L9 - UG HARC 2 Flashcards
1. Anatomy of the female reproductive system, with focus on peritoneal reflections, vasculature and innervation. 2. Anatomy of the male reproductive system: accessory glands, testes and scrotum 3. Understand the formation of the inguinal canal in relation to embryological descent of the gonads: comparison of male and female 4. Describe and distinguish between male and female external genitalia
Where would you find the vesicouterine pouch?
Between bladder and uterus
Where would you find the rectouterine pouch?
key point about this pouch
- Between rectum and uterus.
- Most inferior aspect.
- Point of fluid accumulation.
Uterine tube role (4)
- Receives ovum.
- Fertilisation site commonly ampulla.
- Nourishes fertilised ovum
- and transports it to uterine cavity.
Ovary role (2)
- Production of female germ cells.
- Production of oestrogen and progesterone
Uterus role (3)
Reception, retention and nutrition of fertilised ovum.
What are the two attachments of the ovary?
- Suspensory ligament of the ovary
- ovarian vessels and nerves
- lymphatics - Ovarian ligament
- round ligament
Describe the pathway of the ovum?
5 words
- Fimbriae
- Infundibulum
- Ampulla
- Isthmus
- Intramural
Describe the anatomy of the uterus? (3)
- shape
- approx length
- features
- Pear-shaped
- 7/8cm long
- Has a cervical canal with an internal and external os.
Internal os
- Communicates with the uterine cavity
External os
- Communicates with vaginal canal
- Changes shape post-partum
What is the shape of the external os in post partum women?
Changes from circular to ‘slit like’
Describe the vagina?
surrounds…
extends…
passes through…
- Surrounds cervix.
- Extends between vulva (external genitalia) and uterus.
- Passes through pelvic floor
Describe the position of the vagina?
- Upper half of vagina lies above pelvic floor.
- Lower half below it.
Describe the broad ligament?
- Peritoneum drapes over forming a double layer of peritoneum.
- Encasing structures it covers.
Culdocentesis involves…
- Procedure in which peritoneal fluid obtained from pouch of Douglas.
- Pouch of Douglas AKA Rectouterine pouch.
Give examples of causes of fluid accumulation in the rectouterine pouch?
(2)
- Ectopic pregnancy
2. Peritonitis
Where does the parietal peritoneum line?
Lines the walls of the abdominopelvic cavity
Where does the visceral peritoneum line?
bladder?
Covers the organs.
Bladder is hidden by peritoneal covering.
State the three parts of the broad ligament?
- Mesosalpinx
- Mesovarium
- Mesometrium
What is the name given to the two pouches formed by the draping of the broad ligament?
- Rectouterine
2. Vesicouterine
What is the major artery that gives rise to branches which will supply the female genital tract?
Internal Iliac artery.
State the branches of the internal iliac artery, related to the female reproductive system?
- Uterine a.
- Vaginal a.
- can be a branch of uterine or internal iliac artery.
Where does the ovarian (gonadal) artery originate from?
Abdominal aorta branch.
What is the round ligament? (4)
remnant of…
originates at…
attaches to..
passes through…
- Remnant of the Gubernaculum.
- Originates at uterine horns.
- Attaches to labia majora.
- Passes through inguinal canal.
Uterine horns
Points at which the fallopian tubes enter the uterus.
What are the cardinal ligaments?
- Situated along inferior border of broad ligament.
- House the uterine artery and veins.
What are the two main ligaments that attach to the ovary?
Ovarian ligament.
- connects ovary to side of uterus.
Suspensory ligament.
- extends outwards from ovary to lateral abdominal wall.
What is the function of the suspensory ligament of the ovary
Contains ovarian vessels and nerves.
- ovarian artery
- ovarian vein
- ovarian nerve plexus
- lymphatic vessels
Describe sensory innervation of the vulva
Sensory
- Anterior: Ilioinguinal nerve, branch of genitofemoral nerve
- Posterior: pudendal nerve, branch of posterior cutaneous nerve of thigh
Describe parasympathetic innervation of the vulva?
Uterovaginal plexus
- cavernous nerves
- P.symp innervation for clitoris and vestibule
Ilioinguinal nerve is a branch of the ….
Genitofemoral nerve
Pudendal nerve is a branch of the ….
Posterior cutaneous nerve of the thigh
What delivers both parasympathetic and sympathetic innervation to vagina?
Uterovaginal nerve plexus
What is special about the innervation of the inferior 1/5th of the vagina?
Somatic innervation
via deep perineal nerve which is a branch of the pudendal nerve.
Describe sympathetic innervation of the uterus?
Via uterovaginal plexus.
- anterior and intermediate parts
Describe the parasympathetic innervation of the uterus?
Derived from pelvis splanchnic nerves
s2 - s4
What is the cervix innervated by?
Inferior nerve fibres of the uterovaginal plexus
Describe innervation of Fallopian tubes?
- Symp and parasympathetic
- ovarian and uterine (pelvic plexuses) - Sensory afferents from T11-L1
Male reproductive tract consists of (5)
- Testis
- Epididymus
- Ductus Deferens
- Ejaculatory duct
- Urethra
Describe the pathway of sperm
- Seminferous tubules
- Straight tubules
- Rete testis
- Efferent ductules
- Epididymis
- Ductus Deferens
- Ejaculatory duct
- Urethra
Tunica Albuginea extends into…
- Fibrous septa
Describe the testes and scrotum?
Testes suspended in scrotum by spermatic cord.
- keeps testes 3 degrees lower than body temp for spermatogenesis
Which testes is lower?
Left usually lower, descends first
State, superficial to deep the layers of the scrotum and testes?
- Skin
- Dartos fascia
- External spermatic fascia
- Cremasteric fascia (muscle)
- Internal spermatic fascia
- Tunica Vaginalis (two layers)
- Tunica Albuginea (hidden)
Some damn englishman called it the testis
State the accessory glands
Produce seminal fluid to carry sperm
- Prostate (singular)
- Seminal vesicles (paired)
- Bulbourethral glands (paired)
Describe the structure of the prostate gland?
Inferior to bladder. Five lobes 1. Anterior 2. Posterior 3. Median 4. Lateral 5. Lateral
Which lobe may prostatic cancer be found?
Posterior lobe
Describe the bulbourethral glands?
etc.
found in…
produces…
empties…
- Paired glands.
- Deep perineal pouch.
- Produces pre-ejaculatory fluid
- Empties into spongy urethra.
What are the ductus deferens?
- Muscular tube
- carrying spermatozoa from the testis.
- Primary component of spermatic cord passing in inguinal canal.
What is the major artery supplying the male reproductive system?
Internal iliac artery.
Artery to ductus deferens is a branch of …
branch of superior or inferior vesical arteries
The prostatic arteries are a branch of the …
Inferior vesical arteries
Where is the testicular artery derived from?
- Abdominal aortic branch.
- Travels in spermatic cord in inguinal canal.
Where does the pudendal nerve innervate in the male reproductive system?
what does it supply?
Innervation to the perineum.
Sacral plexus branch.
Supplies
- Ext. urethral sphincter
- Ext. anal sphincter
- Levator ani m.
- Ischiocavernosus m.
- Bulbospongiosus m.
What is the inguinal canal?
- Oblique passage
- through the layers of the abdominal wall in both males and females.
What is the origin of the inguinal canal?
Deep inguinal ring
- opening in transversalis fascia
Where does the inguinal ring terminate?
Opening in external oblique m. aponeurosis
How is the inguinal canal created?
Dragging of structures through the incomplete abdominal wall.
- Processus Vaginalis followed by the gubernaculum.
When do male gonads descend into the scrotum?
By 9 months of development.
Cryptorchidism
Incomplete descent
How far does the female gonad descend
Only as far as the pelvic cavity
Describe formation of the ovarian ligament?
Gubernaculum attached to labioscrotal swelling becomes ovarian ligament and round ligament of the uterus.
What is the perineal body?
- Fibromuscular mass between the two triangles.
- Anchors surrounding musculature.
