Female Reproductive Anatomy Flashcards
Describe descent of the ovaries
Gonads develop within the mesonephric ridge. Descend through the abdomen but stop in the pelvis.
How does the Gubernaculum eventually form into two ligaments?
Gubernaculum interacts with the uterus as it develops, prior to its interaction with the uterus it is called the ovarian ligament, after this interaction it is called the round ligament and passes through the inguinal canal and attaches to the labia majora.
What is the clinical implication of the round ligament?
Lymphatic drainage from the fundus of the uterus run with the round ligaments through the inguinal canal meaning pathologies of the fundus can present in places you wouldn’t expect.
Describe the arterial and venous supply of the ovaries
Arterial supply – direct branches from the abdominal aorta, venous drainage – R ovarian vein from the IVC and L ovarian vein from the L renal vein.
What are the 4 parts of the uterus?
Parts of the uterus – Fundus (palpable during pregnancy), body, uterine tubes and cervix
Describe the different peritoneal recesses in men and women
Peritoneal pouches: anteriorly the uterovesical pouch, posteriorly the rectouterine pouch or pouch of Douglas this is accessible via the posterior fornix of the vagina.
In the male, there is just one recess – the rectovesical pouch.
Describe how development of the uterus leads to formation of the broad ligament
Paramesonephric ducts – a pair of ducts that are open cranially and connect to the urogenital sinus caudally. Persist in the absence of MIH. Fusion of the ducts in the midline creates a broad transverse fold, draped by peritoneum.
The broad ligament
Peritoneal fold in the female pelvis, mesentery of the uterus, uterine tube and ovary.
What is the suspensory ligament?
Suspensory ligament of the ovary contains the vasculature of the ovary.
Describe the relationship of the uterus in relation to the cervix and vagina
The uterus is anteverted with respect to the vagina and anteflexed with respect to the cervix. Meaning it is normally tipped anteriorly onto the top of the bladder.
What is the name of the different parts of the uterine tubes?
Abdominal ostium, fimbria, infundibulum, ampulla and isthmus
Function: to conduct the oocyte into uterine cavity and normally site of fertilisation
Why can’t implantation occur in the fallopian tubes
Lining of the fallopian tube is not that of the uterine cavity i.e. endometrium this has a consequence for ectopic implantation here.
Why are females at slightly higher risk of peritonitis than males?
In the female, the peritoneal cavity is open via the ostium of the uterine tube, this means there is a possible route for infection into the abdominal cavity.
What are the 3 parts of the cervix?
Cervix is made up of the Internal os, endocervical canal and external os.
Why are females more susceptible to pelvic prolapse?
Females are much more susceptible to pelvic prolapse because their pelvic floor also has to support the uterus and vagina.
What are the two ligaments that help prevent pelvic prolapse?
Transverse cervical ligament – Thickening at base of broad ligament at the cervix giving lateral stability of the cervix
Uterosacral ligament – Opposes anterior pull of round ligament, assists in maintaining anteversion
Describe arterial supply to the ovary, uterus and vagina
Ovarian artery – branch of the abdominal aorta supplying the ovary and fallopian tube and part of the fundus of the uterus.
Uterine artery – anterior division of the internal iliac supplying uterus, cervix and top of the vagina.
Internal pudendal – anterior division of the internal iliac supplying the posterior part of the vagina.
Why must surgeons be really careful when performing a vesectomy?
Close relationship of the ureter and the uterine artery – must be careful in vasectomy can tell it is the ureter due to the peristaltic ripples of the ureter. Water under the bridge
Describe the pattern of lymphatic drainage of the uterus, ovaries and vagina?
The uterus has a complex pattern of lymphatic drainage – To paraaortic, external and internal iliac, sacral nodes as well as inguinal nodes.
Fundus - aortic nodes (& inguinal nodes)
Body - external iliac nodes
Cervix - external & internal iliac nodes & sacral nodes
Vagina - Internal Iliac and superficial inguinal nodes
Ovary - Drains to paraaortic nodes
What is the bimanual examination?
Bimanual examination – using both hand to palpate the uterus
Describe the female external genitalia
Labia Majora – enclosing the pudental cleft
Labia Minora – enclosing the vestibule of the vagina – bulbs vestibule and clitoris
Vestibule – orifices of urethra, vagina and greater and lesser vestibular glands.
Vaginal orifice opens into the vestibule along with the external urethral orifice and the ducts of the greater and lesser vestibular glands
What pathologies can you get of the greater vestibular glands
Greater Vestibular glands – Bartholin glands
Infection of these glands can cause Bartholinitis and Bartholin gland cyst (not related to infection just accumulate fluid in the glands)
What are vaginal fornices?
Vaginal fornices (sing. = fornix) – Recesses of vagina around where the cervix projects down. There are lateral, anterior and posterior fornices.
What is Culdocentesis
Culdocentesis – collection of fluid from the pouch of douglas
Describe the innervation of the uterus, vagina and perineum
Inferior 1/5 vagina receives somatic innervation from pudendal nerve and Superior 4/5 vagina and uterus receives innervation from uterovaginal plexus
Pain afferents vary depending on pelvic pain line – Inferior thoracic lumbar spinal ganglia – S2-S4 Spinal ganglia
Perineum – pudental nerve and ilioinguinal nerve
Describe the course and distribution of the pudental nerve
Exits pelvis via greater sciatic foramen
Enters perineum via lesser sciatic foramen
Traveling through pudendal canal
