female pelvis Flashcards
female pelvic organs
Ovary, uterine (Fallopian) tubes Uterus and cervix Vagina Ureter, bladder, urethra Rectum and Caecum, appendix, parts of sigmoid colon and ileum - false pelvis Vessels, nerves and lymphatics
what is close to the posterior wall of the vagina
the rectum
length of uterus
8-9cm
length of urethra and implication of this
4cm - UTI easy
consequence of relative condition of the urinary bladder and the vagina
urinary bladder can haemorrhage through the anterior wall of the vagina
length of vagina
10cm
describe the peritoneum and pelvic fasia in thee female
parietal peritoneum enters pelvic cavity buyt doesn’t hit the pelvic floor
uterine tubes completely covered by the broad ligament - peritoneum
ovaries - suspended by the mesovarium from posterior of the broad ligament - not fully enveloped otherwise eggs couldn’t leave
fascia condesnses = ligaments - supports the viscera (not supported by weak pelvic floor)
where do the bv for the ovaries come from
the lateral wall in the suspendory ligament
describe the broad ligaments
transverse mesenteries
join uterus to the pelvic walls
what is the round ligament for
the development of ovaries
length of cervix
2.5cm
type of muscle for the uterus
sm
features of the uterine tubes
intramural - where the fundus meets the body
isthmus - narrow part
ampulla
infundibulum leads to the abdominal ostium of the uterine tube - fimbriae - motile (move the broad ligament)
describe the stability of the cervix and the vagina
3 sets of fibrous bands - cervical ligaments (condensed FASCIA on the pelvic floor) - anchor cervix in position - stop prolapse
they give passive support - don’t contract
what are the 3 cervical ligaments
transverse cervical (cardinal) ligament - most important
uterosacral ligament
ppubocervical ligament
same fascia just condensed in 3 places
parts of the uterus
fundus, body, lower segment anad cervix
PARTS of the uterine tubes
infundibulum, ampulla, isthmus and uterine parts
how is there a possible path to enter the peritoneum from externally
abdominal opening of the uterine tube and the vaginal opening
what are the vaginal fornixes
lateral
anterior
posterior
posterior - biggest
groove arouynd neck of uterus into the vaginal wall
where is the cervix
protrude into the vagina R angle to vaginal axis though anterior wall
implications of uterus changing shape in pregnancy
difficult to breath
explain the change in uterus shape in pregnancy
up to costal margin in 10th month
then back to false pelvis in 9th
describe the cervix
fibro-muscular cylinder
has internal and external os
cells of the cervix
lined with mucous secreting simple columnar epi
vaginal surface of the cervix - stratified non-keratinised squamous
describe the relation of the uterus to the cervix and vice verca
Body is antiflexed on the cervix
Cervix is anteverted on the vagina
consequence of a short cervix on pregnancy
deliver early
relationship between the urethra and the vagina
Urethra fused with the anterior wall
clinical importance of the posterior fornix
entrance to the pouch of douglas/retrouterine pouch
lowest point of access to peritoneal pouch
drain abscess
what structures are palpable in a digital examination through the vagina
Cervix Ischial spine - pudendal nerve runs - supply the perineum Sacral promontory Uterine artery pulse (lateral fornix) Ovary
describe the arterial supply for the female pelvis
internal iliac artery ->
superior vesicle, uterine, middle rectal
walls supplied by sacral, gluteal and obturator branches
pudendal artery supplies the perineum and the recto-anal region via the inferior rectal branch
uterine artery
main blood supply to uterus - enlarge during preg
run medially towards the cervix
cross ureter 1cm from cervix
uterine branch run close to uterus in the broad ligament
ascending branch supply uterine tube and ovary
descending - supply vagina
describe the relation of the uterine artery and ovary
ovaries lie close to openings of the uterine tubes into the peritoneal cavity.
therefore there is an extra supply of blood to ovaries from the uterine tubes
complications with hysterectomy
ureter damaged when blocking the uterine artery when the uterus is removed
issue if perineal body is damaged
the pedundal canal can tear
describe the deep and superficial perineal spaces
deep - above perineal membrane (PM), below fascia of pelvic diaphragm
superficial - below PM and perineal fascia
spaces become real when full
describe the deep perineal structures for female
deep transverse perineal muscles
compressor urethrae
sphincter urethrovaginalis
external urethral sphincter
describe the urethral sphincters in women
internal - not well developed
external- more intricate - controls continence in women
describe the contents of the perineal pouch
median erectile tissue masses - corpus spongiosum - divides around the vestibule - vestibular bulbs - glans of clitoris
lateral - corpora cavernosa - paored cyklinders attached to ischiopubic rami - body of clitoris
surrounded by skeletal muscle
what are the contents of the superficial perineal pouch
Vulva = collective name for female external genitalia: mons pubis, labia majora & minora, clitoris, vestibule of vagina, vestibular bulbs, vestibular glands
what is the bulb of vestibule in women
labia majora
describe the hymen
in virgin - the vaginal orifice possess a thin mucosal fold - the hymen
normally perforated at the centre
after intercourse/childbirth - torn and only a few tags remain
describe the glands of the urethra and vagina
greater vestibular gland (Bartholin’s) and lesser vestibular glands (skene’s) open into the vaginal vestibule
peri-urethral glands open into vagina
mucosa of the vaginal wall
no gands
kept moist by transudation
cervical canal mucosa
mucus glands active in pre-menopausal women
action of the pudendal nerve S2-S4
main somatic nerve of the perineum
motor to perineal muscles, anal and urethral sphincters, levator ani, sensory to external ganglaia
lymphatic drainage fo the pelvis and perineum
pelvic organs drain to the external and internal iliac nodes
ovary and teste - para-aortic nodes
perineum and external genitalia - drain to superficial inguinal nodes - subcutaneous below inguinal ligament
what is the vestibule of the vagina
the space between the labia majora
