Female Pelvis Anatomy Lecture

Question 1

Boundaries of the vulva

Answer 1

Anterior mons pubis, posterior rectum, lateral genitocrural folds

Question 2

Fourchette

Answer 2

Frenulum of the labia minora

Question 3

Vestibule

Answer 3

External urethral oriface of the vagina, extending from the clitoris to the posterior fourchette, with the orifaces of the vagina and bartholin’s glands as well as remnants of the hymen also opening up into the vestibule

Question 4

Skene’s glands

Answer 4

Paraurethral glands, branched tubular glands adjacent to the distal urethra, homologous to prostate in fluid secretion

Question 5

Bartholin’s glands

Answer 5

Vulvovaginal glands that open into a groove between hymen and labia minora

Question 6

Vestibular bulbs

Answer 6

2 elongated masses of erectile tissue on either side of the vaginal oriface, emptying adjacent to the bartholin’s glands

Question 7

Female bony pelvis vs male

Answer 7

• Wider, larger superior and inferior apertures
• Sacrum is more curved
• oval shaped obturator foramina
• angle formed by ischial tuberocities

Question 8

Pelvic inlet and outlet

Answer 8

Intlet is circular opening btwn abdominal cavity and pelvic cavity enclosed by pelvic brim
Outlet is inferior opening of the pelvis forming the birthing canal, funnel shaped compared to inlet, enclosed by coccyx and ischial tuberocities

Question 9

Anthropoid pelvis

Answer 9

Greater AP diameter than transverse diameter, promotes delivery via occiput posterior position

Question 10

Gynecoid pelvis

Answer 10

Round cylindrical shape throughout, easy birth

Question 11

Android pelvis

Answer 11

Heart shaped inlet, posterior aperture is narrow, poor chance of vaginal birth

Question 12

Platypelloid pelvis

Answer 12

Flattened wide transverse diameter, poor chance of vaginal birth

Question 13

Levator ani muscle

Answer 13

Function: Composed of 3 smaller muscles to, alongside the coccygeus muscle, form the pelvic floor and support the pelvic viscera
Insertion: inner surface of lesser pelvis to coccyx and opposite levator ani
Innervation: S3 and S4

Question 14

Most likely pelvic floor muscle to be damaged during childbirth

Answer 14

Pubococcygeus

Question 15

Vagina

Answer 15

Deep to vulva creating a tube with rugae, rectouterine pouch, and sphincters that travels to create a fornix around the cervix

Question 16

Rectouterine pouch/cul de sac/pouch of douglas

Answer 16

Piece of deep peritoenum that is bound anteriorally by the fornix of the vagina and posteriorally by the rectum

Question 17

Uterus

Answer 17

Projects superior anteriorally over the urinary bladder, has a fundus and bilateral fallopian tubes to exit into, 3 layers of tissue (perietrium, myometrium, endometrium)

Question 18

The endometrium of the uterus is composed of….

Answer 18

…simple columnar epithelium

Question 19

Transition zone of pap smear

Answer 19

Where cells change from simple sqmaous to simple columnar epithelium, often a site for early detection of cervical cancer

Question 20

3 parts of fallopian tubes

Answer 20

1) Infundibulum - reception region of ovary with fibriae attached, most distal
2) ampulla - Long, tortuous portion where fertilization occurs and ectopic implantation
3) isthmus - short segment that enters the uterine part

Question 21

The surface of the ovary is not covered in peritoneum. Why not?

Answer 21

So the oocyte can be expelled into the peritoneal cavity

Question 22

Suspensory ligament of ovary

Answer 22

Attaches tubal end of ovary to lateral wall of pelvis, contains ovarian vessels and nerves

Question 23

Ligament of the ovary

Answer 23

Connects the inferior end of the ovary to the lateral angle of the uterus

Question 24

Broad ligament of the uterus

Answer 24

Sheet like fold of peritoneum covering the uterus like a sheet to keep structures in place

Question 25

Round ligament of the uterus

Answer 25

Travels from uterine horn thru the deep inguinal ring to the labia majora and mons pubis

Question 26

Uterine artery

Answer 26

Derived from: internal iliac artery
Travels deep and medial, giving rise to vaginal artery branch before changing names
Empties into spiral arteries

Question 27

Vaginal artery

Answer 27

Derived from: uterine artery

Travels alongside but inferior to the uterine artery to supply the vaginal walls

Question 28

Spiral arteries

Answer 28

Derived from: uterine artery
Travels alongside the wall of the uterus, constricting hormonally during menstruation to allow for death of endometrial lining

Question 29

Ovarian artery

Answer 29

Derived from: abdominal aorta

Travels from division just below renal arteries into suspensory ligament to supply the ovary

Question 30

Venous drainage of the female pelvis (2 significant blood supplies to know)

Answer 30

• Lateral 2/3 of uterine tube via pampiniform plexus to ovarian veins, drains directly to inferior vena cava
• Medial 2/3 of tube drarin via uterine plexus to internal iliac vein

Question 31

Nerve supply of the perineum from anterior to posterior

Answer 31

• Ilioinguinal nerve and genitofemoral nerve
• Pudendal nerve
• Perineal branc of posterior femoral cutaneous nerve
• Coccygeal and sacral nerves

Question 32

Most lymphatic metastasis for ovarian cancer occurs in what direction….

Answer 32

….superiorally

Question 33

In cancer of the vulva, lymph drainage may occur to either side of the pelvis. Because of this, what is important?

Answer 33

Bilateral node dissection

Question 34

Most common acute complication of lymph node vessel dissection

Answer 34

Pelvic hemorrhage

Question 35

Cystocele

Answer 35

Bladder falling into vagina, treated with pessaries

Question 36

Rectocele

Answer 36

Rectum falling into vagina, treated with pessaries

Question 37

Vaginal prolapse

Answer 37

Inversion of vagina, treated with pessaries