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Semester 4 Anatomy > Female Reproductive System > Flashcards

Female Reproductive System Flashcards

1
Q

What makes up the ‘upper genital tract’?

A

uterus
fallopian tubes
ovary

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2
Q

What is the fundus?

A

anything above where the uterine tubes enter

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3
Q

What is the body?

A

anything below where the uterine tubes enter

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4
Q

Where does the female reproductive system arise from?

A

paramesonephric ducts

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5
Q

What remnant of mesonephric duct persists?

A

gartner’s gland/cyst

on lateral vagina wall

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6
Q

Which 3 germ layers give rise to the genital tract?

A

ectoderm
mesoderm
endoderm

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7
Q

Can normal sized pelvic organs be palpated over the abdomen?

A

no- they need to be examined ‘per vagina’ or ‘per rectum’

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8
Q

What are the 3 tissue layers?

A

perimetrium
myometrium
endometrium

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9
Q

What is a ‘genital septum?’

A

genital tract forms genital septum between GI and GU tract

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10
Q

What are the 3 tracts that go through a female pelvis?

A

Genital tract
GI
GU

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11
Q

What can cause pelvic adhesions?

A

inflammation
scar tissue
infection
endometriosis

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12
Q

What is a pelvic adhesion?

A

adhesion is a band of scar tissue that binds 2 parts of your tissue that aren’t normally joined together.
Pelvic adhesions may involve any organ within the pelvis, such as the uterus, ovaries, fallopian tubes, or bladder, and usually occur after surgery.

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13
Q

When does the uterus receive the developing human?

A

at morula stage
allows implantation
prove environment for development before expelling foetus

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14
Q

What is the size and shape of the uterus?

A

pear

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15
Q

What does version mean?

A

angle between vagina and cervix

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16
Q

What does flexion mean?

A

angle between uterus and cervix

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17
Q

What is the normal position of the uterus in relation to vagina and cervix?

A

anteversion & anteflexion

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18
Q

When is it clinically important to establish the version and flexion of the uterus?

A

to determine risk of prolapse

before inserting IUD

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19
Q

What is uterine prolapse?

A

A uterine prolapse is when the uterus descends toward or into the vagina. It happens when the pelvic floor muscles and ligaments become weak and are no longer able to support the uterus. In some cases, the uterus can protrude from the vaginal opening.

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20
Q

What are the parts of the uterus?

A

fundus, body, cervix

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21
Q

What are the 2 subdivisions of the uterus and what separates them?

A

corpus uterus
(SEPARATED BY INTERNAL OS)
cervix uterus

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22
Q

What can cause uterine prolapse?

A

multiple vaginal pregnancies

connective tissue disease (Marfan’s, Ehlers Danos)

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23
Q

What are round ligaments and ovarian ligaments remnants of?

A

gubernaculum remnant

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24
Q

What does the gubernaculum do?

A

Function during development.
As the scrotum and labia majora form in males and females respectively, the gubernaculum aids in the descent of the gonads (both testes and ovaries). The testes descend to a greater degree than the ovaries and ultimately pass through the inguinal canal.

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25
Q

What does the round ligament do?

A

Connect: uterine fundus to labia majorai.

Travel in roundinguinal canal, above artery of Samspon

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26
Q

What does the ovarian ligament do?

A

Connect: ovary to lateral uterus

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27
Q

How does the broad ligament form?

A

broad ligament forms after the Mullerian ducts join together during development.
During this process, 2 layers of peritoneum join together enveloping the pelvic organs, which is then known as the broad ligament.

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28
Q

What does the broad ligament connect?

A

lateral pelvic walls to the uterus, fallopian tube, ovaries etc.

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29
Q

What is the broad ligament?

A

double layered peritoneum (made of mesothelial cells)

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30
Q

What are the 3 parts of the broad ligament?

A

mesometrium (largest)- pelvic wall to uterus body
mesosalpinx- suspend uterine tubes in pelvic cavity
mesovarium- attach to ovary

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31
Q

What is the cardinal ligament?

A

cervix to pelvic side wall

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32
Q

What does the cardinal ligament contain?

A

uterine vessels (from anterior branch of internal iliac) -> supply uterus

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33
Q

What happens if you do hysterectomy and you affect the cardinal ligament?

A

ligate uterine vessels -> ureter at risk (damaged = hydronephrosis)

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34
Q

What is the uterosacral ligament?

A

connect uterus to sacrum

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35
Q

What does the infundibulopelvic ligament connect?

A

ovary to lateral pelvic wall

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36
Q

What does the infundibulopelvic ligament contain?

A

. Contain: ovarian vessels

i. In oophorectomy -> ligate vessels -> prevent bleeding
i. Ligate ovarian vessels -> ureter courses retroperitoneally -> injury risk
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37
Q

What parts does the cervix have?

A

supra vaginal and intra vaginal

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38
Q

What is the external OS clinically used for?

A

smear test

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39
Q

What is the cervical opening into the vagina and why is a doctor familiar with it?

A

ectocervix (proximal to external Os)

Smear test

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40
Q

What is the blood supply of the uterus and where does it arise?

A

uterine artery

arises from anterior division of internal iliac artery

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41
Q

What structure links closely to the uterine artery?

A

ureter

uterine artery crosses over ureter from lateral to medial

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42
Q

What is the clinical significance between ureter and uterine artery crossing?

A

Important in hysterectomy
in the operation, uterine artery needs to be ligated to prevent excess blood loss
be careful not to ligate ureter too

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43
Q

What is the nerve supply of the uterus and at which spinal level do the afferent nerves enter?

A

sympathetic nerve fibres of the uterus = arise from the uterovaginal plexus.

Parasympathetic fibres of the uterus = pelvic splanchnic nerves (S2-S4).

The afferent fibres mostly ascend through the inferior hypogastric plexus to enter the spinal cord via T10-T12 and L1 nerve fibres.

44
Q

What is the course of the round ligament?

A

originate at uterine horns, in the parametrium.
round ligament exits pelvis via the deep inguinal ring
passes through the inguinal canal
continues on to the labia majora
its fibers spread and mix with the tissue of the mons pubis.

45
Q

What is the male equivalent to round and ovarian ligaments?

A

scrotal ligament

46
Q

At what gestation does the pregnant uterus become palpable per abdomen?

A

after 12 weeks

47
Q

At what gestation does the pregnant uterus reach the umbilicus?

A

20 weeks

48
Q

How does the uterus change during pregnancy?

A

uterus thickens
blood vessels enlarge to provide nourishment to the fetus.
uterus expands

49
Q

What are menstrual disorders?

A

Menorrhagia, metrorrhagia, dysmenorrhoea, oligomenorrhoea

50
Q

What is menorrhagia?

A

abnormally heavy bleeding

51
Q

What is metorrhagia?

A

abnormal bleeding

52
Q

What is dysmenorrhoea?

A

painful menstruation

53
Q

What is oligomenorrhoea?

A

infrequent menstrual periods

54
Q

What are the grades for uterine prolapse?

A

Grade 1: uterus may drop slightly and remain above the introitus
Grade 2: uterus drops further so that the cervix or lower portion of the uterus reach the region of the introitus
Grade 3: cervix or even the entire uterus bulges out of the introitus
Grade 4: drops completely out

55
Q

What are uterine fibroids?

A

benign smooth muscle growth (tumour)

56
Q

What are the symptoms of uterine fibroids?

A 
Heavy menstrual bleeding
Menstrual periods lasting more than 1 week
Pelvic pressure or pain
Frequent urination
Difficulty emptying the bladder
Constipation
Backache or leg pains
57
Q

What is endometriosis?

A

enometrium tissue grows elsewhere like ligaments of uterus, fallopian tube, ovary etc.

58
Q

What are the symptoms of endometriosis?

A 
Pelvic pain- worse during period
period pain that prevents normal activities
pain during/after sex
pain when peeing or pooing
feeling sick
constipation
diarrhoea
blood in pee during period
difficulty getting pregnant
59
Q

Why does endometrial carcinoma incidence increase?

A

more obesity
HRT
diff reproductive trends- less children, have children later

60
Q

What is an adnexa?

A

Structures between the uterus & pelvic side wall: fallopian tubes, ovaries, and ligaments

61
Q

How do you palpate an adnexal mass?

A

bimanual palpation: insert two gloved, lubricated fingers in the vagina & palpate lower abdomen with other hand

62
Q

Which ducts do the fallopian tubes arise from?

A

paramesonephric duct

63
Q

What attaches the oviduct (tubes) to the broad ligament?

A

mesosalpinx

64
Q

How long is the uterine tube?

A

10cm to 13cm

65
Q

What are the 4 parts of the uterine tube?

A

isthmus
ampulla
infundibulum
fimbraie

66
Q

Where does fertilisation take place?

A

ampulla

67
Q

Which is the narrowest?

A

isthmus

68
Q

What type of cells are in the oviduct (tube) and what is the function?

A

ciliated columnar epithelium

move the egg

69
Q

What can happen in the fallopian tube that is a medical emergency?

A

ectopic preggo

70
Q

What is the blood supply of the fallopian tube?

A

medial 2/3rd of tube= UTERINE ARTERY

lateral 1/3rd of tube= OVARIAN ARTERY

71
Q

What is salpingitis?

A

inflammation of the fallopian tubes

72
Q

What is a sequelae?

A

consequence of previous disease

73
Q

What is hydro-salpinx?

A

fallopian tube is blocked and fills with serous or clear fluid near the ovary (distal to the uterus). The blocked tube may become substantially distended giving the tube a characteristic sausage-like or retort-like shape.

74
Q

What is pylosalpinx?

A

fallopian tube filled with pus

75
Q

What is cervical excitation?

A

Severe pain found during pelvic examination. Suggest pelvic pathology, e.g. pelvic inflammatory disease/ ectopic pregnancy

76
Q

How do you test for cervical excitation?

A

bimanual palpation

77
Q

Which germ layer does the ovaries arise from?

A

mesoderm

78
Q

How many oocytes exist at 20 weeks gestation?

A

5 million

79
Q

How many oocytes exist at birth?

A

500,000

80
Q

How many oocytes at puberty?

A

50,000

81
Q

Where do ovaries developmentally start?

A

high on abdominal wall

82
Q

Where do the ovaries descend to?

A

pelvic brim

83
Q

Where do the gonadal arteries arise?

A

abdominal aorta

L2

84
Q

What is the course of the ovarian vessels?

A 
The ovarian (or testicular) arteries arise from the abdominal aorta 
pass downward and laterally on the anterior surface of psoas major.  
They continue to descend and as they cross the pelvic inlet they travel in the suspensory ligament of the ovary.  
The arterial supply must travel a long course because, just like the testes, the ovaries develop high on the posterior abdominal wall and then descend before birth, bringing with them their vessels, lymphatics and nerves
85
Q

What is the infundibulo-pelvic ligament/ suspensory ligament of the ovary?

A

Fold of peritoneum that extends out from ovary to wall of pelvis

86
Q

Where do the ovarian veins drain to?

A

Left: renal vein then IVC
Right: IVC

87
Q

Where do lymphatics drain?

A

para-aortic
iliac nodes involved too

clinical significance: biopsy

88
Q

What does the ovarian ligament do?

A

medial pole of ovary to uterus

89
Q

What is the difference between pre and post menopausal women?

A

Uterus size & ovarian volume decrease

90
Q

What is neoplasia?

A

uncontrolled cell growth

91
Q

What is polycystic disease?

A 
more androgens
facial hair
less periods
infertility
Compression
	- Pain, bleeding, constipation, urge incontinence, bloating
92
Q

Why does ovarian pathology affect medial aspect of thigh?

A

because obturatory nerve goes past ovary

supplies thigh muscles

93
Q

What 3 cells are found in ovary?

A

germ
epithelial
stromal

94
Q

Which cell gives rise to cancer?

A

epithelial cells

95
Q

Why does ovarian cancer have poor prognosis?

A

symptoms late

96
Q

What are they symptoms of ovarian cysts

A

Pain, bloating, irregular period

97
Q

What complications of ovarian cyst can you get that can cause problems?

A

Rupture, haemorrhage, ovarian torsion

98
Q

What are the components of the lower genital tract?

A

cervix, vagina, vulva

99
Q

How long is the vagina?

A

8cm

100
Q

How is the vagina lubricated?

A

It doesn’t have any glands, but there’s transudation & secretion from uterus & Bartholin’s gland

101
Q

What is the posterior relation of the posterior fornix?

A

rectouterine pouch

clinical significance: Pus and urine can collect into them. It’s used for catheters for end stage renal failure

102
Q

What is the plane of the vaginal canal?

A

horizontal and parallel to plane of pelvic inlet

103
Q

What is the blood supply of the vagina?

A

Vaginal & uterine arteries

venous: vaginal venous plexus
lymphatics: superficial inguinal, iliac

104
Q

What is the hymen?

A

Membrane over external vaginal opening

105
Q

What is purpose of hymen?

A

keep germs out

106
Q

Which gland opens below the hymen?

A

bartholin’s gland- If it becomes infected it can cause Bartholin’s abscess. If it’s blocked it causes a cyst

107
Q

What is vestibule?

A

Opening between labia minora

Semester 4 Anatomy (1 decks)

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