C1: Female Reproductive Anatomy Flashcards by M B

What does the innominate bone composed of?

Ilium
Ischium
Pubis

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What is the acetabulum

The socket for the hip joint

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What is the boundary of the pelvis that divides the true and false pelvis?
What is the anterior and posterior boundary?

Accurate line
Anterior boundary is the superior margin of the pubic symphysis
Posterior boundary is the sacral prominence

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What is another word for accurate line?

Linea Terminalis
Pelvis brim
Iliopectineal line

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Structures in the true pelvis

Uterus
Ovaries
Fallopian tube
Vessels
Muscles
Rectum and bowel

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Structures in false pelvis

Bowel

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Segments of the uterus

Fundus
Corpus
Isthmus (flexible)
Cervix (fixed)

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In a retroverted uterus…

The fundus is lower than the cervix

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Shapes of the uterus (reproductive and menop and infant and newborns)

Pear shaped: reproductive and postmenopausal years

Bilobed: newborns and infants

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Normal uterus size (infants and reproductive age)

Infantile: 3cm long and 1cm thick
* neonatal is slightly larger than infants

Reproductive size: 8x5x4 cm
* add a centimetre in all directions for multiparous

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Cx to Uterus ratio

Larger cervix than uterus for infants and post menopause women
1:1 ration instead of 2:1 for the uterus

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Uterine layers

Endometrium
Myometrium
Perimetrium

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Layers Endometrium

Stratum functionalis (also called decidual)
-shed during menstration

Stratum Basalis

2nd layer of endometrium
never shed

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Perimetrium

Peritoneal coat

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Endometrial phases

Menstrual
Proliferative
Secretory

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When does the Menstrual Phase occur and how thick with the endometrium be?

Right after menstration, endometrium will be <1mm

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When does the Proliferative phase occur and how thick is the endometrium?

‘3 stripe phase’

Endometrium is 4-8mm

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When does the Secretory phase occur and how thick is the endometrium

After ovulation, endometrium is the thickest

Endo 7-14mm

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Postmenopausal endometrium thickness (with and without bleeding)

Should be <9mm without bleeding

<5mm with bleeding…. if the endometrium is >5 mm with bleeding then it’s indicative of endometrial cancer

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Vagina relationship to cervix

Vagina attached at the level of the internal os and the fornices are the spaces around the cervix/between the vagina and the cervix

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Fallopian tubes are contained within which ligament?

Contained in the mesosalpinx of broad ligament

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Segments of Fallopian tubes

Interstitial (narrow)
Isthmus
Ampulla (longest and widest)
Infundibulum (has fimbriae)

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Location and structure of Ovaries

Found in the fossa of waldeyer

Ovaries have a cortex and a medulla

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Size and shape of reproductive ovaries (average)

Almond shape

3x2x2….. 6cc, and normal is up to 20ccs

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Neonatal ovarian shape and size

Ranges, up to 3.6cc

Post menopausal size of ovaries

>8cc is abnormal

What area of the ovaries contain the vessels and connective tissue?

Medulla

Where does the uterus get its blood supply?

From an anterior branch of the internal iliac artery

What’s another name for the internal iliac artery?

Hypogastric artery

What are the branches of the uterine artery?

Arcuate artery Radial artery Straight arterioles Spiral arterioles

What do the straight arterioles supply?

The basal layer of the uterus

What do the spiral arterioles supply?

The decidual layer of the uterus

What is the path of venous blood leaving the uterus?

``` Venous plexus Uterine vein Internal iliac vein Common iliac vein IVC ```

Where do ovaries get their blood supply from?

The ovarian artery which branches of the aorta

How does venous blood return from the ovaries to the heart?

Right ovarian vein drains into the IVC | Left ovarian vein drains into the left renal vein, which drain into the IVC

The ovarian arteries for an anastomoses with which artery?

The uterine arteries..... so the ovaries have a supplementary supply of blood from this artery

List the name and number of ligaments in the female pelvis

``` Broad ligaments (2) Round ligaments (2) Uterosacral ligaments (2) Ovarian ligaments (2) Suspensory ligaments (2) (also called infundibulopelvic ligaments) ```

What are the broad ligaments?

Double folds of peritoneum that draped over pelvis organs

What are the names of the two broad ligaments?

1) mesosalpinx - drape over the oviducts | 2) mesovarium - posterior portion of the peritoneum that attaches to the ovary

What are the function of the round ligaments?

They hold the uterine fundus and uterine body in a forward postion

What is the function of the uterosacral ligaments?

Anchor the cervix posteriorly

What is the function of the ovarian ligaments?

They attach the ovary to the uterus

What’s the function of the suspensory or infundibulopelvis ligament?

It attaches the ovary to the lateral wall of the pelvis

Where is the rectus abdominus found?

The anterior wall of the abdomen

What is the linea alba?

Aponeuroses that fuses the 2 rectus muscles, the oblique muscles and the transverse muscles at the midline

Where is the psoas muscle found?

The posterior abdominal wall

Where is the iliopsoas muscle found?

Anterior and lateral in the pelvis... lateral to the external iliacs Its considered to be in the greater/false pelvis

List the muscles found in the true pelvis

Obturator internus muscle Piriformis Levator ani muscle Coccygeus

List the items the make up the perineum

``` Urethra Vagina Rectum Coccygeus muscle Levator ani muscles (Pubococcygeus) (Iliococcygeus) ```

What are the 2 intraperitoneal potential spaces?

1) Posterior cul de sac/rectouterine pouch | 2) anterior cul de sac/vesicouterine pouch

What are the 2 extraperitoneal spaces?

Fornices | Spaces of retzius

Which organs does the peritoneum not line in the pelvis?

Ovaries

What is the landmark for ovaries?

Internal iliac arteries

What part of the ovary contains the follicles?

The cortex

The ovarian artery enters which ligament before reaching the ovary?

Infundibular ligament/suspensory ligament

What shape are the ovaries in infants?

Sausage

What is the maximum ovarian volume for a pre pubescent child?

8cc

The round ligaments are also called?

Ligamentum tere uteri

Where do the utereter travel in relation to the ovaries?

Posterior and inferior to the ovaries

Ovarian volume of >8ccs for postmenopausal women is normal or abnormal?

Abnormal

What is the opening an the end of the infundibulum?

Ostium

where are the obturator interns muscles located

- form side walls of the pelvis | - directly lateral to the uterus (hard to see)

where are the piriformis muscles located

- posterior wall of the pelvis | - posterior to the cervix

where are the levator ani muscles located

MOST INFERIOR MUSCLES | -form the pelvic floor

where are the coccygeus muscles located

posterior floor of the pelvis