L2: clinical anatomy and histology of the female reproductive tract Flashcards
Describe the ovaries
Paired organ & is where oogenesis occurs
Fully enclosed in parietal peritoneum
Contains follicles -> stimulated by FSH to produce a primary follicle, which will then mature to release an ovum
Suspensory ligament of the ovary = passage of the ovarian artery and vein
Lymph: para-aortic nodes
Describe common clinical problems related to the ovaries
Ovary may develop ovarian cysts -> derived from follicles Can be asymptomatic or lead to complications such as torsion or rupture Polycystic ovaries (more than 10 cysts) = common cause of infertility Tumours of the ovary arise most commonly from epithelial components or from germ cells
Describe the fallopian tubes
Allows passage of the ovum to the uterus & is the site where fertilisation occurs
Fimbriae – large surface area to ‘catch’ the ovum in the peritoneal cavity & channel it in to the infundibulum
Continues to the ampulla – most common site of fertilisation
Lined with cilia which enable transport of the ova to the uterus
Describe common clinical problems related to the fallopian tubes
Ectopic pregnancy – medical emergency
-fallopian tubes are not adapted for implantation & therefore the pregnancy is not viable
->causes severe haemorrhage
Tubes can become blocked – due to scarring in chronic infection
-leads to infertility
Describe the uterus
Divided into the fundus, the body and the cervix
-fundus usually expands during pregnancy & is covered by parietal peritoneum
Internally comprised of smooth muscle (myometrium) & an epithelial layer of endometrium (lined with simple columnar epithelium)
Lymph: fundus - para-aortic/superficial inguinal, body - external iliac
Describe the location of the uterus & the different pouches
Bladder is anterior to the uterus & the rectum is posterior to the uterus
Vesicouterine pouch – between the uterus and bladder anteriorly
Rectouterine pouch – between the rectum and uterus posteriorly
Importantly clinically as they are sites of fluid collection
Describe the ligaments around the uterus
Round ligament – originates at the uterine horns, and attaches to the labia majora, passing through the inguinal canal (remnant of the gubernaculum)
Ligament of the ovary – connects the ovary to the side of the uterus
Broad ligament
-mesovarium = surrounding the ovary
-mesometrium = between the pelvic wall and the uterus
-mesosalpinx = surrounding the fallopian tubes
Describe common clinical problems related to the uterus (endometriosis)
Endometriosis = ectopic endometrial tissue is dispersed to various sites along with the peritoneal cavity & beyond
- may be associated with the ovaries or the attachments of the uterus
- severe period pain (dysmenorrhoea), infertility or both
Describe the cervix
Fibrous structure that can change through hormonal stimulation during the menstrual cycle
External os – opening of the cervix into the vagina
Internal os – internal opening of the uterus to the cervix
Lined with simple columnar epithelium -> produces cervical mucus
Normal angle between cervix and vagina = anteversion
Lymph: internal iliac/sacral
Normal angle between cervix and uterus = anteflexion
Describe common clinical problems related to the cervix
Zone close to the external os is called the transitional zone -> epithelium changes from cervical to vaginal epithelium & is most at risk of malignant changes
-early malignant changes are identified through cervical screening
Describe the vagina
Lined with stratified squamous epithelium
Contains lactobacilli -> regulate the pH and keep the environment acidic to prevent infections such as candida
Adapted to expand during birth & its epithelium is designed to resist friction
Cannot provide any lubrication & is therefore dependent on secretions from the cervix
Lymph: superior - internal & external iliac, middle - internal iliac, inferior - superficial inguinal
Describe the vulva
External genitalia
Comprised of the labia majora and labia minora
Vulval tumours can occurs & it can be a site of FGM
