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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
Q

Describe the ampulla?

A

– widest and longest part (2/3)

– fertilization takes place

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26
Q

Describe the isthmus?

A

narrow thick walled joins the cornu (horn)

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27
Q

Describe the uterine part of the fallopian tubes?

A

short, uterine ostium smaller than abdominal

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28
Q

Where are the uterine tubes located?

A

mesosalpinx

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29
Q

Describe the course of the uterine tubes?

A

Extend posterolaterally to the lateral walls of the pelvis & ascend to arch over the ovary

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30
Q

What is the arterial supply of the uterine tubes?

A

uterine + ovarian arteries

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31
Q

Describe the course of the venous drainage of the uterine tubes?

A

Veins are arranged as arteries and drain into the uterine & ovarian veins

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32
Q

Describe the clinical correlates of the uterine tubes?

A

Tubal ligation (TL)

  • Surgical ligation (clip) of the fallopian tube
  • effective method of birth control
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33
Q

Describe the course of the lymphatic drainage of the superior part of the fallopian tubes?

A

Accompany uterine artery and drain into Internal & External Iliac nodes

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34
Q

Describe the course of the lymphatic drainage of the uterine tubes?

A

Lymph vessels run with those of fundus to lumbar LN

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35
Q

Describe the lymphatic drainage of the middle part of the fallopian tubes?

A

Accompany Vaginal artery and drain into Internal Iliac nodes

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36
Q

Describe the lymphatic drainage of the vestibule?

A

to superficial Inguinal Lymph nodes, some to sacral & Common Iliac Lymph nodes

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37
Q

Describe the innervation of the fallopian tubes?

A
  • 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
Q

Describe what the uterus looks like?

A

Pear- shaped muscular organ

7-8 x 5-7 x 2-3cm

39
Q

Describe the position of the uterus?

A

Projects superiorly and anteriorly superior to the bladder (superior end of vagina)
- via the uterine ostium

40
Q

What are the regions of the uterus?

A
  1. Superior 2/3 – body
  2. inferior 1/3 – cylindrical cervix
    - Vaginal part of the cervix communicates with the vagina
41
Q

What are the parts of the uterus?

A
  1. fundus
  2. cornu
  3. isthmus
42
Q

What is the fundus of the uterus?

A

rounded superior part located superior to a line joining points of entrance of the uterine tubes

43
Q

What is the cornu?

A

where the uterine tubes enter

44
Q

What is the isthmus?

A

Narrow Zone of transition between body & Cervix

45
Q

Describe the orientation of the uterus?

A
  1. Anteflexed (cx & body) - Bent anteriorly

2. anteverted

46
Q

Name the 3 layers of the wall of the uterus?

A
  1. perimetrium
  2. myometrium - middle muscular layer
  3. endometrium
47
Q

Describe the perimetrium?

A

outer serous coat

- peritoneum & connective tissue

48
Q

Describe the myometrium?

A

middle muscular layer

  • 12-15mm of muscle
  • blood vessels
49
Q

Describe the endometrium?

A
  1. firmly adherent to myometrium
    • only the body
  2. Endometrium is partly shed during
    menstruation
50
Q

Describe the walls of the cervix?

A
  1. lined by mucus secreting epithelium
  2. Middle coat – Fibrous tissue
    • small amounts of smooth muscle
51
Q

What are the relations of the uterus?

A
  1. Anteroinferior or vesical surface related to bladder

2. Postero-inferior surface or intestinal surface related to intestines

52
Q

What are the relations of the ureter?

A

Ureter is crossed superiorly by the uterine artery at the side of the cervix
- They are separated by right & left borders

53
Q

What are the course of the uterine tubes?

A

extend laterally into peritoneal cavity near ovary and into anterolateral part of uterine cavity

54
Q

Why is the cervix not mobile?

A

Transverse Cervical Ligament

– holds cervix & lateral fornices of vagina to lateral wall of pelvis

55
Q

Name the ligaments of the uterus?

A
  1. uterosacral ligaments
  2. urogenital diaphragm
  3. ligaments of the ovary
  4. round ligaments
  5. broad ligament
56
Q

Describe the uterosacral ligaments

A
  • holds sides of the cervix to Sacrum
  • deep to peritoneum
  • superior to levator ani
57
Q

Describe the function of the urogenital diaphragm?

A

Forms Principal support

– levator Ani, the coccygeus muscle and muscles of the urogenital diaphragm

58
Q

Describe the ligament of the ovary?

A

– found within broad ligament

– attaches posteroinferior surface of the ovary to the uterotubal junction

59
Q

Describe the round ligaments of the uterus?

A

– within Broad ligament
– Anteroinferiorly to the uterotubal junction
– runs between the layers of broad ligament to deep inguinal ring to labium majus

60
Q

Describe the broad ligament of the uterus?

A
  • Body of uterus is enclosed between layers of broad ligament
  • mobile in relation to bladder
61
Q

Describe the peritoneum that covers the uterus?

A
  • covers Anteriorly & Superiorly except for vaginal part of cervix
  • Reflected anteriorly on the bladder
  • reflected Posteriorly over posterior fornix onto the rectum
62
Q

What is the broad ligament?

A

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
Q

Describe the 3 mesenteries of the broad ligament?

A
  1. Mesovarium - gives attachment to ovary
  2. Mesoalpinx - between ligament of ovary , ovary, & uterine tube
  3. Mesometrium - gives attachment to uterus
64
Q

What is the blood supply of the uterus?

A

uterine arteries - internal iliac artery

65
Q

Describe the course of the arterial blood supply of the uterus?

A
  • 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
Q

Describe the venous drainage of the uterus?

A
  • Veins form a plexus on each side of the cervix to drain into Internal Iliac veins
  • Superior rectal – portal systemic anastomosis
67
Q

What is the vagina?

A

Female organ of copulation (7-9cm)

68
Q

Describe the vagina?

A
  • 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
Q

Describe the position of the vagina?

A

Descends anteroinferiorly from the rectouterine pouch

70
Q

Describe the orientation of the vagina?

A

Anterior & posterior walls are normally in apposition except superior end due to cervix

71
Q

What surrounds the orifice of the vagina?

A

Hymen surrounds the orifice

- after child birth only tabs called Hymenal Caruncles

72
Q

State the relations of the vagina?

A
  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
Q

Describe the anterior relations of the vagina?

A
  1. Cervix
  2. base of Bladder
  3. Terminal parts of the ureters & Urethra
74
Q

Describe the superior limit of the relations of the vagina?

A

covered by peritoneum

– 1 to 2cm posterior fornix

75
Q

Describe the relations of the lateral wall of the vagina?

A

attached to broad ligament of uterus

- ureters & uterine vessels

76
Q

Describe the inferior relations of the vagina?

A

Inferiorly in contact with Levator Ani, greater vestibular glands and the bulbs of the vestibule

77
Q

Describe the recesses of the vagina?

A
  1. Anterior to Cervix – Anterior Fornix
  2. Posterior to Cervix – Posterior Fornix
    – Deepest & related to rectouterine pouch
  3. At the sides – Lateral Fornices
78
Q

Consequences of the contraction of the Pubococcygeus muscle?

A

decreases the size of the vaginal lumen

79
Q

What is inferior to the posterior fornix?

A

loose connective tissue of the rectovaginal septum separates rectum
– inferiorly Central Perineal Tendon

80
Q

What is the arterial supply of the vagina?

A

Branches of internal iliac artery

  1. Vaginal artery branch of uterine artery
  2. Internal Pudendal artery
  3. Vaginal branch of Middle rectal artery
81
Q

Describe the venous drainage of the vagina?

A

Vaginal Veins form Vaginal plexus along sides of vagina and mucosa which drain into internal Iliac veins
- vesical, uterine & rectal venous plexus

82
Q

What is the lymphatic drainage of the fundus of the uterus?

A
  1. aortic or Lumbar Lymph nodes via Ovarian vessels
  2. External Iliac
  3. along round ligament to superficial Inguinal nodes
83
Q

What is the lymph drainage of the body of the uterus?

A

External Iliac Nodes through para-uterine LN

84
Q

What is the the lymph drainage of the cervix?

A
  1. Internal Iliac nodes

2. Sacral Nodes

85
Q

Describe the innervation of the uterus?

A
  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
Q

Describe the clinical correlates of the cervix and uterus?

A

carcinoma of the cervix and uterus

- Common disease in women

87
Q

How do you diagnose carcinomas of the cervix and uterus?

A
  1. Inspection
  2. Cytology
  3. Imaging
  4. Biopsy
  5. Dilatation and curettage (D&C)
88
Q

What is a hesterectomy?

A

surgical removal of the uterus

89
Q

What is a total abdominal hesterectomy?

A

removal of uterus, fallopian tubes and cervix

90
Q

What is a salpingo-oophorectomy?

A

removal of uterine tubes and ovaries

91
Q

Describe the clinical correlates of the recto-uterine pouch?

A

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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