female pelvic viscera Flashcards
where is the obturator nerve
on lateral wall of pelvis with the ovary just medial to it
where is obturator fascia
overlies obturator internus and gives origin to levator ani
what is the innervation of levator ani
S3,4
what is puborectalis
the muscle that creates a sling around the rectal anal junction to aid rectal continence
what is pubovaginalis
closure of the vagina and support of genital organs
how big are ovaries
3 cm long
where are ovaries found
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
what might a central dislocation of the hip do
damage the ovaries
is the ovary intraperitoneal
yes, it is truly intraperitoneal due to absorption of the peritoneum into the ovary meaning it lies inside the peritoneal cavity
where is the ligament of ovary
in the broad ligament between the ovary and the uterus
what is the round ligament
the continuation of the ligament of the ovary (remnant of gubernaculum)
passes from the uterus, through the inguinal canal to the labia
where is the ovum released into
the peritoneal cavity, hence why ectopic pregnancies may occur in the peritoneal cavity
what structure is at risk during surgical procedures to the ovary
ureter due to it lying posteriorly
where might ovarian disease refer pain to
medial thigh dues to the obturator nerve lying laterally
what is the blood supply to the ovary
ovarian artery at L1,2 from aorta
what is the sympathetic supply to the ovary
T10/11
where is ovarian referred pain
peri umbilical region and medial thigh
what is the venous drainage of the ovaries
left to left renal vein, right to IVC
what is the lymph drainage of the ovary
para-aortic nodes
what forms the suspensory (infundibulopelvic ligament)
ovarian vessels passing down the posterior abdominal wall
they then enter the broad ligament
where does fertilisation occur
ampulla
where is the mesosalpinx (upper edge of the broad ligament)
between the fallopian tube and the ovary
what are the parts of the fallopian tube
fimbriae around the abdominal ostium infundibulum ampulla isthmus intramural part
what is the blood supply of the fallopian tube
anastomosis between the ovarian and uterine arteries
where is fallopian tube pain referred to
lower abdominal
how big is the uterus
8 cm long, pear shaped
what structures support the uterus
levator ani, perineal body, perineal membrane
where are the fascial thickenings that support the uterus
pass from the uterus to the sacrum, pubis and lateral pelvic walls
what is the tendinous arch of pelvic fascia
where the visceral and parietal fascia mess and fuse as the organs pierce the pelvic floor
runs from pubis to sacrum
what can weakness of the ligaments and muscles of the pelvic floor lead to
prolapse and urinary incontinence
where is the broad ligament
uterus to lateral pelvic wall
where is the round ligament
passes in the broad ligament from the uterus to the deep inguinal ring and down the inguinal canal to fuse with the labia
what is the function of the broad and round ligaments
hold the uterus anteverted and anteflexed
what is the posterior fornix related to
pouch of douglas aka rectouterine pouch
what are the fornices
where the cervix pushes into the vagina
how can the posterior fornix be used clinically
to access the peritoneal cavity
how long is the cylinder of the cervix
2.5 cm long with vaginal and supra vaginal parts
what is the external os
where the vaginal part of the cervix opens into the vagina
what is the internal os
narrowing of the cervix at the isthmus of the uterus
describe the position of the uterine cervix in relation to the vagina
anteverted
describe the position of the cervix and body of the uterus
anteflexed
what can retoversion and retroflexion cause
back ache and difficulty in conceiving
what is the blood supply of the uterus and vagina
uterine and vaginal anastomoses plus vesicle artery involvement
how long is the vagina
1o cm
where is the ureter in relation to the pelvic organs
inferior to the uterine artery and adjacent to the lateral fornices
what sphincter surrounds the vagina
the urethral or urethrovaginal sphincter which is derived from levator ani
what is the blood supply to the vagina
uterine artery, superior vesicle, vaginal, internal, pudendal artery
all from the internal iliac artery
what is the blood supply to the urethra
vaginal and internal pudendal
what is the external pudendal artery derived from
femoral
what does the urethra pass through
deep perineal pouch with external sphincter and perineal membrane
what is the lymph drainage of the bladder and urethra
external and internal iliac nodes
what is the lymph drainage of the ovary
para aortic
what is the lymph drainage of the uterus and proximal vagina
internal iliac nodes
what is the lymph drainage of the uterine tube
para aortic and superficial inguinal
what is the lymph drainage of the distal vagina and urethra
deep and superficial inguinal nodes
what is the value of the sympathetic pre aortic plexus
T10 -T11 from sympathetic trunk
what is the value of the pelvic plexus
pelvic splanchnics- S2-4
what is the value of the internal pudendal nerve
S2-4
what forms the left and right pelvic plexuses
superior hypogastric plexus which is T12 - L2
what is the nerve supply of the ovary
pre aortic sympathetics from T10 and 11
pain is periumbilical
where is pain referred from the uterus
suprapubic - t12 -L1
where is pain from the cervix and proximal vagina felt
deep in the pelvis
what does the gubernaculum form in the female
ligament of ovary and round ligament
what is the nerve value of the pre aortic sympathetic plexus (supplies the ovary)
T10 - L 2 (boosted by lumbar splanchnics)
what is the nerve supply of the superior hypogastric plexus
T12 - L2
what is the sympathetic supply of the ovary
pre aortic sympathetics from T10- 11
pain is peri umbilical
why is uterine pain suprapubic
passes via pelvic plexus- mainly t12-L1
what is the pain line
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
what part of the vagina is supplied by the internal pudendal
distal (somatic)
