PP2 - Female Genitalia Flashcards
list the components of the vulva
mons pubis
labia - labia minora & majora
vestibule
bulbs of the vestibule
greater vestibular glands
clitoris
what is the mons pubis?
rounded pad of skin and fat overlying the pubic symphysis
what does the mons pubis consist of?
skin & fat/ adipose tissue
how does the mons pubis change before & after puberty?
before puberty = relatively flat and hairless & labia minora are poorly formed
after puberty = covered by hair, more prominent
what happens to the mons pubis following menopause?
atrophies
what are the labia majora?
long hair-covered areas with fatty skin folds that form the lateral boundaries of the vulva
describe the position of the labia majora
labia majora on either side extend posteriorly posteriorly from the mons pubis to the perineum but DO NOT join
what male structure is the labia majora the homologue of? why?
scrotum
both derived from the same embryonic structure - labioscrotal swelling
what are the labia minora?
hairless cutaneous folds devoid of fat
describe the position of the labia minora
extend obliquely from the clitoris down the lateral sides, down to the vaginal orifice
what is the vestibule?
enclosed area between the labia minora - houses the external openings of the urethra and vagina
what openings does the vestibule contain?
external urethral orifice
vaginal orifice
smaller openings - two for the greater vestibular glands, others for the lesser vestibular glands
what is the fourchette?
ridge at the posterior point of the vestibule formed when the right and left labia minora come together
what are the greater vestibular glands?
paired pea-sized glands - lateral to the vaginal orifice & deep to each posterior labium minorum
function of the greater vestibular glands
secrete lubricating mucus into the vaginal orifice during sexual arousal to facilitate entry of the penis
what is the only visible part of the clitoris externally?
glans clitoris
what is the clitoris?
small sensitive organ located just anterior to the vestibule, mostly internal
function of the clitoris?
contains erectile tissue that swells with blood during sexual arousal - important in sexual pleasure due to its high concentration of sensitive nerve endings
function of the erectile tissue in the glans clitoris?
the erectile tissue (corpora cavernosa and bulbs of the vestibule) engorges with blood during sexual stimulation - forms the basis of the female sexual response
the clitoris is homologous to the penis - how is the clitoris similar to and different from the penis?
both have glans and a body
the clitoris has no urethra
what covers the glans clitoris?
prepuce of the clitoris
how is the prepuce of the clitoris formed?
each labium minorum bifurcates anteriorly & has an upper and lower layer
the upper layers on each side join and form the prepuce, superior to the glans clitoris
what is the attached part of the clitoris?
root
major structural parts of the clitoris?
- root - attached part
- body - free part
how are the root & body of the clitoris formed?
root - formed by the proximal parts of the corpora cavernosa
body - formed by the unattached parts of corpora cavernosa
what type of erectile tissues make up the clitoris?
paired corpora cavernosa
bulbs of the vestibule
what are the bulbs of the vestibule? where are they located?
erectile tissues homologous to the corpus spongiosum
lie on each side of the vaginal orifice, deep to the bulbospongiosus muscle
which ligaments and structures attach the clitoris to the pubic area?
body is attached to the pubic symphysis via a suspensory ligament
root is attached to the ischiopubic rami
what are the ovaries? position?
paired endocrine glands
retroperitoneal structures on the lateral sides of the uterus
how does the appearance of the ovaries change with ovulation?
before ovulation they’re a smooth shape
after ovulation they have a scarred appearance
what three structures support the suspension of the ovaries in the true pelvic cavity?
- mesovarium of the broad ligament
- suspensory ligament of the ovary
- ovarian ligament
what is the mesovarium?
mesentery of the ovary & part of the broad ligament of the uterus
attachments of the mesovarium?
connects anterior border of the ovary to the posterior layer of the broad ligament
what is the suspensory ligament of the ovary?
peritoneal fold that attaches each ovary to the lateral pelvic wall
attachments of the suspensory ligament of the ovary?
from the superior side of the ovary to the lateral pelvic wall
what is the ovarian ligament?
a fibrous cord of connective tissue that directly attaches the ovary to the uterus
attachments of the ovarian ligament?
from the inferior side of the ovary to the lateral side of the uterus (just below the uterine tube)
which of the supportive ligaments of the ovary contain neurovascular & lymphatic connections?
the suspensory ligament of the ovary
which of the supportive ligaments of the ovary DON’T contain neurovascular & lymphatic connections?
ovarian ligament
mesovarium
function of the ovaries?
contains various cells which secrete steroid sex hormones - oestrogens and androgens
functions of the uterine tubes? (2)
- receive ovulated oocyte released by the ovary & facilitate its movement towards the uterus
- (ampulla is) the site of fertilization
what is the function of the fimbriae?
ciliated finger-like projections that drape over each ovary
generate currents to guide the oocyte from the ovary into the uterine tube
what is the infundibulum - position?
lateral opening of the uterine tube into the peritoneal cavity, just below the fimbriae
function of the infundibulum?
helps capture the oocyte during ovulation
what is the ampulla? its significance?
expanded medial section of the uterine tube, forms half its length
significance: primary site of fertilization
what is the isthmus of the uterine tube? its function?
narrow, medial third of the uterine tube, closest to the uterus
function: helps guide the oocyte toward the uterus
how is the movement of the oocyte through the uterine tube facilitated?
smooth muscle of the uterine tube contracts to produce peristaltic waves
ciliated simple columnar epithelium along the walls of the uterine walls beat & aid in moving the oocyte along the tube
what is the role of non-ciliated cells in the uterine tube?
secrete substances that support the oocyte and facilitate fertilization
what is the mesosalpinx?
part of the broad ligament that provides support to the uterine tubes
what is the role of the mesosalpinx?
- provides support to the uterine tubes
- contains an anastomotic network of uterine and ovarian vessels
describe the superior, inferior, lateral and medial attachments of the mesosalpinx
superior - to the uterine tube
inferior - mesovarium
lateral - suspensory ligament of the ovary
medial - ovarian ligament
functions of the uterus?
- receives, retains, and nourishes a fertilized oocyte during pregnancy
- plays a central role in menstruation and labour
describe the position of the uterus in the pelvic cavity
located in the true pelvis
anterior to the rectum
posterosuperior to the urinary bladder
list the 4 main regions of the uterus
fundus
body
isthmus
cervix
when is the fundus of the uterus in contact with the sigmoid colon? what other structure is it usually in contact with?
in contact with the sigmoid colon when it’s distended
loops of the small intestine
dimensions & appearance of the cervix in a non-pregnant adult female?
2.5 cm in length, more cylindrical in shape than the body
list the 3 layers of the uterine wall from innermost to outermost
endometrium
myometrium
perimetrium
what function does the perimetrium serve?
thin outermost serous layer of the uterine wall - acts as the outer covering for the uterus
main function of the myometrium? what aspect of its structure helps with this?
contracts during childbirth to help expel the foetus
consists of interlacing smooth muscle bundles
what layer of the endometrium sheds during menstruation?
functional layer
what is the importance of the endometrium?
its the innermost mucosal lining of the uterine cavity
during menstruation - undergoes cyclic changes and sheds
during pregnancy - where the embryo implants & continues developing if fertilised
what are the two layers of the endometrium?
functional layer
basal layer
what is the significance of the basal layer of the endometrium?
remains intact as the functional layer is shed during menstruation & regenerates the functional layer after
what connects the cervix to the body of the uterus?
internal os
what is the importance of the external os?
connects the cervix to the vagina
two main functions of cervical mucus?
- prevents bacteria from entering the uterus 2. blocks sperm except during mid-cycle - becomes less viscous to allow sperm passage
what are the three layers of the vaginal wall from outermost to innermost? describe what each is composed of
adventitia - fibrous connective tissue
muscularis - smooth muscle
mucosa - transverse folds/ rugae
purpose of the rugae in the vaginal mucosa? (2)
transverse folds that stimulate the penis during intercourse & flatten to allow for expansion during childbirth
role of the lamina propria in the vaginal mucosa?
contains elastic fibres - allows the vagina to return to its original shape after stretching
why is the vaginal epithelium lined with stratified squamous cells?
stratified squamous epithelium withstands friction & resists bacterial infections
main functions of the vagina? (2)
- serves as a passageway for childbirth
- receives the penis and semen during intercourse
what is the vaginal orifice?
external opening of the vagina
what is the hymen?
a vascularized mucosal membrane forming an incomplete diaphragm near the vaginal orifice
under what circumstances can the hymen rupture?
often occurs during the first instance of sex
can be more delicate in others and rupture during tampon use or during sports
what is the vaginal fornix?
a recess formed around the cervix by the vaginal wall - creates spaces between the cervix and the vaginal walls
subdivisions of the vaginal fornices? (4)
anterior
posterior
lateral (2)
what are the main ligaments supporting the uterus?
lateral/transverse cervical (cardinal) ligaments
round ligaments of the uterus
broad ligament
uterosacral ligament
pubocervical ligament
what is the primary mesentery supporting the uterus?
mesometrium - part of the broad ligament
attachments of the cardinal ligament? what role does it play in uterine support?
anchors cervix & superior vagina to the lateral pelvic walls
provides lateral stability to the uterus & cervix
what is significant about the composition of the cardinal ligament?
consists of dense connective tissue & smooth muscle fibres
contains blood vessels (branches of uterine artery) & nerves - provides vascular and nerve supply to the cervix and vagina
functions of the cardinal ligament? (2)
- provides vascular and nerve supply to the cervix and vagina
- provides lateral stability to the uterus & cervix
how do the round ligaments support the uterus? consider its course
stabilises the uterus by binding it to the anterior body wall
from the uterus - pass through the inguinal canal & exits via the superficial inguinal ring - attaches at the labia majora and anterior pelvic wall
what three components make up the broad ligament?
mesometrium
mesovarium
mesosalpinx
what structure does the mesometrium support?
the uterus
what structure does the mesovarium support?
the ovaries
what structure does the mesosalpinx support?
the uterine tubes
which ligament extends from the posterior cervix to the sacrum, providing posterior support?
uterosacral ligament
function of the pubocervical ligament?
provides anterior stability by attaching the cervix & upper vagina to the pubic bones, with horizontal and vertical portions
what ligament provides anterior support to the cervix & uterus?
pubocervical ligament
origin of the uterine arteries?
arise from the anterior division of the internal iliac arteries
what does the ascending branch of the uterine artery supply?
supplies the upper uterus
anastomoses with the ovarian artery - helps supply the ovary
what does the descending branch of the uterine artery supply?
supplies the cervix and upper vagina
anastomoses with the vaginal artery - helps supply the vagina
where do the uterine arteries course in relation to the ureter?
cross the ureter ANTERIORLY before reaching the cervix
clinical significance of the uterine artery during a hysterectomy?
uterine artery may be ligated to control bleeding during a hysterectomy
clinical significance of the uterine artery during treatment of uterine fibroids?
uterine artery is embolized to block blood supply to fibroids or abnormal areas of uterine tissue
what are the two terminal branches of the uterine artery that supply the uterus?
arcuate arterioles
helicine (terminal) arterioles
where do the ovarian arteries originate?
originate from the abdominal aorta (right and left)
what do the ovarian arteries supply?
ovaries and uterine tubes
describe the course of the ovarian arteries through the pelvic cavity
descend as retroperitoneal structures
cross over the external iliac artery at the pelvic brim
approach the ovaries within the suspensory ligament
where do the uterine and ovarian arteries anastomose? within what ligament?
each lateral side of the uterus within the mesosalpinx of the broad ligament - create a network that supplies the uterus and ovaries
what are the two key anastomoses of the female genitalia?
ascending branch of the uterine artery anastomoses with branches of the ovarian artery
descending branch of the uterine artery anastomoses with branches of the vaginal artery
what is the vesico-uterine pouch? where is it located?
peritoneal space located between the posterior surface of the urinary bladder & the anterior surface of the uterus
clinical significance of the recto-uterine pouch?
the lowest point in the peritoneal cavity where fluid can collect
often examined by ultrasound for fluid, ectopic pregnancies, or infections
how is the recto-uterine pouch accessed for examination or surgical procedures?
accessed through the posterior vaginal fornix
what are the two main types of peritoneum? what structures do they cover?
parietal peritoneum - lines the abdominal cavity walls
visceral peritoneum - covers the abdominal organs and forms folds, creates spaces like the vesico-uterine and recto-uterine pouches
which uterine ligament extends through the inguinal canal?
round ligament of the uterus
why is the uterine artery enlarged during pregnancy?
to meet the increased blood supply demands of the growing uterus &developing foetus
what structures are contained within the suspensory ligament of the ovary?
ovarian arteries - supply the ovaries and uterine tubes
what is the primary role of the mesosalpinx in uterine support?
supports the uterine tubes, forming the upper part of the broad ligament
how does the broad ligament function as a supportive structure?
extends from each side of the uterus to the lateral pelvic walls - supports the uterus, ovaries, and uterine tubes
