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MD3002 > Female Reproductive Organs > Flashcards

Female Reproductive Organs Flashcards

1
Q

Identify the main female reproductive organs.

A 
Uterus 
Ovary
Uterine tubes
Vulva
Vagina
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2
Q

State the main functions of the uterus.

A
  • Implantation
  • Development and nourishment of fetus
  • Childbirth
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3
Q

Identify the main functions of the uterine tube.

A
  • Transport of oocyte

* Site of fertilization

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4
Q

Identify the main functions of the ovaries.

A
  • Production of ovum

* Maintenance of menstrual cycle

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5
Q

Identify the main functions of the vagina.

A
  • Birth canal

* Sexual intercourse

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6
Q

Describe the shape and dimensions of the ovary.

A

Almond-shaped, 3x1.5x1 cm

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7
Q

Describe the surface of the ovary.

A

Smooth surface in young girls but scarred and pitted after puberty

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8
Q

What is another name for ovary.

A

OOPHORON

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9
Q

Describe the location of the ovaries.

A

(Extremely variable in its position but)

  • Located in ovarian fossa
  • True intraperitoneal
  • Attached to the back of the broad ligament by the mesovarium, supported by the ovarian ligament and suspensory ligaments
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10
Q

Identify the main boundaries of the ovarian fossa.

A

superiorly: by the external iliac artery
posteriorly: by the ureter, internal iliac artery
inferiorly: by the obturator nerve
anteriorly: by the obliterated umbilical a.

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11
Q

Identify the main relations of the ovary.

A

The ureter lies posteriorly

The obturator nerve lies laterally

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12
Q

What is the clinical significance of the proximity of the ureter and ovary ?

A

Ureter is at risk during surgical procedures of the ovary

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13
Q

What is the clinical significance of the proximity of the obturator nerve and ovary ?

A

Ovarian disease may cause referred pain to the medial thigh

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14
Q

Identify peritoneal and ligamentous supports of the ovaries.

A

1) Round ligament of ovary, Ovarian ligament
− The remnant of the upper part of gubernaculum
− Extends between cornu of the uterus and ovary

2) Suspensory (Infundibulopelvic) ligament of ovary
− In the broad ligament
− Carries the ovarian blood vessels

3) Mesovarium
− Short peritoneal fold that attaches the ovary to
the back of the broad ligament

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15
Q

Identify other names of the Fallopian tube.

A

UTERINE TUBE (OVIDUCT, SALPINX)

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16
Q

Describe the anatomical location of the uterine tube.

A

In the free superior border of the broad ligament

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17
Q

Identify the main structural features of the uterine tube.

A
  • Made up of infundibulum + Ampulla + Isthmus (from ovary to uterus) + intramural part (at the top of the uterus)
  • Ostium of uterine tube in infundibulum is surrounded by fimbriae which pick up the ovum (has circular and longitudinal smooth muscle fibres on wall and cilia inside)
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18
Q

Describe the anatomical location of the uterus.

A

Central pelvic organ (in true pelvis); anterior to the rectum and posterosuperior to the urinary bladder

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19
Q

Identify the main parts of the uterus.

A 
From superior to inferior
1) Body 
− Fundus  part of the body superior to the cornual of the uterus)
− Body
2) Isthmus (defined by internal os, transition between body and cervix)
− Internal os
3) Cervix
− Supravaginal
− Vaginal

Also:
-Uterine cavity (triangular, where corners
correspond to openings of uterine tubes)

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20
Q

Identify the main parts of the cervix.

A

♦ Cervical canal (supravaginal cervix), two opening:

  • Internal os (orifice)
  • External os

♦ Ectocervix (vaginal cervix)

♦ Cervical transformation zone

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21
Q

What epithelium makes up the cervix ?

A

 Cervical canal
− Columnar epithelium

 Ectocervix
− non-keratinizing stratified squamous epithelium, which contains glycogen

 Cervical transformation zone
− Squamous metaplasia

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22
Q

Identify the layers making up the wall of the uterus.

A

1) Perimetrium (Outermost)
2) Myometrium (Middle layer)
3) Endometrium (Innermost)

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23
Q

What is the perimetrium layer of the uterus made up of ?

A

Thin visceral peritoneum

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24
Q

What is the myometrium layer of the uterus made up of ?

A

Smooth muscle fibres arranged in 3 layers
− Longitudinal
− Spiral (Figure of 8 around vessels)
− Circular → Sphincter

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25
Q

What is the endometrium layer of the uterus made up of ?

A

Mucous membrane and spiral arteries
− Basal layer (regenerates the functional layer)
− Functional layer (shed as menses)

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26
Q

Describe the angle orientation of the uterus.

A

The adult uterus is bent forward on itself at about the level of the internal os to form an angle of 170° (AKA anteflexion of the uterus)

The axis of the cervix forms an angle of 90° with the axis of the vagina (AKA antevertion of the uterus)

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27
Q

Identify possible abnormalities in the angle orientation of the uterus.

A

Retroversion and/or retroflexion may cause backache and difficulty in conception.

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28
Q

Identify the main ligaments of the uterus.

A

Ligamentum teres (AKA round ligament of the uterus, AKA ligamentum rotundum)

Broad ligament

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29
Q

What is the embryological origin of the ligamentum teres ?

A

Remnant of the lower part of gubernaculum

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30
Q

Describe the anatomical path of the ligamentum teres.

A

1) Passes within the broad ligament from the horns of the uterus through the inguinal canal to the labia majora
2) Together with the broad ligament, round ligament of the uterus holds the uterus anteverted and anteflexed over the bladder

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31
Q

What are the main components of the broad ligament of the uterus ? Describe its anatomical path.

A

Broad ligament formed by 2 layers of peritoneum. The peritoneum drapes over the bladder and then the uterus, uterine tube and ovarian ligaments to form the broad ligament from the uterus to the lateral pelvic wall.

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32
Q

Identify the structures contained in the broad ligament of the uterus.

A
  • Ovarian ligament
  • Uterine tubes
  • Uterus
  • Round ligament of uterus
  • Ureter
  • Vessels and nerves of the ovaries and uterus
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33
Q

What are the main parts of the broad ligament of the uterus ?

A
  1. Mesosalpinx: Part of the broad ligament surrounding the uterine tube
  2. Mesovarium: Part of the broad ligament suspending the ovaries
  3. Mesometrium: Part of the broad ligament adjacent to the uterus
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34
Q

Identify the main supportive structures of the uterus.

A

 Supported by muscles of the pelvic floor (esp. levator ani) and ligaments.

 The visceral and parietal fasciae meet and fuse as the organs pierce the pelvic floor forming the tendinous arch of pelvic fascia adjacent to the organs and running from pubis to sacrum

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35
Q

What tissues are ligaments derived from ?

A

Ligaments” are derived from the visceral and parietal fascia

36
Q

Identify a possible clinical problem associated with the supportive structures of the uterus.

A

Weakness of the ligaments supporting the uterus and the pelvic floor muscles may lead uterus to prolapse.

37
Q

Identify the main ligaments supporting the uterus.

A
  • Transverse cervical ligament
  • Uterosacral ligament
  • Uterovesical ligament
  • Pubocervical ligament
  • Sacrocervical ligament
38
Q

How long is the vagina ? Where does it start, and end ?

A

About 10 cm in length, from cervix to vulval vestibule

39
Q

Describe the anatomical location of the vagina.

A

It lies anterior to the rectum, posterior to the bladder. Its anterior and posterior walls are in contact with each other.

40
Q

Describe the anatomical relations of the vagina.

A
  • The urethra is embedded in the anterior wall of the vagina.
  • The ureter passes inferior to the uterine artery and lateral to the lateral fornix
41
Q

To what extent does the vagina contain glands ?

A

Vagina does not contain glands but has Döderlein bacilli (Lactobacilli)

42
Q

Define fornix in the context of the female reproductive system.

A

The cervix pushes into the vagina forming the fornix (anterior, posterior, lateral fornices)

43
Q

What is the significance of the posterior fornix ?

A

− Posterior fornix is related to the rectouterine pouch (of Douglas)
− The peritoneal cavity may be accessed via the posterior fornix

44
Q

To what extent are the fornices distensible ?

A

The fornices are distensible

45
Q

What procedure may pose a risk to the ureters ? Why ?

A

In performing a hysterectomy, the ureter may be accidentally divided while clamping the uterine vessels (because ureter passes inferior to the uterine artery and lateral to the lateral fornix)

46
Q

List the dimensions of the urethra.

A

4 cm long and 6 mm wide

47
Q

To what extent does the urethra contain glands ?

A
  • Paraurethral glands and ducts in distal urethra are homologous to the prostate
  • Periurethral glands opens into urethra
48
Q

Describe the anatomical path of the urethra.

A

Passes through deep compartment/pouch of perineum with external urethral sphincter around, then the perineal membrane and then the superficial perineal pouch (compartment)

49
Q

Which kind of muscle lines the urethra ? What is the physiological significance of this ?

A

External urethral sphincter is a ring with the other muscles being longitudinal to make the urethra short and wide during micturition.

50
Q

Where does the external urethra sphincter open ?

A

Opens immediately anterior to the vagina

51
Q

State any other names of the paraurethral glands.

A

Lesser vestibular glands, Skene glands

52
Q

Describe the function and exact location of the paraurethral glands.

A

♦ Tiny mucous-secreting glands which keep vestibule lubricated during intercourse.
♦ Located at either side of the urinary meatus

53
Q

Which other gland are the paraurethral glands homologous to ?

A

Para-urethral glands are homologous to the prostate

54
Q

State the arterial supply of the ovaries.

A

Ovarian artery (arises from aorta at L2)

55
Q

State the arterial supply of the uterine tube.

A

Tubal branches from the ovarian and uterine arteries

56
Q

State the arterial supply of the uterus.

A

Uterine artery

57
Q

State the veinous drainage of the ovaries.

A

ovarian plexus → ovarian veins → left renal vein or inferior vena cava

58
Q

State the veinous drainage of the uterine tube.

A

Ovarian veins and uterovaginal venous plexus

59
Q

State the veinous drainage of the uterus.

A

Uterovaginal plexus → uterine veins → internal iliac veins

60
Q

Describe the lymphatic drainage of the uterine tube, and ovaries.

A

♪ Ovary: the para-aortic (lumbar) lymph nodes

♪ Uterine tube: para-aortic (lumbar) but may also pass to superficial inguinal

61
Q

Describe the lymphatic drainage of the distal and proximal vagina, and uterus.

A

♫ Uterus and proximal vagina: internal iliac nodes

♫ Distal vagina: deep and superficial inguinal nodes

62
Q

Describe the lymphatic drainage of the urethra.

A

Urethra: external and internal iliac + deep and superficial inguinal nodes

63
Q

Describe where referred pain is felt from female internal genitalia, explaining why.

A

1) The ovary and distal uterine tube:
• Sympathetics from T10-11
• Pain referred to the peri-umbilical region

2) Proximal uterine tube and uterine body:
• Sympathetics from T12-L2
• Pain referred to the suprapubic region

3) Uterine cervix and proximal vagina:
• Parasympathetics from S2-4
• Pain felt deeply in the pelvis

4) Distal vagina:
• Somatic pudendal nerve (S2-4) (not referred since somatic)

64
Q

Identify the main components of the female internal genitalia.

A

Vagina, uterus, cervix, uterine tubes (oviducts or fallopian tubes), and ovaries

65
Q

Identify the main components of the female external genitalia.

A

Surround the vaginal orifice

  • Mons pubis
  • Labia majora
  • Labium minora
  • Clitoris
  • Vaginal vestibule
  • Hymen
  • Vestibular bulbs
  • Greater vestibular gland
66
Q

What structures of the male reproductive system are the labia majora, and minor homologous to ?

A 
Labia majora, homologue of scrotum
Labia minora (Nymphae), homologue of penis skin
67
Q

Describe the main anatomical relations of the labia majora.

A

 Skin folds from mons pubis to perineum
 Enclose the pudendal cleft
 Round ligament of uterus is attached

68
Q

Describe the main anatomical relations of the labia minora.

A

 Medial to the labia majora
 Posteriorly form the posterior labial commissure or fourchette
 Surround the vaginal vesibule

69
Q

What is the vaginal vestibule ?

A

Space (between labia minora) containing urethral, and vaginal openings

70
Q

Define hymen.

A

Thin mucosal fold.

71
Q

Identify possible abnormalities of the hymen.

A

Normally perforated (otherwise cannot get rid of menstrual blood). Can be:

  • Annular
  • Septate
  • Cribiform
  • Semilunar
72
Q

What are the main parts of the clitoris ? Where is it located ?

A

Cavernous tissue at the anterior junction of the labia minora, consisting of 2 crura, body, and glans (head), hooded by the prepuce of the clitoris.

73
Q

What is the clitoris a homologue of in the male reproductive system ?

A

Homologue of penis, but without urethra

74
Q

What is the vestibular bulb made up of ?

A

Vascular erectile tissue covered by bulbospongiosus muscle.

75
Q

Identify any other names given to greater vestibular gland.

A

= Bartholin’s gland

76
Q

Describe the anatomical location of the greater vestibular gland.

A

 Posterior to the end of the vestibular bulb (also covered by bulbospongiosus muscle)

77
Q

Where does the greater vestibular gland drain ? What is its function ?

A

Drains into the vestibule

Secretes mucus for lubrication during sexual arousal

78
Q

What is the greater vestibular gland a homologue of in the male reproductive system ?

A

Homologues of bulbourethral gland in males

79
Q

What is the clinical significance of the greater vestiubular gland ?

A

May be the site of painful cyst or abscess formation

80
Q

Describe the arterial supply and veinous drainage of the female external genitalia.

A

♦ Female external genitalia is supplied by internal pudendal branches of the internal iliac arteries and external pudendal branches from the femoral arteries

♦ The venous return is through vessels that correspond in name and position to the arteries

81
Q

Describe the nervous innervation of the female external genitalia.

A

Parasympathetic, sensory and somatic innervation
− pudendal nerve
− ilio-inguinal nerve
− the genital branch of the genitofemoral nerve

82
Q

Describe the lymphatic drainage of the female external genitalia.

A

Lymphatic flow is mainly to the superficial inguinal nodes, but also drains to deep inguinal and internal iliac nodes

83
Q

Identify any changes to the cervix in pregnancy/puberty.

A

• In a non pregnancy cervix, consistency is firm
during pregnancy, becomes softer.

• In puberty, by the effect of estrogen, external os opens up and cervical transformation zone becomes exposed to vagina. Vagina is acidic, which may cause metaplasia of columnar epithelium in this zone into squamous epithelium. This metaplasia can potentially develop into Cervical intrepithelial neoplasia (CIN).

• When nullipara: external os circular
With each birth: external os becomes slit like

84
Q

Define episiotomy. Why may it be needed in general, and which specific circumstances may it be used ?

A

Surgical incision that may be done during parturition to facilitate delivery and accommodate the head of an emerging fetus.

  • Prevents vaginal tears
  • Shoulder dystocia; forceps or vacuum delivery
85
Q

What are the pros and cons of a midline incision in episiotomy ?

A

PRO
-Easier to repair

CON
-Higher risk of extending into the canal area

86
Q

What are the pros and cons of a mediolateral incision in episiotomy ?

A

PRO
-Protect the anal sphincter

CON
-More painful and more difficult to repair

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