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Block 3 Week 5 > Cobine Female Pelvis > Flashcards

Cobine Female Pelvis Flashcards

1
Q

What structures in the female pelvis is covered by peritoneum?

A 
rectum
bladder
ureter
ovarian vessels in suspensatory ligament
round ligament of the uterus
uterus
ovary
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2
Q

Explain the peritoneal reflections of the female pelvis

A

continues down from anterior abdominal wall at level of pubic bone
covers superior surface of bladder
passes from bladder to the isthmus of uterus
covers fundus and body of uterus
extends over posterior fornix of vagina
passes from uterus to the rectum
passes to the rectum and covers anterior and lateral side of superior rectum and lateral sides of middle rectum
becomes sigmoid mesocolon at S3

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3
Q

How is the rectouterine pouch formed?

A

from the peritoneum passing from the uterus to the rectum

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4
Q

Pararectal fossa on each side of the rectum are formed by what?

A

lateral extensions of the rectouterine pouch

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5
Q

What separates the pararectal fossas?

A

broad ligament of uterus (runs from uterus to lateral pelvic wall)

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6
Q

What does the broad ligament contain?

A

uterine tubes, ovaries, ligaments of the ovaries, and round ligament of the uterus

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7
Q

What are significant about the vesicouterine and rectouterine pouches?

A

fluid can accumulate in the event of infection

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8
Q

What is significant about the rectouterine (pouch of douglas)?

A

located behind posterior fornix of vagina and can collect blood or pus and is susceptible to injury
(can result in peritonitis)

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9
Q

In what circumstance will the pouch of douglas fill with blood?
pus?

A

ectopic pregnancy

ruptured appendix

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10
Q

(blank) is the extraction of fluid from the pouch of douglas via the posterior fornix of the vagina.

A

culdocentesis

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11
Q

What is a small incision into the vagina that allows for the insertion of an endoscope?

A

colpotomy

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12
Q

In the female, the ureter passes (blank) the uterine artery.

A

under

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13
Q

(blank) passes by the lateral part of the vaginal fornix and enters the posterosuperior angle of the bladder.

A

Ureter

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14
Q

In the females, uterine artery passes in front of ureter, but in males (blank) passes this way.

A

vas deferens

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15
Q

The apex of the bladder is in direct relation to the (blank) of the uterus

A

fundus

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16
Q

THe bladder fundus is in direct relation to the (blank) of the vagina

A

anterior wall

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17
Q

What helps keep the bladder in place?

A

lateral ligaments of bladder (pubovesical)

tendinou arch of pelvic fascia

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18
Q

Bladder walls are composed chiefly of the (blank) muscle.

A

detrusor

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19
Q

The ureteric orifices and the internal urethral orifice are at the angles of the (blank)

A

trigone bladder

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20
Q

Ureteric orifices are encircled by loops of (blank) that tighten as the bladder contracts to prevent the reflux of urine into the ureter.

A

detrusor muscle

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21
Q

What is the arterial supply in the female bladder?

A

anteriosuperior bladder- sup. vesicle arteries
fundus and neck- vaginal arteries
obturator and inf gluteal arteries

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22
Q

What is the venous drainage in the female bladder?

A

veins correspond to arteries
vesical venous plexus
uterovaginal venous plexus
vesical venous plexus

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23
Q

(blank) envelopes the pelvic urethra and neck of the bladder, receives blood from the dorsal vein of the clitoris.

A

vesical venous plexus

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24
Q

(blank) communicates with the vaginal or uterovaginal venous plexus

A

vesical venous plexus

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25
Q

(blank) mostly drains bladder through the inferior vesical veins into the internal illiac veins.

A

vesical venous plexus

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26
Q

What are the 5 ligaments of the female pelvis

A 
broad ligament of the uterus
round ligament of the uterus
suspensory ligament of the ovary
ligament of the ovary
cardinal ligaments
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27
Q

(blank) is a double layer of peritoneum extending from the sides of the uterus to the lateral walls and floor of the pelvis keeping the uterus in place.

A

Broad ligament

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28
Q

The uterine tube lies within the (blank)

A

mesosalpinx

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29
Q

The ovary lies within the (blank) (mesentary) on the posterior aspect of the broad ligament.

A

mesovarium

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30
Q

The (blank) acts as mesentary for the uterus itself. It includes almost all of the broad ligament except for the mesovarium and mesosalpinx

A

mesometrium

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31
Q

(blank) is where the broad ligament is prolonged superiorly over the ovarian vessels,lying superolateral to the ovary.

A

suspensory ligament of the ovary

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32
Q

(Blank) lies anteroinferior to the uterotubal junction, courses to deep inguinal canal, passes through the inguinal canal and terminates at the labium majus (majora).

A

Round ligament of the uterus

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33
Q

The round ligament of the ovary and the round ligament of the uterus comes from the (blank)

A

gubernaculum

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34
Q

(blank) extend from the supravaginal part of cervix and lateral vaginal fornices to the lateral walls of the pelvis (contains uterine artery and vein)

A

Transverse cervical (cardinal) ligaments

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35
Q

(blank) are condensations of the pelvic fascia that extend from the cervix to the posterolateral pelvic walls.

A

uterosacral ligaments

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36
Q

Where are the ovaries located?

A

near the attachment of the broad ligament to the lateral pelvic walls

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37
Q

What suspends the ovaries?

A

peritoneal folds

38
Q

What are the peritoneal folds that suspend the ovaries?

A

posteriorsuperior aspect of broad ligament by mesovarium

lateral pelvic walls by suspensory ligaments of ovaries

39
Q

(blank) contains ovarian vessels, lymphatics, and nerves

A

suspensory ligament of the ovary

40
Q

The ovary is suspended in the peritoneal cavity and its peritoneal surface is characterized by (blank) from ovulation.

A

scarrin

41
Q

The oocyte expelled passes into the (Blank)

A

peritoneal cavity

42
Q

Once the oocyte is expelled into the peritoneal cavity, what happens next?

A

the oocyte is trapped by the fimbriae of the infundibulum, of the uterine tube and swept up into the ampulla for possible fertilization

43
Q

What are the two parts of the uterus?

A

body and cervix

44
Q

What are the two surfaces of the uterus?

A

vesical and intestinal

45
Q

Th uterine body lies on the (blank)

A

bladder

46
Q

The cervix lies between what 2 things?

A

the bladder and the rectum

47
Q

The supravaginal part of the cervix is separated from the bladder by (blank) and from the rectum posteriorly by the (blank)

A

loose CT

rectouterine pouch

48
Q

What demarcates the body from the cervix in the uterus?

A

the isthmus (constricted region)

49
Q

What are the 2 parts of the cervix?

A

supravaginal (between isthmus and vagina)

vaginal (protrudes into vagina)

50
Q

The external os of the uterus is surrounded by a narrow space called the (blank)

A

vaginal fornix

51
Q

The uterine wall has three parts which are….?

A

perimetrium
myometrium
endometrium

52
Q

(blank) is the serosal layer of the uterus (peritoneum supported by a thin layer of CT)

A

perimetrium

53
Q

(blank) is the middle coat of smooth muscle, (thinner during pregnancy), main branches of blood vessels are contained here, hormonally stimulated at intervals to dilate the cervical os and expel baby and placenta, produces cramping during menstruation.

A

myometrium

54
Q

(blank) is the inner mucous coat, differs at varying stages of the menstrual cycle, shed during menstruation, if conception has occurred, the blastocyst implants here.

A

endometrium

55
Q

The (blank) is mostly fibrous as compared to the muscular (blank).

A

cervix

muscular uterine body

56
Q

The (blank) is rounded in nulliparous females and H shaped in parous women.

A

external os

57
Q

Blood supply is mostly via the (blank) with partial collateral supply from the (blank).
(blank) also supply the placenta.

A

uterine arteries
ovarian arteries
uterine arteries

58
Q

(blank) accompany uterine arteries into the broad ligament and form a venous plexus which drains into the internal iliac veins.

A

uterine veins

59
Q

What is the normal position of uterus?

A

anteverted w/ respect to vagina

anteflexed w/ respect to cervix

60
Q

What are the degrees of retroversion?

A

1st, 2nd, and 3rd.

2nd is right above the vaginal opening

61
Q

If you have a 2nd degree retroversion what can be problematic?

A

you could get uterine prolapse

62
Q 
What are these:
Retroversion
 Retroflexion
 Hyperanteflexion
 Anteposition, Retroposition, Lateroposition
 Rotation
 Torsion
 Inversion
 Retrocession
 Elevation
 Descensus/Prolapse
A

pathological changes in uterine position

63
Q

What is inversion?

A

placenta makes uterus flip inside out during labor AHHHH!!!!

64
Q

What is a first degree uterine prolapse?

A

cervix is still inside vagina

65
Q

What is a second degree uterine prolapse?

A

cervix appears outside the vulva

66
Q

What is a third degree uterine prolapse?

A

complete prolapse

67
Q

What is this:
Causes and risk factors:
Weakness of pelvic floor muscles and/or ligaments.
More common in women who have had one or more vaginal births, risk of tearing.
Also:
Normal aging
Lack of estrogen after menopause
Anything that puts pressure on the pelvic muscles, including chronic cough and obesity
Pelvic tumor (rare)
Long-term constipation and the pushing associated with it can make this condition worse
Retroversion

A

causes of uterine prolapse

68
Q

What is the major ligament of the pelvic floor that we want to keep an eye on for uterine prolapse?

A

cardinal ligament

69
Q

What are other names for uterine tubes?

A

fallopian tubes, oviducts

70
Q

What do uterine tubes do?

A

conduct the ovum (fertilization usually occurs in the uterine tubes)

71
Q

Where do the uterine tubes lie?

A

in the mesosalpinx in the free edges of the broad ligament

72
Q

What is this:
Ideally, extend symmetrically posterolaterally to the lateral pelvic walls and arch anterior and superior to the ovaries
Commonly asymmetrically arranged with one or the other often lying superior and even posterior to the uterus

A

the uterine tubes

73
Q

What is this:
(most lateral) funnel shaped distal end of the tube opening into the peritoneal cavity through the abdominal ostium; fimbriae are finger like projections that spread over the medial surface of the ovary; one large fimbria is attached to the superior pole of the ovary

A

the infundibulum

74
Q

What is this:

widest and longest part of the uterine tube, where fertilization usually occurs

A

ampulla

75
Q

What is this:

thick-walled part of the tube which enters the uterine horn

A

isthmus

76
Q

What is this:
(most medial)- short segment passing through the wall of the uterus and opens via the uterine ostium into the uterine cavity at the uterine horn

A

uterine part

77
Q

What is atttached to the superior pole of the ovary to keep the ovary in contact with the infundibulum?

A

large fimbria

78
Q

(blank) is where fertilization usually takes place.

A

ampulla

79
Q

What extend from the cervix to the vestibule?

A

the vagina

80
Q

What is this:
Usually collapsed, anterior and posterior walls are in communication with one another except where the cervix holds them apart
Posterior to the urethra (which projects into its inferior anterior wall) and bladder
Anterior to the rectum
Passes through medial margins of the levator ani muscles

A

vagina

81
Q

How does the vagina pass by the levator ani muscles?

A

through the medial margins of the levator ani muscles

82
Q

(blank) is the recess around the cervix, has anterior, posterior and lateral parts

A

Vaginal fornix

83
Q

In the vagina, the (blank) is the deepest part, most closely related to the rectouterine pouch

A

posterior vaginal fornix

84
Q

The vagina is compressed by 4 muscles which act as sphincters; what are these four?

A

pubovaginalis
external urethral sphincter
urethrovaginal sphincter
bulbospongiosus

85
Q

What is the arterial blood supply to the vagina?

A

superior aspect-> uterine arteries

middle and inferior-> vaginal and internal pudendal arteries

86
Q

What is the venous drainage of the vagina?

A

vaginal veins from vaginal venous plexuses (along side of vagina)
The veins are continuous with uterine venous plexus as uterovaginal venous plexus
this plexus also communicates w/ vesical and rectal venous plexuses

87
Q

Are there rugae inside the vagina?

A

yes to help with stretching

88
Q

What can you feel during a female pelvic examination?

A 
external genitalia
vagina and cervix
uterus, ovaries, uterine tubes
uterosacral ligament
rectovaginal septum
uterine position
pregnancy
pap smear
89
Q

What is the external genitalia of a femal?

A

mons, clitoris, labia majora and minora, perineum, and perianal area

90
Q

How can you detect a pregnancy?

A

you can detect softening of the uterine isthmus (hegar sign) -cervix feels separate from body

Block 3 Week 5 (7 decks)

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