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OB > OB Broad Perspective and Anatomy of Female Repro > Flashcards

OB Broad Perspective and Anatomy of Female Repro Flashcards

1
Q

Leading cause of women’s death worldwide as of 2013

A

Cardiovascular disease

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2
Q

Leading cause of maternal death in the Philippines

A

Pregnancy related complications

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3
Q

An average of _ among <20 y/o population has already been pregnant at least once

A

22%

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4
Q

No. of times pregnant, regardless of the duration or outcome (how many times have you been pregnant?)

A

Gravida

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5
Q

Delivered before 37 weeks

A

Preterm birth

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6
Q

Number of abortion that took place in the Philippines (2008)

A

500,000

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7
Q

Number of women who sought treatment for complications after abortion

A

90,000

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8
Q

Maternal causes of death in the Philippines

A

Complications related to pregnancy thru labor, delivery, & puerperium (38.4%)

Hypertension (35.2%)

Postpartum hemorrhage/uterine atony (17.3%)

Abortive outcome (9.1%)

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9
Q

Deals with child birth and treatment of the mother before and after childbirth

Deals with pregnancy, labor, & puerperium (6 weeks after childbirth, mother recovers to non pregnant state)

A

Obstetrics

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10
Q

Maternal mortality rate in the Philippines

A

162 deaths per 100,000 live births

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11
Q

Infant mortality rate in the Philippines

A

19.34 deaths per 1,000 live births

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12
Q

External generative tract

A 
Mons pubis
Labia majora and minora 
Clitoris
Hymen
Vestibule
Vagina
Perineum
Bartholin's
Para urethral glands
Uretha
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13
Q

Internal generative tract

A

Uterus
Cervix
Oviducts/Fallopian tubes
Ovaries

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14
Q

Also known as mons veneris
A fat filled cushion
Forming the escutcheon
Contains many nerve endings

A

Mons pubis

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15
Q

Mons pubis

A

Function: padding during coitus

Embryo: from fusion of labioscrotal swellings

Histo: stratified squamous keratinized epithelium

Blood supply: inferior epigastric artery & deep external pudendal artery

Lymphatics: superficial inguinal lymph nodes

Innervation: ilioinguinal & genitofemoral nerves

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16
Q

Innervation of mons pubis

A

Ilioinguinal and genitofemoral nerves

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17
Q

Has rich venous plexus that may develop varicosities during pregnancy due to increased venous pressure by the enlarged uterus

A

Labia majora

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18
Q

Continuos with the mons pubis superiorly

Posteriorly, merge over the perineal body to form the posterior commisure

Round ligaments terminate at its upper border

A

Labia majora

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19
Q

Highly sensitive (coitus)

Homologous with male scrotum

From labioscrotal swellings

A

Labia majora

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20
Q

Blood supply of Labia majora

A

Internal pudendal artery

Venous plexus

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21
Q

Innervation of Labia majora

A

Ilioinguinal & genitofemoral nerves

Posterior labial nerves

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22
Q

Histology of labia majora

A

Keratinized stratified squamous

Apocrine, eccrine, & sebaceous glands

Dense CT with elastic fibers and adipose

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23
Q

Length: 7-8cm
Depth: 2-3cm
Thickness: 1-1.5cm

A

Labia majora

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24
Q

Paired, thin, hairless tissue fold medial to the labia majora

Length: 2-10cm
Width: 1-5cm

A

Labia minora

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25
Q

2 lamellae of the Labia minora

A

Upper: fuse to form prepuce (hood) of clitoris

Lower: frenulum of the clitoris

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26
Q

Fuse in midline as low ridges of tissue called FOURCHETTE

Highly sensitive (coitus)

A

Labia minora

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27
Q

Derived from urethral (urogenital) folds

Homologous to ventral shaft of penis

A

Labia minora

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28
Q

Histology of labia minora

A

Outer: thinly keratinized stratified squamous

Inner: lateral portion same as outer.
Medial to Hart line: non keratinized

Dermis: CT with elastic fibers, sm, and sebaceous glands

Lacks hair follicles, eccrine, and apocrine glands

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29
Q

Blood supply of labia minora

A

Internal pudendal artery and dorsal artery of the clitoris

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30
Q

Lymphatics and Innervation of Labia minora

A

Lymphatics: deep inguinal nodes

Innervation: dorsal nerve of clitoris and post. labial nerve (perineal nerve)

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31
Q

Beneath prepuce & above the frenulum and urethra

Projects downward and inward towards vaginal opening

Length: 2cm

A

Clitoris

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32
Q

Clitoris is composed of

A

Glans (stratified squamous), corpus, and 2 crura

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33
Q

Principal female erogenous organ

A

Clitoris

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34
Q

Derived from genital tubercle

Erectile homologue of the penis

A

Clitoris

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35
Q

Histology of Clitoris

A

Keratinized stratified squamous without dermal appendages

Abundant in erectile tissues

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36
Q

Blood supply of clitoris

A

Deep artery of clitoris (branch of internal pudendal artery) -body of clitoris

Dorsal artery of clitoris - glans and prepuce

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37
Q

Lymphatics of clitoris

A

Deep inguinal nodes

Internal iliac nodes

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38
Q

Innervation of clitoris

A

Inferior hypogastric plexus

Dorsal nerve of the clitoris (from pudendal nerve)

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39
Q

An almond shaped area. Functionally mature female structure

A

Vestibule

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40
Q

Vestibule

A

Laterally: Hart line

Medially: external hymen

Anteriorly: frenulum of clitoris

Posteriorly: fourchette

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41
Q

Posterior portion of vestibule is called

A

Fossa navicularis

  • posterior portion between fourchette and vaginal opening
  • seen only in nulliparas
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42
Q

Six opening of vestibule

A

Urethra
Vagina
2 bartholins
2 skenes

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43
Q

Vestibule is derived from

A

Urogenital membrane

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44
Q

Histology of vestibule

A

Non keratinized stratified squamous

Minor vestibular glands (acini) -mucinous columnar epi

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45
Q

Also known as greater vestibular glands

Major glands measure 0.5-1cm

A

Bartholin glands

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46
Q

Measure 1.5-2cm and open distal to the hymenal ring (at 5 & 7 o’clock position on the vestibule)

A

Bartholin glands

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47
Q

May swell & obstruct to form cyst or abscess (following trauma or infection)

A

Bartholin glands

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48
Q

Lie inferior to vestibular bulbs & deep to inferior end of the bulbocavernousus muscle

A

Bartholin glands

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49
Q

Also known as skene’s glands

Obstruction & inflammation may lead to urethral diverticulum

A

Paraurethral glands

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50
Q

Lower 2/3 lie immediately above vaginal canal

A

Urethra

Length: 2-3cm
Too short that makes female more prone to UTI

51
Q

Upper portion of vagina is separated from the rectum by

A

Cul-de-sac or pouch of Douglas

52
Q

Vagina is anteriorly separated from the bladder and rectum by

A

Vesicovaginal septum

53
Q

Vagina is posteriorly separated from the rectum by

A

Rectovaginal septum

54
Q

Anterior wall: 6-8cm

Posterior wall: 7-10cm

A

Vagina

55
Q

Transport of sperm, serves as birth canal, physiologic changes during arousal (vasocongestion & lubrication)

A

Vagina

56
Q

Embryology of vagina

A

Upper 1/3: Müllerian duct (paramesonephric)

Lower 2/3: urogenital sinus

57
Q

Histology of vagina

A

Epithelial layer: non keratinized stratified squamous
(Premenopausal, lining becomes thin with folds - rugae)

Muscular layer: sm, collagen, & elastin

Adventitial layer: collagen & elastin

No glands

58
Q

Blood supply of Vagina

A

Proximal: cervical branch of uterine artery & vaginal artery

Posterior: middle rectal artery

Distal: internal pudendal artery

Venous plexus

59
Q

Lymphatics of vagina

A

Upper 3rd: external, internal, and common iliac nodes

Middle 3rd: internal iliac nodes

Lower 3rd: inguinal lymph nodes

60
Q

Innervation of upper vagina

A

Uterovaginal plexus

61
Q

Innervation of lower vagina

A

Pudendal nerve

62
Q

Surrounds vaginal orifice

A

Hymen

63
Q

Diamond shaped area with boundaries that mirror those of the bony pelvic outlet

A

Perineum

64
Q

Boundaries of the perineum

A

Anterior: pubic symphysis

Anterolateral: ischiopubis rami & ischial tuberosities

Posterolateral: sacrotuberous ligaments

Posterior: coccyx

65
Q

Fibromuscular mass found in the midline at the the junction between the anterior and posterior triangle of the perineum

A

Perineal body or central tendon of the perineum

Provides perineal support

66
Q

Homologous with male’s corpora spongiosa

A

Vestibular bulbs

67
Q

Contents of superficial space of anterior triangle

A 
Bartholin glands
Vestibular bulbs
Clitoral body and crura
Pudendal vessels and nerves
Ischiocavernosus
Bulbocavernosus
Superficial transverse perineal muscles
Superficial space bounded by Colles fascia and perineal membrane
68
Q

Helps maintain clitoral erection by compressing the crus of clitoris by obstructing venous drainage

A

Ischiocavernosus muscles

69
Q

Constrict vaginal lumen and aid release of secretion from bartholin glands

Contributes to clitoral erection by compressing the deep dorsal vein of the clitoris

A

Bulbocavernosus muscles

70
Q

Contents of deep space of anterior triangle

A

Urethra and vagina
Internal pudendal artery
Urethrae and urethrovaginal sphincter muscles

Deep space is continuous with the pelvic cavity

71
Q

Happens when veins in vestibular bulbs lacerate or even rupture due to child birth

A

Vulvar hematoma

72
Q

Size of uterus in multiparous women

A

9-10 cm

6-8cm in nulliparous

73
Q

Functions of the uterus

A

Implantation
Pregnancy support
Labor and delivery
Menstruation

74
Q

Uterus is derived from

A

Paramesonephric (Mullerian) ducts

75
Q

Histological parts of the uterus

A

Myometrium: sm bundles with elastic fibers and blood vessels

Endomentrium: basalis and functionalis

76
Q

Blood supply of uterus

A

Uterine artery (from int Iliac artery)

Ovarian artery (from aorta)

77
Q

Venous drainage of Uterus

A 
Arcuate veins 
Uterine vein
Int Iliac vein
Common iliac
Veins in pampiniform plexus
Ovarian vein
Rt ovarian vein
Inf vena cava
Left ovarian vein
Left renal vein
78
Q

Lymphatics of uterus

A

Internal iliac nodes and para aortic nodes

79
Q

Innervation of uteus

A

Autonomic - pelvic viscera

Sympa - presacral nerve/ superior hypogastric plexus (T10-12)

Para- anterior rami of S2-4 / pelvic splachnic nerves

80
Q

Components of Inferior Hypogastric Plexus (Pelvic Plexus)

A

2 hypogastric nerves (sympa) + 2 pelvic splachnic nerves (para)

81
Q

3 divisions of inferior hypogastric plexus

A

Vesical - bladder

Middle rectal - rectum

Uterovaginal - uterus, proximal fallopian tubes, and upper vagina

82
Q

Upper cervical segment that lies above the vagina’s attachment to the cervix

A

Portio supravaginalis

83
Q

Cervical segment that protrudes into the vagina

A

Portia vaginalis

84
Q

Fusiform in shape

A

Cervix

85
Q

Serves as opening of the uterus (sperm transport/ barrier & chilbirth)

Attaches the uterus to vagina

A

Cervix

86
Q

Epithelium of endocervix

A

Columnar mucin-secreting epithelium

87
Q

Epithelium of ectocervix

A

Non-keratinized stratified squamous

88
Q

Where squamous and columnar epithelium of the cervix meets

A

Squamo-columnar junction

89
Q

Blood supply of cervix

A

Cervicovaginal artery (from uterine artery)

90
Q

Lymphatics of cervix

A

Internal iliac nodes

91
Q

Innervations of cervix

A

Uterovaginal plexus

Sensory afferent: pelvic splanchnic n. (S2-S4)

92
Q

Oval organs located in the upper pelvic cavity

Rests on ovarian fossa of Waldeyer

A

Ovary

93
Q

The female gonad

Supported by uteroovarian ligament

A

Ovary

94
Q

Produces mature germ cells (ova)

Source of female hormones

A

Ovary

95
Q

Develops from mesothelial layer of the epithelium (coelomic epithelium)

A

Ovary

96
Q

Epithelium of Ovary

A

Epithelium: simple cuboidal (germinal layer of Waldeyer)

Cortex: oocytes & developing follicles

Medulla: loose CT, arteries and veins, & smooth muscle fibers

97
Q

Blood supply of ovary

A

Ovarian artery (from abdominal aorta)

Ovarian branch of uterine artery

Ovarian vein

98
Q

Lymphatics of ovary

A

Lateral aortic nodes

99
Q

Innervation of ovary

A 
Ovarian plexus (sympa)
Hypogastric and aortic plexus
Vagus nerve (parasympa)
Sensory afferents (T10)
100
Q

Also called oviducts

A

Fallopian tubes

101
Q

Tubular structures arising from the uterine cornua

Length: 8-14cm

A

Fallopian tubes

102
Q

Where fertilization and ectopic pregnancy usually occurs

A

Ampulla

103
Q

Covered by mesosalpinx at the superior margin of the broad ligament

A

Isthmus, ampulla, & infundibulum

104
Q

Conduit of sperm and site of fertilization

A

Fallopian tubes / oviducts

105
Q

Important in ovum transport

A

Tubal peristalsis created by the cilia and muscular layer contractions (endosalpinx of fallopian tubes)

106
Q

Provides support to the uterus and other pelvic structures

A

Ligaments

107
Q

4 major ligaments

A

Round ligament
Broad ligament
Cardinal ligament
Uterosacral ligament

RBCU

108
Q

Corresponds embryologically to the male gubernuculum testes

A

Round ligament

109
Q

Passes thru inguinal canal and terminates at upper portion of labia majora

A

Round ligament

110
Q

Branch of uterine artery that runs within the round ligament

A

Sampson artery

111
Q

Two winglike structures from lateral uterine margins to the pelvic sidewalls

A

Broad ligament

112
Q

Divides the pelvic cavity into anterior and posterior compartments

A

Broad ligament

113
Q

Also known as transverse cervical ligament or Mackenrodt ligament

A

Cardinal ligament

114
Q

Originates at the supravaginal portion of the cervix and inserts into the fascia over sacrum

A

Uterosacral ligament

115
Q

Aids in fallopian tube identification during puerperal sterilization

A

Round ligament

116
Q

Male homologous for scrotum

A

Labia majora

117
Q

Male ventral shaft

A

Labia minora

118
Q

Glans penis

A

Clitoris

119
Q

For protection

A

Mon pubis

120
Q

For sperm transport

A

Vagina

121
Q

Episiotomy: surgical repair

A

Midline: easy

Mediolateral: more difficult

122
Q

Episiotomy: blood loss

A

Midline - less

Mediolateral - more

123
Q

Leading cause of maternal death worldwide as of 2014

A

Pre-existing maternal conditions (cardiovascular disease, renal disease, etc)

OB (2 decks)

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