Pelvic Viscera II Flashcards
Folds comprising two layers of the peritoneum?
Fossae (pouches) continuous with abdominopelvic cavity?
Spaces?
Rectouterine fold, suspensions L of ovary, broad L
Vesicouterine pouch, rectouterine pouch
Retropubic (prevesical), retrovesical, retrorectal (presacral)
Rectouterine and vesicouterine pouches separated by ____.
Rectouterine pouch can be surgically approached through the ____.
The lateral extensions called the ____ can be the deepest.
Recesses lateral to the bladder are called the _____.
Broad L and uterus
Posterior fornix of vagina
Pararectal fossa
Paravesical fossa
What are the contents of the broad L?
What lies in the base of the broad L?
Parts of the broad L and what a do they connect to?
What lies underneath the broad L?
Ovarian vessels (within suspensory L), uterine tube, ovary, uterus, proper ovarian L, round L of uterus
Uterine A and V, ureter
Mesovarium (ovary), mesosalpinx (uterine tube), mesometrium (uterus)
Endopelvic fascia
Female endopelvic fascia contains what ligaments?
What do these ligaments contain?
Pubocervical L: superior vesicular A and V
Cardinal L: uterine A and V
Uterosaral L: middle rectal A and V
The female endopelvic fascia is called ____.
What does it do?
What provides the main support for the uterus?
Uterosacral L is found within the _____.
Hypogastric sheath
Support viscera and conduct neurovasculature to organs
Cardinal L (transverse cervical L)
Rectouterine fold
Uterus is divided into what three parts?
When the cervix protrudes into the vagina, it forms what?
Fundus, body, cervix
Vaginal fornices (internal and external os)
What causes a uterine prolapse?
Can occur when pelvic ligaments (cardinal L) or pelvic diaphragm weakens or tears
Caused by pregnancy, aging, menopause, obesity
Describe uterine positions:
Verted
Flex
Retroverted
Retroflexed
Do uterine positions affect fertility?
Verted: angle between cervix and vagina (normally anteverted)
Flex: angle between uterine body and cervix (normally anteflexed)
Retroverted: genetic, maybe caused by fibroids, endometriosis, PID, labor
Retroflexed: when pregnant, can become trapped by curve of sacrum
No, but can cause lower back pain, dysuria, dyspareunia (painful intercourse)
Where are the uterine tubes?
What is their function?
What are the parts of the uterine tubes?
Lie in the free edge of the broad L
Carries ova to the uterine cavity, assisted by motile cilia within the tube
Mucosal layer folds change during menstruation
Fimbria, infundibulum, ampulla, isthmus, intrauterine
Where are the ovaries?
What ligaments do they attach to?
Lie on lateral wall of the pelvis
Covered laterally by fimbrae of the uterine tube
Attached anteriorly to broad L by mesovarium, laterally to suspensory L, medially to ovarian L
Where is the vagina?
Opening to vestibule of vagina can be partially closed by _____.
Fornix is the recess between the cervix and vaginal wall
Membranous hymen
Where is the female urethra?
What are the parts of the female urethra?
Adjacent to anterior wall of vagina
Penetrates UG membrane
Opens anterior to vaginal vestibule
Only part is the membranous urethra
What is the difference between internal and external female urethral sphincters?
What innervates them?
What is their action?
Internal urethral sphincter: smooth m (inferior hypogastric plexus)
External urethral sphincter: skeletal m (deep perineal branch of pudendal N); aids in reflex closure of the urethra during increased intra-abdominal pressure (sneezing, coughing, laughing)
Proximal EUS is where striated muscle length and thickness are lost with aging
Pelvic floor exercises can increase EUS size
Lymphatic drainage of female reproductive system
What are the exceptions?
Most drain into internal and external iliac nodes
Round L, fundus, and external genitalia drain into superficial inguinal nodes
Ovary, uterine tubes, fundus drain into lumbar nodes
Visceral motor innervation of female pelvis
Inferior hypogastric plexus: primary efferent innervation to female internal viscera; parasympathetic is pelvic splanchnic N
Ovarian plexus: associate with ovarian A; composed of parasympathetic from vagus N and sympathetics from T10-T11 superior hypogastric plexus
