Lecture 20 RH Flashcards
Where do the ovaries initially develop?
Ovaries develop from non-differentiated gonads on posterior wall between abdomen and the pelvis and descend with the assistance of the gubernaculum
What is the post developmental structure that forms from the gubernaculum?
Round ligament of the uterus and ligament of ovary to the labia majora.
What is an imperfect descent in relation to the ovary?
Ovary may reside higher up in the abdominal cavity or too low into the inguinal canal or the labia majora. This is known as an imperfect descent of the ovary.
What is the function of the ovaries?
Has both exocrine and endocrine roles (oestrogen and progesterone +relaxin)
What is the function of relaxin?
relaxation of pelvic ligaments so that baby can pass through birth canal.
Why is the result of diseases relating to the ovary and where is the pain referred to?
Inflammation or cancer of the ovary would cause impingement of obdurator nerve and this causes referred pain to the medial thigh
Where exactly are the ovaries located?
ovaries lie approximately on the posterior pelvic wall at the horizontal plane. It can be palpated at that position.
*between pubic symphysis and coccyx is the horizontal plane.
How are the ovaries held in place?
ovaries are held by peritoneal folds that form the broad ligament
What structure within the broad ligament provides the support of the pelvic viscera?
broad ligament support is provided by the blood vessels contained within it.
How are the ovaries attached to the broad ligament?
Broad sheet above the pelvic viscera is the broad ligament. This ligament is attached to ovaries via the mesovarium.
What is the function of the the suspensory ligament?
suspensory ligament contains the blood vessels to the ovaries and it provides support to the ovaries as well..
Where does the ovary typically prolapse into and why does this happen?
ovary may prolapse into rectouterine pouch (posterior fornix) due to the laxity of the support.
What are the main parts of the uterine tubes?
Intramural part
Isthmus
ampulla
infundibulum
Fimbria
What is the intramural part of the uterine tubes?
The most medial part of the uterine tube found at the wall of the uterus at the uterine OS (opening) and is very narrow.
What does the isthmus look like?
Isthmus is the straightest part of the uterine tube
What is the ampulla?
Widest and longest part of the uterine tube and is the part of the uterine tube where the sperm meets the egg
What is the infundibulum?
infundibulum is the first portion of the uterine tube and conveys the egg into the ampulla.
How does the egg move through the uterine tubes?
ciliary action and peristalsis
Why is it that infection of the vagina can spread into the peritoneum?
Uterine tubes open into the peritoneal cavity and the opening is known as the abdominal os. Infection can travel from the vagina into the peritoneum via this pathway.
What is the function of the fimbriae?
They waft the ovary into the uterine tube (infundibulum). It also holds the ovary to the uterine tube.
What is an ectopic pregnancy?
ectopic pregnancy occurs when ova are released into the peritoneal cavity and implantation typically occurs in the ampulla resulting in rupture of the walls and is typically life threatening.
What are the sections of the uterus?
Fundus
body
cervix
Where do the uterine tubes meet the uterus?
uterine tubes connect with uterus at the point where the fundus meets the uterine body.
At what level is the uterus up to during pregnancy?
endometrial lining gets thicker and wall of the uterus.
Pregnant uterus rises above pelvic lining into the abdomen.
at about 3 months it reaches the suprapubic level.
At about 6 months it is at the iliac crest
At 8 months it is at the xiphisternum
What are the parts of the cervix?
Supra vaginal part
Vaginal part
What is the normal positioning of the uterus?
posterior to the bladder and anteflexed above the bladder.
What causes variations in position of the uterus and ovaries relative to the vagina?
laxity in the mesovarium and the broad ligament
What are the supports that hold the uterus in place?
Cervix (uterus is best supported at the cervix.)
The levator ani
The broad ligament
lateral transverse cervical ligament
Uterosacral ligament
Pubocervical ligament
What is the result of laxity in uterine supports?
Laxity can result in prolapse.
Do males have peritoneum
Male also has peritoneum covering bladder and anterior part of the rectum.
What are the pouches formed by the peritoneal folds over the pelvic viscera?
rectouterine pouch (ovary can prolapse into this pouch)
uterovesical pouch
What blood vessels supply the ovary and the uterus?
Ovary gets its blood supply from ovarian vessels and uterus from uterine and vaginal arteries.
What are the parts of the vagina?
Upper part above pelvic floor and a lower part below pelvic floor within the perineum.
How is the vagina held in position?
Vagina is held in position by elements of the floor of the pelvis and the componenets that come from the pelvic floor. This includes a muscles called the pubovaginalis and the urethrovaginal sphincter.
What are the sphincters of the vagina?
pubovaginalis which arises from pubococcygeus.
urethrovaginal sphincter found within the perineum
bulbospongiosus found within the perineum
How is the penis attached to pelvic viscera?
Penis attaches to perineal structures even though the urethra passes from the pelvic cavity to the exterior.
What structures encapsulate the testis?
Testis is encapsulated by fibrous connective tissue:
White inner coat is the tunica albuginea and the serous membrane is the tunica vaginalis. These structures form a closed peritoneal sac with visceral and parietal layers.
How do the testis descend from the posterior abdominal wall during development?
Gubernaculum guides the testis into the scrotal sac. Left is often lower than the right due to the length of the blood vessels to the testis.
What condition causes undescended testis?
Often the testis do not descend all the way into the scrotum and this causes a condition called cryptorchidism
What structures form the scrotum and the spermatic cord’s covering?
skin and outer layer of the external oblique form the scrotum and the other layers create the coverings of the spermatic cord.
What structure does the vas deferans continue into?
Vas deferans widens behind the bladder and meets the seminal vesicle and forms the ejaculatory duct.
How does sperm pass into the urethra?
sperm passing via the vas deferans pass into urethra through prostatic urethra.
Where does the ejaculatory duct meet the prostatic urethra?
Seminal colliculus
Where does semen enter the prostatic urethra?
prostatic sinuses
Where are the secretions of the bulbourethral glands located?
after the prostatic urethra
Where is the neurovascular supply for the prostate located?
prostate contains a capsule with venous and nerve plexuses around the prostate.
What are the lobes of the prostate?
median and lateral lobe
Which lobe of the prostate enlarges during aging?
Median lobe enlarges during aging
Where is the retrovesical septum located?
rectovesical septum is located behind prostate and ahead of the rectum.
What is the function of the retrovesical septum?
rectovesical septum acts as a barrier to cancer and infection (doesn’t entirely prevent movement but does protect.)
