Female pelvis Flashcards
What do the female internal reproductive organs include?
Uterus
Uterine (Fallopian) Tubes
Vagina
Ovaries
What 3 structures constitute the birth canal?
Uterus
Cervix
Vagina
What are the 3 layers of the uterus?
Perimetrium
Myometrium
Endometrium
The suspensory ligament of the ovary is a continuation of which ligament?
Broad ligament of the uterus
What is the normal position of the uterus in terms of how it lies?
Anteverted = tipped anterosuperiorly relative to the axis of the vagina Anteflexed = Uterine body is flexed or bent anteriorly relative to the cervix
What could happen if the position of the uterus is retroverted and retroflexed?
Uterine prolapse can occur
What are the fornices of the vagina?
Recess around the protruding cervix
Through which vaginal fornix can you access the rectouterine pouch?
Posterior vaginal fornix
Which ligament (part of the pelvic fascia, which is one of the main supports of the uterus) is also called the cardinal ligament of the uterus?
Transverse cervical
What ligament is a remnant of the gubernaculum
Round ligament of the uterus
Goes through the inguinal canal
Apart from the pelvic fascia what other structure in the pelvis is also an important support of the uterus?
Pelvic floor/ diaphragm
The uterine tubes are divided into 4 parts. Name them
Infundibulum
Ampulla
Isthmus
Intramural
Uterine part
Which part of the uterine tube is longest and widest?
Ampulla
Fertilization occurs in which part of the uterine tube?
Ampulla
What is meant by an ectopic (tubal) pregnancy?
Blastocyst implants into mucosa of uterine tube (usually Ampulla) so never reaches uterus
Where does a cronual ectopic pregnancy implant
Uterine horn
Name the two ligaments associated with the ovary
Ovarian ligament: uterus -> ovary
Suspensory ligament: ovary -> pelvic wall
The blood supply to the gonads and genitalia is via two major branches from the aorta. Name them
Gonadal and internal iliac arteries
At what vertebral level do the gonadal arteries originate?
L2
In the female the ovarian artery descends within …………… to supply the ovaries via the …………. Fill in the gaps above
Descends within the suspensory ligament Supply ovaries via broad ligament
The ovarian artery freely anastomoses with which artery and may in fact be replaced by it?
uterine artery
Into which vessels do the gonadal veins drain?
Right = IVC
Left = left renal vein
The uterine artery crosses over the ureter at what level?
Level of ischial spine
At the junction of the cervix and lateral part of fornix of vagina
(“water under the bridge”)
Lymphatic drainage of the internal pelvic organs follows what route?
Follows the arterial supply and venous drainage
Lymph from the labia and distal part of the vagina drain into which group of lymph nodes?
Superficial inguinal lymph nodes
Lymph from the ovary drains into which group of lymph nodes?
Para-aortic nodes
The fundus and upper uterine body drains into which lymph nodes?
Pre-aortic lymph nodes
Most of the uterine body drains into which group of lymph nodes?
External iliac nodes
The uterine cervix and upper vagina drain into which group of lymph nodes?
Internal iliac and sacral lymph nodes
The lower vagina drains into which group of lymph nodes?
Superficial inguinal nodes
What are the breasts?
Highly modified sweat glands lying in the superficial fascia of the pectoral region. They form important accessory organs of the female reproductive system, and provide nutrition to the new born in the form of milk
Each breast consists of 15-25 lobes. What tissue do these lobes contain?
Tubulo-acinar gland (parenchyma)
Stroma (connective tissue)
Where does the breast extend from -> to?
Vertically: 2nd rib -> 6th rib
Horizontal: lateral border of sternum -> anterior axillary line
The breast lies anterior to which muscles?
Pectoralis major
Pectoralis minor
Serratus anterior
The mammary gland is extremely vascular. What arteries are they supplied by?
Branches of subclavian and axillary arteries:
Lateral thoracic -> lateral mammary branches
Internal thoracic -> medial mammary branches
Where does lymph drain from the medial and lateral quadrants of the breast
Lateral -> Axillary lymph nodes
Medial -> Parasternal lymph nodes & other breast
It is possible for lymph from the medial side of one breast to drain to the opposite side. What is the clinical significance of this?
Cancer can spread from one breast to the other
What does the placenta develop from?
Membranes that surround the fetus and the uterine endometrium
What are the 4 functions of the placenta?
- Gaseous exchange
- Nutrient Exchange
- Metabolism (synthesis of glycogen)
- Endocrine secretions (HcG)
It forms a link of physiological exchange between maternal and fetal circulation
What are the functions of the umbilical arteries and veins?
Arteries = carry deoxygenated blood
Veins = carry oxygenated blood
What are the 3 subdivisions of the broad ligament?
Mesosalpinx
Mesovarium
Mesometrium
What are the main supports of the uterus?
Pelvic diaphragm
Pelvic fascia (e.g. round ligaments)
The uterus and cervix are firmly anchored in the pelvis by a number of ligamentous attachments. Name them
Ligament of ovary
Suspensory ligament of ovary
Round ligament
Broad ligament (also middle uterine ligaments)
Why is the cardinal ligament often removed in a hysterectomy
they are common reservoir of cancerous cells.
What are the pubocervical ligaments?
The pubocervical ligaments are bilateral structures, which attach the cervix to the posterior surface of the pubic symphysis.
What are the uterosacral ligaments?
The uterosacral ligaments are also bilateral fibrous bands, which attach the cervix to the sacrum. They are also known as the recto-uterine ligaments or sacrocervical ligaments. This supports the uterus and holds it in place.
Name the ligaments which hold the uterus in place on its superior and middle aspects
Superior aspect
broad ligament
round ligament
Middle aspect
transverse cervical (cardinal ligaments)
pubocervical ligament
uterosacral ligament
What is the most fixed part of the uterus and why
Cervix
It is where all the ligament attach
What is the braod ligament of the uterus
Double layer of peritoneum
What is the function of the fallopian tubes
Transports fertilised egg or ovum
What are the contents of the superficial and deep perinral pouches
Superficial
Ischiocavernosus
Bulbospongiosus
Superficial transverse perineal muscle
External anal sphincter
External gentila
Pernial membrane
Pernial body
Deep
External urethral sphincter
Bulboourethral gland
Compressor urethrae
Deep transverse pernial muscle
Urethrovaginal sphincter
What are the differences between the placenta’s fetal and maternal surface
fetal surface -> smooth
Maternal surface -> rough
What position is the female uterus in early pregnancy
Retroverted and retroflexed
What do the para and pre-aortic LNs drain
Para -> ovaries
Pre -> fundus
Which segment of the uterus is involved in C-sections
Lower 1/3rd
What does the placenta develop from
trophpblast cells
What stage of pregnancy does the placetna seperate from the uterine wall
3rd stage
What are the lumps on the maternal surface of the placenta formed by
Cotlyedon
What happens to the ovarian ligaments during pregnancy and during the menopause
Pregnancy -> displaced
Menopause -> atrophied
