Lecture 2 - Female Repro Flashcards
What structure sits anteriorly to the vagina/uterus?
Bladder
What structure sits posteriorly to the vagina/uterus?
Rectum
What is the external genitals called?
Vulva
Why do women sometimes get sharp pain at ovulation?
The egg bursts out of the ovary at ovulation disrupting the capsule around the ovary
What day is ovulation?
Day 14
Why do nuns commonly get ovarian cancer?
Nuns are celibate so dont use contraception or get pregnant
This means they get the max number of ovulations
This is bad since at every ovulation the capsule gets destroyed which needs to reproliferate which is a risk for ovarian cancer
Why do nuns commonly get ovarian cancer?
Nuns are celibate so dont use contraception or get pregnant
This means they get the max number of ovulations
This is bad since at every ovulation the capsule gets destroyed which needs to reproliferate which is a risk for ovarian cancer
What blood vessels supply the ovaries?
Ovarian vessels
Ovarian artery and ovarian vein
How does the left ovarian vein drain and what is this similar to?
Drains to the left renal vein then into the Inferior vena cava (IVC)
Left testicular vein
What does the right ovarian vein drain into?
Inferior Vena Cava (IVC)
What is an ovarian cyst?
Fluid filled sacs that grow on the ovaries
What is the concern with ovarian cysts?
They are prone to twisting which can lead to loss of blood supply to the ovaries
Ovarian torsion
What are the ways an ovarian cyst may present?
Painless
Painful
Abdominal distension
What is the cervix?
The opening between the uterus and the vagina
What cells line the body of the uterus?
Endometrium
What is the top of the uterus called?
Fundus
What structure joins the uterus to the ovaries?
Fallopian tubes
How does the uterus move when the bladder is full?
Uterus gets pushed up
What is the cervical os?
Opening at ends of cervical canal
What are the fornices/fornix?
Indentations where the vagina bends behind the cervix
What is meant be describing a cervical os as nulliparous?
Hasn’t had a baby passed through it
What does a slip like cervical os indicate?
Likely a baby has passed through it
What is cervical ectropian?
Where the epithelium of cervical canal spreads out likely due to contraception
How can cervical cancer be seen on the cervix?
Areas of haemorrhage
Ulceration
What are some common side effects of pregnancy?
Acid reflux
Constipation
Increased urine frequency
Why do women commonly get acid reflux when pregnant?
Uterus expands pushing the stomach upwards
Why do women commonly get constipation when pregnant?
Rectum gets compressed by the expanding uterus
Why do women commonly get increased urinary frequency when pregnant?
Expanding uterus compresses the bladder
How high up does the uterus expand as the fetus grows?
Grows up to the xiphisternum
This is the cartilaginous tip of the sternum
What are the structures starting with the Fimbriae to the uterus?
Fimbriae -> infundibulum -> Ampulla -> Isthmus -> Uterus
What are the Fimbriae?
Finger like projections at the end of the fallopian tube which sit over the top of the ovary
How are the ovaries and the Fimbriae/fallopian tubes related?
What separates them?
Fimbriae/tubes do not connect to the ovaries they just sit over the top
They are separated by the peritoneal cavity
What is the infundibulum?
The funnel that leads to the tub proper from the Fimbriae
Connects to the ampulla
What is the significance of the ampulla region of the fallopian tubes?
Where fertilisation takes place
Where do ectopic pregnancies most commonly take place?
Ampulla
What is the danger of ectopic pregnancies?
What arteries are at risk?
Tubes cant distend and grow like the uterus, leads to the tubes bursting leading to haemorrhaging from the ovarian artery or uterine artery (connected via anastomoses)
What are the 2 main types of cells lining the fallopian tubes?
Ciliated cells
Peg cells
What is the function of the ciliated cells in the fallopian tubes?
Beat the ovum down to the uterus
What is the function of the peg cells in the fallopian tubes?
Release substances that help keep the sperm going
What area of the uterine tubes open into the peritoneal cavity?
At the Fimbriae
What is the clinical significance of the uterine tubes opening into the peritoneal cavity?
Air can be bubbled through uterine tubes into peritoneal cavity (pneumoperitoneum)
UTIs can spread and lead to infection in the peritoneal cavity
What type of organs with respect to the peritoneum are the pelvic organs?
Subperitoneal organs
(Sit underneath the peritoneum, imagine the peritoneum is like a blanket the is thrown over the top of the organs and it sits in between the gaps )
What is the name of the pouch formed by the peritoneum between the bladder and the uterus?
Vesicouterine pouch
What is the name of the pouch formed by the peritoneum between the uterus and the rectum?
Rectouterine pouch
What are the 4 types of peritoneal ligaments of the uterus and ovary?
Broad ligament
Round ligament
Ovarian ligament
Suspensory ligament
What are the 2 ligaments that are derived from gubernaculum?
Round ligament
Ovarian ligament
What is the suspensory ligament?
Area where the peritoneum gets tented outwards allowing the ovarian vessels and nerves to run to the uterine body
What is the function of the round ligament?
Connects the uterus to the abdominal wall by leading to the Inguinal ring (maintains anteversion)
What is the ovarian ligament?
Connects the ovary to the uterus
What is the broad ligament?
Sheet of folded peritoneum associated with both the uterus and the ovaries
Has 3 parts to it
What are the 3 parts of the broad ligament?
Mesometrium
Mesovarium
Mesosalpinx
What is the mesometrium?
Part of the broad ligament covering the uterus and extending laterally covering the external iliac vessels to the lateral wall
Attactchs uterus to lateral pelvic wall
What is the mesovarium?
Associated with the ovaries by wrapping around their neurovascular supply at the hilum
What is the mesosalpinx?
Surrounds the fallopian tubes acting as a mesentry for the rest of the broad ligament
What branches of artery do the uterine artery and the vaginal artery come from??
Internal iliac artery
What is the round ligament?
Connects the uterus to the anterior abdominal wall by passing through the inguinal canal attaching to the labia majora
What main artery supplies all the abdominal viscera?
Internal iliac artery
What is the angle of AntiVersion?
The angle between the Vagina and the cervix (less than 180 degrees)
If its greater than 180 degrees then its retroVerted
What is the angle of anti Flexion?
Angle between angle of cervix and uterus (less than 180 degrees)
Retroflexed if its greater than 180 degrees
What ligament is responsible for maintaining antiVersion and anti Flexion?
Round ligament
What type of epithelial cells line the vagina?
Why are these cells good?
Stratified squamous epithelium
Need to be able to resist abrasion
What is special about the stratified squamous epithelium lining the vagina?
Have large glycogen granules for lactobacilli to feed on
What is the importance of lactobacilli in the vagina?
They produce lactic acid to maintain an acidic pH preventing the overgrowth of pathogenic bacteria
What is the condition is caught from lack of lactobacilli leading to overgrowth of pathogenic microbes?
Bacterial vaginosis
What are the muscles of the vulva from most inward to outwards?
Labium minus
Labium majus
What is the vestibule of the vulva?
Leads to the vaginal canal
What is Female Genital Mutilation?
When parts or the full vulva are removed (Glans clitoris, labia Majora, labia Minora
What needs to be considered medically in a trans woman?
May have a prostate
Can suffer from symptoms of BPH and/or prostate cancer
Why can pain be felt at the shoulder tip following rupture of an ectopic pregnancy?
Ovum developing in fallopian tube rupture leading to haemorrhaging from the uterine or ovarian artery leading blood in the abdominal cavity,, this can irritate the phrenic nerve of the diaphragm which has the nerve roots C3,C4 and C5 leading to pain around the shoulder
How can a patient with a UTI get peritonitis?
Infection can travel from fallopian tubes through the Fimbriae into the peritoneum
What can happen as a consequence of infection in the fallopian tubes?
Inflammation and scarring/fibrosis which can narrow the tubes
What is endometriosis?
Symptoms:
When ectopici endometrial tissue is dispersed to various sites along the peritoneal cavity
Severe period pain (dysmenorrhoea, infertility)
What are polycystic ovaries?
When the ovaries develop more than 10 cysts often leading to infertility
What lymph nodes does the superior 1/3 of the vagina drain to?
External iliac nodes
What lymph nodes does the middle 1/3 of the vagina drain to?
Internal iliac nodes
What lymph nodes does the inferior 1/3 of the vagina drain to?
Superficial inguinal lymph nodes
What lymph nodes does the inferior 1/3 of the vagina drain to?
Superficial inguinal lymph nodes
What lymph nodes do the ovaries drain to?
Paraortic lymph nodes
What lymph nodes do the ovaries, fundus of the uterus and the fallopian tubes drain to?
Paraarotic lymph nodes
What lymph nodes does the body of the uterus drain to?
External iliac nodes
