Female and male reproductive system Flashcards
1
Q
What is contained within the pelvic cavity?
A
Ovaries
Uterine tubes
Uterus
Superior part of vagina
2
Q
What is contained within the perineum?
A
Inferior part of vagina Perineal muscles Bartholin's glands Clitoris Labia
3
Q
What are the primary reproductive organs in women?
A
Ovaries
4
Q
What is the function of the inferior part of the parietal peritoneum?
A
Floor of peritoneal cavity
Roof over pelvic organs
5
Q
What pouches form in the female peritoneum?
A
Vesico-uterine
Recto-uterine
6
Q
How can fluid from the pouch of douglas be drained?
A
Needle passed through the posterior fornix of the vagina
7
Q
Where will abnormal fluid collect within the peritoneal cavity in women?
A
Pouch of douglas; most inferior part of the peritoneal cavity in the anatomical position
8
Q
Are the pelvic organs intra or sub peritoneal?
A
Sub
9
Q
What part of the pelvic organs are intraperitoneal?
A
Uterine tubes
10
Q
What is the broad ligament and where can it be found?
A
Double layer of peritoneum
Extends between the uterus and lateral walls + floor of pelvis
11
Q
What is the function of the broad ligaments and what is contained within it?
A
Uterine tubes
Proximal part of round ligament
12
Q
What is the round ligament?
A
Embryological remnant
13
Q
Where does the round ligament attach?
A
Lateral aspect of uterus
Passes through the deep inguinal ring to attach to the superficial tissue of the female perineum
14
Q
What are the 3 layers of the uterus?
A
Perimetrium
Myometrium
Endometrium
15
Q
Where will the oocyte be fertilised?
A
Ampulla
16
Q
Where should the zygote implant?
A
Body of uterus; anywhere else is an ectopic
17
Q
What holds the uterus in place?
A
Uterosacral ligaments
Endopelvic fascia
Levator ani
18
Q
What can result from weakness of the structures that hold the uterus in place?
A
Uterine prolapse; inferior movement
19
Q
What is the most common position of the uterus?
A
Anteverted
Anteflexed
20
Q
What does anteverted in terms of the uterus mean?
A
Cervix tipped anteriorly relative to the axis of the vagina
21
Q
What does antiflexed mean in terms of the uterus?
A
Uterus tipped anteriorly relative to the axis of the cervix (mass of uterus lies over the bladder)
22
Q
What is a very normal and common variation of the standard positioning of the uterus?
A
Retroverted and retroflexed
23
Q
Is the vagina usually patent?
A
No; walls tend to be collapsed
24
Q
What must be sampled in cervical screening?
A
Squamocolumnar junction (transformation zone)
25
What is the "salpinx"?
Tube; refers to fallopian tube
26
Where do the fimbriated ends of the uterine tubes open into?
The peritoneal cavity to act as a means of communication between the genital tract and the peritoneal cavity
27
What determines patency of fallopian tubes in a HSG (hysterosalpingogram)?
Radiopaque dye spilling out of the end of the uterine tube and into the peritoneal cavity
28
What size are the ovaries?
Almond shaped and sized in the lateral pelvic cavity
29
Where do the ovaries develop?
Posterior abdominal wall and they will move onto the lateral wall of the pelvis (round ligament(
30
What are the 4 fornix of the vagina?
Anterior
Posterior
2 x lateral
31
What can be felt on a digital vaginal examination ?
Ischial spines - at 4 and 8 o'clock positions
Position of uterus
Palpation of adnexae
32
What are the adnexae?
Uterine tubes and ovaries
33
What is the perineum?
Shallow space between pelvic diaphragm and inferior skin of external genitalia
34
What do the openings of the pelvic floor allow for?
Passage of distal parts of alimentary, renal and reproductive tracts from pelvis to perineum
35
What are the 2 triangles of the perineum?
Urogenital
| Anal
36
What are the boundaries of the perineum?
Pubic symphysis at top
Coccyx at bottom
Ischial spines laterally
37
What is the function of the levator ani muscle?
Tonic contraction
Reflexively contracts further during situations of increased intra-abdominal pressure
Weakness can be a factor in the development of prolapse of the pelvic organs
38
What supplies the levator ani muscle?
Nerve to levator ani; S3,4,5
| ?? pudendal nerve
39
What are the perineal muscles supplied by?
Pudendal nerve
| Superficial and deep
40
What is the perineal body?
Bundle of collagenous and elastic tissue into which the perineal muscles attach
41
What is the function of the perineal body?
Important to pelvic floor strength
| Episiotomy act to preserve perineal body
42
What is the function of bartholin's gland?
Mucus secretion for lubrication
43
What type of tissue lies under the perineal muscles?
Erectile tissue
44
Where does the bed of the breast extend to and from?
Ribs 2-6
| Lateral border of sternum to mid-axillary line
45
Does the breast extend into the axilla?
Yes; axillary tail of spence
46
What does the breast lie on?
Deep fascia covering pec major and serratus anterior
47
What is the retromammary space?
Lies between fascia and breast - allows the breast to move independently of the pec muscle
48
What attaches the breast tissue to the skin?
Suspensory ligaments
49
What makes up the breast tissue?
Fat
| Non lactating lobues; in pregnant/ breast feeding women these become lactating lobules
50
What connects the lactating lobues to the areola?
Lactiferous duct
51
How is the female breast sectioned?
Upper and lower outer
Upper and lower inner
OR
Clock face
52
How can you assess if a breast lump is "fixed" to underlying pectoral fascia?
Ask patient to place her hands firmly on her hips (and in doing so, there is contraction of pectoral muscles)
53
Where will 75% of lymph from the breast drain to?
Ipsilateral axillary lymph nodes -> supraclavicular nodes
54
Where can lymph from inner breast quadrants drain to?
Parasternal lymph nodes which can either drain to supraclavicular ipsilaterally or contralaterally
55
Where can lymph from the lower inner breast quadrants drain to?
Abdominal lymph nodes
56
What can be the implication of axillary node clearance?
Lymphedema; as all lymph from upper limb also drains there
57
What is contained within the axilla?
Brachial plexus
Axillary artery and axillary vein
Axillary lymph
All embedded in axillary fat
58
What are the different levels of axillary node clearance?
Level 1; inferior and lateral to pectoralis minor
Level 2; deep to pectoralis minor
Level 3; superior and medial to pectoralis minor
59
What determines the levels of axillary nodal clearance?
In relation to pectoralis minor
60
What is the arterial supply to the breast?
```
Internal thoracic forms the internal mammary (from subclavian)
Lateral thoracic (axillary artery)
Posterior intercostal arteries 2,3,4 at lateral aspect
```
61
Does the venous drainage of the breast mirror the arterial?
Yes
62
What are the male reproductive organs?
Testes
63
What are the accessory reproductive organs in a male?
Vas
Seminal glands
Prostate gland
Penis
64
What lies within the corpus spongiosum?
Spongy urethra
65
What is the more inferior aspect of the peritoneal cavity in males?
Rectovesical
66
What forms the bladder wall?
Detrusor muscle
67
What openings are present on the trigone of the bladder?
2 ureteric orifices
| Internal urethral orifice
68
What is the function of the internal urethral sphincter in males?
Contracts during ejaculation to prevent retrograde ejaculation
69
Where do the testes develop?
Posterior wall of abdo cavity
70
Through which structure do the testes pass through to reach the scrotum?
Anterior abdominal wall; inguinal canal
71
What is present in the spermatic cord?
Testicular artery and vein
Vas deferens
Lymph
Nerves; autonomic (vas), somatic (cremaster muscle)
72
In what structure do the testis sit within in the scrotum?
Tunica vaginalis
73
What is excess fluid within the tunica vaginalis called?
Hydrocele
74
Where is sperm produced?
Seminiferous tubules
75
What muscle controls the temp of the testes?
Dartos
76
Describe the route of sperm from the seminiferous tubules to vas?
```
Seminiferous tubules
Rete testes
Head of epididymis
Tail of epididymis
Vas
```
77
What is the volume of the testis?
12-25ml
78
What is the arterial supply of the testes?
Testicular artery; lateral aspect of abdominal aorta
79
What is the venous supply of the testes?
Left testicular vein to the left renal vein
| Right testicular vein to the IVC
80
Through which structure does the blood supply and drainage pass through?
Deep inguinal ring (along with vas, lymph and nerves)
81
What is the function of the prostatic urethra?
Drains urine from bladder
| Passes semen in ejaculatino
82
What is the function of the bulbourethral gland?
Mucus secretion
| Lubricates urethra and neutralises acidity
83
What makes up the ejaculatory duct?
Vas deferens
| Duct from seminal gland
84
What is the inferior aspect of the prostate gland in contact with?
Levator ani
85
Where do the majority of prostate cancers arise from?
```
Peripheral zone
(central zone = BPH)
```
86
What is the route of the vas?
Superiorly in spermatic cord to deep inguinal ring
At deep inguinal ring, turns medially into pelvis
Travels posterior to bladder
87
Where do the left and right ejaculatory ducts join?
Within the prostate gland to drain into the urethra
88
What is the anatomical position of the penis?
Erect
89
What is paraphimosis?
Retraction of prepuce causing contraction of neck of glans
90
In what area is the penis?
Within the perineum
91
Where does the root of the penis attach?
Laterally to ischium of pelvis
92
What are the 3 cylinders of erectile tissue within the penis?
2x corpus cavernosum
| Corpus spongiosum
93
What are the contents of the corpus cavernosum?
Transmit deep arteries of the penis
94
What are the contents of the corpus spongiosum?
Spongy urethra
| Expands distally to form glans penis
95
Where does the superficial perineal pouch lie in the male?
Below perineal membrane
96
What is contained within the superficial perineal pouch?
Root of penis:
Bulb (corpus spongiosum, crurs, corpus cavernosum)
Assoc muscles (bulbospongiosus, ischiocavernosus)
97
What is the blood supply to the penis?
Deep arteries of the penis:
| Branches from internal pudendal artery (from internal iliac)
98
What is the blood supply to the scrotum?
Via internal pudendal and branches of external iliac
99
Where does lymph from the testes drain?
Lumbar nodes
100
Where does lymph from the scrotum and most of penis (not glans) drain to?
Superficial inguinal nodes at the superficial fascia of the groin
101
What structures pass through the levator ani in the male?
Rectum and urethra
102
What nerve fibres does the pudendal nerve contain?
Sympathetic
Somatic sensory
Somatic motor
103
What space does the pudendal nerve pass through in the perineum?
Ischioanal fossa
104
What are the components of the fluid secreted by the seminal vesicle?
```
Fructose
Proteins
Prostaglandins
Vitamin C
Flavins
Phosphorycholine
Enzymes
```
105
Which part of the ANS is responsible for orgasms?
Sympathetic
106
What 4 muscles compress to vagina to act like sphincters?
Pubovaginalis
External urethral sphincter
Urethro-vaginal
Bulbospongiosus
107
What is the blood supply to the vagina?
Superiorly; branches of uterine
| Inferiorly; vaginala dn internal pudendal
108
What is the round ligament of the uterus a remnant of?
Ovarian gubernaculum; descend of ovaries from developmental position on the posterior abdominal wall
109
What are the layers of the spine transversed in giving a spinal anaesthesia?
```
From posterior to anterior:
Skin
Subcutaneous fat
Supraspinous ligament,
Interspinous ligament
Ligamentum flavum
Dura mater
Subdural space
Arachnoid mater
Subarachnoid space
```
110
What muscles make up the levator ani?
Puborectalis (sling around rectum)
Pubococcygeus
Iliococcygeus
111
What forms the anterior-inferior pelvic wall?
Bodies and rami of pubic bones and pubic symphysis
112
What forms the lateral pelvic walls?
Bony framework formed by hip bones, including obturator foramen
Obturator internus
113
What forms the posterior pelvic wall?
Bony wall and roof in midline (sacrum and coccyx)
SI joint
Piriformis muscle (leaves via greater sciatic foramen)
Sacral plexus
114
What is the perineum?
Shallow compartment that lies between the levator ani superiorly and perineal skin inferiorly
115
Function of levator ani?
Roof of perineum
Floor of pelvis
Support to pelvic organs
Maintains faecal and urinary continence
116
Nerve fibres of pudendal nerve?
Somatic motor (levator ani and muscles of perineum)
Somatic sensory
Sympathetic nerve fibres
117
Where does lymph from the uterus drain to?
Lumbar/ caval/ paraaortic nodes
118
Route taken by sperm from production to fertilization
```
Seminiferious tubules
Rete testes
Epididymis
Vas deferens in spermatic cord
Ejaculatory duct
Prostatic urethra
Membranous urethra
Spongy urethra
External urethral meatus
Vagina
Cervix
Fallopian tube
```
119
Route taken by ovum from production to fertilization
Ovary
Peritoneal cavity
Gathered by fimbriae into infundibulum of fallopian tube
Moved along to ampulla
120
How can uterine prolapse occur?
Weakened pelvic support
| Increased intra-abdominal pressure
121
Components of fluid secreted by seminal vesicles?
```
Proteins
Enzymes
Fructose
Mucus
Vit C
Flalvins
Phosphorylcholine
Prostaglandin
```
122
What is the main function of the fluid secreted by prostate?
Activation of sperm
123
What are the functions of the fluid secreted by the bulbourethral (cowper's) glands?
Lubricates urethra and helps to neutralise acid in urethra
124
Which structures are located in spermatic cord?
```
Ductus (vas) deferens
Testicular artery
Venous drainage (pampiniform plexus)
Sympathetic nerve fibres
Genital branch of genitofemoral nerve
Lymphatics
```
