Chapter 39 reverse Flashcards

1
Q

reverse

mons pubis

labia majora

labia minora

clitoris

urethral opening

vestibule of vagina

A

Pelvic landmarks

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2
Q

reverse

2 coxal bones

sacrum

coccyx

true and flase pelvis

A

Bony pelvis

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3
Q

reverse

situated inferior to caudal portion of parietal peritoneum

condisered pelvic cavity

A

true pelvis

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4
Q

reverse

posterior wall formed by sacrum and coccyx

posterolateral wall formed by piriformis and coccygeus muscles

anteriolateral walls formed by hip bones and obturator internus muscles, which rim ischium and pubis

lower margin formed by levator ani and coccygeus muscles

known as pelvic diapraghm

A

pelvic cavity

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5
Q

reverse

area below pelvic floor

A

perineum

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6
Q

reverse

posterior: rectum, colon and ileum
anterior: bladder, ureters, ovaries, fallopian tubes, uterus, vagina

A

pelvic cavity

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7
Q

reverse

psoas major: sidewall

iliacus: sidewall

Piriformis: posterolateral wall

Obturator internus: anterolateral pelvic sidewall

Levator ani: pelvic floor (diaphragm)

Coccygeus: posterior pelvic floor (diaphragm)

A

muscles of pelvis

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8
Q

reverse

muscles extend superiorly from xyphoid process to symphysis pubis inferiorly

paried rectus abdominis anteriorly

external obliques

internal obliques

transvers abdominis anteriolaterally

A

Abdominal wall

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9
Q

reverse

Psoas major

iliacus muscles

psoas muscles join with iliacus muscles to form iliopsoas muscles

A

muscles of false pelvis

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10
Q

reverse

Piriformis muscles

obturator internus muscles

muscles of the pelvic diaphragm

A

Muscles of true pelvis

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11
Q

reverse

Levator ani (pubococcygeus, iliococcygeus and puborectalis muscles)

Coccygeus muscles

A

muscles of pelvic diaphragm

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12
Q

reverse

apex: located posterior to pubic bones

Base: anterior to vagina, superior surface related to uterus

Neck: rests on upper surface of urogenital diaphragm; inferiolateral surfaces relate to retropubic fat, obturator internus, levator ani muscles, pubic bone

A

Bladder

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13
Q

reverse

cross pelvic inlet anterior to bifurcation of common iliac arteries

run anterior to internal iliac arteries and posterior to the ovaries

coarse anteriorly and medially under base of broad ligament where crossed by uterine artery

run anterior and lateral to upper vagina to ender posteroinferior bladder

A

Ureters

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14
Q

reverse

collapsed musclular tube that extends from external genitalia to cervix of uterus

approx 9cm in length

l

A

Vagina physical description

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15
Q

reverse

normally directed up and back fromning 90 with uterine cervix

extends up and back from vulva

upper half lies above pelvic floor

lower half lies within perineum

vaginal lumen surrounding cervix divided into 4 fornices

A

Vagina landmarks

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16
Q

reverse

from vaginal and uterine arteries

drains into internal iliac vein

A

Vaginal blood supply

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17
Q

reverse

projects into vaginal canal

endocervix

exocervix

protrudes into upper portion of vaginal canal forming 4 recess (fornices)

continuous ring shaped space with posterior fornix running deeper than ints anterior counterpart

A

Cervix

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18
Q

reverse

cervical canal

communicates with uterine cavity by internal os

with vagina by external os

A

Endocervix

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19
Q

reverse

continuous with vagina

A

exocervix

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20
Q

reverse

hollow pear shaped organ

fundus

body

cervix

usually anteflexed and anteverted

covered with peritoneum except anteriorly below os where peritoneum reflected onto bladder

supported by levator ani muscles, cardinal and uterosacral ligaments

round ligaments hold uterus in anteverted position

A

Uterus

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21
Q

reverse

premenarchal: 1-3 cm long by .5-1 cm wide
menarchal: 6-8 cm long by 3-5 cm wide

w/multiparity: increases by 1-2 cm

postmenapausal: 3.5-5.5 cm long by 2-3 cm wide

A

Uterine size

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22
Q

reverse

posterior to vesicouterine pouch and superior surface of bladder

anterior to rectouterine pouch (of Douglas), ilium, colon

medial to broad ligaments and uterine vessels

uterine cavity is funnel shaped in coronal plane, slitlike in sagital plane

A

uterine body

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23
Q

reverse

perimetrium

myometrium

endometrium

A

layers of uterus

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24
Q

reverse

serous outer layer of uterous

serosa

A

perimetrium

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25
Q

reverse

muscular middle layer of uterus composed of thick smooth muschle supported by connective tissue

A

myometrium

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26
Q

reverse

inner mucous membrane

glandular portion of uterine body

A

endometrium

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27
Q

reverse

broad

mesovarium

mesosalpinx

round

cardinal

uterosacral

suspensory

ovarian

A

uterine ligaments

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28
Q

reverse

lateral aspect of uterus to pelvic sidewall

A

broad uterine ligament

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29
Q

reverse

posterior fold of broad ligament

encloses ovary

A

mesovarium uterine ligament

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30
Q

reverse

upper fold of broad ligament

encloses fallopian tube

A

mesosalpinx uterine ligament

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31
Q

reverse

fundus to anterior pelvic sidewalls

holds uterus forward

A

Round uterine ligament

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32
Q

reverse

extend across pelvic floor laterally

firmly supporst cervix

A

cardinal uterine ligament

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33
Q

reverse

extend from uterine isthmus downward

along side rectum to sacrum

firmly supports cervix

A

uterosacral ligament

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34
Q

reverse

extends from lateral aspect of ovary to pelvic sidewall

A

suspensatory uterine ligament

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35
Q

reverse

extends medially from ovary to uterine cornua

A

ovarian uterine ligament

36
Q

reverse

anteversion

dextroversion

retroversion

retroflexion

A

Uterine postions

37
Q

reverse

most common position

fundus and body bent forward toward cervix

A

Anteversion uterus

38
Q

reverse

normal variant in absence of pelvic masses

A

Dextroversion uterus

levoversion

39
Q

reverse

entire uterus tilted posteriorly

A

retroversion uterus

40
Q

reverse

fundus and body bent backward towards cervix

A

retroflexion uterus

41
Q

reverse

infundibulum

ampulla

isthmus

interstitial portion

12 cm in length

blood supplied by ovarian arteries and veins

A

Fallopian tubes

42
Q

reverse

funner shaped lateral tube projects beyond broad ligament to overlie ovaries

free edge of the funnel has fimbriae

A

fallopian infundibulum

43
Q

reverse

widest part of tube where fertilization occurs

A

Ampulla of fallopian tube

44
Q

reverse

hardest part

lies lateral to uterus

A

isthmus of fallopian tube

45
Q

reverse

pierces uterine wall ar cornua

A

interstitial of fallopian tube

46
Q

reverse

almond shaped

attached at posterior aspect of broad ligament by mesovarium

lie in ovarian fossa

fossa bounded by ext iliacs, ureter obturator nerve

dual blood supply ovarian and uterine artery

blood drained by ovarian vein into IVC on right and renal vein on left

A

Ovaries

47
Q

reverse

anterior to internal iliac artery and vein

medial to external iliac artery and vein

ellipsoid shape with long azis oriented vertically

location highly variable as ligaments loosen, especially after pregnancy

A

Variable postinos of ovaries

48
Q

reverse

outer layer (cortex)

medulla

A

Ovaries normal anatomy

49
Q

reverse

primarily follicles in varying stages of development

covered by layer of dense connective tissue

tunica albuginea

tunica albuginea surrounded by single layer of cells germinal epithelium

A

ovary cortex

50
Q

reverse

composed of connective tissue containing blood, nerves, lymphatic vessels and some smooth muscle at region of hilum

A

medulla of ovary

51
Q

reverse

ovum

two known hormones

estrogen: secreted by follicles
progesterone: secreted by corpus luteum

A

Ovarie reproductive cell

52
Q

reverse

responsible for producing and maintaining secondary gender characteristics

preparing uterus for implantation of fertilized ovum

development of mammary glands in female

A

ovarian hormone responisibility

53
Q

reverse

supported medially by ovarian ligaments originating bilaterally at cornua of uterus

laterally by suspensory (infundibulopelvic) ligament extending from infundibulim of fallopian tubke and ovary to sidewall of pelvis

Ovary also attached to posterior aspect of broad ligament via mesovarium

A

ovarian ligaments

54
Q

reverse

ext iliacs arteries: medial psoas border

ext iliac veins: medial and posterior to arteries

Int iliac arteries: posterior to ureters and ovaries

Int iliac veins: posterior to arteries

uterine arteries and veins: between layers of broad ligaments, lateral to uterus

A

Pelvic vasculature

55
Q

reverse

arcuate arteriers

radial arteries

straight and spiral arteries

ovarian arteries

ovarian veins

A

Pelvic vasculature branches

56
Q

reverse

arclike arteries that encircle uterus in outer third of myometrium

A

arcuate arteries

57
Q

reverse

branches of arcuate arteries that extend from myometrium to base of endometrium

A

radial arteries

58
Q

reverse

branches of radial arteries that supply zona basalis of endometrium

A

Straight and spiral arteries

59
Q

reverse

branch laterally off aorta

run within suspensatory ligaments and anstomose with uterine arteries

A

ovarian arteries

60
Q

reverse

right vein drains into IVC

left drains into left renal vein

A

ovarian veins

61
Q

reverse

reproductive years begin around 11-13 at onset of menses

end around age 50 whn menses ceases

cycle approx 28 days in length

begins with first day of menstrual bleeding

A

Mestrual cycle

62
Q

reverse

mestrual cycle occurs less than 21 days

A

polymenorrheic

63
Q

reverse

menstrual sycel occurs longer than 35 days

A

oligomenorrheic

64
Q

reverse

premenarche: prepuberty
menarche: menstruating approx every 28 days
menopause: cessastion of menses

A

menstrual status

65
Q

reverse

explosive release of ovum from ruptured graafian follicle

rupture associated with small amounts of fliud in posterior cul-de-sac midcycle

midcycle dull ache on either side of lower ab lasting a few hrs

“mittelschmerz” middle pain

A

Ovulation

66
Q

reverse

begins with ovulatoin and about 14 days in length

menstruation almost always occurs 14 days aftern ovulation

cells in lining of ruptured ovarian follicle begin to multiply and create corpus luteum (yellow body)

luteinization and is stimulated by LH surge

corpus luteum begins secreting progesterone

A

luteal phase

67
Q

reverse

corpus luteum degenerates causing progesterone levels to decline

this decline causes menstration to occur and the cycle begins again

A

9-11 days after ovulation

68
Q

reverse

human chorionic gonadotropin (HCG) produced by the zygote causes corpus luteum to persist

it will continue to secrete progesterone for 3 more months until placenta takes over

A

conception and implantation

69
Q

reverse

varying levels of estrogen/progesterone levels induce changes

changes correlate with ovulatory cycles of ovary

3 phases

menstrual phase

proliferative phase

secratory phase

A

endometrial changes

70
Q

reverse

lasta approx 1-5 dyas and begins with declining progesterone levels

causes spiral arterioles to constrict

decreased blood flow to endometrium resulting in ischemia and shedding of zona functionalis

first 5 days coincide with follicular phase of ovarian cycle

as follicles produce estrogen they stimulate the superficial layer of endometrium to regenerate and grow

A

Endometrial menstrual phase

71
Q

reverse

lasts until luteiniation of graafian follicle around ovulation

with ovulation and luteinization of graafian follicle progesterone secreted by ovary causes spiral arteries and endometrial glands to enlarge

prepares endometrium for implanation should conception occur

A

Endometrial proliferative phase

72
Q

reverse

extends from approx day 15 to onset of menses (day 28)

secretory phase corresponds to luteal phase of ovarian cycle

A

Endometrial secretory phase

73
Q

reverse

days 1-14

corresponds to follicular phase of ovarina cycle

mestruation occurs on days 1-4

thin endometrium

estrogen level increases as ovarian follicles develope

‘increasing estrogen causes uterine lining to regenerate and thicken

ovulation occurs on day 14

A

Proliferative phase summary

74
Q

reverse

days 15-28

corresponds to uteal phase of ovarian cycle

ruptured follicle becomes corpus luteum

corpus luteum secretes progesterone

endometrium thickens

no pregnancy, estrogne/progesterone decrease

menses day 28

A

Secretory phase summary

75
Q

reverse

during menses not uncommon to see varying levels of fluid and debris with uterine cavity

with menstruation endometrium becomes thin echogenic line during early proliferative phase

as regeneration occurs endometrium will thicken to 4-8mm in proliferative phase

A

Endometrial changes

76
Q

reverse

hypoechoic

3 line sign

Zona basalis anteriorly and posteriorly

central line representing the cavity

A

endometrium sonogram appearance

77
Q

reverse

measures 6-10 mm and becomes isoechoic with myometrium just before ovulation

after ovulation thickest dimension avg 7-14 mm

becomes echogenic blurring 3 line appearance

A

Endometrium at ovulation

78
Q

reverse

patients NOT on HRT thickness of

patients on HRT or taking tamoxifen may be up to 8 mm

A

postmenopausal endometrium

79
Q

reverse

abnormally heavy or long periods

A

menorrhagia

80
Q

reverse

painful periods

A

dysmenorrhea

81
Q

reverse

absence of menstruation

A

amenorrhea

82
Q

reverse

vesicouterine pouch

rectouterine pouch

\retropubic space

A

pelvic recess

83
Q

reverse

anterior cul-de-sac

anterior to fundus between uterus and bladder

A

vesicouterine pouch

84
Q

reverse

posterior cul-de-sac

posterior to uterine body and cervix

between uterus and rectum

A

rectouterine pouch

85
Q

reverse

space of retzius

between bladder and symphysis pubis

A

retropubic space