clinical anatomy of the female reproductive system Flashcards
what parts of the female reproductive system are in the pelvic cavity?
-ovaries
-uterine tubes
-uterus
-superior part of vagina
what parts of the female reproductive system sit in the perineum?
-inferior part of the vagina
-perineal muscles
-Bartholin’s glands
-Clitoris
-Labia
what is dark green, light green, red, purple and blue?
dark green= true pelvis/ lesser pelvis
light green= false pelvis/ greater pelvis
red dotted line= pelvic inlet
purple= levator ani muscle
blue= perineum
what seperates the false pelvis from the true pelvis?
pelvic inlet
what is the orange, red and yellow
orange= clitoris
red= labia
yellow= vagina
what is the blue, navy, green and purple?
blue= levator ani
purple= rectum
navy= uterus
green= bladder
what is another name for pouch of douglas and why is it clinically relevant?
recto uterine pouch
-most inferior point of an upright female patient and so any excess fluid in peritoneal cavity (pus, blood etc) will go there
what pouches do females have in their pereitoneal cavity?
vesico uterine pouch
recto uterine pouch (pouch of douglas)
what pouches do males have in their peritoneal cavity?
rectovesicle (pouch between their bladder and rectum)
what is the floor of the peritoneal cavity?
inferior part of the parietal peritoneum
what is the roof over pelvic organs?
inferior part of parietal peritoneum
what covers the superior aspect of organs and so forms the pouches in the female peritoneal cavity?
inferior part of the parietal peritoneum
fill in the blanks (peritoneum of a female)
light blue= right ovary
navy= right uterine tube
purple= vesico- uterine pouch
orange= bladder
yellow= uterus
green= rectum
red= recto uterine pouch (pouch of douglas)
what is the dotted line?
left broad ligament
what is the broad ligament of the uterus made out of
-made of a double layer of peritoneum
what is the role of the broad ligament of the uterus?
it helps maintain the uterus in its correct midline position
where is the broad ligament found?
-it extends between the uterus and the lateral walls + floor of the pelvis
where is the proximal part of the round ligament found?
the broad ligament
what is the round ligament of the uterus made out of?
it is an embryological remnant
what is labelled blue and orange?
blue= right round ligament
orange= left broad ligament
where does the round ligament attach to the uterus?
it attaches to the lateral aspect of the uterus
where is the round ligament of the uterus found?
-passes through the deep inguinal ring to attach to the superficial tissue of the female perineum
-attaches to the lateral aspect of the uterus
-the proximal part of the round ligament is contained in the broad ligament
what are the 3 layers of the uterus?
-perimetrium
-myomtrium
-endometrium
which layer of the uterus is the perimetrium
outer
which layer of the uterus is the myometrium and what is it made of?
middle layer and is made of muscle (contracts + cramps during menstruation)
which layer of the uterus is the endometrium?
-the inner layer (thickens for fertalised eggs, sheds during menstruation)
where does impantation of a zygote occur?
in the body of the uterus
where in this uterus would implantation of a zygote occur?
in the body
name the parts of the uterus
orange= fallopian tubes/ uterine tubes
yellow= body
red= external cervical os (opening of cervix into vagina)
green= cervix
blue= vagina
if implantation occurs outwith of the body of the uterus- what is it called?
ectopic pregnancy (usually happens in the fallopian tubes)
what supports the uterus?
-number of strong ligaments (e.g. uterosacral ligaments)
-endopelvic fascia
-muscles of the pelvic floor (e.g. levator ani)
what happens if there is weakness in the uterine ligaments, endopelvic fascia or muscles of the pelvic floor?
weakness of these supports can result in uterine prolapse (movement of the uterine inferiorly)
what is green and orange?
orange= uretosacral ligament
green= levator ani
what are the most common positions for a uterus to be in?
-anteverted and anteflexed
-anteverted (cervix tipped anteriorly relative to the axis of the vagina)
-anteflexed (uterus tipper anteriorly relative to the axis of the cervix and so the mass of the uterus lies over the bladder)
what is the retroverted and retroflexed variation of positioning of the uterus?
retroverted- the cervix is tipped posteriorly relative to the axis of the vagina
retroflexed- the uterus is tipped posteriorly relative to the axis of the cervix
where does fertilisation occur?
in the ampulla
what is a bilateral salpingo- oophrectomy?
removal of both uterine tubes and ovaries
what is a unilateral salpinegectomy?
removal of one of the uterine tubes
blue= isthmus (narrow part)
green= ampulla
yellow= infundibulum (funnel part)
orange= fimbriae of the infundibulum
red= left ovary
what part of the uterus opens into the peritoneal cavity?
the fimbriated end of the uterine tubes
what allows communications between the genital tract and the peritoneal cavity and why is it clinically relevant?
-the fimbriated end of the uterine tubes (because they open into the peritoneal cavity)
-clinically relevant because in theory infection can pass between the two areas
-radioplaque dye can even spill out of the end of uterine tube and into peritoneal cavity
what are almond sized and shapes and located laterally in the pelvic cavity?
ovaries
what do ovaries ecrete in response to FSH and LH?
oestrogen and progesterone
where do ovaries develop and move to?
-Develop on the posterior abdominal wall and move onto the lateral wall of the pelvis
where is the only place where the vaginas walls are not in contact?
superiorly where the cervix holds them apart forming a fornix (space around the cervix)
what are the 4 parts of the fornix?
-anterior
-posterior
-2x lateral
are the walls of the vagina usually open?
no they are usually collapsed
what part of the vagina is sampled when doing a cervical screening?
the squamo columnar junction (transformation zone)
what is the perineum?
-shallow space between the pelvic diaphragm and the skin
what forms the roof of the perineum?
pelvic diaphragm
what are the anatomical borders of the uregenital triangle and the anal triangle (anatomical borders of perineum)?
anterior- pubic symphase
posterior- tip of coccyx
laterally- inferior pubic rami and inferior ischial rami and the sacrotuberous ligament
roof- pelvic floor
base- skin and fascia
what muscle is this?
levator ani muscle
what type of muscle is the levator ani msucle?
voluntary skeletal muscle
what is the role of the levator ani muscle?
-it provides continual support for the pelvic organ with tonic contraction and it reflexively contracts during situations of increased intra abdominal pressure
what supplies the levator ani muscle?
S2-4
-‘nerve to levator ani’
what nerves supply the perineal muscles??
-pudendal nerve
what is the perineal body?
-bundle of collagenous and elastic tissue into which the perineal muscle attach
(the star)
what is the perineal body important for?
for pelvic floor strength
what can gland commonly develop cysts andabscess in the perineum?
Bartholins gland
darker green= mons pubis (anterior to pubic bones)
light blue= labium majus
yellow= labium minus
light green= anus
darker blue= vaginal orifice
purple= vestibule
red= external urethral orifice
orange= clitoris
where do the bed of breast extend from?
ribs 2-6
-lateral border of sternum to mid axillary line
what muscles do breasts cover?
they lie in deep fascia covering pec major and serratus anterior
what lies between the fascia and breast?
retromammary space
how do female breasts attach to the skin?
via suspensory ligaments
what does it mean if a breast has A FIXED LUMP?
means it could have gone through the retromamillary space and stuck to the underlying tissue
where is from breasts drained into?
Most (>75%) of lymph from breast tissue drains to the ipsilateral axillary lymph nodes > supraclavicular nodes> right lymphatic duct
Lymph from inner breast quadrants can drain into parastinal lymph nodes
Lymph from lower inner breast quadrant can drain to abdominal lymph nodes
where does lymph from the upper lymp and most of the lymph from breast drain to?
axillary nodes (and then breast goes from axillary nodes to supraclavicular nodes and to the right lymphatic duct)
what are the different levels of axillary lymph nodes?
Level I- level III
level I- inferior and lateral to pectorals minor
level II- deep to pectoralis minor
level III- superior and medial the pectoralis minor
which are the level I axillary lymph nodes?
level I- inferior and lateral to pectorals minor
what are the level II axillary lymph nodes?
level II- deep to pectoralis minor
what are the level II axillary lymph nodes?
superior and medial to pectoralis minor
what are these arteries? (supply the breast)
red= axillary artery
orange= subclavian artery
yellow= internal thoracic (internal mammary
