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MD3002 post MSA > female pelvic viscera > Flashcards

female pelvic viscera Flashcards

1
Q

where is the obturator nerve

A

on lateral wall of pelvis with the ovary just medial to it

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2
Q

where is obturator fascia

A

overlies obturator internus and gives origin to levator ani

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3
Q

what is the innervation of levator ani

A

S3,4

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4
Q

what is puborectalis

A

the muscle that creates a sling around the rectal anal junction to aid rectal continence

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5
Q

what is pubovaginalis

A

closure of the vagina and support of genital organs

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6
Q

how big are ovaries

A

3 cm long

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7
Q

where are ovaries found

A

on lateral pelvic wall in ovarian fossa between the internal and external iliac vessels, medial to the obturator nerve and thin wall of the acetabulum

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8
Q

what might a central dislocation of the hip do

A

damage the ovaries

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9
Q

is the ovary intraperitoneal

A

yes, it is truly intraperitoneal due to absorption of the peritoneum into the ovary meaning it lies inside the peritoneal cavity

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10
Q

where is the ligament of ovary

A

in the broad ligament between the ovary and the uterus

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11
Q

what is the round ligament

A

the continuation of the ligament of the ovary (remnant of gubernaculum)
passes from the uterus, through the inguinal canal to the labia

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12
Q

where is the ovum released into

A

the peritoneal cavity, hence why ectopic pregnancies may occur in the peritoneal cavity

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13
Q

what structure is at risk during surgical procedures to the ovary

A

ureter due to it lying posteriorly

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14
Q

where might ovarian disease refer pain to

A

medial thigh dues to the obturator nerve lying laterally

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15
Q

what is the blood supply to the ovary

A

ovarian artery at L1,2 from aorta

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16
Q

what is the sympathetic supply to the ovary

A

T10/11

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17
Q

where is ovarian referred pain

A

peri umbilical region and medial thigh

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18
Q

what is the venous drainage of the ovaries

A

left to left renal vein, right to IVC

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19
Q

what is the lymph drainage of the ovary

A

para-aortic nodes

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20
Q

what forms the suspensory (infundibulopelvic ligament)

A

ovarian vessels passing down the posterior abdominal wall

they then enter the broad ligament

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21
Q

where does fertilisation occur

A

ampulla

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22
Q

where is the mesosalpinx (upper edge of the broad ligament)

A

between the fallopian tube and the ovary

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23
Q

what are the parts of the fallopian tube

A 
fimbriae around the abdominal ostium
infundibulum
ampulla 
isthmus
intramural part
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24
Q

what is the blood supply of the fallopian tube

A

anastomosis between the ovarian and uterine arteries

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25
Q

where is fallopian tube pain referred to

A

lower abdominal

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26
Q

how big is the uterus

A

8 cm long, pear shaped

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27
Q

what structures support the uterus

A

levator ani, perineal body, perineal membrane

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28
Q

where are the fascial thickenings that support the uterus

A

pass from the uterus to the sacrum, pubis and lateral pelvic walls

29
Q

what is the tendinous arch of pelvic fascia

A

where the visceral and parietal fascia mess and fuse as the organs pierce the pelvic floor
runs from pubis to sacrum

30
Q

what can weakness of the ligaments and muscles of the pelvic floor lead to

A

prolapse and urinary incontinence

31
Q

where is the broad ligament

A

uterus to lateral pelvic wall

32
Q

where is the round ligament

A

passes in the broad ligament from the uterus to the deep inguinal ring and down the inguinal canal to fuse with the labia

33
Q

what is the function of the broad and round ligaments

A

hold the uterus anteverted and anteflexed

34
Q

what is the posterior fornix related to

A

pouch of douglas aka rectouterine pouch

35
Q

what are the fornices

A

where the cervix pushes into the vagina

36
Q

how can the posterior fornix be used clinically

A

to access the peritoneal cavity

37
Q

how long is the cylinder of the cervix

A

2.5 cm long with vaginal and supra vaginal parts

38
Q

what is the external os

A

where the vaginal part of the cervix opens into the vagina

39
Q

what is the internal os

A

narrowing of the cervix at the isthmus of the uterus

40
Q

describe the position of the uterine cervix in relation to the vagina

A

anteverted

41
Q

describe the position of the cervix and body of the uterus

A

anteflexed

42
Q

what can retoversion and retroflexion cause

A

back ache and difficulty in conceiving

43
Q

what is the blood supply of the uterus and vagina

A

uterine and vaginal anastomoses plus vesicle artery involvement

44
Q

how long is the vagina

A

1o cm

45
Q

where is the ureter in relation to the pelvic organs

A

inferior to the uterine artery and adjacent to the lateral fornices

46
Q

what sphincter surrounds the vagina

A

the urethral or urethrovaginal sphincter which is derived from levator ani

47
Q

what is the blood supply to the vagina

A

uterine artery, superior vesicle, vaginal, internal, pudendal artery
all from the internal iliac artery

48
Q

what is the blood supply to the urethra

A

vaginal and internal pudendal

49
Q

what is the external pudendal artery derived from

A

femoral

50
Q

what does the urethra pass through

A

deep perineal pouch with external sphincter and perineal membrane

51
Q

what is the lymph drainage of the bladder and urethra

A

external and internal iliac nodes

52
Q

what is the lymph drainage of the ovary

A

para aortic

53
Q

what is the lymph drainage of the uterus and proximal vagina

A

internal iliac nodes

54
Q

what is the lymph drainage of the uterine tube

A

para aortic and superficial inguinal

55
Q

what is the lymph drainage of the distal vagina and urethra

A

deep and superficial inguinal nodes

56
Q

what is the value of the sympathetic pre aortic plexus

A

T10 -T11 from sympathetic trunk

57
Q

what is the value of the pelvic plexus

A

pelvic splanchnics- S2-4

58
Q

what is the value of the internal pudendal nerve

A

S2-4

59
Q

what forms the left and right pelvic plexuses

A

superior hypogastric plexus which is T12 - L2

60
Q

what is the nerve supply of the ovary

A

pre aortic sympathetics from T10 and 11

pain is periumbilical

61
Q

where is pain referred from the uterus

A

suprapubic - t12 -L1

62
Q

where is pain from the cervix and proximal vagina felt

A

deep in the pelvis

63
Q

what does the gubernaculum form in the female

A

ligament of ovary and round ligament

64
Q

what is the nerve value of the pre aortic sympathetic plexus (supplies the ovary)

A

T10 - L 2 (boosted by lumbar splanchnics)

65
Q

what is the nerve supply of the superior hypogastric plexus

A

T12 - L2

66
Q

what is the sympathetic supply of the ovary

A

pre aortic sympathetics from T10- 11

pain is peri umbilical

67
Q

why is uterine pain suprapubic

A

passes via pelvic plexus- mainly t12-L1

68
Q

what is the pain line

A

structures inferior to the peritoneum is via the p’sympathetic pelvic splanchnics and so felt deep in the pelvis
i.e. abdominal viscera (cervix) where as vagina is somatic due to it not being an internal organ

69
Q

what part of the vagina is supplied by the internal pudendal

A

distal (somatic)

MD3002 post MSA (66 decks)

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