Female Internal Genetalia Flashcards

1
Q

What is the shape of the uterus

A

Hollow, pear-shaped

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2
Q

What is the size of the uterus

A

8cm long
5cm wide
3cm thick

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3
Q

What are the parts of the uterus

A

Body
Fundus
Isthmus
Cervix (neck)

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4
Q

What is the shape and position of the cervix

A

Cylindrial
Projects into the superior vagina
Thick-walled canal

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5
Q

What are the layers of the uterine walls

A

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
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6
Q

What are the positions of the uterus

A

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

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7
Q

What are the ligaments of the uterus

A

Broad ligament:

  • Mesosalpinx
  • Mesovarium
  • suspensory ligament of the Ovary

Mesometrium
Lig. of uterus
Round Ligament of Uterus

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8
Q

Describe the Broad Ligament

A

Double layer of peritoneum

Extends

  • from sides of uterus
  • to lateral pelvic walls
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9
Q

Describe the mesovarium

A

Suspends the ovary from the posterior lamina of the broad ligament

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10
Q

Describe the mesosalpinx

A
  • Part of broad ligament
  • Above level of ovary and mesovarium
  • Sweeps over the uterine tubes
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11
Q

Describe the mesometrium

A
  • ligament below mesovarium

- encloses blood vessels and nerves

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12
Q

Describe the lig. of ovary

A
  • Attaches ovary to uterus

- Remnant of proximal part of embryonic gubernaculums

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13
Q

Describe the Round Ligament of the Uterus

A
  • 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
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14
Q

Describe the suspensory ligament of the Ovary

A
  • Extension of the broad ligament superiorly on the posterolateral pelvic wall
  • Covers the ovarian vessels, associated nerves and lymphatics
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15
Q

What are the relations of the uterus

A

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
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16
Q

What is the arterial supply of the uterus

A
Uterine arteries (from Internal iliac A)
Vaginal Arteries 
Ovarian Artery
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17
Q

What is the venous drainage of the uterus

A

Uterine venous plexus to the Internal Iliac Veins

18
Q

What is the lymphatic drainage of the uterus

A

Drain to:

  • External iliac LN
  • Internal Iliac LN
  • Sacral LN
  • Superficial Inguinal LN (Along Round Ligament)

See diagram

19
Q

What is the innervation of the uterus

A

Inferior Hypogastric Plexus (Uterovaginal Plexus

Sympathetic:
-Lower lumbar segments (Lumbar Splanchnic Nerves)

Parasympathetic:
- S2-S4

See Diagram

20
Q

How long are the fallopian tubes

A

10cm long

21
Q

Where are the fallopian tubes

A

Run in the broad ligament (mesosalpinx)

22
Q

What are teh four parts of the Fallopian Tubes

A

Infundibulum
Ampulla
Isthmus
Intramural (uterine part)

23
Q

Where is fertilisation supposed to happen

A

In the Ampulla of the fallopian tubes

24
Q

What is the arterial supply of the Fallopian Tubes

A

Anastomoses:

  • Uterine arteries
  • Ovarian arteries
25
Q

What is the venous drainage of the Fallopian Tubes

A

Uterine venous plexus

Ovarian Veins

26
Q

What is the lymphatic drainage of the Fallopian tubes

A

Lumbar LN

27
Q

What shape are the ovaries

A

Ovoid in shape

28
Q

What is the size of the ovaries

A

4cm long

2cm wide

29
Q

What is the position of the ovaries

A

Ovarian Fossa

Attached to broad ligament by mesovarium

Attached to lateral pelvic wall by suspensory ligament

30
Q

What are the boundaries of the Ovarian Fossa

A

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

31
Q

What is the arterial supply of the ovaries

A

Ovarian and Tubal branches of:

-Ovarian A (br. of Abdominal Aorta)

32
Q

What is the venous drainage of the ovaries

A

Pampiniform plexus:

  • drains into IVC on Right
  • drains into Lt. renal vein on Left
33
Q

What are the sites of ectopic pregancies

A
Uterine Tube (most common)
Ovarian (rare)
Abdominal wall (peritoneal - very rare)
34
Q

What does the vagina communicate with both superiorly and inferiorly

A

Superiorly - uterus

Inferiorly - vestibule

35
Q

Where are the fornices

A

Area around the cervix has anterior, deep, posterior and lateral fornices

36
Q

What are the relations of the vagina?

A

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
37
Q

What is the arterial supply of the vagina

A

Superior Part:
-uterine arteries

Middle part:
-vaginal arteries

Lower part:

  • Middle rectal arteries
  • Internal pudendal arteries
38
Q

What is the venous drainage of the vagina

A

Uterine venous plexus (drains to Internal Iliac vein)

39
Q

What is the innervation of the vagina

A

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

40
Q

What are the possible clinical associations with the uterus

A

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