Gynecology Flashcards

1
Q

Which structures are in the pelvis?

A

Uterus and uterine tubes

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2
Q

What are the different parts of the uterus?

A

Fundus, body, isthmus, cervix

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3
Q

Describe the size of the uterus throughout life

A

After childbirth it has adult proportions (2/3 body to 1/3 cervix) due to maternal hormone influence
Postpartum the uterus reduces to a 1/2 body 1/2 cervix ratio
During puberty the body returns to the 2/3 size until menopause where it again returns to a 1/2 to 1/2 ratio

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4
Q

What is the ratio of the nulliparous adult uterus?

A

2:1

Has never given birth

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5
Q

What is the ratio of the multiparous uterus in the adult?

A

3:1

Has given birth two or more times

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6
Q

What is the fundus of the uterus?

A

Rounded superior portion b/w uterine horns

Furthest away from the vaginal opening

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7
Q

What is the body of the uterus?

A

Upper 2/3 of uterus

Contains uterine horns (superolateral region and entrance point for the uterine tubes) and the uterine cavity

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8
Q

Describe the uterine cavity

A

Internal space in the body of the uterus

Contains internal Os of the uterus (passage from the uterine cavity to the cervical canal)

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9
Q

What is the isthmus of the uterus?

A

Tapering region superior to the cervix

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10
Q

What is the cervix?

A

Cylindrical narrow inferior region that protrudes into the uppermost vagina
Includes the supravaginal part, vaginal part and cervical canal

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11
Q

What is the supravaginal part of the uterus?

A

Between isthmus and vaginal part

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12
Q

What is the vaginal part of the cervix?

A

Part of the cervix that extends into the upper most vagina

Surrounded by fornix

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13
Q

What is the cervical canal?

A

Small fusiform space in the cervix of the uterus

Contains external Os of the uterus (inferior opening of the cervical canal into the vagina)

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14
Q

Cervical cancer was the leading cause of death of North American women until the 1940s with the advent of the what?

A

Pap smear which can detect premalignant cervical conditions

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15
Q

What are the three layers of the uterine wall?

A

Permietrium, myometrium and endometrium

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16
Q

What is perimetrium?

A

Outer layer

Serous coat of peritoneum

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17
Q

What is myometrium?

A

Middle muscular layer of uterine wall

Most vascular layer

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18
Q

What is the endometrium?

A

Inner mucous layer

Closely adherent to the myometrium

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19
Q

What is a hysterectomy?

A

Excision of the uterus through the anterior abdominal wall or vagina
Can be partial, total or radical

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20
Q

What is a partial hysterectomy?

A

Cervix, uterine tubes and ovaries are left behind while uterus is removed

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21
Q

What is a total hysterectomy?

A

Uterus and cervix are removed leaving the uterine tubes and ovaries

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22
Q

What is a radical hysterectomy?

A

Removal of all uterine parts and the vagina

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23
Q

What are the uterine and ovarian ligamentous structures?

A

Broad L of uterus, suspensory L of ovary, round L of uterus, ligament of the ovary, transverse cervical L, uterosacral L

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24
Q

What is the round L of the uterus?

A

Fibrous remnant of the inferior part of the ovarian gubernaculum
Extends fro the lateral uterus through the mesometrium to the labia majora via the inguinal canal

25
Q

What is the ligament of the ovary?

A

Fibrous remnant of the superior part of the ovarian gubernaculum
Extends from the lateral uterine wall to the ovary through the mesometrium

26
Q

What are the uterine tubes?

A

Conveys oocytes from the ovary to the uterus

Includes the infundibulum, ampulla, isthmus and uterine part

27
Q

What is the infundibulum of the uterine tubes?

A

Funnel shaped distal end open to the peritoneal cavity near the ovaries
Contain abdominal ostium and fimbriae

28
Q

What is the abdominal ostium?

A

Opening that leads from the peritoneal cavity to the infundibulum of the uterine tube

29
Q

What are fimbriae?

A

Finger like projections from the end of the infundibulum over the ovaries
Contains ovarian fimbrion (one long infundibular fimbria that attaches to the superior end of the ovary)

30
Q

What is the ampulla of the uterine tubes?

A

Longest portion

Form the infundibulum to the isthmus

31
Q

What is the isthmus of the uterine tubes?

A

Thick walled portion which enters the uterus horn

32
Q

What is the uterine part of the uterine tubes?

A

Short segment which passes through the uterine wall

Contains uterine ostium (opening that leads from the uterine tube to the uterine cavity

33
Q

Ligation of the uterine tubes is done either abdominal or laparoscopically through the what?

A

Umbilicus and involves ligating the uterine tubes so the oocytes never reach the uterine cavity

34
Q

Describe the ovaries

A

Small almond shaped glands suspended by mesovarium

Responsible for the production and expulsion of oocytes

35
Q

Describe the vagina

A

Musculomembranous tube from the cervix of the uterus to the vestibule of the vagina between the labia minora
Normally a collapsed tube except at the superior most part that surrounds the cervix
Contain the vaginal fornix

36
Q

What are the vaginal fornices?

A

Short recess around the cervix

Typically described as having a deep posterior part, a shallow anterior and lateral parts

37
Q

Which structures are in the perineum?

A

Contains female external genitalia or pudendum (vulva)

Mons pubis, pudendal cleft, labia majora, labia minora, clitoris, vaginal vestibule

38
Q

What is the mons pubis?

A

Rounded fatty prominence anterior to the pubic symphysis

39
Q

What is the pudendal cleft?

A

Anterior slit between the labia majora

40
Q

What are the labia majora?

A

Prominent skin folds that protect external urethral and vaginal orifices
Contain the anterior and posterior labial commissures

41
Q

What is the anterior labial commissure?

A

Junction of the right and left labia majora

Anterior to the angle of the clitoris

42
Q

What is the posterior labial commissure?

A

Posterior limit of the pudendum
Overlies the perineal body
Usually not repent after first vaginal birth

43
Q

What are the labia minora?

A

Folds of fat-free, hairless skin enclosed within the pudendal cleft and labia majora
Surround the vestibule of the vagina

44
Q

What is the frenulum of the labia minora?

A

Fourchette
Small and posteriorly located transverse mucosal fold
Exists pre-sexual activity

45
Q

Describe the clitoris

A

Erectile organ extends from the anterior junction of the labia minora posteriorly to the pubic symphysis
Branches into two crura which associate with corresponding inferior pubic rami
Parts: glans clitoris, angle of clitoris, body of clitoris, crura of clitoris, prepuce of clitoris, frenula of clitoris and suspensory L of clitoris

46
Q

What is the glans clitoris?

A

Distal anterior projection

Externally visible

47
Q

What is the angle of the clitoris?

A

At the pubic symphysis
Bend in the clitoris at the junction of the crura and the body of the clitoris
Described as being comprised of two corpora cavernosa

48
Q

What is the body of the clitoris?

A

Comprised of two corpora cavernosa

49
Q

What are the crura of the clitoris?

A

Associated with the corresponding inferior pubic ramus
Posterolateral projections of the corpora cavernous
Right and left crus of the clitoris

50
Q

What is the prepuce of the clitoris?

A

Anterior most junction of the labia minora which travels anterior to and variably covers the glans clitoris

51
Q

What is the frenula of the clitoris?

A

Travel posteriorly from the clitoris to the paired labia minora

52
Q

What is the suspensory L of the clitoris?

A

Extends from the pubic symphysis to the body of the clitoris

53
Q

What is the vaginal vestibule?

A

Between paired labia minora

Contains the vaginal and external urethral orifices

54
Q

What is the external urethral orifice?

A

Exit point of the urethra

55
Q

What is the vaginal orifice?

A

Opening of the vagina

Contains the hymen (membranous structure surrounding the vaginal orifice)

56
Q

What are the bulbs of the vestibule?

A

Paired elongated erectile tissue
Surrounding the vaginal orifice
Homologous to the bulb and the corpus spongiosum of the penis

57
Q

What are the greater vestibular glands?

A

Paired glands posterior to the vestibule

Secrete mucus upon sexual arousal

58
Q

What are the lesser vestibule glands?

A

Paired glands on either side of the vaginal vestibule

Secrete mucous between external urethral orifice and vaginal orifice moistening labia and vaginal vestibule

59
Q

What is the pathway that oocytes take from the ovary to the vagina?

A

Abdominal ostium —> infundibulum —> ampulla —> isthmus of uterine tube —> uterine part of the uterine tube -> through the uterine ostium —> uterine cavity —> internal Os —> cervical canal —> external Os —> vagina