Block 5 Revision Flashcards
Give some examples of primative reflexes
What are they an indication of?
Moro (arm aduction, abduction, crying) , Asymmetrical Tonic Neck Reflex (turn head one side & see ipsilateral extension of limbs & contralateral flexion of limbs), Rooting, Grasping
Indication of motor development- underlying myelination of higher cortical motor pathways
What are the stages of childhood?
Baby 0-1 yrs
Infant 0-2yrs
Childhood 2-10yrs
Early Adolesence 11-13yrs
Middle Adolescence 14-17yrs
Late Adolescence 18-21yrs
What are the 1001 Critical Days?
From conception –> Birth for building optimum security & healthy brain development
Which region develops almost fully after birth?
Orbitofrontal cortex develops almost completely post-natally
Female Repro: What is the tendinous arch? What is its role?
Thickening of fascia over obturator internus. Provides attachment for pelvic floor
What is the perineum?
Space between plevic floor and thighs. Split into Urogenital and Anal triangle. Uses Sacrum, Pubic Symphesis & Ischial Spines as landmarks.
What is covered in perineal membrane?
What is it?
What is its role?
The urogenital triangle
Tough fibrous sheet
Attachment point for external genitalia
What is the perineal body?
What is its function?
Sits between the vagina & anus and is a mass of fibres
Functions:
Union between pelvic floor & perineal membrane
Important for pelvic floor integrity
Supports posterior vaginal wall
Attachment point for anal sphincters
What are the ischioanal fossae? What is the function of it?
Fat filled regions. Deep to the pelvic floor either side of the anus. Extensions into urogenital triangle. Helps support the pevlic floor & anal canal
What musculature does the deep perineal pouch contain in females? What is the innervation?
Compressor urethrae
External urethral sphincter
Sphincter Urethrovaginalis
Deep transverse perineal muscle
What is the contents of the deep perineal pouch in males?
If there is a muscle in here what is it’s innervation?
Bulbourethral glands (although open into urethra superficial to perineal membrane)
External urinary sphincter
Deep Transverse muscles
What structures are considered external genitalia for females?
Which is in the superficial perineal pouch? What provides an attachment point?
- Mons Pubis
- Clitoris (Formed by paried Corpora Cavernosa & Vestibular bulb)
- Labia majora
- Labia menora (surrounds the vestibule-space between L.menora where vag/urethra open onto)
- Opening of the Greater Vestibular Glands (bartholian glands)/ (actual) Bartholian Glands
Superficial Perineal Pouch
- Vestibular bulb (spongy explansile vascular tissue w/ overlying muscles. Lies deep to skin w/ on either side of vestible. Helps form clitoris w/ corpora cavernosa)
- Corpora Cavernosa (form cura of clitoris)
- Overlying: Ischiocavernous muscle (over Cura or Clitoris) & Bulbospongiosus muscle ( over greater vestibular glands & greater vestibule)
Attachment: Perineal membrane
What is sensory to the clitoris (& distal vagina & urethra)?
Pudendal
You perform a midline episiotomy, what are you going to cut through?
Skin & Subcut tissue
Transverse perineal muscles & bulbospongiosus muscle
Perineal membrane
Levator ani
Posterior wall of the vagina
How does the epithelium change in the cervix proximal to distal?
Proximal = Columnar
Distal = Squamous
Female Repro: What is the are the fornix?
Where the cervix projects into the vaginal vault forming a recess.
Posterior fornix is deepest and adjacent to rectouterine pouch
Where is the uterus linked to the uterine tubes?
Uterine horns (cornua)
Female Repro: What are fibroids and where do they form (think layers)
Benign smooth muscle tumors
Can form in uterus
If an ectopic pregnancy occurs in the uterine tubes and ruptures what does this lead to?
Haemoperitoneum
What nerve can ovarian pathologies impinge on?
Obturator nerve
What are the key ligaments of female repro?
Broad ligament
Suspensory ligament of ovary (contains lymph & vessels)
Round ligament of ovary (ovary –> uterus)
Round ligament of uterus (uterus –> labia majora via inguinal canal)
What is the broad ligament?
What is its function?
What are the 3 parts?
Double layered fold of peritoneum
Support & Surround: Ovary, Uterine tubes, Uterus
Mesovarium, Mesosalpinx, Mesometrium
The round ligaments (of ovary & uterus):
a) What are they remnanents of?
b) Clinically why is the round ligament of the uterus important?
a) Remanents of Gubernaculum
b) Provides a route of travel for cancer from ovary and uterus to the superficial inguinal lymph nodes
What has been removed in:
a) TAH
b) Subtotal hysterectomy
c) Radical hysterectomy
d) Bilateral Salpingoophorectomy
a) Uterus & Cervic
b) Cervix preserved
c) Uterus, Cervix, Associated supporting tissue Lymphatics
d) Uterine tubes & ovaries
