Female reproduction Flashcards
Bimanual exams
cervix is anterior to fingertips, not distal
Speculum exams
blades place in the anterior & posterior fornices
the cervix swings into view as the speculum opens
uterine blood supply
ovarian artery - from abdominal aorta
uterine artery from internal illiac
Arcutate arteries
Menstruation and hormone cycles
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
Ovary structure
primordal follicle primary follicle secondary follicle Graffian follicle Ovum Developing corpus luteum Corpus luteum degenerating corpus luteum
Pregnancy
implantation of embryo causes release of human chronic gonadotropin (hCG) that supports corpus luteum until the placenta develops
Hysterosalpingography
contrast medium injected into uterus
travels through uterus and uterine tubes to determine pregnancy
Tubal ligation
surgical method of birth control
Uterine tubes are cut to prevent joining of egg and sperm
uterine ligaments - peritoneal folds
mesovarium
mesosalpinx
mesometrium
uterine ligaments - developmental remnants
ovarian ligament
round ligament
uterine ligaments - endopelvic fascia
true supporting ligaments of the uterus and bladder
cardinal ligament
uterosacral ligament
puboservical fascia
Pelvic wall muscles
Piriformis
Obturator Internus
Pelvic floor muscles
Coccygeus
Illiococcygeus
Pubococcygeus
Puborectalis
Urogenital diaphram
Superior urogenital fascia Deep perineal pouch perineal membrane Deep transverse muscle external urethral sphincter
Compressor urethrae (females) Urethrovaginal sphincter (females)
Superficial perineal pouch
ischicavernous muscle bulbospongiosus muscle superficial transverse perineal muscle Perineal body External anal sphincter
Vagina
tubular fibromuscular organ
cervix enters vagina at 90degree angle
- forms deep recess - fornix
four layers of vagina
adventita (outer)
muscularis (smooth)
submucosa
muscosa with transverse rugae (inner)
Blood supply - vagina
vaginal artery
Vulva
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
Vestibular glands
secrete mucus to vestibule
greater vestibular glands have greater secretions during arousal
lesser vestibular glands antimicrobial function
clitoris
innervation by the dorsal nerve or the clitoris (from pudendal nerve)
Embryo - Genital tubercle
Female - clitoris
Male - Penis
Embryo - urethral folds
Female - vestibule & labia minora
Male - Spongy urethra
Embyo - labioscrotal swelling
Female - labia majora
Male - Scrotum
Emybryo - Gubernaculum
Scrotal ligament
Female orgasm nerve
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
Parturition - Labour
Dilation
Expulsion
Placental stage
Perineal injuries
weaken pelvic floor
decrease support for pelvic organs
predispose incontinence and sexual dysfunction
prophylactic epilepsy
Uterine prolapse
loss of facial support
Eversion of the vagina
Labour nerve blocks
Spinal block from lumbar puncture
Caudal epidural block
pudendal nerve block
Perineal nerve block
Given prior to episiotomy or prior to stage 2
alternative if missed epidural
