MATERNAL ANATOMY Flashcards
arranged transversely, Pfannensteil incision has superior cosmetic results
Langer lines
abnormally wide separation of rectus abdominis muscle
Diastesis Recti
maybe lacerated during a maylardincision during muscle transection(rectus sheath hematoma)
Inferior EpigastricVessels
can be severed during a low segment incision or entrapped during closure
Iliohypogastric and Ilioinguinal nerve
EXTERNAL GENITAL ORGANS
❖Mons pubis ❖Clitoris ❖Urinary meatus ❖Labia majora ❖Labia minora ❖Vestibule ❖Bartholin’sglands ❖Periurethralglands
INTERNAL GENITAL ORGANS
❖Vagina ❖Uterus ❖Cervix ❖Fallopian Tubes ❖Ovaries
❖Pair of cutaneous folds
❖Pigmented with hair, sweat & sebaceous glands
❖Size related to fat content
❖Homologous to scrotum
labia majora
❖Pair of small, red cutaneousfolds
❖Between the labia majora& hymen
❖Fuses anteriorlyto form prepuce of clitoris & inferiorly as its frenulum
❖Dense connective tissue, elastic fibers & sebaceous glands
❖Prominent in children & postmenopausal women
labia minora
Lowest portion of urogenital sinus
Cleft between labia minora
From clitoris to the posterior fourchette
Perforated by 6 openings: Orifices of the urethra, vagina, paraurethralglands & ducts of Bartholin’sglands open into it
With numerous small mucinous glands
VESTIBULE
❖Membranous conduit for urine from the urinary bladder to the vestibule
❖3.5 to 5 cm in length
URETHRA
mucosal lining of Urethra
❖Proximal 2/3
❖Distal 1/3
❖Distal orifice
stratified transitional epithelium
stratified squamous
4-6mm with everted mucosa
❖Paraurethral glands
❖Branched, tubular glands adjacent to the distal urethra
❖Parallel to the long axis of urethra
❖Ducts open into the area just outside the urethral orifice
❖Largest of paraurethral glands
❖Homologous to male prostate
SKENE’S GLAND
❖May be infected ❖Chronic infection-one or more urethral diverticula; ❖symptoms like UTI –Frequency –Urgency –Dysuria
SKENE’S GLAND
❖Vulvovaginal glands at postero ateral aspect of vaginal opening (4:00 & 8:00)
❖Pea-sized pair of lobulated racemous glands
❖Gland of cuboidal epithelium
❖2 cm long ducts are lined by transitional epithelium
❖Ducts open into a groove between hymen & labia minora
BARTHOLIN’S GLAND
labia majora homologues to male
scrotum
labia minora
penile urethra/ skin of penis
clitoris
penis
skene’s glands
prostate
Bartholin’s gland
Cowper’s gland
vestibular bulbs
bulb of penis
- Most common large cystic structure of the vulva
- Cyst may become infected - May develop into abscess
Bartholin’s gland cyst
❖Perforated membrane at the entrance of the vagina
❖Variations in structure & shape
❖Stratified squamous epithelium, fibrous tissue & few small blood vessels
HYMEN
small tags/ nodules of firm fibrous material as remnants in the adult
Carunculae myrtiformes in Hymen
❖Thin-walled, distensible, fibromuscular tube
❖Rugae
❖fornices
VAGINA
pelvic support for middle 3rd of Vagina
levator ani muscles and lower portion of the cardinal ligaments
pelvic support for upper 3rd of Vagina
upper portions of the cardinal ligaments
blood supply of PROXIMAL PORTION of vagina
Vaginal artery-directly from uterine a. or as a branch of the internal iliac artery with anastomosis to cervical branch of uterine artery to form the azygous artery
blood supply of POSTERIOR PORTION of vagina
middle rectal artery
blood supply of DISTAL WALLS of vagina
internal pudendal artery
lymphatic drainage of VAGINA
UPPER 1/3
MIDDLE 2/3
LOWER 3RD
- external, internal and common iliac nodes
- internal iliac nodes
- inguinal lymph nodes
❖Thick-walled, hollow, muscular organ
❖Inverted pear
UTERUS
lower uterine segment
Isthmus
dome-shaped top of uterus
Fundus
❖From the Latin word for neck
❖Shape: cylindrical to conical
❖Consist of fibrous tissue
CERVIX
cervix in nulliparous
Small, regular, oval opening
cervix in parous
the orifice is converted into a transverse slit that is divided into anterior and posterior lip
endocervical canal and glandular structures epithelium
single layer of columnar epithelium
ectocervix epithelium
non-keratinized stratified squamous
In early pregnancy, cervix is vascular and edematous which produces blue tint and softening characteristics called
Chadwick and Hegar signs
Rests in the ovarian fossa of waldeyer
OVARIES
ovarian surface epithelium
single layer of cuboida lepithelium -> germinal epithelium
ovarian histology
Outer cortex
Inner medulla
Extend 8-14 cm from the uterine serosa
FALLOPIAN TUBES
FALLOPIAN TUBES
artery
vein
lymphatic
Arterial: terminal branches of the uterine and ovarian arteries
Venous: runs parallel to the arterial supply
Lymphatic: internal iliac and aortic node
majority of Ectopic pregnancies occur in
FT
in ectopic pregnancies, catastrophic bleeding occurs when the implantation site is in WHAT SEGMENT of the tube
intramural segment of the tube
in female sterilization, where is the preferred site to apply clip
isthmic segment
pelvic ligaments
uterosacral
round
cardinal
Important anastomoses of uterine and vaginal venous plexuses
- Superior rectal v. –> Inferior mesenteric v. –> Portal circulation
- Lateral sacral v. –> Perivertebral plexus venous –> sinuses of the brain
PELVIC INNERVATION arises from what level
T10 - S4
innervates the uterus; this actually the level of the spinal cord which is blocked during epidural anesthesia so that the mother would not feel any pain during labor contractions
T10 –L1
innervates the cervix, vagina and the vulva
S2 –S4
