Mid Unit Review

Question 1

Whats the function of the pelvic floor

Answer 1

• support pelvic organs
• maintain intra abdominal pressure
• facilitate defaecation
• maintain urinary and faecal continence
• facilitate birth

Question 2

What do the cardinal ligaments support?

Answer 2

Hold the cervix and upper vagina in place

Question 3

What do the uterosacral ligaments support?

Answer 3

Hold the back of the cervix and the upper vagina laterally

Question 4

What does the round ligament support?

Answer 4

Maintain the antverted position of the uterus

Question 5

What are the 3 mechanisms of support of the pelvic floor?

Answer 5

1) suspension>vertical support working against gravity
2) attachment> important in maintaing urinary continence
3) fusion> supports lower half of vagina

Question 6

What provides attachment to pelvic floor

Answer 6

• arcus tendinosus fascia ‘white line’

- endpelvic fascia stretched from white line to the vaginal wall (like a hammock)

Question 7

Lower half of the vagina is supported by?

Answer 7

Fusion of the vaginal endopelvic fascia to the perineal body posteriorly, the levator ani laterally and urethra anteriorly

Question 8

All pelvic floor muscles join and insert where?

Answer 8

All muscles join and insert at perineal body

Question 9

General composition of pelvic floor

Answer 9

• levator ani muscles
• urogenital diaphragm/perineal membrane
• perineal body
• perineal muscles
• posterior compartment

Question 10

Whats the blood/ nerve supply to the pelvic floor

Answer 10

Internal and external pudendal arteries

Branches of pudendal nerve (derives its fibrs from the 2/3/4 sacral nerve)

Question 11

Whats the lymphatic drainage of the pelvic floor

Answer 11

Via the inguinal lymph nodes

Question 12

What is the anatomical point of insertion fo the levator ani muscles?

Answer 12

Perineal body

Question 13

What superficial muscle acts as an additional support for the vagina?

Answer 13

Bulbospongiosus

Question 14

Which structure is responsible for maintaining faecal continence?

Answer 14

Puborectalis

Question 15

Which nerve supplies the muscle responsible for the patients incontinence?

Answer 15

Pudendal nerve

Question 16

Whatre the similarities between the development of the reproductive tracts

Answer 16

• germ cells migrate and drive development of the gonad
• gonads descend
• duct system forms internal genitalia

Question 17

Whats the inital step of the development of the reproductive tract?

Answer 17

Same for M and F

Primordial germ cells migrate along retroperitoneum to the gonad at the urogenital ridge

Question 18

Whats Congenital adrenal hyperplasia? Symptoms?

Answer 18

• enlargement of adrenal gland
  Often involved in deficiency of 21 hydroxylase
  Los of aldosterone and cortisol from cortex. No subsequent loss of testosterone.
  > drives the ambiguous genitalia.

Symptoms:

• lethargic
• loss of weight (due to dehydration. Aldosterone loss. Salt inbalance)
• ambiguous genitalia

Question 19

What are the stages of the ovarian cycle

Answer 19

Follicular -1st half

Luteal= second half of menstrual cycle

Question 20

What are the stages of the uterine cycle?

Answer 20

Proliferative= 1st half

Secretory=2nd half menstrual cycle

Question 21

Why is there low levels of oestrogen at the start of menstrual cycle?

Answer 21

To prevent negative feedback on pituitary gland and hypothalamus

Question 22

A surge of what cause ovulation

Answer 22

LH

Question 23

What is released in large amounts by the corpus luteum?

Answer 23

Progesterone

Also produces oestrogen BUT in lesser amounts

Question 24

Syncytiotrophoblast releases?

Answer 24

B-hCG

Beta

Question 25

Which phase corresponds with the secretory phase?

Answer 25

Luteal phase

Question 26

Production of testosterone by the leydig cells is stimulated by?

Answer 26

LH

Question 27

Pregnancy test

Answer 27

B-hCG