Female Pelvis & Perineum Flashcards
Significant potential spaces in the female pelvs
- UTEROVESICLE POUCH
- RECTOUTERINE POUCH (douglas)
Which points along the uterus are references for uterus angulation?
- further up = ANGLE OF ANTEFLEXION
- closer to vagina = ANGLE OF ANTEVERSION
What are the 3 layers of the uterus?
ENDOMETRUM
MYOMETRIUM
PERIMETRIUM
Parts of the uterus
FUNDUS
CORPUS
ISTHMUS
significance of retrovert and retroflexed uterus?
bc above the vagina, with increased abdo pressure, increased risk of prolapse down into vagina
+ painful menstruation, sex
Fornices of the vagina
anterior
posterior - resevoir = cervical permeation
* assess pouch of douglas
lateral fornix
Ligaments of the uterus and cervix
- ROUND LIGAMENT = diagonal, v obvious
- remnant of the embryonic gubernaculum.
LIGAMENTS associated with OVARIES
2. OVARIAN LIGAMENT
- SUSPENSORY LMGT. OF OVARY
- extends outwards from the ovary to the lateral abdominal wall.
- contain the ovarian vessels and nerves (ovarian artery, ovarian vein, ovarian nerve plexus and lymphatic vessels)
Broad ligament
flat sheet
- MESOSALPINX = encloses fallop. tube
- Mesometrium = surrounds uterus, largest section of sheet +iliac vessel covering
- Mesovarium = covers ovaria hilum and neurovasc. travelling
What is the cardinal ligament?
transverse cervical lgt. = contains UTERINE ART. and vasc.
Parts of the F. Tubes
- INFUNDIBULUM - ovary. finger.
- AMPULLA - wide. fert.
- ISTHMUS - narrow.
- UTERINE
Lymphatic drainage of ovaries
Lymph from the ovaries drains into the para-aortic nodes.
Ovary vascular supply
ovarian art
ovarian vein = L drain to renal; R = IVC drain
The ovaries receive sympathetic and parasympathetic innervation from the ovarian and uterine (pelvic) plexuses, respectively.
within the ovarian lgt.
Lymph drainage of the uterus and vagina
FUNDUS & upper uterine => pre-aortic LN
Superior – drains to external iliac nodes
Middle - internal LN & sacral LN
Lower - superficial inguinal nodes
Vascular supply of vagina
The arterial supply to the vagina is via the uterine and vaginal arteries – both branches of the internal iliac artery.
Venous return is by the vaginal venous plexus, which drains into the internal iliac veins via the uterine vein.
Vaginal innervation
uterovaginal nerve plexus (both para and symp)
inferior 1/5 of the vagina receives somatic innervation: the deep perineal nerve.
