Female Reproductive System Flashcards
Attachment to the lateral pelvic wall
Contains the ovarian artery, vein & nerve
Suspensory ligament of ovary
Almond-shaped
Posterior to the broad ligament
Ovaries
Surface is covered by simple cuboidal epithelium (germinal epithelium), devoid of peritoneal covering
Ovaries
Blood supply of ovaries
Abdominal aorta via ovarian arteries
Venous drainage of ovaries
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)
Referred down the inner thigh through the obturator nerve
Ovarian pain
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
Ovarian cancer
4 divisions of Uterine (Fallopian) tubes
Infundibulum
Ampulla
Isthmus
Intramural
Supported by mesosalphinx (a region of the broad ligament)
Fallopian tubes
Opens onto the peritoneal cavity
Infundibulum
Site of fertilization
Ampulla
Opens into uterine cavity
Intramural
Most common cause of infertility
Bacterial infection (gonococcal) with inflammation ➡️ scarring
Predisposes to ectopic tubal pregnancy
Salpingitis
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
Ectopic tubal pregnancy
Types of ovarian cysts
Follicular cyst
Corpus luteum cyst
Theca luteum cyst
Functional cyst - physiologically & hormonal lay active, resolves spontaneously
SSX: sudden, extreme pelvic pain, especially in adolescent girl
Ovarian cyst
4 regions of uterus
Fundus
Cornu
Body
Cervix
Superior to Cornu
Contributes greatly to upper segment of uterus during pregnancy
As high as xiphoid process (T9) during pregnancy
Fundus
Hear the entry of uterine tubes
Cornu
Between Cornu & cervix
Body
Part of the body that divides the body from the cervix, preferred site for surgical incision during cesarean delivery
Isthmus
Contains the internal os, cervical canal and external os
Cervix
Round in nulliparous woman, transverse in parous women
External os
Formed by pubococcygeus & ileococcygeus muscles
Pelvic diaphragm (levator ani muscles)
Remnant of gubernaculum in the embryo
Round ligament of the uterus
Extends laterally from cervix to pelvic side walls
Located at the base of broad ligament
Contains the uterine artery (from internal iliac artery)
Transverse cervical ligament (Cardinal ligament of MACKENRODT)
Extends posteriorly from cervix to the sacrum
Places the uterus in anteverted position
Uterosacral ligament
Extends anteriorly from cervix to the pubic symphysis
Helps to prevent cystocele
Pubocervical ligament
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)
Broad ligament
Anterior bend of the uterus at the angle between cervix & body of the uterus
Anteflexed
Anterior bend of the uterus at the angle between the cervix & vagina
Anteverted
May spread to the pelvic side walls, obstructing the ureters –> hydronephrosis
Obturator lymph nodes
Cervical carcinoma
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
Uterine fibrinoid (leiomyoma)
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
Vagina
Related to vesicouterine pouch
Urinary bladder is palpable through it on DRE
Anterior fornix
Lateral to the cervix
Lateral fornix
Related to recto uterine sac of Douglas
Rectum, sacral promontory (S1) & coccyx are palpable through it on DRE
Site for culdocentesis
Posterior fornix
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
Culdocentesis
Urinary bladder herniates into the anterior vaginal wall
Cystocele
Urinary bladder herniated into the posterior vaginal wall
Rectocele
Hairy skin with underlying fat pads
Labia majora
Hairless, located medial to labia majora
Enclose the vestibule
Continuous anteriorly with the prepuce & frenulum of clitoris; posteriorly with the fourchette
Labia minora
Space between labia minora
Contains the urethral orifice, paraurethral glans of Skene, vaginal introitus, greater vestibular glands of Bartholin, lesser vestibular glands
Vestibule
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
Clitoris
