Female reproduction

Question 1

Bimanual exams

Answer 1

cervix is anterior to fingertips, not distal

Question 2

Speculum exams

Answer 2

blades place in the anterior & posterior fornices

the cervix swings into view as the speculum opens

Question 3

uterine blood supply

Answer 3

ovarian artery - from abdominal aorta
uterine artery from internal illiac
Arcutate arteries

Question 4

Menstruation and hormone cycles

Answer 4

LH and FSH surge induces ovulation after rising estrogen levels
progesterone rises from remaining corpus luteum which stimulates growth of functional layer of endometrium
if no fertilization, progesterone drops, inducing shed of functional endometrium

Question 5

Ovary structure

Answer 5

primordal follicle
primary follicle
secondary follicle
Graffian follicle
Ovum
Developing corpus luteum
Corpus luteum
degenerating corpus luteum

Question 6

Pregnancy

Answer 6

implantation of embryo causes release of human chronic gonadotropin (hCG) that supports corpus luteum until the placenta develops

Question 7

Hysterosalpingography

Answer 7

contrast medium injected into uterus

travels through uterus and uterine tubes to determine pregnancy

Question 8

Tubal ligation

Answer 8

surgical method of birth control

Uterine tubes are cut to prevent joining of egg and sperm

Question 9

uterine ligaments - peritoneal folds

Answer 9

mesovarium
mesosalpinx
mesometrium

Question 10

uterine ligaments - developmental remnants

Answer 10

ovarian ligament

round ligament

Question 11

uterine ligaments - endopelvic fascia

Answer 11

true supporting ligaments of the uterus and bladder

cardinal ligament
uterosacral ligament
puboservical fascia

Question 12

Pelvic wall muscles

Answer 12

Piriformis

Obturator Internus

Question 13

Pelvic floor muscles

Answer 13

Coccygeus
Illiococcygeus
Pubococcygeus
Puborectalis

Question 14

Urogenital diaphram

Answer 14

Superior urogenital fascia
Deep perineal pouch
perineal membrane
Deep transverse muscle
external urethral sphincter

Compressor urethrae (females)
Urethrovaginal sphincter (females)

Question 15

Superficial perineal pouch

Answer 15

ischicavernous muscle
bulbospongiosus muscle
superficial transverse perineal muscle
Perineal body
External anal sphincter

Question 16

Vagina

Answer 16

tubular fibromuscular organ
cervix enters vagina at 90degree angle
- forms deep recess - fornix

Question 17

four layers of vagina

Answer 17

adventita (outer)
muscularis (smooth)
submucosa
muscosa with transverse rugae (inner)

Question 18

Blood supply - vagina

Answer 18

vaginal artery

Question 19

Vulva

Answer 19

mons pubis
- adipose tissue
- covers symphysis
- cushioning during coitis
Labia majora
- longitudinal fold
Labia minora
- longitudinal fold
- encloses vestibule
- prepuce covers clitoris
Clitoris
Vaginal Vestibule
Vestibular glands
- lubricates viginal orifice

Question 20

Vestibular glands

Answer 20

secrete mucus to vestibule
greater vestibular glands have greater secretions during arousal
lesser vestibular glands antimicrobial function

Question 21

clitoris

Answer 21

innervation by the dorsal nerve or the clitoris (from pudendal nerve)

Question 22

Embryo - Genital tubercle

Answer 22

Female - clitoris

Male - Penis

Question 23

Embryo - urethral folds

Answer 23

Female - vestibule & labia minora

Male - Spongy urethra

Question 24

Embyo - labioscrotal swelling

Answer 24

Female - labia majora

Male - Scrotum

Question 25

Emybryo - Gubernaculum

Answer 25

Scrotal ligament

Question 26

Female orgasm nerve

Answer 26

dorsal n of clitoris travels to lumbarsacral spinal cord
Lumbar splanchnic nerve -> smooth muscles in vagina, cervix, uterus contract
Pudendal nerve -> contraction in the ischiocavernosus bulbospongiosus, urethrovaginal sphincter

Question 27

Parturition - Labour

Answer 27

Dilation
Expulsion
Placental stage

Question 28

Perineal injuries

Answer 28

weaken pelvic floor
decrease support for pelvic organs
predispose incontinence and sexual dysfunction
prophylactic epilepsy

Question 29

Uterine prolapse

Answer 29

loss of facial support

Eversion of the vagina

Question 30

Labour nerve blocks

Answer 30

Spinal block from lumbar puncture
Caudal epidural block
pudendal nerve block

Question 31

Perineal nerve block

Answer 31

Given prior to episiotomy or prior to stage 2

alternative if missed epidural