DR2 Flashcards
What are the two main parts of the uterus?
Upper 2/3 including fundus = body
Cervix = lower part of the uterus
What is the fundus?
Dome-shaped uppermost part of the body above the fallopian tubal openings
Wall of uterus
Perimetrium (outer lining)
Myometrium
Endometrium (inner lining)
Cervical canal
Narrower than uterine opening
Cervical canal openings
Internal os - communicates superiorly with the uterine cavity
External os - communicates inferiorly with the vagina
Nulliparous
Women who have not given birth to children
Narrow and circular external os
Parous
Women who has had children hence external os remains enlarged thus forming a transverse slit
Main divisions of the broad ligament
Mesovarioum
Mesosalpinx
Mesometrium
Mesovarioum
Posterosuperior portion that surrounds the ovary
Mesosalpinx
Small anterosuperior portion that encloses the Fallopian tube
Mesentery of the uterine tube
Mesometrium
Larger portion, inferior to the Fallopian tubes
Mesentery of the uterus
Attachment point of broad ligament
Lateral edge of uterus inferior to the entrance of the uterine tube
Ligaments associated with the uterus
Broad ligament
Ovarian ligament
Suspensory ligament of ovary
Round ligament of the uterus
Ligaments embedded within the broad ligament
Ovarian ligament
Suspensory ligament of ovary
Round ligament of the uterus
Ovarian ligament
Medial border of the ovary to where the fallopian tube joins the uterus
Suspensory ligament of the ovary
Lateral border of the ovary to the parietal peritoneum
Keeps the ovaries suspended
Round ligament of the uterus
From fundus region of the uterus
Travels across the pelvic brim and enters the deep inguinal ring, crosses the inguinal canal and exits the pelvis to terminate within the labia majora
Uterine artery
Crucial to differentiate the ureter and uterine artery from each other in order to prevent clamping of the artery by mistake
What structures relating to the uterus are closely interlinked?
Uterine artery and ureter
Ureter arches inferiorly to the uterine artery
Describe the position of the uterus.
Anteverted - curved anteriorly over the bladder which it partially obscures
Recto-uterine pouch or pouch of Douglas
2/3 down the rectum, the peritoneum reflects onto the posterior surface of the uterus
Lowest part of the peritoneal cavity in the female
Utero-vesical pouch
Between the uterus and the bladder, the peritoneum arcs
Clinical relevance of recto-uterine pouch
Potential site for accumulation of fluid
Ovaries
Located close to the lateral walls of the pelvis
Atrophy after menopause
Two endpoints of the vagina
Cervix
Vestibule
Anterior and posterior fornix
Recess where the vagina attaches to the cervix
Wall of the vagina
Thin muscular layer
Muscle may assist with childbirth
Main factors responsible for delivery
Contraction by myometrium
Increase in abdominal pressure
Anterior and posterior walls of vagina
Generally in contact except at cervical end
Vaginal canal is normally collapsed
Recto-vesical pouch
Extending from the middle part of the rectum on to the posterior surface of the bladder and seminal vesicles
Pararectal fossae
Peritoneum reflects laterally at this point from the sides of the rectum to the abdominal wall
Vas deferens
Travels from the scrotum to the point it enters the abdomen
Duct appears from the deep inguinal ring and travels to the posterior aspect of the bladder
Blood supply to the vas deferens
Anastamosis of the vesical and testicular arteries
Venous drainage to the vas deferens
Vesical vein
Testicular vein
Ampulla of the vas deferens
Diameter dilates at its distal end
Seminal vesicles
Lateral to the two ampullae
Ejaculatory ducts
Ducts from seminal vesicles join ampulla of vas deferens
Prostate gland
Inferior to the bladder
Prostatic urethra
Surrounded by the prostate gland
Small median lobe of the prostate
Between ejaculatory ducts and urethra
Benign senile hypertrophy of the prostate
Enlargement of the median lobe of the prostate
Penile urethra
Spongy urethra
Structures and openings of the vulva
Mons pubis Labia majora and minora Glans of the clitoris Prepuce Urethral openings Vaginal openings
Mons pubis
Anterior to the vulva
mass of fatty tissue lying over the joint of the pubic bones
Prepuce
Surrounds the glands of the clitoris
Anal opening
Close proximity between the anal and urethral/vaginal openings
Perineal membrane
Sphincter muscles on the left hand side in the deep perineal pouch
Clitoris
Erectile organ comparable to the male penis
Role purely as an organ of arousal in females
Sensitive organ as greater proportion of nerve terminals located in the glans
Bulbs of vestibule/Bartholin’s glands/greater vestibule glands
Surround vaginal opening
Enlarged when filled with blood via pudendal artery
Crus of the clitoris
Two erectile tissue structures that converge on the clitoral body
Scrotum
Contains the egg-shaped testis
Spermatic cord
Contains all supportive elements linking the testes to the intra-abdominal space
Tunica vaginalis
Encloses testis and epididymis
Tunica albuginea
Intimate layer covering the outer surface of the testis
Whitish appearance
Testis
Inner lobules containing numerous, highly coiled seminiferous tubules where sperm are produced
Gonadal vessels
Descend from the abdominal region/aorta L2
Main structures of the penis
Glans
Body
Root
Tissue within penis
2 corpora cavernosa
1 corpus spongiosum
Corpora cavernosa
Dorsal side of penis
Responsible for erection after filling with blood to produce considerable hydraulic pressure
Corpus spongiosum
Surrounds the spongy or penile urethra
Cavernosa bodies
Fibre arrangement prevents penis from ballooning thus keeping its characteristic cylindrical shape
Tunica albuginea
Surrounding tough fibrous cover over the testis
Limits distension
Corpus cavernosum
Forms the bulk of the penis and the clitoris
Define the Broad ligament
Double layer of peritoneum on either side of the uterus that acts to stabilise the uterus
Physiological causes of fluid accumulation in the recto-uterine pouch
Ruptured follicles
Retrograde menstruation
Increase in ovarian permeability due to oestrogen influence
Pathological causes of fluid accumulation in the recto-uterine pouch
Ruptured ectopic
Pelvic inflammatory disease
Tubo-Ovarian abscess
Pelvic abscess/haematoma
Cul-de-Sac
Recto-uterine pouch or Pouch of Douglas
Possible symptoms for pouch of Douglas
Painful periods Painful intercourse (dyspareunia) Abdominal pain Abdominal distension Abnormal uterine bleeding Reduced stool
Vasectomy
Vas deferens cut or sealed to act as a form of contraception by preventing sperm entering the urethra
What happens to sperm during a vasectomy?
Sperm will be produced by the Sertoli cells but they degrade in the testis as there is no need for the testis - prevents accumulation of sperm in testes
Four parts of the Fallopian tube
Isthmus
Fimbrae
Infundibulum
Ampulla
Layers of the Fallopian tube
Mucosa - folded walls with ciliated cells
Muscularis externa
Serosa
Where is an ovum fertilised?
Ampulla
Buck’s Fascia
Around corpus cavernosum and corpus spongiosum
Tunica dartos
Superficial layer around superficial veins
Ischiocavernosus muscle
Men - stabilises erect penis
Women - tenses the vagina during orgasm
Cavernous veno-occlusive mechanism
As the corpus cavernosum fills with blood, the tunica albuginea stretches and the veins fill with blood. This causes an increase in the venous pressure and decrease in venous outflow (PS innervation) to form a hard penis.
Vaginismus
Involuntary contraction of the perineal muscles preventing vaginal penetration
Vaginal changes
Premenopausal vagina - folds in the wall of vagina provides lubrication
Postmenopausal vagina - smoother inner vaginal wall with reduced lubrication
