Female Internal Genetalia Flashcards
What is the shape of the uterus
Hollow, pear-shaped
What is the size of the uterus
8cm long
5cm wide
3cm thick
What are the parts of the uterus
Body
Fundus
Isthmus
Cervix (neck)
What is the shape and position of the cervix
Cylindrial
Projects into the superior vagina
Thick-walled canal
What are the layers of the uterine walls
Perimetrium - outer layer of peritoneum
Myometrium - middle thick layer of smooth muscle
Endometrium
- vasular inner mucosal layer
- Thickness of this layer varies with age and menstrual cycle
What are the positions of the uterus
1: anteflexion:
- Bends forwards between the cervix and body
- Most common
2: Antevertion
- Anterior inclination of the whole uterus on vagina
- i.e. bent beween vagina and cervix
- no problems but uncomfortable
3: Retrovertion
- Posterior inclination of whole uterus on vagina
- Disturbs sigmoid colon
What are the ligaments of the uterus
Broad ligament:
- Mesosalpinx
- Mesovarium
- suspensory ligament of the Ovary
Mesometrium
Lig. of uterus
Round Ligament of Uterus
Describe the Broad Ligament
Double layer of peritoneum
Extends
- from sides of uterus
- to lateral pelvic walls
Describe the mesovarium
Suspends the ovary from the posterior lamina of the broad ligament
Describe the mesosalpinx
- Part of broad ligament
- Above level of ovary and mesovarium
- Sweeps over the uterine tubes
Describe the mesometrium
- ligament below mesovarium
- encloses blood vessels and nerves
Describe the lig. of ovary
- Attaches ovary to uterus
- Remnant of proximal part of embryonic gubernaculums
Describe the Round Ligament of the Uterus
- Extends from lateral wall of uterus to the pelvic wall
- Enters deep inguinal ring
- Passes through inguinal canal to Labium Majus
- Remnant of Embryonic Gubernaculums
Describe the suspensory ligament of the Ovary
- Extension of the broad ligament superiorly on the posterolateral pelvic wall
- Covers the ovarian vessels, associated nerves and lymphatics
What are the relations of the uterus
Anterior:
- Vesicouterine pouch
- Superior surface of bladder
Posterior
- Rectouterine pounc
- Anterior surface of recum
- Loops of intestine in pouch
- Uterosacral Ligament
Lateral:
- Broad ligament
- Transverse cervical (cardinal) ligament
- Ureters
- Uterine artery
What is the arterial supply of the uterus
Uterine arteries (from Internal iliac A) Vaginal Arteries Ovarian Artery
What is the venous drainage of the uterus
Uterine venous plexus to the Internal Iliac Veins
What is the lymphatic drainage of the uterus
Drain to:
- External iliac LN
- Internal Iliac LN
- Sacral LN
- Superficial Inguinal LN (Along Round Ligament)
See diagram
What is the innervation of the uterus
Inferior Hypogastric Plexus (Uterovaginal Plexus
Sympathetic:
-Lower lumbar segments (Lumbar Splanchnic Nerves)
Parasympathetic:
- S2-S4
See Diagram
How long are the fallopian tubes
10cm long
Where are the fallopian tubes
Run in the broad ligament (mesosalpinx)
What are teh four parts of the Fallopian Tubes
Infundibulum
Ampulla
Isthmus
Intramural (uterine part)
Where is fertilisation supposed to happen
In the Ampulla of the fallopian tubes
What is the arterial supply of the Fallopian Tubes
Anastomoses:
- Uterine arteries
- Ovarian arteries
What is the venous drainage of the Fallopian Tubes
Uterine venous plexus
Ovarian Veins
What is the lymphatic drainage of the Fallopian tubes
Lumbar LN
What shape are the ovaries
Ovoid in shape
What is the size of the ovaries
4cm long
2cm wide
What is the position of the ovaries
Ovarian Fossa
Attached to broad ligament by mesovarium
Attached to lateral pelvic wall by suspensory ligament
What are the boundaries of the Ovarian Fossa
superiorly:
- external iliac artery and vein
anteriorly and inferiorly:
- broad ligament of the uterus
posteriorly:
- ureter,
- internal iliac artery and vein
inferiorly:
- obturator nerve, artery and vein
What is the arterial supply of the ovaries
Ovarian and Tubal branches of:
-Ovarian A (br. of Abdominal Aorta)
What is the venous drainage of the ovaries
Pampiniform plexus:
- drains into IVC on Right
- drains into Lt. renal vein on Left
What are the sites of ectopic pregancies
Uterine Tube (most common) Ovarian (rare) Abdominal wall (peritoneal - very rare)
What does the vagina communicate with both superiorly and inferiorly
Superiorly - uterus
Inferiorly - vestibule
Where are the fornices
Area around the cervix has anterior, deep, posterior and lateral fornices
What are the relations of the vagina?
Upper Portion:
- Anterior:
- –Cervix
- –Base of bladder
- –Ureters
- –Urethra
- Posterior
- –Rectovaginal septum
- –Rectouterine pouch
- –Ampulla of rectum
- Lateral
- –Lateral fornices
- –Ureters
- –Uterine vessels
Lower Portion:
- Levator ani
- Greater vestibular glands
- Bulb of vestibule
What is the arterial supply of the vagina
Superior Part:
-uterine arteries
Middle part:
-vaginal arteries
Lower part:
- Middle rectal arteries
- Internal pudendal arteries
What is the venous drainage of the vagina
Uterine venous plexus (drains to Internal Iliac vein)
What is the innervation of the vagina
Upper portion is the same as the uterus :::
Inferior Hypogastric Plexus (Uterovaginal Plexus
Sympathetic:
-Lower lumbar segments (Lumbar Splanchnic Nerves)
Parasympathetic:
- S2-S4
See Diagram
Lower Portion:
-Only Somatic innervation. Therefore, -pudendal nerve
No parasympathetic supply
What are the possible clinical associations with the uterus
Uterine prolapse:
pelvic floor muscles and ligaments stretch and weaken and no longer provide enough support for the uterus. As a result, the uterus slips down into or protrudes out of the vagina.
Fecal incontinence:
Fecal incontinence is one of the symptoms that may occur with pelvic organ prolapse
