Gynecology Flashcards
Which structures are in the pelvis?
Uterus and uterine tubes
What are the different parts of the uterus?
Fundus, body, isthmus, cervix
Describe the size of the uterus throughout life
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
What is the ratio of the nulliparous adult uterus?
2:1
Has never given birth
What is the ratio of the multiparous uterus in the adult?
3:1
Has given birth two or more times
What is the fundus of the uterus?
Rounded superior portion b/w uterine horns
Furthest away from the vaginal opening
What is the body of the uterus?
Upper 2/3 of uterus
Contains uterine horns (superolateral region and entrance point for the uterine tubes) and the uterine cavity
Describe the uterine cavity
Internal space in the body of the uterus
Contains internal Os of the uterus (passage from the uterine cavity to the cervical canal)
What is the isthmus of the uterus?
Tapering region superior to the cervix
What is the cervix?
Cylindrical narrow inferior region that protrudes into the uppermost vagina
Includes the supravaginal part, vaginal part and cervical canal
What is the supravaginal part of the uterus?
Between isthmus and vaginal part
What is the vaginal part of the cervix?
Part of the cervix that extends into the upper most vagina
Surrounded by fornix
What is the cervical canal?
Small fusiform space in the cervix of the uterus
Contains external Os of the uterus (inferior opening of the cervical canal into the vagina)
Cervical cancer was the leading cause of death of North American women until the 1940s with the advent of the what?
Pap smear which can detect premalignant cervical conditions
What are the three layers of the uterine wall?
Permietrium, myometrium and endometrium
What is perimetrium?
Outer layer
Serous coat of peritoneum
What is myometrium?
Middle muscular layer of uterine wall
Most vascular layer
What is the endometrium?
Inner mucous layer
Closely adherent to the myometrium
What is a hysterectomy?
Excision of the uterus through the anterior abdominal wall or vagina
Can be partial, total or radical
What is a partial hysterectomy?
Cervix, uterine tubes and ovaries are left behind while uterus is removed
What is a total hysterectomy?
Uterus and cervix are removed leaving the uterine tubes and ovaries
What is a radical hysterectomy?
Removal of all uterine parts and the vagina
What are the uterine and ovarian ligamentous structures?
Broad L of uterus, suspensory L of ovary, round L of uterus, ligament of the ovary, transverse cervical L, uterosacral L
What is the round L of the uterus?
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
What is the ligament of the ovary?
Fibrous remnant of the superior part of the ovarian gubernaculum
Extends from the lateral uterine wall to the ovary through the mesometrium
What are the uterine tubes?
Conveys oocytes from the ovary to the uterus
Includes the infundibulum, ampulla, isthmus and uterine part
What is the infundibulum of the uterine tubes?
Funnel shaped distal end open to the peritoneal cavity near the ovaries
Contain abdominal ostium and fimbriae
What is the abdominal ostium?
Opening that leads from the peritoneal cavity to the infundibulum of the uterine tube
What are fimbriae?
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)
What is the ampulla of the uterine tubes?
Longest portion
Form the infundibulum to the isthmus
What is the isthmus of the uterine tubes?
Thick walled portion which enters the uterus horn
What is the uterine part of the uterine tubes?
Short segment which passes through the uterine wall
Contains uterine ostium (opening that leads from the uterine tube to the uterine cavity
Ligation of the uterine tubes is done either abdominal or laparoscopically through the what?
Umbilicus and involves ligating the uterine tubes so the oocytes never reach the uterine cavity
Describe the ovaries
Small almond shaped glands suspended by mesovarium
Responsible for the production and expulsion of oocytes
Describe the vagina
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
What are the vaginal fornices?
Short recess around the cervix
Typically described as having a deep posterior part, a shallow anterior and lateral parts
Which structures are in the perineum?
Contains female external genitalia or pudendum (vulva)
Mons pubis, pudendal cleft, labia majora, labia minora, clitoris, vaginal vestibule
What is the mons pubis?
Rounded fatty prominence anterior to the pubic symphysis
What is the pudendal cleft?
Anterior slit between the labia majora
What are the labia majora?
Prominent skin folds that protect external urethral and vaginal orifices
Contain the anterior and posterior labial commissures
What is the anterior labial commissure?
Junction of the right and left labia majora
Anterior to the angle of the clitoris
What is the posterior labial commissure?
Posterior limit of the pudendum
Overlies the perineal body
Usually not repent after first vaginal birth
What are the labia minora?
Folds of fat-free, hairless skin enclosed within the pudendal cleft and labia majora
Surround the vestibule of the vagina
What is the frenulum of the labia minora?
Fourchette
Small and posteriorly located transverse mucosal fold
Exists pre-sexual activity
Describe the clitoris
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
What is the glans clitoris?
Distal anterior projection
Externally visible
What is the angle of the clitoris?
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
What is the body of the clitoris?
Comprised of two corpora cavernosa
What are the crura of the clitoris?
Associated with the corresponding inferior pubic ramus
Posterolateral projections of the corpora cavernous
Right and left crus of the clitoris
What is the prepuce of the clitoris?
Anterior most junction of the labia minora which travels anterior to and variably covers the glans clitoris
What is the frenula of the clitoris?
Travel posteriorly from the clitoris to the paired labia minora
What is the suspensory L of the clitoris?
Extends from the pubic symphysis to the body of the clitoris
What is the vaginal vestibule?
Between paired labia minora
Contains the vaginal and external urethral orifices
What is the external urethral orifice?
Exit point of the urethra
What is the vaginal orifice?
Opening of the vagina
Contains the hymen (membranous structure surrounding the vaginal orifice)
What are the bulbs of the vestibule?
Paired elongated erectile tissue
Surrounding the vaginal orifice
Homologous to the bulb and the corpus spongiosum of the penis
What are the greater vestibular glands?
Paired glands posterior to the vestibule
Secrete mucus upon sexual arousal
What are the lesser vestibule glands?
Paired glands on either side of the vaginal vestibule
Secrete mucous between external urethral orifice and vaginal orifice moistening labia and vaginal vestibule
What is the pathway that oocytes take from the ovary to the vagina?
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
