Female Anatomy & Physiology Flashcards
The vuvla is also known as
Pudendum
List and label all structures part of the vulva
Mons pubis
Labia majora
Labia minora
Clitoris
Urethral Opening
Vaginal Opening
Vestibule
Prepuce
Fourchette
Hymen
Perineum
The area between rectum and uterus
Posterior cul-de-sac
Area between bladder and uterus
Anterior cul-de-sac
What is the vestibule
Opening to the vagina and urethra
The prepuce surrounds the
Clitoris
What is the major role of the clitoris
Sensitive and important role in sexual activity
The greater vestibule glands are known as the
Bartholin glands
The fourchette is the
Frenulum of labia majora
Small, thin piece of tissue at the opening of the vagina
Hymen
What are the 4 bones of the pelvis
2 Innominate
Sacrum
Coccyx
What are the 2 compartments of the pelvis
False pelvis
True pelvis
What is the difference between the male and female pelvis
Female - Wider than 90 degrees
Male - Smaller than 90 degrees
The false pelvis is also known as the
Greater or major pelvis
The false/greater pelvis communicates superiorly and inferiorly with the
Superiorly with abdominal cavity
Inferiorly with pelvic cavity
The true pelvis is also known as the
Lesser or mino pelvis
What are the structures within the anterior pelvic cavity
Bladder
Ureters
Fallopian tubes
Ovaries
Uterus
Vagine
What are the structures within the posterior pelvic cavity
Rectum
Colon
Ileum
Name the 4 muscles that are part of the abdomen/pelvis in order from most superior to most inferior
Rectus abdominis
Transverse abdominis
Internal oblique
External oblique
The rectus abdominis connects to the
Xiphoid process of sternum and symphysis pubis
External oblique muscle goes from the
Lower ribs to iliac crest
Internal oblique attaches from the
Lower 3 ribs to linea alba and from inguinal ligament to iliac crest
Transverse abdominal muscle wraps around the
Torso (from front) to back and from ribs to pelvis
What are the muscles of the false pelvis
Psoas major
Iliacus
What are the muscles of the true pelvis
Piriformis
Obturator internus
Pelvis diaphragm muscles
What are the muscles of the pelvis diaphragm
Levator ani
Coccygeal
Where are the levator muscles located
Front
Where are the coccygeal muscles located
Behind
Label the muscles of the true pelvis
(Use picture from pp) In order top to bottom
Piriformis
Coccygeus
Ischial spine
Obturator internus
White line
Iliococcygeus
Pubococcygeus
Puborectalis
Name the 3 muscles of the pelvic diaphragm
Pubococcygeus
Puborectalis
Iliococcygeus
The 3 muscles of the pelvic diaphragm are ___ and ____
Separated and paired
The pelvic diaphragms separates above the ____ and below the ____
Above pelvic cavity
Below the perineal cavity
The pelvic diaphragms keep the pelvic organs
In place
Name the 3 levator ani muscles and are located in the ____ of the body
Pubococcygeus
Puborectalis
Iliococcygeus
Located in front
The coccygeus muscles is located in the ___ of the body
Behind
The pubococcygeus muscles surround the
Urethra, vagina, rectum
The puborectalis muscle surrounds and forms
Lower portion of the rectum Forms sling
The coccygeus is also known as the
Ischiococcygeus muscle
The coccygeus pulls the coccyx ___ after ____
Forward after defication
The bladder and ureters get rid of
Waste products from kidneys
What are the 3 parts of the bladder
Apex
Base
Neck
Where is the apex of the bladder located
Posterior to the pubic bone
Where is the base of the bladder located
Anterior to vagina, superior surface of the uterus
Where is the neck of the bladder located
Upper surface of urogenital diaphragm, inferolateral surface retropubic fat, obturator internus, levator ani, pubic bone
The ureters runs anterior to the _____ and posterior to the _____
Anterior to internal iliac arteries
Posterior to ovaries
The ureters enter the
Posterioinferior bladder
The vagina has a ___ membrane that
Mucous membrane that lines the muscular walls
Where is the Gartner’s duct located
Between the layer of the broad ligament of the uterus and in wall of vagina
Bartholin’s gland are located on
Each side of the vaginal opening
How many fornixes are there
4
The area of vaginal lumen surround the cervix is called
Fornixes
Where does the vagina get blood supply and where is the blood drained
Gets arterial supply from vaginal and uterine arteries
Drains to internal iliac vein
What are the average uterus measurements during menarcheal
6-8 cm length
3-5 AP & width
The uterus divides into what 3 parts
Fundus
Body
Cervix
What does premenarchal mean
Pre-menstrual/puberty
What does nulliparous mean
No kids
What does multiparity mean
Multiple kids
Postmenopausal means
Post menstrual life at least one year without a period
What is the average length and width of a permenarcheal uterus
1.0-3.0 cm length
0.5-1.0 cm width
What is the average length, width, and AP of a menarcheal (Nulliparous) uterus
6-8cm L
3-5 cm W & AP
How much does a multiparity uterus increase by
1-2 cm
What is the average length, width, and AP of a multiparity uterus
8-10 cm L
5-6 cm W & AP
What is the average length, width, and AP for postmenopausal uterus
3.5-5.5 cm L
2-3 W & AP
The uterine length is measured in what plane and measured from where to where
Midsagittal plane
From outer serosal surface of fundus to external cervical os
The uterine thickness (AP) is measured in what plane and measured from where to where
Midsagittal plane anterioposteriorly
From outer to outer serosal surfaces
The uterine width is measured in what plane
Midtransverse
What is the widest portion of the uterus
fundus
What is the cornua
Where the Fallopian tubes enter the uterine cavity
The body of the uterus is also known as ____ & ____
Myometirum
Corpus
What is the largest portion of the uterus
Body
Label the uterus diagram
Look at uterus picture on slide 28
What are the 2 parts of the cervix
Internal and external os
What is the isthmus
Outer transition point between the body and cervix
Where is the isthmus located
Point where the uterus bends anteriorly or posteriorly when bladder is empty
What are the 3 layers of the uterus
Perimetrium
Myometrium
Endometrium
What is the perimetrium
Serous outer layer of the uterus
What is the endometrium
Inner mucous membrane
Glandular portion of the body
How does the myometrium appear on ultrasound
Homogeneous and hypoechoic “halo” that surrounds the endometrium
What are the characteristics of the endometrium
Inner layer that lines uterine cavity
Glandular mucous membrane
What are the 2 layers of the endometrium
Functional and basal layers
The functional layer is known as the
Zona functionalis
Of the two layers of the endometrium which is the innermost and the outermost
Innermost layer - Functional layer
Outer layer - Zona basalis
Name the 4 ligaments in the uterus
Broad
Round
Cardinal
Uterosacral
This ligament has double fold of peritoneum
Broad ligament
The broad ligament drapes over the
Fallopian tubes, uterus, ovaries
Broad ligament provides a small
Amount of support for the uterus
Broad ligaments contain ____ & ____
Uterine blood vessels and nerves
What are the 3 parts of the broad ligament
Mesosalpinx
Mesovarium
Mesometrium
Where are the round ligaments located
Between the layers of the broad ligament
What is the role of the round ligament
Aid in holding the uterine fundus and body in forward position
The cervix is the ____ portion frimly supported by these 2 ligaments
ONLY portion
Cardinal & Uterosacral ligament
What cavity contains 2 potential spaces and what are those spaces called
Peritoneal cavity
Anterior and posterior cul-de-sac
The cardinal ligament is the continuation of what ligament
Broad ligament
Where does the uterosacral ligaments originate from
The lateral uterine isthmus
What does the peritoneal cavity contain
Visceral organs
Liver, stomach, small & large intestines, associated smaller organs
The peritoneal cavity is formed by the
Caudal portion of parietal peritoneum
What is the significance of the peritoneal cavity to sonography
Potential space for fluid to accumulate
The anterior cul-de-sac is also known as
Vesicouterine Recess (pouch)
The vesicouterine recess has a fold of
Peritoneum over the uterus and the bladder
Where is the vesicouterine recess located
Anterior to the fundus between the bladder and uterus
The posterior cul-de-sac is known as what 2 other things
Pouch of Douglas
Rectouterine recess
Where is the rectouterine recess located between the ___ & ___ and is the most ___ & ___ region
Between uterus and rectum
Most inferior and posterior region
The space of Retzius is also known as
Retropubic space
Where is the space of Retzius located
Between anterior bladder wall and symphysis pubis
The space of Retzius is usually what type of fat
Subcutaneous fat
An angle of version between the axis of the ____ body and the ____ is how many degrees and the cervix angles
Uterine and vagina, <90 degrees, forward
An angle of flexion between the longitudinal axis of the _____ body and the _____ _____ is how many degrees and the body is ____
Uterine, uterine cervix, >90 degrees, body is flexed forward
The mesosalpinx is attached to the
Fallopian tubes
The mesovarium is attached to the
Ovary
The mesometrium is attached to the
Myometirum
What is the most common uterus position and is tipped ___
Anteverted, forward
Anteverted position is where the ___ and ___ of uterus are at almost ____ ____
Cervix, body, the same axis
What does a retroverted uterus mean
Uterus is tipped backward
What does an anteflexed uterus mean
Fundus is tipped forward
What does a retroflexed uterus mean
Tipped backwards the fundus is tipped backwards towards the rectum
Draw the positions of the uterus
Look at pic on slide 49
Draw and label Fallopian tube diagram
Look at pic on slide 51
What are the 4 parts that the fallopian tube divides into and what are their segments
Infundibulum - LS
Ampulla - MIS
Isthmus -MES
Interstitial - STC
Where do the ovaries usually lie
Posterior to the pelvis and lateral to the uterus, level of cornua
The ovaries are suspended from the ____ aspect of the this part of the broad ligament
Posterior aspect of the mesovarium
Where are the ovaries usually located
Anterior to ureter
Anterior/medial to internl iliac vessels
The outer layer of the ovaries is called the
Cortex
The follicles in the ovaries are covered by the ____ ____ and are surround by a single, thin layer of cells known as the
Tunica Albugniea
Germinal epithelium of Waldeyer
The center of the ovary is known as the
Medulla
The ovaries are composed of C.T that contain these 4 things
B.V, nerves, lymphatic v., smooth muscle at hilum region
Ovaries produce what reproductive cell
Ovum
Name the 2 hormones produced by the ovaries and what they are secreted by
Estrogen - Follicles
Progesterone - Corpus lute
Transvaginal ultrasound help to show these 3 things
Cysts, benign & malignant tumors
What is the average measurement L, W, T of the ovaries
3.5 X 2.5 X 1.5 cm
What will the measurement of the ovaries be after menopause
2 X 1.5 X 1 cm or less
What is the simplified evaluation of equation for polycystic ovaries
0.52 X L X W X T
Pie/6 X L X W X T
The ovary is supported medially but the
Ovarian ligament
The ovary is supported lateraly by the
Suspensory/infundibulopelvic ligament
The ovary is supported posteriorly by the
Broad ligament via the mesovarium
What are the 9 arteries and veins that help support the female reproductive system
Aorta
External iliac artery
Internal iliac artery
Uterine artery/veins
Arcuate arteries
Radial arteries
Straight & spiral arteries
Ovarian arteries
Ovarain veins
The aorta bifurcates into the
R & L common iliac arteries
The aorta bifurcates a second time into the
External and interal iliac arteries
The external iliac artery becomes the
Femoral artery
The internal iliac artery is also known as the
Hypogastric artery
The internal iliac artery subdivides into
Uterine and vaginal artery
What is the location of the uterine arteries and veins
Between layers of broad ligament and lateral to the uterus
What are the arcuate arteries
Arc-like arteries that encircle the uterus in the outer third of the myometirum
The radial arteries branch off the
Arcuate artery
The radial arteries extend from the
Myometirum to the base of the endometirum
The straight and spiral arteries supply the
Zona basalis of the endmetirum
The ovarian arteries branch
Laterally off the aorta
There is ____ within the uterine artery
Anastomoses
Where do the right and left ovarian veins drain into
R - Drains into IVC
L - Drains to left renal vein
The menstrual cycle governs the
Prep and maintenance of the uterine lining
The ovarian cycle governs the
Prep of endocrine tissues and release of eggs
The ovarian secretion of estrogen and progesterone governs the amoung of ___ & ___ produced and secreted by the ___ ___ ____
FSH and LH, by the anterior pituitary gland
Estrogen is the principle modulator of the
Hypothalamus-pituitary activity
The endocrine cycle is controlled by
Hormones
What are the sources of the endocrine
Hypothalamus
Pituitary gland
Ovarian axis
The hypothalamus controls the
Follicle stimulating hormone releasing factor (FSHRF)
Luteinizing hormone releasing factor (LHRF)
This hormone is referred to as the female sex hormone
Estrogen
Estrogen is the fundamental hormone in the development of feminization which includes 6 things
Uterus (Menstrual cycle and pregnancy)
Physical shape
Breasts
External genitalia
Skin texture
Emotion
This hormone is the ‘pro’ pregnancy hormone
Progesterone
Progesterone modifies the estrogen effect on
Uterus
Breasts
Emotions
What are the 5 phases of the menstrual cycle
Menstrual phase
Follicular phase
Proliferative phase/Preovulatory
Ovulation
Luteal/secretory phase
Name the day(s) of each phase in the menstrual cycle
Menstrual phase
Follicular phase
Proliferative phase
Ovulation
Luteal phase
MP - Days 1-4
FP - Days 1-13
PP - Days 5-13
O - Day 14
LP - Days 15-28
This phase is days 1-5 with a 1-4 mm thick endo
Menstural phase
This phase is days 5-13, corresponds with follicular phase, thin endo, and increased estrogen levels
Proliferate phase
This phase is days 15-28 and corresponds to the luteal phase of the ovarian cycle
Secretory/luteal phase
Ruptured follicles become
Corpus luteum
This secretes progesterone
Corpus luteum
Name the 4 phases of the mesntrual cycle
Menstrual phase
Follicular phase
Ovulation phase
Luteal phase
Draw the 3 looks/appearances of the endometrium
Look at slide 75
Right after menses the endometrium will appear ____ and will be __-__ mm
Homogenous
1-4 mm
Proliferative phase the endo will appear with a ____ ___ and will be ___ - ___
Triple layer
7-10 mm
Luteal phase the endo will appear with a ___ and __ - __
Hyperechogenic
8-16 mm
Progesterone is secreted by the corpus luteum in what part of the cycle
second half of cycle
This hormone helps prep and maintain the endo for the arrival and implantation of an embryo
Progesterone
What is the main function of progesterone
- induce secretry activity in the endo glands that have been primed by e & prep a site for fertilized ovum
Ovarian cycle governs the
Prep of endocrine tissues and release eggs
At birth each ovary contains approx. _______, ______ follicles
200,000 primary follicles
Absence of menstrual flow is called
Amenorrhea
On day 1 of the menstrual cycle -, ____ follicles begin to grow
4-5, primary follicles
On days 4-5 of the ovarian cycle one of the ____ follicles develops into a ____ follicle
Primary follicles –> Secondary follicle
In the preovulatory/proliferative phase the secondary follicles mature and develop into a
Graafian follicle
In the luteal phase the ruptured Graafian follicle is healed by
Capillary bleeding and eventually absorbed
Cell division that results into 4 daughter cells each with 1/2 # of chromosomes of the parent cell
Meiosis
If fertilization does not occur ____ ____ will usually regress by days __-__
Corpus luteum
26-28
Regressed form of corpus luteum in absence of fertilization
Corpus Albicans
No visible follicles transabdominally
Small follicles seen transvaginally
Menstrual phase
Multiple small developing follicles
Days 8-14 will begin to see dominant follicle
Follicular phase
When dominant follicle reaches 2-2.5 cm ovulation takes place within 24 hrs
Hypoechoic rim around follicle may be seen
Ovulation
Phase one of the endometrial changes
Menses, menstrual phase
Phase two of endometrial changes
Postmenstrual phase
Phase three of endometiral changes
Interval, proliferative, preovulatory
Phase 3 of endo changes corresponds to the ____ phase of uterus and ____ blood levels of ____
Follicular phase of uterus
High blood levels of estrogen
Phase four of endo changes
Secretory
During endo changes there may be a ____ “___”
Hypoechoic/Subendometrial “Halo”
T or F:
You include the hypoechoic “halo” in your measurment
False
Typically post menopause endo is less than
5 mm
If a women postmenopause is on tamoxifen the endo will be
8-11 mm
Most common cause of postmenopausal changes
Inflammation and thinning of vaginal lining
The inflammation and thinning of vaginal or womb lining is caused by
Lower estrogen levels
Cervical or womb polyps
What percentage of postmenopausal bleeding is due to cancer
9%
