Female Pelvis

Question 1

What is the broad ligament composed of?

Answer 1

A double layer of peritoneum

Question 2

What is enclosed between the two layers of the broad ligament?

Answer 2

Uterine tubes, ovarian ligament, round ligament of uterus

Question 3

What suspends the ovaries in the peritoneal cavity?

Answer 3

The mesovarium

Question 4

What covers the ovaries?

Answer 4

Surface epithelium, not peritoneum

Question 5

What structure delivers the ovarian artery and vein to the ovaries?

Answer 5

The suspensory ligament of the ovary

Question 6

Where do the ovarian arteries terminate?

Answer 6

They anastamose with the uterine arteries

Question 7

What does the uterus rest on?

Answer 7

The urinary bladder

Question 8

The cervix of the uterus runs between what two structures?

Answer 8

Bladder and rectum

Question 9

What are the three parts of the uterus?

Answer 9

Body, isthmus, cervix

Question 10

What provides active support to the uterus?

Answer 10

Pelvic diaphragm (levator ani and coccygeus)

Question 11

What provides passive support to the uterus?

Answer 11

Its position, Uterine ligaments (transverse cervical (cardinal) ligaments, uterosacral ligaments)

Question 12

What uterine ligament is palpable during a rectal exam?

Answer 12

Uterosacral ligaments

Question 13

Transverse cervical ligaments attach what to what?

Answer 13

The cervix of the uterus to the lateral wall

Question 14

Anterior relations of the uterus

Answer 14

Vesicouterine pouch, Superior surface of urinary bladder, Peritoneum

Question 15

What structure is immediately posterior to the uterus?

Answer 15

The rectouterine pouch

Question 16

What structures are lateral to the uterus?

Answer 16

Broad ligament, ureters, and uterine arteries

Question 17

What structures are anterior to the vagina?

Answer 17

Fundus of bladder and urethra

Question 18

What structures are posterior to the vagina?

Answer 18

Anal canal, rectum, and rectouterine pouch

Question 19

What structures are lateral to the vagina?

Answer 19

Levator ani, visceral pelvic fascia, ureters

Question 20

Which vaginal fornix is larger?

Answer 20

The posterior vaginal fornix is larger than the anterior vaginal fornix

Question 21

Lymphatic drainage of ovarian and uterine tubes

Answer 21

Follow ovarian vessels to lumbar nodes

Question 22

Lymphatic drainage of the fundus of the uterus

Answer 22

Follow ovarian vessels to lumbar nodes and follow round ligament to superficial inguinal nodes

Question 23

Lymphatic drainage of the body of the uterus

Answer 23

Follow broad ligament to external iliac nodes

Question 24

Lymphatic drainage of the cervical region of the uterus

Answer 24

Follow uterine vessels to internal iliac nodes, and follow uterosacral ligament to sacral nodes

Question 25

Lymphatic drainage of each of the parts of the vagina

Answer 25

Superior - Internal and external iliac nodes, Middle - internal iliac nodes, Inferior - sacral, common iliac nodes, External orifice - superficial inguinal nodes

Question 26

Trace the route followed by sympathetic fibers which innervate female internal genital organs

Answer 26

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

Question 27

Trace the route of parasympathetic fibers which innervate the female internal genital organs

Answer 27

Originate at S2-S4, travel through pelvic splanchnic nerves to inferior hypogastric plexus to pelvic plexuses

Question 28

What is the uterovaginal plexus a subplexus of?

Answer 28

The inferior hypogastric plexus

Question 29

What do nerves of the uterovaginal plexus travel with and what structures do they innervate

Answer 29

Travel with uterine artery, innervate uterus, superior 3/4 of vagina, ovaries, and uterine tubes

Question 30

What provides somatic innervation to the inferior 1/4 of the vagina?

Answer 30

The deep perineal nerve (off the pudendal nerve)

Question 31

List the intraperitoneal organs

Answer 31

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

Question 32

List the retroperitoneal organs

Answer 32

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

Question 33

List the infraperitoneal/subperitoneal organs of the abdomen

Answer 33

Rectum (lower 1/3), Urinary bladder, distal ureters

Question 34

Visceral afferent fibers leaving the uterus follow which types of fibers, and how do you know this?

Answer 34

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