L7.2 Pelvic viscera 2 Flashcards
1
Q
Development of the female genital tract
A
- 6 weeks → paramesonephric ducts develop into components of the genital tract
- Uterine tubes
- Uterus
- Upper part of vagina
- Has bilateral BS (2 components coming together to form the genital tract)
2
Q
Ovaries
A
- Differentiated from gonads
- Descent into pelvic cavity (LAT pelvic wall)
- Gubernaculum (becomes the vestigial remnant of the round ligament and ligament of the ovary) precedes the descent
- Imperfect descent - not reached position on LAT pelvic wall
- Endocrine (estrogen, progesterone, relaxin) & Exocrine
3
Q
Position of the ovary
A
- Lies on peritonuem in ovarian fossa next to in/ex iliac vessls, and ON obturator N (on the plane of coccyx to pubis)
- Ovarian infections → affects & refer pain via obturator N to medial thigh
4
Q
What are the ovaries held in position by?
A
- Peritoneal folds (Broad ligament - which are then strengthened by traversing BVessels)
- Attaches to ovary: via the mesovarium
- Attaches to uterus: via ligament of the ovary
- Attaches to LAT pelvic wall: via suspensory ligament
5
Q
Where does the ovary prolapse into?
A
Rectouterine pouch
6
Q
5 main parts of the uterine tube
A
- Intramural (within uterus wall)
- Medial opening = uterine ‘os’
- Isthmus (straight part)
- Ampulla (longest, widest & most tortuous)
- Where fertilisation takes place
- Infundibulum
- Opening to perineal cavity = abdominal ‘os’
- Infected material able to pass from vagina → peritoneal cavity
- Fimbria
- Finger-like strands → brings ovaries into tube
- Ovarian-fimbria attaches to ovary
7
Q
How is the ovary conveyed through the ovarian tube?
A
- Conveys fertilised egg via peristalsis & cilia
- Smooth wall muscles → allows peristalsis
8
Q
Ectopic pregnancy
A
- Implanted in the wrong place (most common = ampulla)
- If ruptured → release material into perineal cavity → hemorrhage
9
Q
Uterus
A
- Body narrowing to cervix = internal ‘os’
- Cervix leading to vagina → external ‘os’
- Body (upper 2/3 of uterus) → where implantation occurs
- Cornus → where uterine tube comes into fundus
10
Q
Enlargement of uterus during pregnancy
A
- Rises into ab cavity
- 3 months = suprapubic levels
- 6 months = iliac crest
- 8 months = xiphisternum → pressure on urinary bladder
11
Q
Cervix
A
- Has Supra-vaginal & Vaginal part
- Normal position:
- Anteverted cervix (relative to vag) and Anteflexed body (relative to cervix)
- Laxity of support post birth → variation in position of cervix and body
- Leads to retroversion and retroflexion → increase risk of prolapse
12
Q
Support of the uterus
A
- L.Ani (form below)
- Ligaments:
- Broad
- LAT (transverse) cervical
- Pubocervical
- Uterosacral
13
Q
What are the two pouches formed by the peritoneum
A
- Rectouterine
- Uterovesical
14
Q
Vagina
A
- Upper part (above pelvic floor)
- Lower part (below pelvic floor in perineum)
- POS fornix (only part with peritoneal coverings) → where vag meets termination of uterus → If penetrated → goes straight into peritoneal cavity
15
Q
Sphincters holding the vagina in position
A
- Pubovaginalis (floor of pelvis)
- Urethrovaginal (in perineum)
- Bulbospongiosus (in perineum)
16
Q
Testes and the epididymus
A
- Located in scrotum
- Endo & exocrine
- Epididymus → stores sperm (at the head)
- Transmits sperm via peristalsis to vas deferens
- Testis encapsulated by fibrous tissues
- Outer: terminal vaginalis
- Inner: Tunica albuginea
17
Q
Development of testes
A
- In POS ab wall
- Gubernaculum precedes testis (and draws testes down)
- L lower than the R
- Undescended testes → becomes non-viable
- Cryptochidism → testes NEVER reaches the scrotum
- Ectopic testes → lies close the ab cavity
18
Q
Pathway of Vas deferens
A
- From epididymus → into inguinal canal → back of bladder → pierce seminal vesicle (which secretes semen) → forms ejaculatory duct → pierces prostatic urethra
19
Q
Prostate
A
- Prostatic urthrea is the widest in young males (but narrows with age as it hypertrophies)
- On the POS wall of prostatic urethra → elevated area = seminal colliculus (Where ejac ducts opens into urethra)
- Prostatic sinus (where semen comes in) on seminal colliculus
- Prostatic duct drains into urethra through prostatic sinus
20
Q
Lobes of the prostate
A
- Median
- May be enlarged with age → projects into bladder → obstructs outlet of bladder
- L & R LAT lobes
21
Q
Capsule of prostate
A
- Contains BS and NS
- Pudendal N - responsible for erectile function in males and females
- Susceptible to injury in procedures involving removal of prostate gland (i.e. for prostatic cancer)
- 40% will involve in some loss of control following prostate surgery
22
Q
Function of the bulbourethral gland
A
- Bulbourethral gland = mucus secretions
23
Q
Rectovesical septum
A
- Lies behind prostate, has fascial layer → protective of infection & cancer cells to prevent or slows passage of cancer cells (an embryological structure)
24
Q
Zones of prostate
A
- Transition zone:
- Site of benign prostatic hypertrophy/hyperplasia
- Encroaches on the urethra
- Peripheral zone:
- Area for prostatic cancer zones
25
Q
Penis
A
- Made up of cavernous tissues
- Corpora caveronsa (vascular spaces)
- Contains the erectile tissues which is filled with blood during erection
- The erect position of penis = anatomical position
- Originate from the bulb (root of the penis)’
- Corpus spongiosum
- Also have cavernous tissues (Contributes to erectile state)
- Spongy(penile) urethra passes through it
- Glands of penis = glands
- Corpora caveronsa (vascular spaces)
- Prepuce = foreskin
- Inside of prepuce very sensitive to AIDS
26
Q
Navicular fossa
A
- Navicular fossa in male penis
- Dilation distal to the opening narrowing
- Navigating pelvic floor and urthrea is the tricky part
27
Q
Fascia of the penis
A
- Erection surrounded by fascia
- Dartos fascia (superficial)
- Deep penile fascia (Deep)
