Female Pelvis Flashcards
What is the broad ligament composed of?
A double layer of peritoneum
What is enclosed between the two layers of the broad ligament?
Uterine tubes, ovarian ligament, round ligament of uterus
What suspends the ovaries in the peritoneal cavity?
The mesovarium
What covers the ovaries?
Surface epithelium, not peritoneum
What structure delivers the ovarian artery and vein to the ovaries?
The suspensory ligament of the ovary
Where do the ovarian arteries terminate?
They anastamose with the uterine arteries
What does the uterus rest on?
The urinary bladder
The cervix of the uterus runs between what two structures?
Bladder and rectum
What are the three parts of the uterus?
Body, isthmus, cervix
What provides active support to the uterus?
Pelvic diaphragm (levator ani and coccygeus)
What provides passive support to the uterus?
Its position, Uterine ligaments (transverse cervical (cardinal) ligaments, uterosacral ligaments)
What uterine ligament is palpable during a rectal exam?
Uterosacral ligaments
Transverse cervical ligaments attach what to what?
The cervix of the uterus to the lateral wall
Anterior relations of the uterus
Vesicouterine pouch, Superior surface of urinary bladder, Peritoneum
What structure is immediately posterior to the uterus?
The rectouterine pouch
What structures are lateral to the uterus?
Broad ligament, ureters, and uterine arteries
What structures are anterior to the vagina?
Fundus of bladder and urethra
What structures are posterior to the vagina?
Anal canal, rectum, and rectouterine pouch
What structures are lateral to the vagina?
Levator ani, visceral pelvic fascia, ureters
Which vaginal fornix is larger?
The posterior vaginal fornix is larger than the anterior vaginal fornix
Lymphatic drainage of ovarian and uterine tubes
Follow ovarian vessels to lumbar nodes
Lymphatic drainage of the fundus of the uterus
Follow ovarian vessels to lumbar nodes and follow round ligament to superficial inguinal nodes
Lymphatic drainage of the body of the uterus
Follow broad ligament to external iliac nodes
Lymphatic drainage of the cervical region of the uterus
Follow uterine vessels to internal iliac nodes, and follow uterosacral ligament to sacral nodes
Lymphatic drainage of each of the parts of the vagina
Superior - Internal and external iliac nodes, Middle - internal iliac nodes, Inferior - sacral, common iliac nodes, External orifice - superficial inguinal nodes
Trace the route followed by sympathetic fibers which innervate female internal genital organs
T12-L2 or L3, 3 or 4 Lumbar Splanchnic Nerves, synapse at Intermesenteric Ganglia, to Intermesenteric Plexus, to Superior Hypogastric Plexus, through R and L Hypogastric Nerves to Inferior Hypogastric Plexus to pelvic plexuses
Trace the route of parasympathetic fibers which innervate the female internal genital organs
Originate at S2-S4, travel through pelvic splanchnic nerves to inferior hypogastric plexus to pelvic plexuses
What is the uterovaginal plexus a subplexus of?
The inferior hypogastric plexus
What do nerves of the uterovaginal plexus travel with and what structures do they innervate
Travel with uterine artery, innervate uterus, superior 3/4 of vagina, ovaries, and uterine tubes
What provides somatic innervation to the inferior 1/4 of the vagina?
The deep perineal nerve (off the pudendal nerve)
List the intraperitoneal organs
Stomach, First part of the duodenum [5 cm], jejunum, ileum, Cecum, appendix, transverse colon, sigmoid colon, Rectum (upper 1/3), uterus (above cervix), fallopian tubes, ovaries
List the retroperitoneal organs
Last 3 parts of duodenum, ascending colon, descending colon, Rectum (middle 1/3), pancreas (except tail), Kidneys, adrenal glands, proximal ureters, renal vessels, Gonadal blood vessels, IVC, aorta
List the infraperitoneal/subperitoneal organs of the abdomen
Rectum (lower 1/3), Urinary bladder, distal ureters
Visceral afferent fibers leaving the uterus follow which types of fibers, and how do you know this?
Above cervix - Follow sympathetic fibers, because above the cervix the uterus is intraperitoneal, and thus above the pelvic pain line. Cervix and below - Follow parasympathetic fibers, because this part is subperitoneal and thus below pelvic pain line
