Lecture 21-22 Female Flashcards

1
Q

What are the subdivisions of the broad ligament (4)

A

Mesometrium
Mesosalpinx
Mesovarium
Suspensory ligament of the artery

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2
Q

What is the anatomical position of the broad ligament

A

Lateral pelvic wall to the sides of the uterus

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3
Q

What are the two ligaments derived from the gubernaculum

A

Ovarian ligament

Round ligament

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4
Q

The round ligament is a continuation of the ovarian ligament true or false?

A

True

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5
Q

What does the ovarian ligament span?

A

Median pole of ovary to the upper uterus - below the entry of uterine tubes

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6
Q

Where does the round ligament span?

A

Lateral sides of upper uterus to the deep inguinal ring, through the inguinal canal to mons and labium majora.

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7
Q

What is the round ligament accompanied with in the inguinal canal?

A

Blood vessels, nerves and lymph vessels which empty into superficial inguinal nodes

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8
Q

What does the anterior ligament join?

A

Bladder to cervix in the uterovesicular fold

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9
Q

What does the posterior ligament join?

A

Rectum to posterior fornix in the rectovaginal fold

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10
Q

What are the lateral edges of the posterior ligament?

A

Uterosacral ligaments

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11
Q

What do the transverse/cardinal cervical ligaments join?

A

Sides of the cervix and vault of the vagina to the lateral wall of the penis

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12
Q

How long is the ovary approximately?

A

3cm

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13
Q

Where are the ovaries located?

A

The ovarian fossa adjacent to the lateral wall of pelvis.

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14
Q

What is the ovarian fossa?

A

A shallow indentation between the lateral attachment of the broad ligament anteriorly, the ureter and internal iliac vessels posteriorly.

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15
Q

What are the surfaces of the ovary? (4)

A
Mesovarian (anterior)
Free border (posterior)
Tubal extremity (superior)
Uterine extremity (inferior)
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16
Q

What is the hilum of the ovary?

A

Where vessels enter the ovary from the suspensory ligament

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17
Q

Which structures anterior to the ovary curve around it?

A

The ampulla and infundibulum of uterine tubes

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18
Q

What does the ovary consist of internally?

A

Inner vascular medulla and an outer cortex with ovarian follicles.

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19
Q

What do ovarian follicles contain?

A

An ovum and surrounding supporting endocrine cells.

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20
Q

Several follicles develop each cycle and are ovulated true or false?

A

False, just one

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21
Q

What do more mature follicles accumulate?

A

A viscous fluid (antral fluid) in an internal cavity or antrum

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22
Q

When is the intact surface of the ovary broken?

A

During ovulation

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23
Q

Where does the ovum go following ovulation?

A
  1. Collection by the fimbrae of the uterine tube, by a combination of ciliary action and muscular contractions
  2. Ovum + supporting cells transported to the ampulla of the uterine tube where either fertilisation occurs or ovum degerenates
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24
Q

Where does fertilised ovum go?

A

Transported through the isthmus and intramural of the uterine tube and into uterus where implantation occurs. The supporting cells degenerate shortly after fertilisation

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25
Q

What do the endocrine cells of the follicle produce prior to ovulation and what to they become following ovulation?

A

Oestrogen

Corpus luteum which produces progesterone

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26
Q

What is superior to the ovary?

A

External iliac vessels

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27
Q

What are posterior to the ovary?

A

Internal iliac vessels and ureter

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28
Q

The entire uterine tube is anterosuperior to the ovary true or false?

A

False, the infundibulum is lateral

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29
Q

How long are the uterine tubes?

A

10cm

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30
Q

What are the uterine tubes attached to?

A

The upper margin of the broad ligament

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31
Q

The uterine tubes are open at both ends true or false?

A

True

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32
Q

What are the four regions of the uterine tubes?

A

Infundibulum with folds (fimbrae), ampulla, isthmus, intramural

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33
Q

What are the 3 layers of the uterine tube?

A

Mucosa, smooth muscle and serosa (peritoneum)

34
Q

There are glands in the elaborately folded uterine tube mucosa true or false?

A

False

35
Q

What cells do the epithelium lining the uterine tube consist of? What do they do

A

Ciliated cells - move the ovum

Secretory cells - produce nutritive fluid to maintain the ovum

36
Q

Where may vestigial structures in the form of tubules or cysts (remnants of mesonephric ducts) occur

A

Mesosalpinx and also other parts of the broad ligament and in the walls of the uterus, cervix and vagina

37
Q

Where does the uterus lie?

A

Between the bladder and rectum

38
Q

What direction is the uterus in 80% of women

A

Anteverted (tilted forward with respect to both cervix and vagina)

39
Q

What direction is the uterus in 20% of women

A

Retroverted

40
Q

What occurs to the direction of the uterus as the bladder fills?

A

It becomes more vertical

41
Q

What are the three regions of the uterus?

A

Fundus (above entry of tubes), body and cervix

42
Q

What are the three layers of the uterus?

A

Endometrium (specialised mucosa containing uterine glands)
Myometrium (smooth muscle)
Serosa (continuous with peritoneum)

43
Q

What changes occur to the uterus during pregnancy?

A

The wall thins
Muscle cells hypertrophy
Abdominal organs are displaced - fundus reaches epigastric region by 8th month of pregnancy

44
Q

What are the two layers of the endometrium

A

Functionalis

Basalis

45
Q

Which layer of the endometrium is sloughed at menstruation?

A

Functionalis

46
Q

The functionalis and basalis share blood supplies true or false?

A

False

47
Q

What are the four phases of the menstrual cycle?

A

Menstrual Phase
Proliferative Phase
Ovulation
Secretory phase

48
Q

What occurs during the menstrual phase?

A

Shedding of the functionalis as a result of declining progesterone levels as corpus luteum ceases functioning

49
Q

What occurs during the proliferative phase?

A

Regeneration of a new functionalis under the influence of oestrogen form the developing ovarian follicles

50
Q

What occurs during ovulation?

A

High levels of oestrogen which in turn causes a surge of pituitary hormone luteinising hormone (LH)

51
Q

What occurs during the secretory phase?

A

The endometrial glands secrete a nutritive fluid which will support a blastocyst should fertilisation have occurred. If there is fertilisation, the corpus luteum degenerates.

52
Q

What does degeneration of the corpus luteum result in?

A

A sharp decline in levels of circulating progesterone which affects the blood vessels supplying the functionalis which subsequently breaks down.

53
Q

What is the shape of the cervix compared to the uterus?

A

Narrower, more cyclindrical

54
Q

What are the anterior and lateral sides of the cervix embedded in? Posterior side?

A

Pelvic fascia

Peritoneum which is part of the lining of the rectouterine pouch

55
Q

What is the name of the groove around the opening of the cervix?

A

Fornix

56
Q

What are the 2 regions of the cervix

A

Endocervix and ectocervix

57
Q

What are enlarged cervical glands called?

A

Nabothian cysts

58
Q

What are the 2 layers of the cervix + 3rd posteriorly

A

Mucosa, muscle and peritoneum posteriorly

59
Q

The mucosa of the cervix is involved in menstruation true or false?

A

False

60
Q

What is the endocervix

A

Simple columnar epithelium lining plus mucous producing glands

61
Q

What is the ectocervix

A

Stratified epithelium lining, protrudes into the vault of the vagina

62
Q

Where does the vagina extend over?

A

Vault to vestibule

63
Q

What is the orientation of the vagina

A

Posterosuperiorly

64
Q

What is the lumen of the vagina like?

A

H-shaped with opposing walls touching except at the vault

65
Q

All the sides of the vagina are embedded in pelvic fascia true or false?

A

False, the posterior vault faces the rectouterine pouch

66
Q

What is the origin of the ovarian artery?

A

Abdominal aorta

67
Q

What is the path of the ovarian artery?

A

Descends on psoas, crosses external iliac artery at pelvic brim, enters suspensory ligament and divides into ovarian and uterine tube branches

68
Q

There anastomoses between contralateral uterine and vaginal branches of the internal iliac artery true or false?

A

True

69
Q

What does the pampiniform plexus form in the suspensory ligament

A

2 ovarian veins

They then join to form single ovarian vein to empty on right into IVC and on left into left renal vein

70
Q

What is the venous drainage of the uterine tube

A

Lateral 1/3 to ovarian veins

Medial 2/3 to uterine veins

71
Q

How are the lymph vessels drained? (8)

A

To the internal and external iliac nodes, rectal and sacral, superficial inguinal, aortic and preaortic

72
Q

How are the uterus and vagina drained?

A

Uterine and vaginal plexuses -> uteirne and vaginal veins -> internal iliac vein

73
Q

What are the six components of the female external genitalia

A

Mons, labia majora, labia minora, clitoris, vaginal orifice, urethral orifice

74
Q

What are the labia majora separated with?

A

Pudendal cleft

75
Q

What are the labia minora

A

Folds on either side of the vaginal and urethral openings

76
Q

What are the superior and inferior sides of the labia minora called

A

Prepuce

Frenulum

77
Q

Where does the urethral orifice lie?

A

Between vaginal orifice and clitoris

78
Q

What does the internal pudendal artery supply

A

Labia, bulb and clitoris

79
Q

What do the labia minora anteriorly split to enclose

A

The clitoris.

80
Q

What are the labia majora joined at

A

Anterior and posterior commissures