Pelvic anatomy Flashcards
where does the ovarian artery come from?
the abdominal aorta
where do the ovaries drain to?
the vena cava on the patient right, but to the renal vein on the patient’s left.
What vessels do the suspensatory ligament of the ovary contain? what is the other job of the ligametn
the ovarian artery and vein
what is ovarian torsion?
when the suspensatory ligament becomes twisted and the blood supply becomes constricted
what is one cause of ovarian torsion
ovarian cysts.
where does the vascular supply of the uterus come from?
the internal iliac arteries branch to the uterine arteries
Postpartum hemorrhage definition
500cc after Vaginal delivery
1000cc after C-section
FYI this is a big deal in a non-postpartum person
what is the first line and a non-surgical method to control postpartum bleeding?
uterine massage.
what medical interventions are there for postpartum hemorrhage?
oxytocin/pitocin
methergen
hemabate
what is the last non-medical treatment for postpartum hemorrhage
balloon tampenade
essentially a catheter in the uterus.
what are the surgical interventions for postpartum hemorrhage?
1) ligation of uterine artery if still bleeding 2) ligation of the internal iliac (this is last line ligation) 3) hysterectomy Always try to spare as much as possible
where does venous drainage run for the uterus
through the uterosacral ligament
what does the cardinal ligament do
keeps the uterus in place side to side and front to back. connects to the pelvic side wall
what is often confused for the uterosacral ligament
the ureters
what happens when you weaken the cardinal ligament
you cause pelvic floor relaxation.
what happens when you weaken the cardinal ligament anteriorly and the bladder falls?
cystocele
what happens when you weaken the cardinal ligament posteriorly and the rectum falls?
rectocele
what happens when you weaken the cardinal ligament and the uterus falls?
uterine inversion
what are cystocele, rectocele and uterine inversion all associated with
pelvic floor relaxation. this is caused by large multiple births.
patient presents with back pain, vaginal fullness.
diagnosed with speculum examination.
what does cystocele look like on speculum
upper vaginal wall bulging
what does rectocele look like on speculum
lower vaginal bulging
what does uterine inversion look like on speculum
cervix in your face
how do we treat uterine inversion
hysterectomy
how do we treat cystocele and rectocele
anterior and posterior repair.
what is associated with cystocele
incontinence
what is associated with rectocele
constipation.
stage I uterine inversion
slightly dislodged into vaginal cavity
stage II uterine inversion
uterus close to the vaginal opening in the vault
stage III uterine inversion
uterus out of the vaginal opening
Stage IV uterine inversion
uterus completely outside of the vaginal vault and inverted.
