Pelvic cavity and organs

Question 1

Parts of the uterus

Answer 1

Fundus, body, cervix
Lower part of cervix is inside the vagina
Narrower lower part of body = isthmus
Junction between lumen of body and lumen of isthmus = internal os
Opening of cervix into vagina = external os
Spaces around vagina inside cervix = vaginal fornices, anterior, lateral, posterior

Question 2

Describe the position of the body of the uterus

Answer 2

Ususally bent forward “anteflexed” and lies on superior surface of bladder

Question 3

What stabilises the position of the cervix?

Answer 3

tone of the levator ani muscle (pelvic diaphragm) and by condensations of pelvic fascia – the CERVICAL LIGAMENTS

Question 4

What parts of the uterus, vagina, and cervix are covered by peritoneum?

Answer 4

Whole posterior surface of the upper 1/3 of vagina and is reflected onto the uterus forming the rectouterine pouch

Supravagaginal part of the cervix and the isthmus are not covered by peritoneum. These parts enlarge during pregnancy and become the lower segment of the uterus

Question 5

What is the blood supply to the uterus?

Answer 5

UTERINE ARTERY (branch of internal iliac) - passes above ureter (water under the bridge) adjacent to lateral fornix, before ascending up in the broad ligament of uterus
OVARIAN ARTERY - supplies fundus, passes along uterine tube and anastomoses with uterine artery

Question 6

What is the lymphatic drainage of the uterus?

Answer 6

Lymph vessels from fundus follow the ovarian vessel and drain into the para-aortic nodes.
Lymph vessels from body draon into external iliac nodes
Lymphatics from cervix, drain into internal iliac, external iliac and sacral nodes

Question 7

How are the ovaries suspended in the abdomen?

Answer 7

By a double fold of peritoneum called the mesovarium

Question 8

Where does the ovary normally lie?

Answer 8

In the ovarian fossa, formed by the angle between the internal and external iliac arteries. Cose relations = ureter, obturator nerve, obturator vessels

Question 9

What are the ligaments of the ovary?

Answer 9

SUSPENSORY LIGAMENT - continuation of the broard ligament from ovary to side wall of pelvis
OVARIAN LIGAMENT - thin fibrous cord, connects ovary to uterus. This ligament extends to the labium majus through inguinal canal as the round ligament of the uterus

Question 10

Blood supply of the ovary

Answer 10

OVARIAN ARTERY - from abdominal aorta

Veins form a plexus which eventually forms a single trunk. L - drains into renal vein, R- drains into IVC

Question 11

Lymphatics of ovary?

Answer 11

Lymphatics drain into para-aortic nodes

Question 12

Where does the vagina terminate?

Answer 12

Passes between the pubovaginalis part of the levator ani, the deep perineal pouch, terminating at the Introitus by opening into the vestibule between the labia minora. Urethra is embedded on the anterior wall of the lower 1/3

Question 13

How is the vagina adapted for streching

Answer 13

Has a rich anastomoses of a number of arteries in its wall

Question 14

Uterine tube

Answer 14

Lies in broard ligament.

Opening into uterus = ostium

Question 15

What is the mons pubis?

Answer 15

Rounded hair-bearing elevation of skin located in front of the pubic symphisis

Question 16

What surrounds the vestibule?

Answer 16

The labia majora, extending posteriorly from the mons pubis are prominent hair-bearing fold of skin that cover the vestibule
The vestibule is bounded laterally by soft folds of hairless skin, the labia minora
Vaginal orifice open into vestibule posteriorly
Clittoris lies at anterior limit of vestibule
External urethral meatus is located between the clittoris and vaginal orifice

Question 17

Describe the route of the vas / ductus deferens

Answer 17

From the deep inguinal ring, the ductus deferens passes along the side wall of the pelvis, then turns medially onto the back of the bladder. Here it has a dilated portion - the AMPULLA which lies medial to the seminal vesicle

Question 18

Where does the vas deferens terminate?

Answer 18

When it joins the seminal vesicle to form the ejaculatory duct