Female Reproductive System

Question 0

Attachment to the lateral pelvic wall

Contains the ovarian artery, vein & nerve

Answer 0

Suspensory ligament of ovary

Question 1

Almond-shaped

Posterior to the broad ligament

Answer 1

Ovaries

Question 2

Surface is covered by simple cuboidal epithelium (germinal epithelium), devoid of peritoneal covering

Answer 2

Ovaries

Question 3

Blood supply of ovaries

Answer 3

Abdominal aorta via ovarian arteries

Question 4

Venous drainage of ovaries

Answer 4

L ovarian vein ➡️ L renal vein

R ovarian vein ➡️ IVC
- R-sided hydronephrosis in females may indicate thrombosis of R ovarian vein that is constricting the ureter (because R ovarian vein crosses the ureter to enter the IVC)

Question 5

Referred down the inner thigh through the obturator nerve

Answer 5

Ovarian pain

Question 6

MC type: epithelial tumor

Lymphatic drainage: deep para-aortic lymph nodes near the renal artery

Associated with HNPCC, Lynch syndrome II, p53 tumor suppressor gene mutation

Tumor markers: CEA, CA-125

Answer 6

Ovarian cancer

Question 7

4 divisions of Uterine (Fallopian) tubes

Answer 7

Infundibulum

Ampulla

Isthmus

Intramural

Question 8

Supported by mesosalphinx (a region of the broad ligament)

Answer 8

Fallopian tubes

Question 9

Opens onto the peritoneal cavity

Answer 9

Infundibulum

Question 10

Site of fertilization

Answer 10

Ampulla

Question 11

Opens into uterine cavity

Answer 11

Intramural

Question 12

Most common cause of infertility

Bacterial infection (gonococcal) with inflammation ➡️ scarring

Predisposes to ectopic tubal pregnancy

Answer 12

Salpingitis

Question 13

MC site: ampulla

Risk factors: PID, pelvic surgery, in-utero exposure to diethylstilbestrol

SSX: sudden onset abdominal pain, delayed menses, +B-hCG test, intraperitoneal blood on culdocentesis

Answer 13

Ectopic tubal pregnancy

Question 14

Types of ovarian cysts

Answer 14

Follicular cyst

Corpus luteum cyst

Theca luteum cyst

Question 15

Functional cyst - physiologically & hormonal lay active, resolves spontaneously

SSX: sudden, extreme pelvic pain, especially in adolescent girl

Answer 15

Ovarian cyst

Question 16

4 regions of uterus

Answer 16

Fundus

Cornu

Body

Cervix

Question 17

Superior to Cornu

Contributes greatly to upper segment of uterus during pregnancy

As high as xiphoid process (T9) during pregnancy

Answer 17

Fundus

Question 18

Hear the entry of uterine tubes

Answer 18

Cornu

Question 19

Between Cornu & cervix

Answer 19

Body

Question 20

Part of the body that divides the body from the cervix, preferred site for surgical incision during cesarean delivery

Answer 20

Isthmus

Question 21

Contains the internal os, cervical canal and external os

Answer 21

Cervix

Question 22

Round in nulliparous woman, transverse in parous women

Answer 22

External os

Question 23

Formed by pubococcygeus & ileococcygeus muscles

Answer 23

Pelvic diaphragm (levator ani muscles)

Question 24

Remnant of gubernaculum in the embryo

Answer 24

Round ligament of the uterus

Question 25

Extends laterally from cervix to pelvic side walls Located at the base of broad ligament Contains the uterine artery (from internal iliac artery)

Answer 25

Transverse cervical ligament (Cardinal ligament of MACKENRODT)

Question 26

Extends posteriorly from cervix to the sacrum Places the uterus in anteverted position

Answer 26

Uterosacral ligament

Question 27

Extends anteriorly from cervix to the pubic symphysis Helps to prevent cystocele

Answer 27

Pubocervical ligament

Question 28

Double fold of parietal peritoneum Extends laterally from uterus to pelvic side walls 4 regions: - mesosalphinx - mesovarium - mesometrium - suspensory ligament of the ovary Contains the ff structures: - uterine artery, vein & artery - uterine tubes - ovarian ligament of the uterus (remnant of gubernaculum) - epoophoron (remnant of mesonephric tubules) - paraophoron (remnant of mesonephric tubules) - Gartner duct ( remnant of mesonephric duct) - ureter (at the base of broad ligament, posterior & inferior to uterine artery) - uterine artery, vein & nerves (at the base of broad ligament within the transverse cervical ligament)

Answer 28

Broad ligament

Question 29

Anterior bend of the uterus at the angle between cervix & body of the uterus

Answer 29

Anteflexed

Question 30

Anterior bend of the uterus at the angle between the cervix & vagina

Answer 30

Anteverted

Question 31

May spread to the pelvic side walls, obstructing the ureters --> hydronephrosis Obturator lymph nodes

Answer 31

Cervical carcinoma

Question 32

Smooth muscle proliferation which may become calcified Location: - submucosa (beneath the endometrium) - intramural (within myometrium) - subserosal (beneath the serosa) Palpated as irregular, nodular masses that protrude against the anterior abdominal wall May cause infertility if they block the uterine tube or prevent implantation of conceptus

Answer 32

Uterine fibrinoid (leiomyoma)

Question 33

Extends from cervix to the vestibule Degree of distention during childbirth is limited by the ischial spines & sacrospinous ligaments Forms a recess around the cervix called fornix

Answer 33

Vagina

Question 34

Related to vesicouterine pouch Urinary bladder is palpable through it on DRE

Answer 34

Anterior fornix

Question 35

Lateral to the cervix

Answer 35

Lateral fornix

Question 36

Related to recto uterine sac of Douglas Rectum, sacral promontory (S1) & coccyx are palpable through it on DRE Site for culdocentesis

Answer 36

Posterior fornix

Question 37

Needle passed through the posterior fornix into the recto uterine pouch of Douglas Fluid collection for analysis or to collect oocytes for in vitro fertilization

Answer 37

Culdocentesis

Question 38

Urinary bladder herniates into the anterior vaginal wall

Answer 38

Cystocele

Question 39

Urinary bladder herniated into the posterior vaginal wall

Answer 39

Rectocele

Question 40

Hairy skin with underlying fat pads

Answer 40

Labia majora

Question 41

Hairless, located medial to labia majora Enclose the vestibule Continuous anteriorly with the prepuce & frenulum of clitoris; posteriorly with the fourchette

Answer 41

Labia minora

Question 42

Space between labia minora Contains the urethral orifice, paraurethral glans of Skene, vaginal introitus, greater vestibular glands of Bartholin, lesser vestibular glands

Answer 42

Vestibule

Question 43

Homologous with the penis Has no corpus Spongiosum Body of the clitoris - formed by 2 corpora cavernosa Glans of the clitoris - formed by fusion of the vestibular bulbs

Answer 43

Clitoris