Pelvic Viscera 2 Flashcards
The peritoneum, in the female body, makes up the following, name them: 1 fold 2 ligaments 2 pouches 3 spaces
rectouterine fold
suspensary lig of ovary; broad lig
vesicouterine and rectouterine pouches
retropubic, retrovesical, and retrorectal spaces
2 sets of recesses, found in both M and F, are….
pararectal fossae
paravesical fossae
Contents of the broad ligament (8)
ovarian vessels (within the suspensory ligament) uterine tube ovary uterus proper ovarian ligament round ligament of uterus and in the base... uterine a and v ureter
3 parts of the broad ligament
mesovarium
mesosalpinx
mesometrium
3 ligs made by the F endopelvic fascia? And what vessels are contained within?
What are they collectively referred to as?
- pubocervical lig, superior vesicular a and v
- cardinal lig, uterine a and v
- uterosacral lig (within rectouterine fold), middle rectal a and v
referred to as the hypogastric sheath
What are the 3 types of female pelvic ligs, and what are their properties?
Which ligaments fall under each (6 total)?
- peritoneal folds; weak and pliable; suspensory and broad ligs
- fibromuscular ligs; stretch; round ligs
- fibrous; strong; uterosacral, cardinal, and pubocervical ligs
3 parts of the uterus
body, fundus, cervix
cervix forms what 3 structures?
vaginal fornices
internal os
external os
3 layers of the uterus
perimetrium
myometrium
endometrium
What are the 2 uterine positions, and what is the norm?
verted: angle between cervix and vagina
normal: anteverted
flex: angle between uterine body and cervix
normal: anteflexed
Retroverted uterus:
- causes
- symptoms
- complications in pregnancy
causes: usually genetic, but also fibroids, endometriosis, PID, labor
symptoms: low back pain, dysuria, dyspareunia
* no effect on fertility
preg: can become trapped by the curve of the sacrum
How does a uterine prolapse occur?
What are some causes of a uterine prolapse?
occurs when pelvic ligaments, particularly the cardinal, OR the pelvic diaphragm weaken or tear
main cause: pregnancy
other causes: aging, menopause, obesity
What are the 4 parts of uterine/fallopian tubes?
AND what is the structure/feature found at the end of the tube?
intrauterine, isthmus, ampulla, infundibulum
fibriae
3 layers of the uterine tube
mucosa, muscularis, serosa
Describe the uterine tube:
- lies within what
- function?
lies in the free edge of the broad ligament
carries ova into the uterine cavity, assisted by motile cilia within the tube
also…mucosal folds slightly change during menstruation
Describe the ovaries:
- lie where in pelvis?
- covered laterally by what?
lies on lateral wall of pelvis
covered laterally by fimbrae
The ovaries are attached to what 3 structures?
anteriorly: broad lig via mesovarium
laterally: suspensory lig
medially: to proper ovarian lig
What are 3 features of the vagina?
fornix: recess b/w cervix and vaginal wall
vestibule
hymen: membranous, partially closes opening to vestibule
Describe the female urethra
- location in relation to vagina
- penetrates what structure
- opens where, in relation to vestibule?
- adjacent to anterior vaginal wall
- penetrates UG membrane
- opens anterior to vaginal vestibule
How do the urethral sphincters differ between the sexes?
in proximity and length
F: superficial/deep
M: proximal/distal
Describe the female external urethral sphincter:
- muscle type
- innervation
- action
- effects of aging
- how to increase EUS size?
muscle: skel
innervation: deep perineal branch of pudendal n
action: reflex closure of urethra during coughing, sneezing, laughing (ie: high intra-abd P)
aging: loss of striated muscle length and thickness
increase size: pelvic floor exercise
What are 5 arteries supplying the female pelvic region?
from the internal iliac:
superior vesicle a, inferior vesicle a, uterine a + vaginal branch, vaginal a
from the aorta: ovarian a
What are the 3 groups of LN that the female pelvis drains lymph into?
iliac, superficial inguinal, lumbar
what structures drain into the superficial inguinal LN?
round ligament, fundus, external genitalia
what structures drain into the lumbar nodes?
ovary, uterine tube, fundus
The fundus of the uterus drains into what 2 sets of LN?
superficial inguinal + lumbar
What 5 nerve groups supply the female pelvis?
superior hypogastric plexus inferior hypogastric plexus ovarian plexus sacral splanchnic n pelvic splanchnic n
What nerve group provides primary efferent innervation to F internal viscera?
inferior hypogastric plexus
What nerve group is assoc w/ ovarian a, and is composed of both PSNS and SNS fibers?
ovarian plexus
PSNS: vagus n
SNS: T10/11
Where is the pelvic pain line?
inferior limit of the peritoneum
Anesthesia can target what?
pelvic pain line differences
what do spinal blocks/lumbar punctures block?
waist down
intra and sub-peritoneal plus somatic areas
what does a caudal block, block?
sub-peritoneal and somatic areas innervated by pudendal n
What does a pudendal n block, block
blocks areas innervated by the pudendal n
