Female Reproductive Organs Flashcards

1
Q

What are the functions of the uterus?

A
  • Implantation
  • Development and nourishment of fetus
  • Childbirth
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2
Q

What are the functions of the ovary?

A
  • Production of ovum

- Maintenance of menstraul cycle

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3
Q

Describe the shape/structure of the ovary?

A
  • Almond-shaped
  • 3 x 1.5 x 1 cm
  • Smooth surface in young girls but scarred and pitted after puberty
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4
Q

Where is the ovary located?

A
  • True intraperitoneal
  • Located in ovarian fossa
  • Attached to the back of the broad ligament by the mesovarium, supported by the ovarian ligament and suspensory ligaments
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5
Q

What is at risk during surgery of the ovary?

A

The ureter is at risk as it lies posterior to the ovary

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6
Q

Where does the obturator nerve lie in relation to the ovary?

A

Lateral

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7
Q

What anchors the ovary?

A
  • Round (ovarian) ligament
  • Supsensory (infundibulopelvic) ligament of the ovary
  • Mesovarium
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8
Q

What is the round ligament of the ovary?

A
  • Extends between cornu of uterus and ovary
  • Keeps ovary close to uterus
  • Remnant of upper part of gubernaculum
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9
Q

Where can ovarian disease refer pain to due to the obturator nerve’s position?

A

Medial thigh

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10
Q

What happens to the ovary after pregnancy?

A

Less stable and position is more varibale

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11
Q

What is the suspensory (infundibulopelvic) ligament of ovary?

A
  • In the broad ligament

- Carries the ovarian blood vessels

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12
Q

What is the mesovarium?

A
  • Short peritoneal fold that attaches to the ovary to the back pf the broad ligament
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13
Q

What are the areas of the fallopian tube from ovary in towards the uterus?

A
  • Infundibulum
  • Ampulla
  • Isthmus
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14
Q

What are the finger-like projections called that pick up the ovum and into the fallopian tubes?

A

Fimbria

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15
Q

Where does fertilisation usually take place?

A

Ampulla

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16
Q

What cause the ovum to move towards the uterus?

A
  • Cilia

- Circular and longitudinal smooth muscle peristaltic movements

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17
Q

Where do ectopic pregnancys usually take place?

A

Ampulla

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18
Q

Where is the uterus located?

A

Anterior to the rectum and posterosuperior to the urinary bladder

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19
Q

What are the 3 main parts of the uterus?

A
  • Body
  • Isthmus
  • Cervix
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20
Q

Where is the fundus of the uterus located?

A

Superior to the corner of the uterus at the top of the body

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21
Q

WHere is the internal os located?

A

Isthmus

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22
Q

How can the cervix be divided?

A
  • Supravaginal cervix

- Vaginal cervix

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23
Q

What is the uterine cavity?

A

Inside of uterus (tringular shaped)

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24
Q

What is the consistancy of the cervix like?

A

Changes

- Unpregnant cervix = firm, softened during pregnancy

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25
Q

What are the 2 openings of the cervical canal?

A
  • Internal os (orifice)

- External os

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26
Q

What is the epithelium of the cervical canal?

A

Columnar epithelium

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27
Q

What is the boundary between the supravaginal and vaginal cervix?

A

squamocolumnar junction, cervical transformation zone external os opens up and becomes exposed after puberty , can be seen when ooking into vagina

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28
Q

What is the vaginal cervix also known as?

A

Ectocervix

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29
Q

What is the epithelium of the ectocervix?

A

Non-keratinizing stratified squamus epithelium, which contains glycogen

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30
Q

When can the columnar epithelia of the cervix become squamus?

A

Metaplasia can devolp into cervical intraepithelial neoplasia

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31
Q

What happens to the external os after someone has given birth?

A

Becomes slit-like instead of circular

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32
Q

What are the layers of the uterus from the outer layer to the innermost layer?

A
  • Perimetrium
  • Myometrium
  • Endometrium
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33
Q

What layer of the uterus is thin visceral peritoneum?

A

Perimetrium

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34
Q

What are the layers of the myometrium?

A

Smooth muscle fibres arranges in 3 layers

  • Longitudinal
  • Spiral (figure of 8 around vessels)
  • Circular -> sphincter around uterine tubes and internal orifice
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35
Q

What is the endometrium and whar are the layers?

A

Innermost layer of uterus
Mucous membrane and spiral arteries
- Basal (deep) layer (regenerates the functional layer)
- Functional (superficial) layer (shed as menses)

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36
Q

What happens if the basal layer is destroyed (eg in abortion)?

A

Woman becomes infertile is it cannot produce the functional layer

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37
Q

At what angle does the adult uterus sit?

A
  • Bent forward on itself at about the level of the internal os to form an angle of 170 degrees, lies on superior surface of uterus (anteflexion of the uterus)
  • Axis of cervix forms an angle of 90 degrees with the axis of the vagina (antevertion of the uterus)
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38
Q

What can retroversion and/or retroflexion cause?

A

Backache and difficulty in conception

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39
Q

What are the other names for round ligament of the uterus?

A
  • Ligamentum teres

- Ligamentum rotundum

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40
Q

What does the round ligament pass through and where does it go to?

A

Passes within the broad ligament from the cornu of the uterus through the inguinal canal to the labia majora

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41
Q

What is the round ligament of the ovary a remnant of?

A

Upper part of gubernaculum

42
Q

What ligaments hold the uterus anteverted and anteflexed over the bladder?

A

Round ligament of uterus and broad ligament

43
Q

What is the broad ligament formed by?

A
  • 2 layers of the peritoneum
  • Peritoneum drapes over the bladder and then the uterus, uterine tube and ovarian ligaments from the uterus to the lateral pelvic wall
44
Q

What is contained within the broad ligament?

A
  • Ovarian ligament
  • Uterine tubes
  • Uterus
  • Round ligament of uterus
  • Ureter
  • Vessels and nerves of the ovaries and uterus
45
Q

What is the part of the broad ligament surrounding the uterine tube called?

A

Mesosalpinx

46
Q

What is the part of the broad ligament surrounding the ovaries called?

A

Mesovarium

47
Q

What is the part of the broad ligament adjacent to the uterus called?

A

Mesometrium

48
Q

What are the 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
49
Q

What are the “ligaments” derived from?

A

Visceral and parietal fascia

50
Q

What can weakness of the ligaments and pelvic floor muscles result in?

A

Prolapse, urinary incontinance (common in menapausal women)

51
Q

What are the supportive ligaments of the uterus?

A
  • Cardinal (transverse cervical) ligament
  • Uterosacral ligament
  • Uterovesical ligament
  • Pubocervical ligament
  • Sacrocervical ligament
52
Q

How long is the vagina?

A

~ 10 cm in length

53
Q

WHere does the vagina lie?

A

Anterior to the rectum and posterior to the bladder

54
Q

Where is the urethra located in the vagina?

A

Embedded in anterior wall of vagina

55
Q

What bacteria does the vagina house and what does this result in?

A

Doderlein bacilli (lactobacilli) converts glycogen into lactic acid (making it acidic)

56
Q

What does the cervix pushing into the vagina form?

A

The fornix

57
Q

How may the peritoneal cavity be accessed?

A

Via the posterior fornix (it is distensible)

58
Q

What is the posterior fornix related to?

A

Rectouterine pouch (of Douglas)

59
Q

What is the relationship between the ureter and the uterine artery and lateral fornix?

A

Passes inferior to the uterine artery and lateral to the lateral fornix (“water under the bridge”)

60
Q

What can be at risk during a hysterectomy?

A

Ureter may be accidentally divided while clamping the uterine vessels

61
Q

How long and wide is the urethra?

A
  • 4 cm long

- 6 mm wide

62
Q

What are the paraurethral glands and ducts homologous to?

A

Prostate

63
Q

What does the female uretha pass through?

A
  • Deep perineal pouch (compartment) with external urethral sphincter around
  • Then the perineal membrane
  • And then the superficial perineal pouch (compartment)
64
Q

Where does the urethra open?

A

Immediatelt anterior to the vagina

65
Q

Where is the external urethral sphincter found?

A
  • Deep perineal pouch

- Surrounds membranous part of urethra and ur

66
Q

What is the function of the para-urethral glands?

A
  • Tiny mucous-secreting glands
  • Located at either side of urinary meatus
  • Keep vestibule lubricated during intercourse
67
Q

Where do the peri-urethral glands open?

A

Into urethra

68
Q

Where do the para-urethral glands open?

A

Vestibulum

69
Q

What are para-urethral also known as?

A

Lesser vestibular or skene glands

70
Q

Where do the ovarian arteries arise?

A

From aorta at L2

71
Q

What artery is the uterine tube supplied by?

A

Tubal branches from the ovarian and uterine arteries

72
Q

What artery is the uterus supplied by?

A

Uterine artery

73
Q

What is the venous drainage of the ovary?

A
  • Ovarian plexus
  • > Ovarian veins
  • > Left renal vein or IVC
74
Q

What is the venous drainage of the uterine tube?

A

Ovarian veins and uterovaginal venous plexus

75
Q

What is the venous drainage of the uterus?

A
  • uterovaginal plexus
  • > uterine veins
  • > Internal iliac veins
76
Q

What is the lymoh drainage of the ovary?

A

Para-aortic (lumbar) lymph nodes

77
Q

WHat is the lymph drainage of the uterine tubes?

A

Para-aortic (lumbar) but may also pass to superficial inguinal

78
Q

What is the lymph drainage of the uterus and proximal vagina?

A

INternal iliac nodes

79
Q

What is the lymph drainage of the distal vagina?

A

Deep and superficial inguinal nodes

80
Q

What is the lymph drainage of the urethra?

A

External and internal iliac + deep and superficial inguinal nodes

81
Q

Where is pain from the ovary and distal uterine tube referred to?

A
  • Sympathetics from T10-11

- Peri-umbilical region

82
Q

Where is pain referred to from the proximal uterine tube and uterine body?

A
  • Sympathetics from T12-L2

- Suprapubic region

83
Q

Where is pain referred to from the uterine cervix and proximal vagina referred to?

A
  • Parasympathetics from S2-4

- Deep pelvis

84
Q

Where is pain referred to from the distal vagina?

A

Somatic pudendal nerve (S2-4)

85
Q

What is the external female genitalia known as?

A

Vulva

86
Q

What is the labia majora?

A
  • Skin folds from mons pubis to perineum
  • Mainly fatty (superficial) layer of the subcutaneous tissue of the perineum
  • Encloses pudendal cleft
  • Round ligament of uterus is attached
  • Homologue of scrotum
87
Q

What is the labia minora (nymphae)?

A
  • Medial to the labia majora
  • Posteriorly from the posterior labial commissure or fourchette
  • Surround the vaginal vestibule
  • Homologue of penis skin
88
Q

What opens at the vaginal vestibule?

A
  • Urethra

- Vagina

89
Q

What is the hymen??

A
  • Thin mucosal fold
  • Partially closes vagina
  • Perforated: Annular, semilunar, septate or cribriform
90
Q

What is the clitoris?

A
  • Cavernous tissue at the anterior junction of the labia minora
  • Consists of 2 crura, body and glans (head), hooded by the prepuce of the clitoris
  • Homologue of penis but w/o urethra
91
Q

What is the bulb of the vestibule?

A
  • Vascular erectile tissue

- Covered by bulbospongiosus muscle

92
Q

What is the function of the greater vestibular gland?

A
  • Secretes mucus for lubrication during sexual arousal
93
Q

Where is the greater vestibular gland located?

A

Posterior to the end of the vestibular bulb

94
Q

What is the greater vestibular gland also known as?

A

Bartholin’s gland

95
Q

What covers the greater vestibular gland?

A

Bulbospongiosus muscle

96
Q

What is the homologue of the greater vestibular gland?

A

Bulbourethral gland in males

97
Q

Where can be the site of a painful cyst or abscess formation?

A

Greater vestibular gland

98
Q

What is the arterial supply to the external genitalia?

A

Internal pudendal branches of the internal iliac arterues and external pudendal branches from the femoral arteries (venous return has corresponding names)

99
Q

What is the parasympathetic, visceral and somatic sensory and somatic innervation to the external genitalia?

A
  • Pudendal nerve
  • Ilio-inguinal nevre
  • Genital branch of the genitofemoral nerve
100
Q

What is the lymphatic drainage of the external genitalia?

A

Mainly to superficial inguinal nodes, but also drains to deep inguinal and internal inguinal iliac nodes

101
Q

What is an episiotomy?

A
  • Surgical incsision that may be done during parturition to fascilitate delivery and accomodate the head of an emerging fetus
  • Often used when baby too bigin relation to mother or shoulder dystocia
102
Q

What are the 2 types of episiotomy and what are the advantages of each?

A
  • Midline incision - advantage is that it heals more easily, disadvantage is that you can damage anal sphincter
  • Mediolateral - protects spincter, more painful, more difficult to repair