Female Genetalia Flashcards
Identify the indicated features of the female genetalia
Posterior view
Identify the indicated features of the female genetalia from an superior view
What is adnexa?
The space taken up by the ovary, uterin tubes & some of the round ligament
What is the function of the uterus?
What type of organ is it?
How large is it?
serve as site for reception, retention, and nutrition of the fertilized ovum, mensuration
thick-walled, hollow muscular organ
dynamic size (~8cm * 5cm * 2cm non-pregnant adult)
Identify the indicated featues of the provided image
- uterine ostium
- receives the uterine tubes
- perimetrium
- serosal layer (thin connective tissue)
- myometrium
- thickest layer (smooth muscule, vasculature)
- contraction = period cramps
- Endmetrium
- mucous layer for uterus
- shed during menses
How could you tell if this individula has given birth?
the cirvical os is circular & would be more of a line in an individual who had previously given birth
What is the normal orientation of the uterus?
- Normal
- anteverted
- relative to vagina cervix tilts anteriorly
- anteflexed
- relative to cervix uterine body tilts anteriorly
- anteverted
- Abnormal
- retroverted
- relative to vagina, cervix tilts posteriorly
- retroflexed
- relative to cervix, uterine body tilts posteriorly
- retroverted
Identify the two indicated pouches
Why is it clinically important to know these?
Places of possible fluid accumulation
Identify the two indicated ligaments
Name their attachement points
- Transverse/Cardinal ligament
- base of the uterus, cervix, vagina to the lateral pelvic wall
- will carry uterine vessels
- Uterocervical/Sacrocervical Ligament
- attaches cervix to sacrum
- Publcervical Ligament
- from pubis to cervix
Identify the ligaments depicted in the provided image
Provide the attachment sites for each
-
Broad ligament
-
Mesometrium
- broadest section that covers the uterus
- covers external iliac vessels
-
Mesovarium
- suspends the ovaries (posterior connection), but does not wrap all the way around
-
Mesosalpinx
- covers the uterine tube
- anastamoses between uterine & ovarian vessels
-
Suspensory/infundibular
- carries ovarian artery & vein
- from the lateral abdominal wall and attaches to the lateral pole of the ovaries
-
Mesometrium
-
Ovarian ligament
- connect medial pole of ovaries to uterus
- opposite end of suspensory ligament
-
Round ligament of the uterus
- connects the uerine cornu to labia majora after passing through inguinal canal
-
Cardinal
- connects cervix and lateral pelvic wall
- contains uterine vessels
-
Uterosacral
- connects cervix and sacrum
-
Pubocervical (not shown)
- connected cervix and posterior pubic symphysis
What is a uterine prolapse & what are the most common causes?
outward displacement of the uterus via the vagina
- Ligaments weakening
- levator ani
- uterosacral ligament
- child birth
- downward displacement
- menopause
- vagina
Identify the arterys that supply the female genetalia
name each stucture supplied by each artery
name where each artery arises from
-
ovarian artery (from abdominal aorta)
- ovaries
- tube
- uterus
-
uterine (from internal iliac)
- uterus
- tube (small amount)
- vagina
-
Vaginal artery (from internal pudendal)
- vagina
What the relationship between the ureters and uterine arteries?
Why is this important?
ureters lie inferior to the uterine arteries
(water under the bridge)
If someone is trying to take the uterus out, and instead of ligating the uterine, they ligate the ureter. So, knowing this anatomical spatial relationship is key
What is a hysterectomy & what are some reasons a person may have one?
What are the 2 approaches to this surgery?
surgical removal of the uterus
- Causes
- cancer, chronic pain, chronic bleeding, endometriosis, fibroids, & uterine prolapse
- Approaches
- abdominally
- laparoscopically/transvaginal (more common now)
What is a pap test and why are they performed?
- screening for cervical cancer
- cells from the cervix are sampled using a speculum & cytobrush and sent for cytological assessment
Identify where lymphatics drain to from the following structures
body & cervix
cervix
fundus
round ligament
-
body & cervix
- external iliac lymph nodes
-
cervix
- obturator, internal and sacral lymph nodes
-
fundus
- paraaortic lymph nodes
-
round ligament
- superficial inguinal lymph nodes
What is the function of ovaries?
Where are they located?
Their shape changes with what variables/
- Function: oocyte development, endocrine
- Location: ovarian fossa
- Shape: almond shape; changes w/ puberty, pregnancy & menopause – surface epithelium also changes
Identify the 3 ovaria ligaments
What is the general function of these ligaments?
- suspended by the mesovarium (part of broad ligament)
-
suspensory ligament of the ovary
- attaches the ovary to the lateral pelvic wall & carries the ovarian vessels. becomes continuous with the mesovarium.
-
Ligament of the ovary
- attaches ovary to latera edge of uterus, inferior to the uterine tube
Identify the arterial branches & associated structures
Describe the venous drainage pattern from the uterus & ovaries
- Uterus will drain into the uterine vein which will drain into the internal iliac
- the network of veins on the ovaries (paminiform plexus) will converge to a single vein on each side
- right ovarian vein will drian directly to the inferior vena cava
- left ovarian vein will drain into the left renal vein
What is the concern with ovarian cysts?
How are they discovered?
- Cysts
- rupture of abnormal cysts can lead to life-threatening hemmorhage
- irregularities of ovaries may be felt during manual pelvic examination
- other types of cysts can develop into ovarian cancer
What is the concern with ovarian torsion?
the ligaments are twisted
this is a medical emergency because if the suspensory ligament is twisted & the blood supply is cut off, this may lead to tissue death, inflammation, and necrosis
What is the function of uterine tubes?
What is the average length of a uterine tube?
Where are the located?
- conduct the oocyte, typical site of fertilization
- 10 cm
- Location:
- lie in the mesosalpinx
- extend laterally from uterine horns and open into the peritoneal cavity
Identify the indicated featues of the uterine tubes
What is the name of the opening that allows the uterine tube to comunicate with the peritoneum?
What is the function of the ovarian fimbria?
- communicates with peritoneum
- abdominal ostium in the in infundibulum
- Ovarian fimbria
- the only fimbria of the uterine tube to be in contact with the ovary
Wha is an ectopic pregnancy?
What are the symptoms?
Why is it a medical emergency?
When fertilization occurs somewher other than the ampulla & implantation occurs somewhere other than the uterus
- Symptoms:
- unilateral lower abdominal/pelvic pain,
- internal bleeding and/or spontaneous abortion,
- remembles appendicitis
- Medical emergency becasue the walls of the tubes are not thick enough to handle a pregnancy & will rupture, which can lead to massive internal bleeding
- >90% will occur in the ampulla
What are the 3 types of uterine tube surgeries?
Surgical techniques?
- Salpingostomy
- surgical incision to remove a blockage
- Tubal ligation/occlusion (permanent method birth control)
- permanently blocks a section of the tube
- Salpingoectomy
- removes the affected tube entirely
- Surgical techniques
- open abdominal (suprapubic incision)
- laparoscopic (near umbilicus)
Identify the indicated features of the vagina
What is the vagina?
What is its function?
- Vagina
- 7-9cm distensible mucosalmembraneous tube
- Functin
- copulation, birth canal, canal for menses flow
What is the arterial supply for the vagina?
What veins drain the vagina?
- Arterial suppy
- superior part: vaginal arteries (from uterine)
- middle & inferior: vaginal/internal pudendal
- Venous drainage
-
vaginal venous plexuses
- uterine venous plexus
- internla iliac
- uterine venous plexus
-
vaginal venous plexuses
What is the vaginal fornix?
Why are they clinically relevant?
the recess around the cervix (anterior, posterior, and lateral)
Culdocentesis
deepest is posterior and associated to the recto-uterine pouch (to collect any fluid built up in the pouch of douglas)
What features can be assessed through a bimanual pelvic exam?
- can guestimate the health of the
- cervix
- ovarian mass
- tube mass
- can assess through a rectal exam
