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Human Development 2 > Applied Anatomy of the Female Reproductive system > Flashcards

Applied Anatomy of the Female Reproductive system Flashcards

1
Q

What are the three parts that make up the pelvis

A

= Ileum
= pubis
= ischium

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2
Q

Where are the pelvis joined together

A

Joined at the sacroiliac joint posterior and pubic symphysis anteriorly

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3
Q

what kind of joint is the pubic symphysis

A

cartilaginous

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4
Q

what kind of joint is the sacroiliac joint

A

partially cartilaginous and partially synovial,

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5
Q

where do the ileum, pubis and ischium all meet

A

acetabulum

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6
Q

what are in vertical alignment with each other in the bony pelvis

A

The ASIS and pubic symphysis

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7
Q

describe what makes up the ileum

A

Iliac crest
Posterior superior iliac spine
Anterior superior iliac spine – inguinal ligament and satrious
Anterior inferior iliac spine – attachment for rectus femoris

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8
Q

what makes up the pubis

A

Pubic tubercle
Inferior pubic ramus
Superior pubic ramus

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9
Q

what bones form the obturator foramen

A

pubic bone and ischium

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10
Q

what are the two important parts of the ischium

A
  • Ischial tuberosities – large bony parts that we sit on

- ischial spine

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11
Q

What goes through the obturator foramen

A
  • Obturator artery – goes through the obturator foramen and then in the medial compartment of the thigh where it supplies the medium compartment of the thigh
  • Obturator nerve
  • Obturator vein
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12
Q

What goes under the inguinal ligament

A
  • Femoral artery
  • Femoral nerve
  • Femoral vein
  • These pass into the anterior aspect of the thigh and supply the anterior aspect of the thigh
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13
Q

where is the sacrospinous ligament versus the sacrotuberous ligament

A

Sacrospinous ligament
- Ischium spine and sacrum
Sacrotuberuous ligament
- Ischial tuberosity and sacrum

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14
Q

describe the pelvic inlet

A

extends from the top of the sacrum and round, extends along the ileum and the pubis towards the pubic symphysis and then back around

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15
Q

describe the pelvic outlet

A

this is coccyx posteriorly extends towards the ischial tuberosity and pubic symphysis then back to the ischal tuberitiy and cocylx

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16
Q

describe the structure of the female pelvis

A

Wide sub-pubic angle (greater than 80°)- allow baby out

Wide pelvic inlet and outlet if the baby goes through he pelvis inlet it needs to go out of the pelvic outlet

Thin and light structure

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17
Q

describe the structure of the male pelvis

A

Narrow sub-pubic angle (less than 70°)

Narrow pelvic inlet and outlet, pelvic inlet is larger than pelvic outlet

Thick and heavy structure - thicker muscles attach here

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18
Q

what is above and below the pirmforis muscle

A

above is the greater sciatic foramen and superior gluteal neurovascuarl

Below piriformis is the lesser sciatic foramen and inferior gluteal neurovascualr bundle

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19
Q

what goes out of the greater sciatic foramen

A
  • Gluteal arteries
  • Gluteal veins
  • Gluteal nerves
  • Sciatic nerve
  • Pudendal nerve
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20
Q

what goes in the lesser sciatic foramen

A
  • Pudendal nerve
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21
Q

what does the common iliac artery divide into

A

into the external and internal iliac artery

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22
Q

where does the external iliac artery go

A
  • External iliac artery goes underneath the ilignual ligament and becomes the femoral artery
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23
Q

how many branches leave and stay in the internal iliac artery in the pelvis

A
  • 4 branches leave the pelvis 3 remain
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24
Q

describe the 4 branches that leave that branch of the internal iliac artery out of the pelvis

A

= obturator artery- leaves via the obturator foramen,
= gluteal arteries – leaves via greater sicatic foramen, inferior below primforis, superior above primforis
= internal pudendal artery also goes out the greater sciatic foramen

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25
Q

name the three arteries from the internal iliac artery that remain

A
  • Uterine artery – goes to the uterus
  • Superior vesicular artery – goes to the bladder
  • Middle rectal artery – goes to the rectum
    In males wouldn’t have a uterine artery instead you would have an inferior vesicular artery
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26
Q

what 4 muscles is the pelvic floor made out of

A

levator ani

  • puborectalis
  • pubococcygeous
  • illococcygeous

and
- cocygeous

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27
Q

what is the role of puborectalis

A
  • go from the pubic bone, wrap around the rectum and then go back to the pubic bone,
  • they wrap around the rectum at the point where the rectum becomes the anal canal,
  • when they contract they cause an acute angle and when they relax they straighten out of the angle between the rectum and anal canal
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28
Q

where is cocygeous

A

= just superior to the sacrospinous ligament

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29
Q

what is the pelvic floor

A

a musical sheet which closes the pelvic outlet

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30
Q

what overlies piriformis

A

the sacral plexus

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31
Q

what muscle fills the majority of obturator foramen

A

obturator interns

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32
Q

what does obturator interns help create

A

it creates a tendinous arch which levator ani attached to

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33
Q

what is above and below the pelvic floor

A
  • above the pelvic floor is the pelvic organs

- below the pelvic floor is the perineum

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34
Q

what triangles is the perennial membrane made out of

A
  • urogenital triangle anteriorly

- anal triangle posteriorly

35
Q

what is the perennial membrane

A
  • thick membrane underneath the pelvic floor
36
Q

what is on the perenial membrane

A

all the external genital

37
Q

what traverses the perineal membrane

A

The urethra, vagina and anal canal all transverse the floor

38
Q

describe the male perineal membrane

A

Penis

  • this is made out of the corpus cavernous and corpus spongosium
  • the corpus cavernous attaches laterally to each side of the perineum as the crura of the penis
  • the corpus spongiosum attaches the perineal membrane but in the midline where it becomes the bulb of the pneis
39
Q

describe the female perineal membrane

A
  • the crura of the clitoris attaches to either side of the perineum, these extend down into the clitoris itself
  • bulb of the vestibule which is attached to the midline of the perineal membrane
  • bulb of the vestibule splits into two and forms the vaginal and urethra in between
  • also have bartholin glands (greater vestibular glands)
40
Q

where do the greater vestibular glands drain

A

into the vestibule of the vagina

41
Q

what happens if the bartholin glands/ greater vestibular glands have a blockage

A
  • If they block this then form a Bartholin cyst
  • If they become infected then they can form an abcess
  • Bartholin glands or greater vestibular gland are blocked and swell
42
Q

what causes blockage of a bartholin gland or greater vestibular gland

A
  • Obstruction typically secondary to trauma or inflammation

- Then can develop secondary infection leading to abscess formation

43
Q

What are the muscles of the perineal membrane

A
  • Over the bulb of the vestibule there is the bulbospongius
  • Over the cruca of the clitoris there is the ischiocavernous muscle
  • Have transverse perineal muscles on each side
  • Perineal body
  • Have external anal spincher
44
Q

what is the perineal body

A
  • this is a fibromuscualr mass which is the site of convergence of the perennial and pelvic floor muscles
  • it is the final support of the pelvic viscera
45
Q

what can disruption of the perineal body result in

A

disruption of the perineal body can result in prolapse of the pelvic viscera

46
Q

what is susceptive to tear during childbirth and how do you treat this

A
  • The perineal body is particularly susceptible to tearing during childbirth.
  • episiotomy may be performed to prevent tear
47
Q

what is an episiotomy

A

surgical incision of the pernium and posterior vaginal wall

48
Q

what are the two types of episiotomy

A
  • Midline episiotomy and mediolateral episiotomy
49
Q

describe the benefits and negatives of the two types of epiostomy

A

Midline Episiotomy

  • go from the posterior aspect of the labia minor along the midline
  • scar tissue will be in similar composition to the perineal body therefore there is better healing
  • but this tear goes towards the anal so risk of tearing anal canal

mediolateral episotomy

  • labia minora posterior aspect towards midpoint between ischial tuberosity and anus
  • direct tearing away from the anus but muscle won’t heal as well
  • done in the UK
50
Q

where does the pudendal nerve travel

A

It branches from the sacral plexus and leaves the pelvis through the greater sciatic foramen, before turning back to enter the lesser sciatic foramen to enter the perineum

51
Q

what does the pudendal nerve innervate

A

sensory and motor innervation to the perineum and is therefore sensory to the genitals and motor to the external urethral and anal sphincters.

52
Q

what spinal roots does the pudendal nerve emerge from

A

S2-S4

53
Q

describe the structure of the uterus

A
  • fundus
  • body
  • cervix
  • Fallopian tube join it
54
Q

name the 4 parts that make up the Fallopian tubes

A
  • Fimbrae – closet to the ovary
  • Infundibulum – starts to funnel down
  • Ampulla – slight swelling
  • Isthmus – narrowed portion going towards the uretuer
55
Q

What is the blood supply from the female reproductive system derived from

A
  • Blood supply to the female reproductive system is derived from the uterine artery (int. iliac artery) and the ovarian artery (abdominal aorta).
56
Q

what does the uterine artery pass over and why is this a problem

A
  • The uterine artery passes over the ureter. The ureter is therefore at risk during hysterectomies
57
Q

the uterine artery gives off

A
  • Uterine artery gives of the vaginal artery
58
Q

what is an ectopic pregnancy

A
  • Implantation happening anywhere other than the uterine wall then there is an ectopic pregnancy
59
Q

where does fertilisation tend to take place

A

ampulla

60
Q

what is the most common type of ectopic pregnancy

A
  • Most common type is tubule ectopic pregnancy where it is implanted into the fallopian tube as opposed to the uterus
  • These are not viable as cannot stand the size of the fallopian tube
  • Happens in the isthmus or ampulla
61
Q

what happens if an ectopic pregnancy is left

A
  • If they continue grown and rupture then you can get perfused bleeding which can be life threatening
62
Q

name the normal position of the uterus

A

anteverted and anteflexed

63
Q

describe what

  • anteverted
  • anterflexed means
A
  • Normally the cervix is anterior positioned with respect to the vagina therefore this is anteversion this means an anterior position of the cervix
  • If you look at the fundus of the uterus this is anteriorly positioned with respect to the cervix and vagina therefore this is ante flexion
64
Q

what does

  • retroverted
  • retroflexed mean
A
  • Retroverted uterus – this is when the funuds is orientated anterior but the cervix is posionted posterior
  • Retroverted and retroflex – cervix and fundus are both positioned posteriorly
65
Q

how is the uterus supported

A
  • ligaments aid in supporting the uterus
  • ligaments originate from the fascia of obturator interns and run across the cervix = cardinal ligaments
  • uretroscaral and pubocervical ligaments helps keep the uterus in its position
66
Q

what is uterine prolapse

A
  • Descent of the uterus into the vagina

- - caused by pelvic floor and uterine ligament dysfunction

67
Q

How do you treat uterine prolapse

A
  • Ring pessary – plastic ring that can be poisoned within the vaginal and this helps supports the uterus and prevent it from prolapsing
68
Q

name two ligaments that are associated with the uterus and derived from the peritoneum

A
  • Rectouterine pouch of douglas – rectum and uterus

- Vesicouterine pouch – baladder and uterus

69
Q

what is the clinical use of the rectouterine pouch

A
  • most inferior part of the pierneal cavity so can collect blood
  • can assess this blood and samples through the posterior fornix
70
Q

describe the ligaments of the female reproductive system

A
  • Suspensory ligament of the ovary – has blood vessels coming towards the ovary
  • Broad ligament – where the peritoneum folds on the top
  • Round ligament of the uterus – remnant of the foetal gubercunulm – attaches to the anterior abdominal wall
  • Ovarian ligament – between ovary and uterus
71
Q

what does the gubernaculum do

A
  • in foetal life if guides the descent of the ovaries from the abdomen
72
Q

describe how the size of the uterus changes over adulthood

A
  • In childhood the uterus is the same size as the cervix and due to the small size of the childhood pelvis the majority of the uterus is abdominal.
  • During puberty the body of the uterus rapidly grows to obtain adult proportions.
  • Following puberty the uterus is pear-shaped and lies in the pelvic cavity.
  • During pregnancy the uterus expands to accommodate the foetus.
  • During menopause the uterus decreases in size.
73
Q

describe the anatomy of the cervix

A
  • highly muscular

- made up of an internal os, cervical canal and external os

74
Q

what is a function of the cervix

A
  • keeps bacteria out of the uterus
75
Q

describe the somatic nervous system

A
  • Sensory and motor
  • Distributed to the somatic; musculoskeletal system and skin
  • Senses and reacts mainly to the external environment
76
Q

describe the visceral nerve system

A
  • Sensory and motor
  • Motor split into parasympathetic and sympathetic
  • Distributed to the viscera (organs)
  • Senses and reacts mainly to the internal environment
77
Q

what is the only parasympathetic supply to the pelvis

A

S2-S4 pudnendal nerve

78
Q

below and above the peritoneum what is pain sensation carried by

A
  • Below the peritoneum pain sensation is carried by parasympathetic fibres (S2-4). At the level of the peritoneum and above, pain is carried by sensory fibres (T1-L2).
79
Q

what causes pain sensation in the uterus

A

Uterus is intraperitonum – pain sensation is carried by sympathetic nerves

80
Q

what is pain from the cervix and upper part of the vaginal canal carried by

A

Pain from the cervix and upper part of the vaginal canal is carried by parasympathetic nerves S2-S4

81
Q

describe a lumbar block

A
  • Subarachnoid space L4-5. Complete anaesthesia below waist monitoring of uterine contractions. Commonly followed by headache
  • Cant go higher than L4/L5 as spinal cord ends at ;L1/L2
  • Block all feeling from the waist down and all feeling in the uretus, also block all motor so you cant participate in childbirth therefore this is used for a C section normally
82
Q

describe a caudal epidural block

A
  • Anaesthetic administered to Cather in sacral canal but most done in advance
  • Blocks from parasympathetic nerves and sympathetic nerves
  • Most anaesthetic can be administered in necessary
  • Limbs still unaffected
  • Can still participate in birth
83
Q

describe a pudendal nerve block

A
  • Peripheral nerve block S2-4 – perineum and lower ¼ vagina – mother can feel/assist contractions

Human Development 2 (34 decks)

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