Applied Female Anatomy Flashcards
What is the most important blood supply to the pelvis?
Internal iliac artery
Where do all the arteries exiting the pelvis pass through?
Greater sciatic foramen
What muscles does the superior gluteal artery supply?
Gluteus medius and minimus
What muscle does the inferior gluteal artery supply?
Gluteus maximus
What branches does the inferior pudendal artery give rise to?
Perineum arteries:
> Inferior rectal
> Perineal
> Dorsal clitoris/penis
Name the branches from the internal iliac artery that go to the pelvic viscera
> Superior vesical artery > Inferior vesical artery > Obturator artery > Uterine artery > Vaginal artery > Middle rectal artery
What is an ectopic pregnancy?
A pregnancy in which the fetus develops outside the uterus, typically in a fallopian tube
Where may an ectopic pregnancy occur?
Ampulla (most common), isthmus, ovary, cervix or in the wall (cornual)
What are the signs/symptoms of an ectopic pregnancy?
Light vaginal bleeding, lower abdominal pain, sharp abdominal cramps, pain on one side of the body
What structures are involved in supporting the uterus?
Levator ani, transverse/cardinal ligament, pubocervical ligament, sacrocervical ligaments
How are the transverse/cardinal cervical ligaments involved in supporting the uterus?
Band of fibromuscular fibres that connect the lateral pelvic wall to the cervix and upper vagina
How are the pubocervical ligaments involved in supporting the uterus?
Two firm bands of connective tissue which connect the pubis to the cervix either side of the bladder
How are the sacrocervical ligaments involved in supporting the uterus?
Fibromuscular bands that connect the cervix to the sacrum
What is the fimbriae of the fallopian tube?
‘Hairs’ at the very end of the fallopian tube
What is the infundibulum of the fallopian tube?
The head of the fallopian tube
What is the ampulla of the fallopian tube?
The main segment of the tube as a pipe to the uterus
What is the isthmus of the fallopian tube?
The small portion of tube before the opening into the uterus (narrowest portion of fallopian tube)
What is the normal positioning of the uterus?
Anteverted and ante flexed
Which structures form the pelvic floor?
Levator ani and coccygeus muscles and their covering fascia
Which muscles make up levator ani?
Sphincter vaginae, puborectalis, pubococcygeus and iliococcygeus
What is likely to cause injury to the pelvic floor/levator ani?
Difficult childbirth where levator ani fails to recoil, or atrophy of pelvic viscera after menopause
What are the contents of the female superficial pouch?
Two bulbs of vestibule, crura of clitoris, bulbospongious, ischiocavernosus and superficial transverse perineal muscles, greater vestibular (Bartholin’s gland) and the perineal body
What is the function of the bulbospongiosus muscle in the female superficial pouch?
Reduces the size of the vaginal orifice and compresses the dorsal vein of the clitoris to aid in engorgement
What is the function of the ischiocavernosus muscle in the female superficial pouch?
Assists clitoral erection
Which structures pass through the pudendal canal?
Pudendal nerve (S2-S4), internal pudendal artery and vein
Describe the path of the pudendal canal
Leaves the pelvis through the greater sciatic formate and enters the perineum via the lesser sciatic foramen
Describe the sensory supply to the pelvis above the pelvic pain line
Visceral general afferents travel in the sympathetic nervous system from T5-L2
Describe the sensory supply to the pelvis below the pelvic pain line
Visceral general afferents travel in the parasympathetic nervous system (S2-S4)
Outline spinal block by lumbar puncture as anaesthesia in childbirth
Anaesthesia is given in the subarachnoid space between L4 and L5 which results in complete anaesthesia below the waist (no motor or sensory capacity)
Outline pudendal nerve block as anaesthesia in childbirth
Anaesthesia administered between S2-S4 and provides anaesthesia to the perineum and lower 1/4 of the vagina but the mother can still feel and assist in contractions
Outline caudal epidural block as anaesthesia in childbirth
Where anaesthetic is administered via a catheter to the sacral canal (must be done in advance) but the limbs will remain unaffected
