Applied Maternal Anatomy Flashcards
What are the layers of the abdomen?
Skin
SQ layer -> Camper’s facia (superficial layer; fatty), Scarpa’s fascia (more membranous, deeper layer)
Muscles (rectus abdominis, pyramidalis muscle, external & internal Oblique, Transversus abdominis)
Transversalis fascia
Peritoneum
What is the strongest layer of the abdomen?
Fascia
What are the 3 arteries that arise from the fetal artery?
Superficial circumflex artery
Superficial epigastric artery
External pudendal artery
What are the borders of the Hesselbach triangle?
Lateral = inferior epigastric vessels
Inferior = inguinal ligament
Medial = lateral border of the recuts abdominis
What is the diff betw indirect and direct inguinal hernia?
Direct = hernia protrudes through the abdominal wall in the boundary of the H triangle
Indirect = hernia bulges through the deep inguinal ring that lies lateral to the H triangle
What are the nerves and corresponding incision types?
Intercostal & Subcostal nerve = Pfannenstiel Incision
Ilioinguinal & Iliohypogastric = Low transverse
What are the important dermatomes in suitability in delivery?
T4 = Cesarean deliveryif pureperal sterilization
T10 = labor & vaginal delivery
What condition is common in pregnancy where uterus enlarges due to the advancing age of gestation and the round ligmanet also stretches?
Round ligament syndrome
What are the landmarks for Pudendal block?
Ischial spines
What are the 6 openings?
Urethra
Vagina
2 greater vestibule (bartholine) gland ducts
2 paraurethral (skene) gland ducts
What is the position of the Bartholin GLand ducts ?
At 5 o’clock and the other at the 7 o’clock on the vestibule
What are the largest pareurethral glands canlled?
Skene’s glands (near urethra)
What are the blood supplies of the vagina?
Proximal wall = cervical br of the uterine a and vaginal a
Posterior wall = middle rectal artery
Distal wall = internal pudendal artery
What are the boundaries of the perineum?
Anterior = pubic symphysis
Anterolateral = ischiopubic rami and ischial tuberosities
Posterolateral = sacrotuberous ligaments
Posterior = Coccyx
What are the components of the perineal body?
Bulbospongiosus
Superficial transverse perineal muscle
External anal sphincter muscles
What is the significance of the perineal body?
Incised during episoiotomy (done if there is a tear forms in the perineal body during delivery)
What muscle will not be cut during a mediolateral episiotomy?
Superficial transverse perineal muscle
What is composed of th pelvic diaphragm?
Levator ani muscles
Coccygeus muscle
Whata are the risk factors for Pelvic Organ Prolapse during vaginal birth?
Eldgerly age
Muliparity
level of activitiy (hard and intense work)
What is the most commonly damages muscle in Pelvic Organ Prolapse?
Pubovisceral muscle
What divides the perineum into anterior and anal triangle?
Perineal body
What is the normal vs pregnant appearance of cervix?
Normal: smooth, pinkish, no lesions
Pregnant (normal):
- Chadwick’s sign, Goodell’s sign, Hegar’s sign, Leukorrhea (as long as whitish w/o foul smell)
What is the appearance of the Chadwick’s sign, Goodell’s sign, Hegar’s sign?
Hegar’s sign = softening of the uterine isthmus
Goodell’s sign = softening of the vaginal portion of the cervix due to INC vascularity
Chadwick’s sign = purplish to blue cervix due to INC vascularity
Where does the round ligmanet terminate?
Labia majora
What condition has pregnant px complaining of inguinal pain at the vagina area?
Round ligament syndrome = this is being stretch
What artery is seen in the round ligament?
Sampson artery aka Artery of the round ligament
What are the boundaries of uterosacral ligaments?
Form the lateral boudnaries of the Pouch of Douglas
What is the blood supply of the uterus?
Inferior Vena cava = Left renal vein (ovarian vein), Right renal vein, Common Iliac vein (External, Internal iliac vein)
Aorta = Ovarian a, Common iliac (external & iliac arteries)
What are the 2 major divisions of the internal iliac artery?
Posterior division (SIL): Superior gluteal a, Iliolumbar a, Lateral sacral a
Anterior division = Parietal, Visceral
Parietal = Obturator, Internal pudendal, Inferior gluteal
Visceral = Umbilical, middle vesical, middle hemorrhoidal, uterine, vaginal
What is the most common site of ectopic pregnancy?
Ampulla
What are the blood and nerve supply of the bladder?
BS: Superior vesical arteries
NS: Vesical plexus
What aer the boundaries of the pelvic inlet?
Anterior = pubic symphysis, superior pubic rami
Posterior = sacral promontory, sacral alae
Lateral = Linea terminalis
What is the most important part of the pelvic inlet?
Obstetrical conjugate: shortest distance between the sacral promontory & symphysis pubis
What is the normal obstetrical conjugate?
DC - 1.5 to 2cm
What are the diff types of pelvis?
Gynecoid = most round shape (50% of women)
Platypelloid = longer transverse diameter
Anthropoid = Longer anteropposterior diameter
Android = heart-shaped pelvis
