Internal Female Genitalia Flashcards
Ovaries are related ant to…..& post to…….
Obliterated umbilical artery
Ureter & internal iliac artery
In nullpara, long axis of ovary is…..while in multipara it is……
Vertical
Horizontal
Uterine end of ovary is connected by…..to…..
Ligament of ovary
Supero-lateral angle of uterus just inf to entrance of uterine tube
……..forms hilum of ovary attached to broad ligament by…….
Anterior border
Mesovarium
Part of broad ligament that extends from tubal end of ovary & fibriated end of tube to side wall of pelvis is called…….
Suspensory ligament of ovary
Mention relations of the 2 ovarian surfaces
Lat surface related to parietal peitoneum of ovarian fossa separating it from obturator n & vessels
Medial surface: related to fibriated end of uterine tube
Describe relation of fimbriated end of uterine tube to ovary
TRIPLE relation, related to tubal end, posterior border & medial surface
Describe blood supply of ovary
- Ovarian artery from abdominal aorta
- Uterine artery through its ovarian branches
Veisn emerge from hilum to form paminiform plexus of veins that form ovarian vein that drains differently on rt & lt (similar to male)
Describe LD & nerve supply of ovary
-Lateral & pre-aortic LNs
-By autonomic plexus around the ovarian artery
List parts of uterine tube & their length
- Infundibulum (2 cm)
- Ampulla (3 cm)
- Isthmus (2 cm)
- Intramural (1 cm)
The uterine ostium lies at……
Junction of fundus with the body
…..is widest part of uterine tube while……is narrowest
Ampulla
Intramural part
……is the site of ferilization
Ampulla of uterine tube
Describe nerve supply, blood supply & LD of uterine tubes
-Medial 2/3 supplies by uterine nerve plexus, lateral 1/3 supplied by ovarian nerve plexus
-Medial 2/3 supplied by uterine blood vessels, lateral 1/3 supplied by ovarian nerve plexus
-Most lymphatics end in lateral aortic & pre-aortic nodes, isthmus & utero-tubal junction accompany round ligament to superficial inguinal LNs
The most common site of ectopic pregnancy is…..
Uterine tubes
Describe normal position of uterus
- Long axis of uterus forms a 90deg angle with axis of vagina (anlge of anteversion)
- At level of iternal os the body is slightly bent forward on cervix forming angle of anteflexion which is 170 deg
The part of body of uterus above entrance of tubes is…….
Fundus
Part of uterus above entry of tubes is called
Fundus
List relations of each of the following parts of uterus:
1. Fundus
2. Anterior surface
3. Posterior surface
- Coils of ileum & sigmoid colon
- Urinary bladder with uterovesical pouch in between
- Sigmoid colon & colis of terminal ileum
Describe relations of lateral border of uterus
-At their upper ends the uterine tube enters, at this level there is attachment of round ligmanet of uterus & ligament of ovary, anteroinferiorly & posteroinferiorly respectively
-The uterine tubes & two ligaments run in the broad ligament which extends from lateral uterine border to lateral plevic wall
-Along the lateral border the uterine artery ascends in tortuous course
The supravaginal part of cervix is surrounded ant & on each side by…..
Paranetrium
Describe featuresof isthmus of cervix
It is the upper 1/3 of cervix, it resembles uterine body in structure. In non-pregnant women it undergoes menstrual changes, during pregnancy it is taken up into body & called lower uterine segment.
Anterior ligament corresponds to……while posterior ligament corresponds to……
Uterovesical fold
Rectovaginal fold
Describe feature of ant border & sup layer of broad ligament
-Ant border medial 4/5 contains uterine tube, lateral 1/5 forms suspensory ligament of ovary
-Sup border is connected to Ovary by mesovarium &cis pierced by infundibulum of uterine tube
Uterine artery crosses ureter at…….
A point about 2 cm from cervix
List the fibromuscular ligaments of uterus
Transverse cervical, uterosacral, pubocervical, round ligaments of uterus
The mesosalpinx in found between………., it contains……..
Uterine tube, mesovarium, ovary & ligament of ovary
List contents of the broad ligament
- One tube uterine tube
- Two ligaments: round ligament of uterus, ligament of ovary
- Two vessels: uterine & ovrian
- 2 nerve plexues: uterovaginal & ovarian
- 2 embryological remnants, epoophoron& Gartner’s duct + paroophoron
- Other: lymphatics & parametrium
The ligament supporting uterus is…..
Transvrse cervical (cardinal)
The ligament which keeps uterus in AVF position is…..
Uterosacral
The round ligament if uterus hooks around…..
Inferior epigastric vessels
Describe blood supply of uterus
Art: uterine artery gives cervical & vaginal branches then ascends in tortuous course giving uterine branches & passes laterally dividing into tubal & ovarian branches within broad ligament
Ven: uterine venous plexus extends along side of uterus plexus drains into uterine, vaginal & ovarian veins
List supporting mechanisms of uterus
- Fibromuscular ligaments
- Muscular factors
- Perineal body
- Surrounding viscera
Describe nerve supply & LD of uterus
-uterovaginal autonomic plexus from inferior hypogastric plexus
LD: Cervix drains into external & internal iliac & sacral lymph nodes, body to external iliac LNs, uterotubal junction to superficial inguinal LNs, fundus to para-aortic LNs
The vaginal fornix covered by peritoneum is
Posterior
Lateral vaginal fornices recieve attachment of……
Mackenrodt’s ligament
Describe posterior relations of vagina
- Lower 1/4 related to anal canal with perineal body in-between
- Middle 2/4 is related to rectum with loose fibroareolat tissue in-between
- Upper 1/4 is related to rectum with rectovaginal pouch in-between
Describe lateral relations of vagina
Lower part: related to Greater vestibular glands with perineal body in-between & muscles of urogenital diaphragm
Middle part related to sphincter vaginae (part of levator ani)
Upper part gives attachment to Mackenrodt’s ligament
Describe blood supply of vagina
-Vaginal branches of uterine artery & branches of vaginal artery (both form azygos artery) + middle rectal & internal pudendal artery
-Drains into vaginal venous plexus which drains into vaginal veins then to internal iliac vein
Describe LD & nerve supply of vagina
-LD: below hymen superficial inguinal LNs, above it external & internal iliac LNs
-NS: Lower inch is pain sensitive supplied by pudendal nerve through inferior rectal & posterior labial nerves. Remaining upper part of vagina is pain insensitive supplied by uterovaginal plexus from inferior hypogastric plexus.
List stages of oogenesis & their outcome
- Proliferation: primordial germ cells from endoderm of yolk sac, migrate to cortex of ovary & develop into oogonia that proliferate by mitosis giving daughter oogonia early in fetal life.
- Growth: 3rd month of prenatal life, oogonia enlarge in size giving 1ry oocyte which enter prophase of 1st meiotic divison & remain arrested in diplotene phase of prophase (46 d-ch, 4N). They are surrounded by single layer of flat epithelial cells giving primordial follicles
- Maturation:
a) Completion of 1st meiotic divison to give 2ry oocyte & 1st polar body (23 d-ch)
b) Second meiotic divison completed only at fertilization gives ovum & 2nd polar body (23 s-ch)
GR: Incidence of Down syndrome inc with mother age
As 2ry oocyte remain arrested in 1st meiotic divison for 12-50 yrs. This long period of meiotic arrest exposes 1ry oocyte to adverse environmental influences & may contribute to errors in meiotic divison as nondisjuction.
Tunica albuginea is covered from outside by…..
Germinal epithelium which simple cubical in yound overy & simple squamous in adults
Spiral artery is found in……
Stroma of the medulla
Medulla of ovary has epithelioid cells called……., their func is…..
Hilus cells
Androgen secretion
Primordial follicles consists of……., they are found in……
1ry oocyte surrounded by single layer of follicular cells
Superficial cortex under tunica albuginea
Describe structure of follicular cells in primordial follicle
Flat squamous cells joined together by desmosomes & are separted from the vascular CT stroma by basal lamina acts as blood-follicle barrier
What is fate of primordial follicle?
A group of them is recruited to begin a process of follicular growth, as they grow, they move deeper into ovarian cortex
Primordial follicle under effect of…….from…….
FSH
1ry follicles
Describe EM features of 1ry follicles
Numerous mitochondria, more extensive rER & enlarged golgi complex. Formation of secretory granules called cortical granules containing various proteases which undergo exocytosis early in fertilization.
