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OB Review for Oral Revalida > Maternal anatomy > Flashcards

Maternal anatomy Flashcards

1
Q

importance of langer lines

A

They describe the orientation of dermal fibers within the skin.

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2
Q

langer lines in the anterior abdominal wall are arranged

A

transversely

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3
Q

Pfannenstiel is a

A

low transverse incision that follows the langer lines of the anterior abdominal wall

which leads to superior cosmetic results

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4
Q

the subcutaneous layer of the anterior abdominal wall can be separated into

A

Camper fascia - superficial fatty

Scarpa -deeper membranous

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5
Q

campe fascia continues onto the perineum to provde fatty substance to the

A

mons pubis and labia majora and then bled with the fat of the ischioanal fossa

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6
Q

Scarpa fascia continues inferiorly onto the perineum as

A

colles fascia

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7
Q

Importance of scarpa’s fascia

A

perineal infection or hemorrhage superficial to colles fascia has the ability to extend upward to involve the superficial layers of the abdominal wall

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8
Q

anterior abdominal wall consist of the

A 
midline rectus abdominis
pyramidalis muscles
external oblique
internal oblique
transversus abdominis muscles
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9
Q

what form the primary fascia of the anterior abdominal wall

A

fibrous aponeuroses of external oblique, internal oblique and transversus abdominis

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10
Q

fibrous aponeuroses of external oblique, internal oblique and transversus abdominis
fused in the

A

midline at the linea aba

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11
Q

linea alba measures

A

10-15 mm wide below the umbilicus

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12
Q

abnormally wide separation at the linea alba may reflect

A

diastasis recti or hernia

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13
Q

the three aponeuroses also invest the rectus abdominis as

A

rectus sheath

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14
Q

the construction of the rectus sheath varies above and below a boundary called

A

arcuate line

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15
Q

cephalad to the arcuate line

A

the aponeuroses invest the rectus abdomnis bellies on both dorsal and ventral surfaces

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16
Q

caudal to te arcuate line

A

all aponeuroses lie ventral or superficial to the rectus abdominis muscle

only the thin transversalis fascia and peritoneum lie beneath the rectus

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17
Q

originate from the public crest, insert into the linea alba

lie atop the rectus abdominis muscle, but beneath the anterior rectus sheath

A

pubic crest

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18
Q

These vessels supply the skin and subcutaneous layers of the anterior abdominal wall

A

superficial epigastric
superficial circumflex iliac
superficial external pundendal

SE + SCI + SEP arteries

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19
Q

superficial epigastric
superficial circumflex iliac
superficial external pundendal

SE + SCI + SEP arteries
aries from the

A

femoral artery

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20
Q

superficial epigastric
superficial circumflex iliac
superficial external pundendal

SE + SCI + SEP arteries

aries from the femoral artery in this area

A

just below the inguinal ligament

within the femoral triangle

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21
Q

from their origin, course diagonally toward the umbilicus

with incision, identified at a depth halfway between skin and anterior rectus sheath, above scarpa fascia, several centimeters from midline

A

superficial epigastric vessels

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22
Q

inferior “deep” epigastric vessels
and
deep circumflex iliac vessels

IDE, DCI

are branches of the

A

external iliac vessels

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23
Q

supply the muscles and fascia of the anterior abdominal wall

A

inferior “deep” epigastric vessels
and
deep circumflex iliac vessels

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24
Q

what incision may lacerate inferior epigastric artery during muscle transection

A

Maylard incision during cesarean delivery

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25
Q

what happens when an inferior epigastric artery ruptures following abdominal trauma

A

rectus sheath hematoma

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26
Q

Hesselbach triangle bounded

A

laterally by - inferior epigastric vessels
inferiorly - inguinal ligament
medially- lateral border of rectus muscle

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27
Q

Hernias the protrude through the abdominal wall in Hesselbach triangle are termed

A

direct inguinal hernias

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28
Q

indirect inguinal hernias protrude through the

A

deep inguinal ring

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29
Q

deep inguinal ring lies ____ to the hesselbach triangle

A

lateral

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30
Q

the anterior abdominal wall is innervated by

A 
intercostal nerves (T7-11)
subcostal nerve (T12)
iliohypogastric
ilioinguinal nerves (L1)
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31
Q

what is the transversus abdominis plane

A

the intercostal and subcostal nerves (anterior rami of thoracic spnal narves)

run along lateral then anterior abdominal wall between the transveres abdominis ad internal oblique muscles

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32
Q

why is there a risk of severing intercostal and subcostal nerves during a pfannenstiel incision

A

because these nerves (intercostal and subcostal nerves) pierce the posterior sheath, rectus muscle and then anterior sheath to reach the skin.

they may be severed dat the point in which the overlying anterior rectus sheath is separated from the rectus muscle

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33
Q

iliohypogstric and ilioinguinal original from the anterior ramus of the

A

first lumbar spinal nerve

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34
Q

iliohypogastric and ilioinguinal nerves emerge lateral to this muscle

A

psoas muscle

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35
Q

emerge lateral to the psoas muscle, travel retroperitoneally across the quadratus lumborum

inferiomedially toward the iliac crest

A

iliohypgastric and ilioinguinal nerves

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36
Q

near the iliac crest the iliohypogastric and ilioinguinal nerves pierce the

A

transversus abdominis musle and course ventrally

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37
Q

IH and II

at a site 2-3 cm medial to aSIS, the nerves pierce this muscle

A

internal oblique muscle and course superficial to it toward the midline

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38
Q

perforates the external oblique aponeurosis near the lateral rectus border to provide sensation to the skin over the suprapubic area

A

iliohypogastric nerve

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39
Q

superficial inguinal ring formes by splitting of

A

external abdominal oblique aponeurosis fbers

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40
Q

this nerve supplies the skin of mons pubis, upper labia majora, and medial upper thigh

A

ilioinguinal nerve

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41
Q

these nerves can be severed during a low transverse incision or entrapped during closure, especially if incisions extend beyond the lateral borders of rectus musle

A

ilioinguinal and iliohypogastric nerves

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42
Q

injury to ilioinguinal and iliohypogastric leads to

A

loss of sensation within the areas supplied (skin of suprapubic area, mons pubis, upper labia majora, medial upper thigh)

rarely chronic pain may develop

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43
Q

dermatome that approximates the level of the umbilicus

A

T10 dermatome

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44
Q

regional anesthesia for CS delivery or for puerperal sterilization ideally blocks at what dermatomal levels

A

T10- L1 levels

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45
Q

can provide broad blockade to the intercostal and subcostal nerves

A

transversus abdominis plane block

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46
Q

block that may be placed postcesarean to reduce analgesia requirements

A

transversus abdominis plane

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47
Q

pudendsa commonly designated as the

A

vulva

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48
Q

pundenda (vulva) includes

A

all structures visible externally from the symphysis pubis to the perineal body

  1. mons pubis
  2. labia major
  3. labia minora
  4. clitoris
  5. hymen
  6. vestibule
  7. urethral opening
  8. greater vestibular or bartholin glands
  9. minor vestibular glands
  10. paraurethral glands
49
Q

mons pubis aka

A

mons veneris

50
Q

fat filled cushion overlying the symphysis pubis

A

mons pubis

51
Q

after puberty the mons pubis is covered by curly hair that forms the

A

escutcheon

52
Q

labia majora is homologous with the

A

scrotum

53
Q

round ligaments terminate at the

A

upper borders of the labia majora

54
Q

labia majora are contiguous superiorly with the

A

mons pubis

55
Q

posteriorly the labia majora taper and merge into the area overlying the perinel body to form the

A

posterior commisure

56
Q

glands abundant in the labia majora

A

apocrine, eccrine, sebaceous glands

57
Q

labium minus is homogous to

A

ventral shaft of penis

58
Q

the lower lamellae of the labia major fuse to form the

A

frenulum of the clitoris

59
Q

the epithelia of the labia minor is covered by keratinized stratified squamous epithelium up to this demarcating line

A

hart line -medial to this is nonkeratinized squamous epithelium

60
Q

labia minor contains this glands

A

sebaceous glands

61
Q

principal female erogenous organ

A

clitoris

62
Q

erectile homologue of the penis

A

clitoris

63
Q

clitoris is composed of a

A

glands, corpus, 2 crura

64
Q

usually less than 0.5 cm in diameter, is covered by stratified squamous epithelium, and is richly innervated.

A

glans

65
Q

clitoral body contains

A

2 corpora cavernosa

66
Q

clitoral blood supply stems from the

A

internal pudendal artery (deep artery)

67
Q

supplies the clitoral body

A

deep artery of the clitoris (internal pudendal)

68
Q

suplies the glands and prepuce

A

dorsal artery of the clitoris (internal pudendal artery)

69
Q

this is the functionally mature female structure derived from the embryonic urogenital membrane

A

vestibule

70
Q

almond shaped area enclosed by the hart line (laterally)

and external surface of the hymen (medially)

A

verstibule

71
Q

largest paraurethral glands

A

skene glands

72
Q

6 openings of the vestibule

A

urethra, vagina, 2 bartholin gland ducts, 2 ducts of skene glands

73
Q

posterior portion of the vestibule between the fourchette and vaginal opening is called

A

fossa navicularis

74
Q

fossa navicularies is usually observed only in

A

nulliparas

75
Q

bartholin glands position

A

5 and 7 o clock

76
Q

are a collective arborization of glands whose multiple small ducts open predominantly along the entire inferior aspect of the urethra

A

paraurethral glands

77
Q

2 largest paraurethral glands

A

skene glands

78
Q

inflammation and duct obstruction of any of the paraurethral glands can lead to

A

urethral diverticulum formation

79
Q

__ part of urethra lie immediately above the anterior vaginal wall

A

lower 2/3 of urethra

80
Q

adequate pelvis

A

inlet:
1. diagonal conjugate - sacral promontory not accessible > = 11.5 cm

midpelvis

  1. ischial spines not prominent
  2. pelvic side walls not convergent
  3. sacrum curved

outlet

  1. intertuberous diameter >8 cm
  2. subpubic arch >90
81
Q

is a rare malformation in which the vaginal orifice is occluded completely causing retention of the menstrual blood

A

imperforate hymen

82
Q

over time the hymen transforms into severall nodules termed as

A

hymeneal or myrtiform caruncles

83
Q

anteriorly, the vagina is separated from the bladder and urethra by a connectie tissue called

A

vesicovaginal septum

84
Q

posteriorly , between the lower portion of vagina and rectum is this connective tissue

A

rectovaginal septum

85
Q

upepr 4th of vagina is separated from the rectum by

A

rectouterine pouch or cul-de-sac or pouch of Douglas

86
Q

vaginal lining is composed of

A

nonkeratinized stratified squamous epithelium and underlying lamina propria

87
Q

vagina is lubricated by

A

a transudate that originates from the vaginal subepithelial capillary plexus

88
Q

vaginal blood supply

A

proximal portion- cervical branch of uterine artery and by

vaginal artery

89
Q

vaginal artery arise from

A

uterine or inferior vesical or directly from internal iliac artery

90
Q

contributes supply to the posterior vaginal walld

A

middle rectal artery

91
Q

the distal vaginal walls receive blood supply from

A

internal pudendal artery

92
Q

diamond-shapred area between the thighs

A

perineum

93
Q

Perineum has boundaries that mirror those of the

A

pelvic outlet:

anterior - pubic symphysis
anterolaterally- ischiopubic rami and ischial tuberosities
posterolaterally - sacrotuberous ligmanets
posteriorly- coccyx

94
Q

this arbitarary line that divides the perineum is based on this landmark

A

ischial tuberosities

95
Q

anterior triangle also called

A

urogenital triangle

96
Q

posterior triangle

also called

A

anal triangle

97
Q

is a fibromuscular mass found in the midline at the junction between anterior and posterior triangles

A

perineal body

98
Q

central tendon of perineum

A

perineal body

99
Q

Anterior triangle is divided into superficial and deep spaces by the

A

perineal membrane

100
Q

perineal membrane previously known as the

A

inferior fascia of the urogenital diaphragm

101
Q

this muscle helps maintain clitoral erection by compressing the crus to obstruct venous drainage

A

ischiocavernosus muscle

102
Q

this muscles constrict the vaginal lument and aid in release of secretions from the bartholin glands

A

bilateral bulbocavernosus muscles

103
Q

they contribute to clitoral erection by compressing the deep dorsal vein of the clitoris

A

bulbocarvernosus

104
Q

pull the clitoris downward

A

bulbocavernosus and ischiocavernosus

105
Q

embryologically the vestibular bulbs correspond to ___ of penis

A

corpora spongiosa

106
Q

pelvic diaphragm is composed of

A

levator ani

and coccygeus muscle

107
Q

levator ani is composed of

A

pubococcygeus
puborectalis
iliococcygeus

108
Q

pubococcygeus also termed

A

pubovisceral

109
Q

pubococcygeus is subdivided based on points of insertion

A

pubovaginalis
puboperinealis
puboanalis

110
Q

vaginal birth conveys significant damage to levator ani

of this ____ is more commonly damaged

A

pubovisceral

111
Q

risk after vaginal birth damage to levator ani

A

pelvic organ prolapse or urinary incontinence

112
Q

clinically, injury to the vessels in the posterior triangle can lead to hematoma formation in the

A

ischioanal fossa

113
Q

this distal continuation of the rectum begins at the level of the kevator ani attachment to the rectum and ends at the skin

A

anal canal

114
Q

anal canal mucosa consists of columnar epithelium in the uppermost, but at this boundary stratified squamous epithelium begins an continues to the anal verge

A

dentate or pectinate line

115
Q

anal cushions (submucosl arteriovenous plexuses) aid in

A

complete closure of the canal and fecal continence

116
Q

external hemorrhoids receive sensory innervation from the

A

inferior rectal nerve

117
Q

internal hemorrhoids are those that form above the dentate line and covered by

A

insensitive anorectal mucosa

118
Q

two sphincters surround the anal canal to provide fecal continence

A

external and internal anal sphincters

OB Review for Oral Revalida (1 decks)

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