Female Anatomy Flashcards
What ligaments are in the female reproductive system?
- Broad
- Gubernaculum derived (ovarian and round)
- Other ligaments (lower uterus, cervix, upper vagina)
Where is the broad ligament?
Lateral pelvic wall to sides of uterus
What are the subdivisions of the broad ligament?
- Mesometrium
- Mesoalpinx
- Mesovarium
- Suspensory ligament of ovary
What passes through the suspensory ligament of the ovary? Where do they go?
Blood vessels, nerves and lymph vessels.
Ovary
What is an anterior fold of the ‘other ligaments’?
Uterovesicular fold
Where does the uterovesicular fold extend?
Bladder to cervix
What is a posterior fold of the ‘other’ ligaments?
Rectovaginal fold
Where does the rectovaginal fold extend?
Rectum to posterior fornix
What ligaments are the lateral edges of the rectovaginal fold?
Uterosacral ligaments
How is the cervical ligament oriented?
Radially
What are the most important sides of the cervical ligament?
Transverse/cardinal
Where does the cervical ligament extend?
Sides of cervix/vault of vagina to lateral wall of pelvis
How long is the ovary?
3cm
Where are the ovaries located?
In ovarian fossa adjacent to lateral wall of pelvis
What is the ovarian fossa?
Shallow indentation between the lateral attachment of the broad ligament anteriorly and the ureter and internal iliac vessels posteriorly
Why might the position of the ovary vary?
Pregnancy
What are the surfaces of the ovary?
- Mesovarian (anterior)
- Free border (posterior)
- Tubal extremity (superior)
- Uterine extermity (inferior)
To which surface does the suspensory ligament and single ovarian fimbra from uterine attach?
Tubal extremity
What is the hilum of the ovary?
Where vessels enter ovary from suspensory ligament
Where do the ampulla and infundibulum of uterine tubes curve around the ovary?
Posteriorly
What does the inside of the ovary consist of?
Innver vascular medulla
What does the outside of the ovary consist of?
Outer cortex with ovarian follicles
What does each follicle contain?
Ovum and surrounding endocrine cells.
What does the mature follicle accumulate? Where does it accumulate?
Viscous fluid (antral fluid) Internal cavity or antrum
What is ovulation?
Temporary break in the otherwise intact surface of the ovary
What are the ovum and supporting cells collected by? How?
Fimbriae of the uterine tube
Combination of ciliary action and muscular contractions
Where do the ovum and supporting cells go after collection?
They are transported to the ampulla of the uterine tube where either fertilisation occurs or the ovum degenerates.
What happens if fertilisation occurs?
The fertilised ovum (blastocyst) is transported through the isthmus and intramural of the uterine tube and into the uterus where implantation occurs.
What happens to the supporting cells after fertilisation?
They degenerate
What do the endocrine cells of the follicile produced prior to ovulation?
Oestrogen
What do the remaining endocrine cells after ovulation form?
Corpus luteum
What does the corpus luteum produce?
Progesterone
Where is the uterine tube in relation to the ovary?
Anterosuperior
Where is the infundibulum in relation to the ovary?
Lateral
Where are the external iliac vessels in relation to the ovary?
Superior
Where are the internal iliac vessels and ureter in relation to the ovary?
Posterior
How long are the uterine tubes?
10 cm long
What are the uterine tubes attached to?
Upper margin of the broad ligament
The uterine tubes are open at both ends making them vulnerable. T or F.
True
What are the 4 regions of the uterine tubes?
- Infundibulum with folds (fimbriae)
- Ampulla (lateral 2/3, fertilisation occurs here)
- Isthmus
- Intramural
What are the 3 layers of the uterine tubes?
- Mucosa
- Smooth muscle
- Seros (peritoneum)
The mucosa layer is elaborately folded in the distal parts of the tube but there are no glands. T or F.
True
What are all regions in the uterine tubes lined with?
Epithelium consisting of ciliated and secretory cells.
What is the function of the cilia?
Involved in the movement of the ovum
What is the function of the secretory cells?
Produce a nutritive fluid to maintain the ovum.
What are the vestigal structures in the form of tubules or cysts a remnant of? Where does this occur?
Mesonephric dcuts.
In the mesoalpix and also in other parts of the broad ligament and in the walls of the uterus, cervic and vagina.
Where is the uterus located?
Between the bladder and rectum.
What is the general orientation of the uterus?
Anteverted in 80% of women.
What happens to the uterus as the bladder fills?
Becomes more vertical.
What are the 3 regions of the uterus?
Fundus, body, cervix
Where is the fundus of the uterus?
Above entry of tubes
What are the 3 layers of the uterus?
- Endometrium
- Myometrium
- Serosa
What is the function of the endometrium?
Specialised mucosa containing uterine glands
What type of muscle is the myometrium comprised of?
Smooth
What is the serosa continuous with?
Peritoneum
What happens to the uterus during pregnancy?
- Wall thins
- Muscle cells hypertrophy
- Abdominal organs displaced - fundus reaches epigastric region by 8th month of pregnancy
What are the 2 regions of the endometrium?
- Thick inner layer (functionalis)
2. Thinner outer region adjacent to the muscle (basalis)
What happens to the functionalis during menstruation?
It is sloughed
What happens to the basalis after menstruation?
Regenerate into a new functionalis
Where do the glands of the endometrium extend?
Across both regions
The functionalis and basalis have their separate blood supplies. T or F.
True.
What are the phases of the menstrual cycle?
- Menstrual phase
- Proliferative phase
- Ovulation
- Secretory phase
What occurs during the menstrual phase?
Shedding of functionalis as a result of declining progesterone levels as corpus luteum ceases functioning.
What occurs during the proliferative phase?
Regeneration of a new functionalis under the influence of oestrogen from the developing ovarian follicles (this regeneration is actually initiated during the latter part of the menstrual phase, whilst the previous functionalis is still being sloughed)
What stimulates ovulation?
High levels of oestrogen which in turn causes a surge of pituitary hormone (LH)
What happens during the secretory phase if fertilisation occurs?
Endometrial glands secrete a nutritive fluid which will support a blastocyst should fertilisation have occurred.
What happens during the secretory phase if fertilisation doesn’t occur?
The corpus luteum degenerates
What happens when the corpus luteum degenerates?
Results in a sharp decline in levels of circulating progesterone which affects the blood vessels supplying the functionalis which subsequently breaks down.
How does the cervix compare to the uterus?
It is narrower, more cylindrical and less mobile. Narrow canal.
What the anterior and lateral sides of the cervix embedded in?
Pelvic fascia
What is the posterior surface of the cervix covered with?
Peritoneum, which is part of the lining of the rectouterine pouch
What are the 2 regions of the cervix? What are each comprised of?
- Endocervix (simple columna epithelium lining plus mucus producing glands)
- Extocervix (stratified epithelium lining, protrudes into vault of vagina)
What is the junction between the two types of epithelium called?
Transformation zone.
What are enlarged cervical glands called?
Nabothian cysts.
What is the groove around the protruding opening called?
Fornix - a single groove but often described as consisting of anterior, posterior, lateral regions
What are the 2 layers of the cervix?
Mucosa, muscle + peritoneum posterioly
What are the exceptions to the layers of the cervix?
Posteriorly there are 3 layers
Mucos is involved in menstruation. T or F.
False
What is the vagina?
Vault to vestibule
How is the vagina oriented?
Posterosuperiorly
What is the shape of the vagina?
Lumen H shaped with opposing walls touching except at vault.
What is the vagina embedded in? Where are the exception?
Pelvic fascia.
Except posterior vault which faces rectouterine pouch
What are the arteries of the internal female genitalia?
- Ovarian artery
- Uterine branch of internal iliac artery
- Vaginal branches of internal iliac artery
Where is the ovarian artery located?
Off abdominal aorta
Where does the ovarian artery travel?
- Crosses external iliac artery at pelvic brim
- Enters suspensory ligament
- Divides into ovarian and uterine tube branches (1-3 per side)
Where does the uterine branch of internal iliac artery travel?
Ascends through broad ligament and supplies transverse branches to uterus and uterine tube
There are extensive side to side anastomoses between contralateral uterine and vaginal branches. T or F.
True
What veins drain the ovaries?
Pampinform plexus forms 2 ovarian veins in suspensory ligament.
What do the 2 ovarian veins becomes? Where do each side empty?
Join to form single ovarian vein to empty on right into IVC and on left into left renal vein
What veins drain the uterine tube?
- Lateral 1/3 –> ovarian veins
2. Medial 2/3 –> uterine veins
What veins drain the uterus and vagina?
Uterine and vaginal plexus –> uterine and vaginal vein –> internal iliac vein
What lymph vessels drain the female internal genitalia?
Internal and external iliac nodes
Rectal and sacral
Superifical inguinal
Aortic and preaortic
What nerves supply the female internal genitalia?
Ovarian and hypogastric plexuses
What are the structures in the external female genitalia?
- Mons
- Labia majora
- Labia minor
- Clitoris
- Vaginal orifice
- Urethral orifice
What is the mons?
Fatty and fibrous CT covered with hairy skin anterior to pubic symphysis
What is the labia majora?
Folds containing fatty CT
What is the labia majora covered with?
Hairy skin externally and lined with smooth moist skin.
What is the labia majora separated by?
Pudendal cleft
Where does the labia majora join?
Anterior and posterior commissures
What and where is the labia minora?
Folds on either side of vaginal and urethral openings, within the labia majora.
What is the labia minor covered with?
Moist skin
What does it anteriorly split to cover?
Clitorus (superior - prepuce, inferior - frenulum)
What is the posterior side of the labia minora called?
Frenulum of labia
What does the clitoris resemble? What is different?
Penis. It does not contain urethra
What does the clitoris contain?
- 2 Corpora cavernosae
- Crura
- Ischiocavernous muscle
- Glans + 2 bulbs separated by vaginal vestibule + bulbospongiosus muscle
Where is the ischiocavernous muscle located?
Just medial to ischopubic rami
Where is the urethral orifice?
Between vaginal orifice and clitorus
What are the vascular structures involved in female genitalia?
Internal pudendal artery supplies labia, bulb and clitorus.