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Reproductive Anatomy > Female Pelvic Viscera > Flashcards

Female Pelvic Viscera Flashcards

1
Q

Name the components of the female pelvic viscera?

A
  1. urinary bladder
  2. rectum
  3. reproductive tract
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2
Q

What are the components of the reproductive tract?

A
  1. ovaries
  2. Uterus
  3. vagina
  4. Clitoris
  5. Greater vestibular glands
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3
Q

Describe what the ovaries look like?

A

Oval, almond-shaped, pinkish-white glands

3cm x 1.5 cm x 1cm

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4
Q

Where are the ovaries located?

A

in the Ovarian Fossa on the wall of the Pelvic minor

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5
Q

Describe the boundaries of the ovarian fossa?

A
  1. Laterally - medial umbilical ligament
  2. Posteriorly - ureter & internal iliac artery
  3. superiorly - external iliac artery
  4. anteriorly - obliterated umbilical artery
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6
Q

What is the ampulla of the fallopian tubes?

A

long central portion of the fallopian tube that leads from the infundibulum
- The Ampulla curves over the lateral end of ovary so that the infundibulum curls around it

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7
Q

Name the portion of the fallopian tube that attaches to the ovary?

A

ovarian fimbria

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8
Q

What is the broad ligament of the uterus and what is its function?

A

double layer fold of the peritoneum that attaches the lateral portions of the uterus to the lateral pelvic sidewalls
- covers the uterus, ovaries and fallopian tubes

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9
Q

What is the mesovarium?

A

attaches ovary to the posterosuperior aspect of the broad ligament
- Vessels pass through to hilum of ovary

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10
Q

What is the ligament of the ovary?

A

attaches the ovaries to the uterus by a band of fibrous tissue

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11
Q

What is the suspensory ligament of the ovary?

A

a fold of parietal peritoneum that extends out from the ovary to the wall of the pelvis near the pelvic brim

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12
Q

What does the suspensory ligament of the ovary contain?

A
  1. ovarian artery and vein
  2. ovarian nerve plexus
  3. lymphatic vessels
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13
Q

Describe the relations of the suspensory ligament of the ovary?

A

passes over iliac vessels & Psoas Major

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14
Q

Describe the ovary in a young person?

A

Surface of the ovary is not covered by peritoneum

– has cuboidal epithelium

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15
Q

When do oogonia (immature female reproductive cell) develop?

A

during foetal period from primordial germ cells

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16
Q

Describe the ovary before and after puberty?

A
  1. Before puberty - the surface is smooth

2. after puberty - contain scars of Corpora Lutea

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17
Q

Describe the course of the ovarian arteries?

A
  • arise from abdominal aorta at L2
  • Descend on the posterior abdominal wall and on the brim cross over external iliac vessels and enter suspensory ligament
  • Sends branches to ovary and pass medially in broad ligament to the uterine tubes and anastomose with uterine artery
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18
Q

Describe the course of the ovarian veins?

A
  • leave the hila and form Pampiniform plexus in the broad ligament.
  • Communicates with uterine plexus.
  • Each vein arises from the plexus and leaves pelvis minor with artery
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19
Q

Describe the ovarian venous drainage?

A
  1. Right vein drain to Inferior vena cava

2. left vein drain into left renal vein

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20
Q

Describe the clinical correlates of the ovaries?

A

Ovarian cancer
– commonly originate from surface epithelium
– Occur at any age but more in older women
– Factors include family histories
– Spread through blood and lymphatics

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21
Q

Describe what fallopian tubes look like?

A

10 to 12 cm long & 1mm in diameter

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22
Q

What are the functions of the uterine tubes?

A
  1. allows communication between peritoneal cavity and exterior of body
  2. Conduct oocytes and Sperm to fertilization site in the ampulla
    - Extends from cornu of the uterus to Ovary
  3. Conveys dividing zygote to the uterine cavity
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23
Q

Name the parts of the uterine tubes?

A
  1. infundibulum
  2. ampulla
  3. isthmus
  4. the uterine part
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24
Q

Describe the infundibulum?

A
  • funnel shaped distal end

- has abdominal ostium on which there is fimbriae with one (Ovarian Fimbria) attaching the superior pole of the ovary

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25
Describe the ampulla?
– widest and longest part (2/3) | – fertilization takes place
26
Describe the isthmus?
narrow thick walled joins the cornu (horn)
27
Describe the uterine part of the fallopian tubes?
short, uterine ostium smaller than abdominal
28
Where are the uterine tubes located?
mesosalpinx
29
Describe the course of the uterine tubes?
Extend posterolaterally to the lateral walls of the pelvis & ascend to arch over the ovary
30
What is the arterial supply of the uterine tubes?
uterine + ovarian arteries
31
Describe the course of the venous drainage of the uterine tubes?
Veins are arranged as arteries and drain into the uterine & ovarian veins
32
Describe the clinical correlates of the uterine tubes?
Tubal ligation (TL) - Surgical ligation (clip) of the fallopian tube - effective method of birth control
33
Describe the course of the lymphatic drainage of the superior part of the fallopian tubes?
Accompany uterine artery and drain into Internal & External Iliac nodes
34
Describe the course of the lymphatic drainage of the uterine tubes?
Lymph vessels run with those of fundus to lumbar LN
35
Describe the lymphatic drainage of the middle part of the fallopian tubes?
Accompany Vaginal artery and drain into Internal Iliac nodes
36
Describe the lymphatic drainage of the vestibule?
to superficial Inguinal Lymph nodes, some to sacral & Common Iliac Lymph nodes
37
Describe the innervation of the fallopian tubes?
- Derived from Uterovaginal plexus which lies at the base of the broad ligament on each side of cervix - Sympathetic, Parasympathetic and afferent fibers pass through the plexus
38
Describe what the uterus looks like?
Pear- shaped muscular organ | 7-8 x 5-7 x 2-3cm
39
Describe the position of the uterus?
Projects superiorly and anteriorly superior to the bladder (superior end of vagina) - via the uterine ostium
40
What are the regions of the uterus?
1. Superior 2/3 – body 2. inferior 1/3 – cylindrical cervix - Vaginal part of the cervix communicates with the vagina
41
What are the parts of the uterus?
1. fundus 2. cornu 3. isthmus
42
What is the fundus of the uterus?
rounded superior part located superior to a line joining points of entrance of the uterine tubes
43
What is the cornu?
where the uterine tubes enter
44
What is the isthmus?
Narrow Zone of transition between body & Cervix
45
Describe the orientation of the uterus?
1. Anteflexed (cx & body) - Bent anteriorly | 2. anteverted
46
Name the 3 layers of the wall of the uterus?
1. perimetrium 2. myometrium - middle muscular layer 3. endometrium
47
Describe the perimetrium?
outer serous coat | - peritoneum & connective tissue
48
Describe the myometrium?
middle muscular layer - 12-15mm of muscle - blood vessels
49
Describe the endometrium?
1. firmly adherent to myometrium - only the body 2. Endometrium is partly shed during menstruation
50
Describe the walls of the cervix?
1. lined by mucus secreting epithelium 2. Middle coat – Fibrous tissue - small amounts of smooth muscle
51
What are the relations of the uterus?
1. Anteroinferior or vesical surface related to bladder | 2. Postero-inferior surface or intestinal surface related to intestines
52
What are the relations of the ureter?
Ureter is crossed superiorly by the uterine artery at the side of the cervix - They are separated by right & left borders
53
What are the course of the uterine tubes?
extend laterally into peritoneal cavity near ovary and into anterolateral part of uterine cavity
54
Why is the cervix not mobile?
Transverse Cervical Ligament | – holds cervix & lateral fornices of vagina to lateral wall of pelvis
55
Name the ligaments of the uterus?
1. uterosacral ligaments 2. urogenital diaphragm 3. ligaments of the ovary 4. round ligaments 5. broad ligament
56
Describe the uterosacral ligaments
- holds sides of the cervix to Sacrum - deep to peritoneum - superior to levator ani
57
Describe the function of the urogenital diaphragm?
Forms Principal support | – levator Ani, the coccygeus muscle and muscles of the urogenital diaphragm
58
Describe the ligament of the ovary?
– found within broad ligament | – attaches posteroinferior surface of the ovary to the uterotubal junction
59
Describe the round ligaments of the uterus?
– within Broad ligament – Anteroinferiorly to the uterotubal junction – runs between the layers of broad ligament to deep inguinal ring to labium majus
60
Describe the broad ligament of the uterus?
- Body of uterus is enclosed between layers of broad ligament - mobile in relation to bladder
61
Describe the peritoneum that covers the uterus?
- covers Anteriorly & Superiorly except for vaginal part of cervix - Reflected anteriorly on the bladder - reflected Posteriorly over posterior fornix onto the rectum
62
What is the broad ligament?
Double layered sheet of peritoneum extends from the sides of the uterus to the lateral walls and floor of pelvis (continuous as they surround uterine tubes) - contains Parametrium
63
Describe the 3 mesenteries of the broad ligament?
1. Mesovarium - gives attachment to ovary 2. Mesoalpinx - between ligament of ovary , ovary, & uterine tube 3. Mesometrium - gives attachment to uterus
64
What is the blood supply of the uterus?
uterine arteries - internal iliac artery
65
Describe the course of the arterial blood supply of the uterus?
- Enter broad ligament beside the lateral fornices of vagina superior to ureters - At Isthmus divide – Larger Ascending & Smaller descending - Anastomose with ovarian artery from abdominal aorta
66
Describe the venous drainage of the uterus?
- Veins form a plexus on each side of the cervix to drain into Internal Iliac veins - Superior rectal – portal systemic anastomosis
67
What is the vagina?
Female organ of copulation (7-9cm)
68
Describe the vagina?
- Musculo-membranous tube - Forms the Inferior portion of the female genital tract and birth canal - Communicates superiorly to the cavity of uterus - Inferiorly opens into vestibule of vagina between labia minora
69
Describe the position of the vagina?
Descends anteroinferiorly from the rectouterine pouch
70
Describe the orientation of the vagina?
Anterior & posterior walls are normally in apposition except superior end due to cervix
71
What surrounds the orifice of the vagina?
Hymen surrounds the orifice | - after child birth only tabs called Hymenal Caruncles
72
State the relations of the vagina?
1. posterior to - urinary bladder 2. anterior to - rectum 3. passes medial margins of levator Ani muscles 4. Uterus passes at right angle to vagina
73
Describe the anterior relations of the vagina?
1. Cervix 2. base of Bladder 3. Terminal parts of the ureters & Urethra
74
Describe the superior limit of the relations of the vagina?
covered by peritoneum | – 1 to 2cm posterior fornix
75
Describe the relations of the lateral wall of the vagina?
attached to broad ligament of uterus | - ureters & uterine vessels
76
Describe the inferior relations of the vagina?
Inferiorly in contact with Levator Ani, greater vestibular glands and the bulbs of the vestibule
77
Describe the recesses of the vagina?
1. Anterior to Cervix – Anterior Fornix 2. Posterior to Cervix – Posterior Fornix – Deepest & related to rectouterine pouch 3. At the sides – Lateral Fornices
78
Consequences of the contraction of the Pubococcygeus muscle?
decreases the size of the vaginal lumen
79
What is inferior to the posterior fornix?
loose connective tissue of the rectovaginal septum separates rectum – inferiorly Central Perineal Tendon
80
What is the arterial supply of the vagina?
Branches of internal iliac artery 1. Vaginal artery branch of uterine artery 2. Internal Pudendal artery 3. Vaginal branch of Middle rectal artery
81
Describe the venous drainage of the vagina?
Vaginal Veins form Vaginal plexus along sides of vagina and mucosa which drain into internal Iliac veins - vesical, uterine & rectal venous plexus
82
What is the lymphatic drainage of the fundus of the uterus?
1. aortic or Lumbar Lymph nodes via Ovarian vessels 2. External Iliac 3. along round ligament to superficial Inguinal nodes
83
What is the lymph drainage of the body of the uterus?
External Iliac Nodes through para-uterine LN
84
What is the the lymph drainage of the cervix?
1. Internal Iliac nodes | 2. Sacral Nodes
85
Describe the innervation of the uterus?
1. Inferior Hypogastric plexus - Uterovaginal plexus in broad ligament 2. Nerves to cervix - form a plexus with small paracervical ganglia with large one called Uterine Cervical Ganglion (Vasomotor) 3. Afferent fibres ascend through hypogastric plexus & enter the spinal cord via T10 to T12 and L1
86
Describe the clinical correlates of the cervix and uterus?
carcinoma of the cervix and uterus | - Common disease in women
87
How do you diagnose carcinomas of the cervix and uterus?
1. Inspection 2. Cytology 3. Imaging 4. Biopsy 5. Dilatation and curettage (D&C)
88
What is a hesterectomy?
surgical removal of the uterus
89
What is a total abdominal hesterectomy?
removal of uterus, fallopian tubes and cervix
90
What is a salpingo-oophorectomy?
removal of uterine tubes and ovaries
91
Describe the clinical correlates of the recto-uterine pouch?
Clinically important as a site where infections and fluids collect. - Examined by transvaginal and transrectal digital palpation

Reproductive Anatomy (16 decks)

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