OB/GYN Pt 2 Flashcards
What are the two perineal boundaries
What seperates these two boundaries
? procedure is performed to prevent tearing during delivery
Urogenital (anterior): Symphysis Tuberosities
Anal (posterior): Perineum Anal complex Coccyx Tuberosities Sacrotuberous
Transverse perineal muscles
Perineal body
Episiotomy- perineal body
Labia majora is homologous to ? male structure
? structures are found here and ? structure terminates at the upper boundary
Labia minora is homologus to ? male structure
Scrotum
Sebaceous Exocrine Apocrine glands Venous plexus;
Round ligaments
Ventral shaft of penis
Labia minora contains ? type of glands
What does this join to form
What demarcation line is found here
Sebaceous
Superior: prepuce/clitoris frenulum
Inferior: fourchette
Hart Line- demarcation between skin/mucous membranes (outter: keratinized; inner: non-keratinized)
Glans of clitoris are homologous to ? male structure
This is the principle ? and is made of ? three parts
Define Vestibule and four structures found here and how many openings are found here
Erectile tissue
Female erogenous zone;
Glans, Corpus (body), Crura (x2)
Embryonic urogenital membrane derivative;
6- Vagina, Urethra, Bartholin/Skene glands
Where are the Bartholin glands are AKA and located ? in the vestibule w/ ? function
Define Minor Vestibular glands and where they’re located
Where are the Skene glands located and their function
Which ones are the largest paraurethral glands
Greater Vestibular Glands;
4 and 8- Lubrication
Mucin secreting glands along Hart line
Near urethral meatus, anterior vaginal wall;
Lubricate urethral opening
Skene
Vagina is a tube from ? to ? and contains ? type of cells
What is the name of the collagen elastin layer
Since no glands are found here, how is the structure lubricated
Hymenal ring to Uterus
Non-keratinized, stratified squamous
Adventitia
Sub-epithelial capillary transudate
Define Fornix and which one is used for surgical access to peritoneal cavity
What anatomical changes will be seen w/in the vagina post-menopause
Define Pouch of Douglas
Recess bordering cervix;
Posterior
Loss of rugae
Rectourterine pouch- lowest point of abdominal cavity
? is the lower portion of the uterus called
What is the upper and lower boundary of this called
What is the name of the area above where the vagina attaches to this area
Cervix
Internal os; External os
Portio Supravaginalis
What are three pregnancy induced changes seen on the cervix
Define Ecto/Endocervix
Define Squamocolumnar Junction and two factors that can alter it’s position
Hegar: isthmus softens d/t edema
Chadwick: ectocervical blue tinge d/t inc vascularity
Goodell: outer cervical softening d/t edema
Ecto: stratified squamous
Endo: canal covered by columnar tissue
Where columnar cells meet squamous cells;
Age, hormone status
Define Cervical Transformation Zone
Why is this zone important
What type of cellular changes are seen within the cervix at puberty ages
Area between original and new Squamocolumnar Junction
95% of cervical neoplasms develop here
Inc estrogen causes columnar proliferation onto ectovervix;
Acidified vagina, forces columnar transformation to squamous via glycogen utilization by lactobacilli
Define Uterine Corpus
What joins the Corpus to the Cervix and what does this become during pregnancy
What is the Posterior Wall AKA and why is it important
Muscular upper portion
Isthmus;
Lower uterine segment
Visceral peritoneum;
MC site of implantation
Uterine position is typically ?
Most of the upper uterus is called ? segment
What is the function of this segment
Anteroverted
Myometrium
Hemostasis at placental site during stage 3 of labor
What are the four parts of the fallopian tube from lateral to medial
What structure enclosed the fallopian tubes
What two MCs does the second structure have
Infundibulum Ampulla Isthmus Interstitial/Intramural
Broad ligament
Ampulla: MC site of fertilization and ectopic pregnancy
Ovaries secrete ? and are supplied w/ blood by ?
What is the MC location for ovarian Ca to develop
Where do they drain blood to
E/P; Ovarian/Uterine arteries
Epithelium, outer layer
L: left renal vein
R: IVC
Ovarian ligament holds ovaries to ? and suspensory ligament holds ovaries to ?
What are the two parts of the pelvic anatomy
What two shapes are most favorable for delivery and what two are least favorable
O: ovary to lateral uterus
S: ovary to pelvic wall
True: immobile, constraining to fetus/area of concern
False: above linea terminalis; supports pregnant uterus
+: Gynecoid*, Anthropoid
-: Android, Platypelloid
During delivery, dorsal lithotomy position can increase pelvic outlet size by ? much
Where do arteries supplying superficial abdominal wall arise from
Where do arteries supplying deeper abdominal wall arise from
1.5-2cm
Femoral artery below inguinal ligament
External iliac vessels
What is the name of the cesarean incision and ? structure is lacerated during it
What is the risk of vertical incision
What is the name and benefit of transverse incision
Maylard- inferior epigastric artery, lateral to rectus belly
Higher tension= wider scars
Pfannenstiel- follow Langer lines;
Less scars
What is the risk during low transverse incisions
? structure remains unchanged during pregnancy
What are the 3 tissue sources that develop into gonads
Severing iliohypogastric/ilioinguinal nerve= lost sensation to lateral glute/hypogastric region supplied by L1
Ovaries
Mesothelium- posterior abdominal wall
Mesenchyme- embryotic CT
Primordial germ cells- earliest undifferentiated sex cells
When does gonad differentiation begin and when is it committed by
Testes develop by week ? and ovaries develop by week ?
Mesonephric ducts are AKA ? and paramesonephric ducts are AKA ?
Start week 5, committed by week 7
T: 7wks; O: 12wks
Ovary histologically identified at week 10
M: Wolffian ducts
P: Mullerian ducts
What type of cell replication occurs in female fetus
What stimulates testis to begin to develop and when
Where are the glycoprotein anti-Mullerian hormones made and what is their function
Mitosis of oogonia
HCG peak at 8-12th week
Sertoli/Sustentacular cells- suppress paramesonephric ducts (uterus, fallopian tubes)
How are testis develop
? ducts are male reproductive
? ducts are female reproductive
Undifferentiated cell + TDF=
+ Mullerian inhibiting factor
+ testosterone
+ DHT
Undifferentiated cell w/out TDF=
- MIF, - testosterone
Regression of wolffian ducts
M= Mesonephric/Wolffian F= Paramesonephric/Mullerian
If uterine/vaginal developmental errors are going to occur, when does it happen and why
Define Didelphys
Define Bicornuate Uterus
Define BIcornuate Uterus w/ Rudimentary Horn
Define Septate Uterus
Define Unicornuate Uterus
Arrested development of uterovaginal primordium at week 8
Double Uterus and/or vagina- failed inferior duct fusion
Duplicated upper uterus body d/t slowed growth
Slowed growth of one paramesonephric duct
Failed resorption= thin septum internally
One paramesonephric duct fails to develop; inc risk for preterm delivery/loss
46 XY D/o Sexual Development
46XY S/o Sexual Development
Androgen Insensitivity Syndrome
Partial Androgen Insensitivity Syndrome
Female fetus exposed to excess androgen, causes external genital virilization;
Normal ovary, Clitoral hypertrophy, Partial majora fusion
Chromatin negative nuclei w/ variable in/external genitals d/t insufficient testosterone/MIH production by testis;
Ambiguous genitals
X-linked recessive inheritance, 46XY;
Externally female, blind pouch w/ testis in abdomen/inguinal
Resistance to testosterone= failed masculinization
Point mutation coding for androgen receptors
Define Turner Syndrome
Mullerian dysgeneis is AKA ? syndrome
Define Gamtogenesis
Primary Hypogonadism; 45XO; Hyper Hypo
Inc FSH, LH; Low E
Streak gonads= gonad dysgenesis
Mayer Rokitansky Kuster Hauser, 46XX
Formation and development of ova/sperm precursors into gamets- oocyte/spermatozoa