Female Reproductive Tract Flashcards
What are the remnants of the gubernaculum?
Ovarian ligament
Round ligament
Where does the ovarian lig run?
Ovary to uterus
Where does the round lig run?
Uterus through inguinal canal
What is the arterial supply to the ovaries?
L and R ovarian arteries (direct from abdominal aorta)
What is the venous drainage of the ovaries?
R ovarian vein -> IVC
L ovarian vein -> L renal vein
What is the fundus of the uterus?
Most superior part
Palpable as pregnancy proceeds
What is the ideal implantation site for pregnancy?
High up on posterior wall of uterine body
What is the endocervical canal?
Channel that runs through the cervix
How are the vaginal fornices made?
Cervix dips down into the vagina
Where is the uterovesical pouch?
Between urinary bladder and uterus
Where is the rectouterine pouch?
Pouch of Douglas
Between uterus and rectum
Lowest part of peritoneum
How is the pouch of Douglas accessible?
Put a needle through the posterior fornix of vagina
Sample the fluid
What is the suspensory ligament?
Suspends ovary from lateral wall of pelvis
Contains vasculature of ovaries
Describe the position of the uterus
Anteverted - inclined forward with respect to vagina
Anteflexed - fundus pointing forward relative to the cervix
Uterus lies on top of the bladder
Where is the internal Os?
Opening of uterus to cervix
Where is the external Os?
Opening of cervix to vagina
What is the transverse cervical ligament?
Thickening at the base of the broad ligament
Lateral stability of cervix
What is the uterosacral ligament?
Opposes the anterior pull of the round lig
Assists in maintaining anteversion
Where does the ovarian artery supply?
Ovary
Fundus and upper body of uterus
Fallopian tube
Where do the uterine artery and internal pudendal artery branch from?
Anterior division of internal iliac
The vaginal artery is a branch of …
Uterine artery
Why do we need to be careful of ureter in a hysterectomy?
Ureter runs underneath the uterine artery
Need to ligate uterine artery in the surgery
Describe a bimanual examination
Palpation of cervix and uterus via vagina
(2 fingers)
Other hand palpate anterior abdo wall
Where does ovary lymph drain to?
Para-aortic nodes
Where does fundus of the uterus lymph drain to?
Para-aortic nodes
Inguinal nodes
Where does the lymph of body of uterus drain to?
External iliac nodes
Where does the lymph from the cervix drain?
External and internal iliac nodes
Sacral nodes
Where are the labia majora?
Enclosing the pudendal cleft
Where are the labia minora?
Enclosing vestibule of vagina
What is contained within the vestibule of the vagina?
Orifices of urethra and vagina
Greater and lesser vestibular glands
What is the alternative name for greater vestibular glands?
Bartholin glands
Give 2 pathologies that can affect Bartholin glands
Bartholinitis
Bartholin gland cysts
How many vaginal fornices do we have and what are they called?
4
Anterior, posterior and 2 lateral
What is the innervation to the uterus and superior 4/5 of vagina?
Uterovaginal plexus
What is the innervation to the inferior 1/5 vagina?
Pudendal nerve
Somatic
The perineum is mostly innervated by …
Pudendal nerve
Describe some of the route of pudendal nerve
Exits pelvis via greater sciatic foramen
Enters perineum via lesser sciatic foramen
Travels through pudendal canal
