Class 1: Female Pelvic Anatomy Flashcards
what is the pear shaped muscular organ in the female pelvic cavity called?
uterus
what are the 4 parts of the uterus?
- fundus
- corpus/body
- isthmus
- cervix
what is the widest & most superior portion of the UT?
fundus
what is the cornua?
the lateral border of the fundus where fallopian tubes enter the UT
what is the largest part of the UT?
body/corpus
what part of the UT is within the uterine cavity?
body/corpus
which part of the UT is the transition point between the body & cervix?
isthmus
where is the most flexible part of the UT?
isthmus – this is the point where UT bends either ANT or POST
what is the part of the uterus that is cylindrical in shape & projects into the vagina?
cervix
what are the 2 openings of the cx?
internal-os & external-os
what does the internal-os open to?
opens from cx to UT
what does the external-os open to?
opens from cx to vagina
how many fornices form when the cx projects into the va?
4 – 2 lateral, anterior, posterior
what are the layers of the UT from superficial to deep?
- perimetrium/serosa
- myometrium
- endometrium/mucosal layer
which layer of the UT is part of the visceral peritoneum & isn’t seen on U/S?
perimetrium/serosa
what is myometrium composed of?
smooth muscle and CT
what is the function of the myometrium?
it contracts with labor & menstruation
what is the thickest layer of the UT?
myometrium
what layer of the myometrium is the junctional zone?
the inner layer
what does the junctional zone look like?
it can sometimes be seen as a hypoechoic halo around the endometrium
what are the 2 layers of the endometrium called?
- zona basalis/basal layer/deep layer
- superficial layer/functional layer/zona functionalis
which endometrium layer sheds with menses?
the functional layer of the endometrium
which layer varies in thickness depending on the phase of the menstrual cycle?
endometrium
what does the UT look like prior to menarche?
cylindrical & narrow
what is the size of the UT after menopause?
sag 3-6 cm
trv & ap 2-3 cm
what is the size of the UT in a nulliparous female?
sag 6-8 cm
trv & ap 3-5 cm
what is the ratio of the cervix to body/fundus in pediatric patients?
2/3 cx to 1/3 fundus & body
what are the 6 variants in uterine position?
- anteverted
- anteflex
- retroverted
- retroflexed
- dextroverted
- levoverted
urinary bladder & rectal distention does not affect uterine position. true/false?
false
in an anteverted uterus, the body & fundus tilt anterior to the cx. T/F?
true
what is the most common UT variant?
anteverted
which variant shows the body & fundus tilting towards the cx?
anteflexed
which variant shows the body & fundus going away from the urinary bladder?
retroverted
which variant shows the body & fundus tilting posteriorly towards the rectum?
retroflexed
what is the length of the fallopian tubes?
7-14 cm
4 parts of the fallopian tubes?
- interstitial/intramural
- isthmus
- ampulla
- infundibulum
which part of the FT passes through the cornua?
interstitial/intramural
which part of the FT is the narrowest part?
interstitial/intramural
which part of the FT is the medial segment?
isthmus
which part of the FT is the middle segment, the longest & widest, coild & turtuous?
ampulla
which part of the FT is the site of fertilization?
ampulla
which part of the FT is the most common location for ectopic pregnancies?
ampulla
where else in the FT besides the ampulla can ectopic pregnancies occur?
interstitial/intramural portion – interstitial ectopic pregnancy
which part of the FT is the last and lateral segment?
infundibulum
what are the fimbriae?
finger like projections from the infundibulum of the FT that move the ovum to the ovary
how many layers do the FT have & what are they?
- serosal
- muscular
- mucosal
what are the 3 pelvic spaces?
- anterior cul de sac/vesicouterine pouch
- posterior cul de sac/retrouterine pouch/rectouterine pouch/pouch of douglas
- space of retzius
what is the fold of peritoneum over the anterior surface of the UT & UB?
anterior cul de sac/vesicouterine pouch
what is the posterior cul de sac?
the fold of peritoneum over the posterior surface of the UT & rectum
which pelvic space is the most posterior & inferior portion of the peritoneal cavity?
posterior cul de sac
the anterior cul de sac is the most dependent area of the peritoneal cavity. T/F?
false – posterior cul de sac is the most dependent area
the space of retzius is within the folds of the peritoneum. T/F?
false – it is not within the peritoneum folds
where is the space of retzius located?
between the pubic symphysis & UB
what does it mean if we see the space of retzius?
it is NOT fluid accumulation, it is an abscess
function of the uterine ligaments?
to secure the uterus in the pelvic cavity & to house vessels
4 uterine ligaments?
- broad
- round
- cardinal/lateral
- uterosacral
what is the broad ligament?
the part of the peritoneum that divides the true pelvis into anterior & posterior positions
what does the broad ligament cover?
it covers the FT, UT, and is attached to the ovaries posteriorly
where is the broad ligament?
it extends from the lateral sides of the UT to the side wall of the pelvis
which part of the broad ligament covers the uterus?
mesometrium
which part of the broad ligament covers the FT?
mesosalpinix
which part of the broad ligament attaches to the ovaries?
mesovarium/mesovarian
what does the round ligament support?
attaches the cornua to the anterior pelvic wall
function of the round ligament?
helps maintain anteversion of UT
what can excess stretching of the round ligament lead to?
retroversion/retroflexion
what does the uterosacral ligament attach?
attaches the cervix to sacrum to provide posterior support
what does the cardinal ligament attach?
attaches the cervix to the side wall of the pelvis to provide lateral support
4 bones that make up the pelvic girdle?
- sacrum
- coccyx
3-4. 2 innominate bones
which bones form the posterior wall of the pelvis?
sacrum & coccyx
what bones make up the anterior & lateral wall of the pelvis?
innominate bones/coxal bones
what are the coxal bones made of?
- ilium
- ischium
- pubis
what divides the pelvis into the true & false pelvis?
iliopectineal line/linea terminalis
where does the linea terminalis extend from?
extends from the superior border of sacrum to superior margin of the pubic symphysis
where is the true pelvis?
in the area below the pelvic brim/iliopectineal line
the true pelvis holds the reproductive organs. T/F?
true
where is the false pelvis?
above the pelvic brim/iliopectineal line
where is the rectus abdominis muscle?
extends from the xiphoid process to the pubic symphysis area
what are the 3 false pelvis muscles?
- psoas major
- iliacus
- iliopsoas
where may we see the iliopsoas muscle on US?
during a TA pelvic exam at the lateral aspect
what 4 muscles make up the true pelvis?
- obturator internus
- piriformis
- levator ani muscles
- coccygeus muscle
where is the obturator internus muscle?
lateral portion of the true pelvis
where is the piriformis muscle?
the posterior portion of the true pelvis
what muscles make up the levator ani muscles?
- pubococcygeus
- puborectalis
- iliococcygeus
which true pelvis muscles makes up the pelvic floor/pelvic diaphragm?
levator ani muscles & coccygeus muscle
which muscles play a part in urinary & rectal continence?
levator ani muscles
which muscle makes up the POSTERIOR pelvic floor?
coccygeus muscle
what is the size of the ovaries?
3x2x1 cm
what is the formula for the ovarian volume?
LxWxAP/2 (cm3)
what are the 3 ovarian ligaments?
- mesovarian
- ovarian
- infundibulopelvic/suspensory
function of the mesovarian ligament?
anchors the ovary to the posterior surface of the broad ligament
function of the ovarian ligament?
to anchor the meidal aspect of the ovary to the cornua
function of the infundibulopelvic ligament?
anchors lateral aspect of ovary to the pelvic brim & holds ovarian vessels
why is the ovary also called “nude ovary”?
because it’s the only ABD organ that isn’t covered by the peritoneum
what hormones do the ovaries make?
estrogen & progesterone
what are the 2 parts of the ovaries?
outer: cortex
inner: medulla
what does the cortex of the ovaries hold?
primordial follicles
what does the medulla of the ovaries hold?
CT
nerves
blood supply
lymphatics
smooth muscle
how many primordial follicles are we born with & how many mature?
we’re born with millions but only 300-400 mature
what is the follicle that matures each month?
graafian follicle
what size does the graafian follicle mature at and when?
ruptures during ovulation at 1.8-2.5 cm
what does the follicular cavity become?
corpus luteum
what happens to the corpus luteum if the ovum is not fertilized?
it regresses/resolves
what do the follicles of the ovaries look like on US?
swiss cheese appearance
tips to image post menopausal ovaries (3)
- decrease gain
- look for posterior enhancement
- ovaries may be anterior to internal iliac vessel
what are the arteries that supply the uterus?
- IIA/hypogastric artery
- uterine artery
- ovarian artery
the ovaries have a dual blood supply. what are the ateries?
- ovarian artery
- uterine artery
pathway of blood from the aorta to the uterus
abdominal aorta –> RCIA/LCIA –> IIA/hypogastric –> UA –> arcuate artery –> radial artery –> basal artery –> spiral artery
what artery supplies the uterus, ovaries, and fallopian tubes?
uterine artery
what artery supplies the vagina?
vaginal artery
what artery supplies the external genitals?
pudendal artery
what do the basal/straight arteries supply?
basal layer of endometrium
what do the spiral arteries supply?
superficial layer of endothelium
which arteries shed blood during menses?
spiral arteries
what do the arcuate arteries supply?
the outer 1/3 of myometrium
what do the radial arteries supply?
the inner 2/3 of myometrium
another name of ovarian arteries?
gonadal arteries
where does the right ovarian vein drain to?
IVC
where does the left ovarian vein drain to?
LRV –> IVC
