulla of rectum, perineal body
Lateral- ureters, levator ani, urogenital diaphragm and Bulb of vestibule

55
Q

Ovarian artery

A

From Aorta
Goes in via suspensory ligament
Supplies ovaries, uterine tube

56
Q

Uterine artery

A

From internal iliac

Gives off Radial arteries + arcuate artery –> uterus

57
Q

Vaginal artery

A

From internal iliac

58
Q

Autonomic nerves of Pelvis

A

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
Q

Parasympathetic to IHP

A

From Pelvic splanchnic nerves, S2,3,4

60
Q

Sympathetic to IHP

A

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
Q

Pudendal nerve

A

Somatic

S2,3,4

62
Q

Spinal Anaesthesia

A

Subarachnoid space L4-5

Complete anaesthesia below waist monitoring of uterine contractions

63
Q

Caudal epidural block

A

Anaesthetic administered to catheter in sacral canal

Limbs unaffected

64
Q

Pudendal nerve block

A

S2-4
Perineum + lower 1/4 vagina
Mother can feel/assist contractions

HD CC (22 decks)

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