female pelvis

Question 1

female pelvic organs

Answer 1

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

Question 2

what is close to the posterior wall of the vagina

Answer 2

the rectum

Question 3

length of uterus

Answer 3

8-9cm

Question 4

length of urethra and implication of this

Answer 4

4cm - UTI easy

Question 5

consequence of relative condition of the urinary bladder and the vagina

Answer 5

urinary bladder can haemorrhage through the anterior wall of the vagina

Question 6

length of vagina

Answer 6

10cm

Question 7

describe the peritoneum and pelvic fasia in thee female

Answer 7

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)

Question 8

where do the bv for the ovaries come from

Answer 8

the lateral wall in the suspendory ligament

Question 9

describe the broad ligaments

Answer 9

transverse mesenteries

join uterus to the pelvic walls

Question 10

what is the round ligament for

Answer 10

the development of ovaries

Question 11

length of cervix

Answer 11

2.5cm

Question 12

type of muscle for the uterus

Answer 12

sm

Question 13

features of the uterine tubes

Answer 13

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)

Question 14

describe the stability of the cervix and the vagina

Answer 14

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

Question 15

what are the 3 cervical ligaments

Answer 15

transverse cervical (cardinal) ligament - most important
uterosacral ligament
ppubocervical ligament

same fascia just condensed in 3 places

Question 16

parts of the uterus

Answer 16

fundus, body, lower segment anad cervix

Question 17

PARTS of the uterine tubes

Answer 17

infundibulum, ampulla, isthmus and uterine parts

Question 18

how is there a possible path to enter the peritoneum from externally

Answer 18

abdominal opening of the uterine tube and the vaginal opening

Question 19

what are the vaginal fornixes

Answer 19

lateral
anterior
posterior

posterior - biggest

groove arouynd neck of uterus into the vaginal wall

Question 20

where is the cervix

Answer 20

protrude into the vagina R angle to vaginal axis though anterior wall

Question 21

implications of uterus changing shape in pregnancy

Answer 21

difficult to breath

Question 22

explain the change in uterus shape in pregnancy

Answer 22

up to costal margin in 10th month

then back to false pelvis in 9th

Question 23

describe the cervix

Answer 23

fibro-muscular cylinder

has internal and external os

Question 24

cells of the cervix

Answer 24

lined with mucous secreting simple columnar epi

vaginal surface of the cervix - stratified non-keratinised squamous

Question 25

describe the relation of the uterus to the cervix and vice verca

Answer 25

Body is antiflexed on the cervix Cervix is anteverted on the vagina

Question 26

consequence of a short cervix on pregnancy

Answer 26

deliver early

Question 27

relationship between the urethra and the vagina

Answer 27

Urethra fused with the anterior wall

Question 28

clinical importance of the posterior fornix

Answer 28

entrance to the pouch of douglas/retrouterine pouch lowest point of access to peritoneal pouch drain abscess

Question 29

what structures are palpable in a digital examination through the vagina

Answer 29

``` Cervix Ischial spine - pudendal nerve runs - supply the perineum Sacral promontory Uterine artery pulse (lateral fornix) Ovary ```

Question 30

describe the arterial supply for the female pelvis

Answer 30

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

Question 31

uterine artery

Answer 31

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

Question 32

describe the relation of the uterine artery and ovary

Answer 32

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

Question 33

complications with hysterectomy

Answer 33

ureter damaged when blocking the uterine artery when the uterus is removed

Question 34

issue if perineal body is damaged

Answer 34

the pedundal canal can tear

Question 35

describe the deep and superficial perineal spaces

Answer 35

deep - above perineal membrane (PM), below fascia of pelvic diaphragm superficial - below PM and perineal fascia spaces become real when full

Question 36

describe the deep perineal structures for female

Answer 36

deep transverse perineal muscles compressor urethrae sphincter urethrovaginalis external urethral sphincter

Question 37

describe the urethral sphincters in women

Answer 37

internal - not well developed | external- more intricate - controls continence in women

Question 38

describe the contents of the perineal pouch

Answer 38

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

Question 39

what are the contents of the superficial perineal pouch

Answer 39

``` Vulva = collective name for female external genitalia: mons pubis, labia majora & minora, clitoris, vestibule of vagina, vestibular bulbs, vestibular glands ```

Question 40

what is the bulb of vestibule in women

Answer 40

labia majora

Question 41

describe the hymen

Answer 41

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

Question 42

describe the glands of the urethra and vagina

Answer 42

greater vestibular gland (Bartholin's) and lesser vestibular glands (skene's) open into the vaginal vestibule peri-urethral glands open into vagina

Question 43

mucosa of the vaginal wall

Answer 43

no gands | kept moist by transudation

Question 44

cervical canal mucosa

Answer 44

mucus glands active in pre-menopausal women

Question 45

action of the pudendal nerve S2-S4

Answer 45

main somatic nerve of the perineum | motor to perineal muscles, anal and urethral sphincters, levator ani, sensory to external ganglaia

Question 46

lymphatic drainage fo the pelvis and perineum

Answer 46

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

Question 47

what is the vestibule of the vagina

Answer 47

the space between the labia majora