Chapter 1 — Female Reproductive Anatomy Flashcards by Dani Coryell

The pelvic is divided into 2 regions by?

Linea Terminalis
Which is an imaginary line

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When pelvis is divided into 2 regions what are the regions called

False pelvis / greater pelvis
— Above the Linea
True pelvis / lesser pelvis
— below the Linea

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This uterine ligament is situated anterior & inferior to the broad ligament & tubes & attached to the the Uterine Cornu to anterior pelvic wall

Round Ligament

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This uterine ligament extends from later uterus & attaches to the lateral pelvic side wall

Broad ligament
- Mesosalpinx
- Mesovarium
- Mesometrium

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This uterine ligament connects to the uterus at the level of the cervix to provide support for uterus and cervix

Cardinal ligament (Lateral Cervical)

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This uterine ligament provides posterior support

Uteroscaral ligament

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This ovarian ligament attaches to the inferior ovary to unterine cornu

Ovarian ligament

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This ovarian ligament attaches the ovary to the portion layer of the broad ligament on each side

Mesovarium

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This ovarian ligament attaches to lateral ovary to posterolateral pelvic wall & transmits the ovary vessels & nerves

Suspensory ligament
— infundibuopelvic

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This pelvic muscle is forms most of the anterior body wall, extends from xiphoid to pubic symphysis, it is also responsible for refraction/ghosting artifact

Rectus abdominus muscle (6 pack)

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This pelvic muscle originates from the lower thoracic & lumbar vertebrae, courses laterally & anteriorly through the abdomen, below the level of the iliac crest fibers of this muscle begin to merge (interdigiate) with fibers from medial aspect of iliacus m forming iliopsoas m which inserts on the lesser trochanter of the femur.

Psoas Major

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This muscle will most likely be mistaken for an ovary sonographically

Iliopsoas

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This muscle arises at the iliac crest & extends inferiority until it merges with the psoas major m and forms part of the lateral margins of the pelvic basin

Iliacus

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This muscle is a triangular sheet of muscle anchored along the brim of the true pelvis, it extends posterior;y & medically along the side wall of the true pelvis, passing beneath the lavator ani to exit through the lesser sciatic foramen & inserts on the greater trochanter

Obturator internus

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This muscle is located deeply posterior in the true pelvis, ;essentially routinely imaged due to its deep location

Piriformis

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What is composed of the coccygenus m & levator ani m and its functions are to resist increased intra-abdominal pressure and resist gravity

Pelvic diaphragm

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What are the orifices that pass through levator ani m (from anterior to posterior)

Urethra
Vagina
Rectum

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This muscle forms the posterior floor

Coccygeus

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This muscle is located between the pubis & coccyx and forms the anterior / middle pelvic floor

Levator ani m group
- iliococcygeus m
- pubococcygeus m
- puorectalis

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Which muscles is located in the abdominopelvic region

Rectus Abdominus m (anterior wall)
Psoas major m (posterior wall)

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Which muscles are located in the false pelvis

Iliacus m (iliac fossa)

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Which muscles are located in the true pelvis

Obturator internus m (lateral wall)
Levator ani m (middle & anterior flor)
Coccygeus m (posterior floor)
Piriformis m (posterior wall)

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This pelvis organ is a hallow musculomembranous organ & located between symphysis pubis & vagina, the ureters inserts at the inferior posterior portion of this organ (trigone)

Urinary Bladder

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This organ is approximately 7-10cm canal of smooth muscle, the upper portion of this organ surrounds the cervix creating gutters known as the vaginal fornices

Vagina

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Which vaginal fornix surrounds the anterior aspect of the extrernal cervix & is smaller than the posterior

Anterior fornix

Which vaginal fornix surrounds the posterior aspect of the external cervix & is a frequent site for vaginal fluid collection due to the gravity dependence

Posterior fornix

Which vaginal fornix has 2 and surrounds the lateral aspect of the external cervix on either side

Lateral fornices

This organ is pear shaped, hallow located between the urinary bladder & rectum

Uterus

This portion of the uterus is the upper expanded portion between the fallopian tubes

Fungus / dome

This portion of the uterus is the main portion

Body / corpus

This portion of the uterus is the area between body & cervix, it is the most flexible portion of the uterus & grows at the most rapid rate during pregnancy

Isthmus / lower uterine segment

This portion of the uterus is a cylindrical projection into the vagina which provides an alkaline secretion favorable for sperm penetration & acts as a sphincter during pregnancy

Cervix

This portion of the uterus is the continuation of the endometrial cavity into the cervix

Endometrial canal

This cervical is is the opening from the cervix into the uterus

Internal os

This cervical os is the opening from the cervix into the vagina

External os

Uterine size Age: 2-8, 9-menarche, nulliparous, muliparous Length (mm): 33, 43, 80, 90 AP (mm): 7.5, 13, 30, 40 Postomenopausal - varied, based on parity & years since menopause

A newborn uterus has a relatively larger cervical length & width — 2/3 cervix & 1/3 body & uterus A pediatric uterus is 1/2 cervix & 1/2 body & fundus A postmenopausal uterus has normal adult proportions — 1/3 cervix & 2/3 body & uterus

Which layer of the uterus is the outer serosal layer which is part of the visceral peritoneum, laterally it becomes the broad ligament & anteriorly it forms vesicouterine pouch (anteriorly curl-de-sac) & posteriorly forms rectouterine pouch (pouch of Douglas / posterior cul-de-sac) & is the most dependent recess in the body

Perimetrium

Which layer of the uterus is the middle muscular layer, which is composed of 3 layers of smooth muscle which contract during parturition, this layer is thick and has a relatively homogeneous appearance sonographically, & the inner portion sometimes appears hypoechoic &nis referred to as the junctional zone

Myometrium

Which layer of the uterus is the inner mucous layer & consists of the superficial functional layer (stratum functionalis) & deeper permanent basel layer (stratum basalis)

Enometrium

Uterine layers (outer-inner) - perimetrum > myometrium > basal layer of endo > functional layer of endo

Which uterine positional variation is forward placement of the uterus at the cervix (forming a 90 degree angel with the vagina)

Anteversion

Which uterine positional variation is tiliting backward of the uterus at the cervix (oriented more literarily in relationship to the vagina)

Retroflextion

Which uterine positional variation is bending forward of the uterus at the body

Anteflextion

Which uterine positional variation is a bending backward of the uterus at the body (may become incarcerated during pregnancy - symptom is urinary retention)

Retroflexion

Transvaginal (endovaginal) - higher transducer frequencies than transabdominal greater than 7.5 MHz - convex or phased array - high level disinfection following scan * NO AUTOCLAVING *

Ovarian Size Premenopausal (varies), postmenopausal (varies) Size: 3.5 x 2.0 x 1.5 cm, 2.0 x 1.0 x 0.5 cm Mean volume: < 9.8 cm3, < 5.8cm3

This is a pair organ, ovoid in shape & suspended within the pelvic peritoneal sac, posterior to the broad ligament

Ovaries

This part of the ovarian parenchyma is the outer functional layer, it constitutes the bulk of the ovarian substance & contains a large number of primordial & developing follicles

Cortex

This part of the ovarian parenchyma is the inner ovary which contains blood vessels & connective tissue

Medulla

What is the area called that the ovarian vessels & nerves enter & exit the ovary

Ovarian hilum

Which pelvic organ is paired musculomembranous tubes extending laterally from the uterine cornu, is 7-4cm in length, & function to transport the fertilized ovum to the uterus by means of peristaltic contractions

Fallopian tubes (oviducts)

This region of the fallopian tube is narrow & relatively straight; located within uterine wall (Cornu)

Interstitial / intramural

This region of the fallopian tube is the medial portion closest to uterus (medial 1/3)

Isthmus

This region of the fallopian tube is the longest portion & curved around the ovary, is thin walled & distendable, normally site of fertilization (middle 1/3)

Ampulla

This region of the fallopian tube is the outer, trumpet-shaped end (distal 1/3)

Infundibulum

This region of the fallopian tube has numerous finger-like projections which maintain a close relationship between the tube & ovary

Fimbriae

Which peritoneal recesse is located between the pubic bone & the anterior urinary bladder wall, rarely fluid is seen in this space but masses in this space will displace the urinary bladder posteriorly

Space of retzius (retropubic / prevesical space)

Which peritoneal recesse is located anterior to the uterus & posterior to the urinary bladder, space is usually empty but may contain loops of bowel

Vesicouterine space (anterior curl-de-sac)

Which peritoneal recesse is located posterior to the uterine cervix & anterior to the rectum, uterosacral ligaments form the lateral boundaries of the body, therefore the most common site for free peritoneal fluid to collect

Rectouterine space (posterior curl-de-sac)

Blood supply to the pelvic viscera is provided by the major branches of the

Distal abdominal aorta

Abd AO bifurcates at the level of the L4 into right & left common iliac arteries, the common iliac arteries bifurcates into the external & internal iliac arteries Right & left external arteries supply the lower extremities with blood Right & left internal iliac (hypogastric) arteries supply the pelvic visceral with blood via several branching arteries, including the uterine arteries

Uterine artery crosses the ureternon each side, &at the cervix ascends along the lateral portion of the uterus within the broad ligament At the uterine Cornu the uterine arteyncourses laterally to reach the ovary & ends by joining the ovarian artery

Uterine artery gives rise to actuate arteries (circumferential within outer myometeium) Arcuate give rise to radial arteries (supply deeper layers of myometerium Radial give rise to spiral arteries which supply the endometrium with blood

Branches of Uterine A. (Outer > Inner & Superficial > Deep)

Uterine A > Arcuate A > Radial A > Spiral A

This is the lateral branches of the abdominal AO & rise just below level of the renal arteries, course to the pelvis & reach ovarian glum via the infundinopelvic ligament

Ovarian A (generally called Gonadal A)

Venous System Parallels with the arteries Right gonadal (ovary) vein empties into inferior vena cava (IVC) just below the level of the right renal vein, while left gonadal vein empties into the left renal vein

Uterine A (non-gravida pt) Moderate-high velocity/ high resistance Higher resistance in proliferation phase Higher resistance in postomenopausal

Ovarian Arteries Follicular phase low velocity, high resistance Periovulatory period & Luteal phase resistance drops on dominant follicle side (lower PI & RI) low resistance Postmenopausal RI approach 1.0 (high resistance)