Relevent Anatomy Flashcards
1
Q
Other name for Müllerian ducts
For wolfian duct
A
Paramesonephric
Mesonephric
2
Q
Which of the following is false
- Müllerian ducts are lateral to wolfian ducts
- Both ducts appear in foetus at 8weeks
- Müllerian duct disappears in male at 9 weeks
- Müllerian duct disappears due to MIS (mullerian inhibiting substance)
- Wolffian duct disappears in female at 10weeks
A
2 and 5 are false
Both ducts appear at 6 weeks of gestation
Wolffian duct in female and Müllerian duct in male both disappears at 9 weeks of gestation
3
Q
Source of MIS
A
Sertoli cells
4
Q
Ipsilateral release of MIS from testes will cause what
A
Disappearance of Müllerian duct of same side
5
Q
Müllerian duct forms
A
Uterus
Cervix
Fallopian tube
Upper 2/3rd of vagina
6
Q
Wolffian duct forms
A
Seminal vesicles Ejaculatory duct Epididymis Ductus deferens When testosterone acts on the wolffian duct it converts into male internal genitalia
7
Q
Remnants of mullerian duct will be present in male or female and name them
Remnants of wolfian duct will be present in male or female and name them
A
Male child ,appendix of testis
Female child ,
Epoophoran (cranial remnant of duct )
Paroophoron (caudal remnant of mesonephric tubule )
Gartner’s duct (caudal remnant of mesonephric duct )
Hydatid of morgagni
8
Q
Relation of paroophoron ,epoophoron, gartner’s duct, hydatid of morgagni with broad ligament
A
Paroophoron is medial part of broad ligament
And the rest i.e epoophoron , gartner’s duct, hydatid of morgagni lateral part of broad ligament
9
Q
D/d of cyst on lateral wall of vagina
A
Anterolateral wall of vagina - gartner’s duct cyst
Posteriolateral wall of vagina - bartholin’s duct cyst
10
Q
Where does garter’d duct open
A
Lateral wall of vagina
11
Q
Mc cyst of vagina
A
Inclusion cyst
12
Q
How is uterus formed
At what period of gestational age is uterus formed
Cavity of uterus is formed when
Septum dissolution is in high direction
A
Mullerain duct lateral to wolfian duct comes in midline and fuse to form uterus
10 weeks
*fusion begins in centre and then more cranial and caudal
18 weeks
Caudalto cranial
13
Q
Internal genitalia differentia into male and female at what age
A
10 weeks
14
Q
Mc mullerian anomaly is
A
Septate uterus
15
Q
Appearance of uterus on Saggital section and coronal section
Gross appearance of uterus
A
Cleft like and triangular
Pyriformis
16
Q
Weight of uterus in nulliparous and multiparous
A
50-70gm nulliparous
80gm multiparous
17
Q
Length of uterus
A
6-8cm long
18
Q
Volume of non pregnant female uterus
A
10ml cube
19
Q
Weight of pregnant uterus
A
1000gm / 1.1kg `
20
Q
Volume of uterus at term
A
5L
21
Q
Which of the following is false
- Uterus undergoes hypertrophy more then hyperplasia
- Pregnant uterus weighs 1.1kg where as normal uterus weighs 50gm
- Pregnant uterus volume 5L where as normal uterus volume 10ml
- Weight of uterus at 6 weeks post partum is 80-100gms
A
All of the following statements are true
22
Q
At what level uterus opens into cervix
A
Internal os
23
Q
Isthmus is present between what
A
Anatomical and histological internal os (just 1cm)
*histological internal os is below anatomical internal os
24
Q
At what time LUS is formed
It is formed by
And during labour it is formed by
At term the length of LUS
A
Begins forming after 1st trimester
Formed by isthmus
During labour LUS formed by isthmus + cervix (known as effacement )
5cm which stretch to become 10cm and by that time the pt. goes into labour +Ca is taken up
25
Where is LSCS done(site)
At LUS (below loose fold of peritoneal attachments )
26
In OT while doing LSCS how to identify the LUS
Loose fold of peritoneal attachment is through which we identify
27
Most common incision for uterus for LS
2nd incision
3rd incision
And the risk of rupture
Lower segment pfannensteil or transverse incision -KERRS incision (0.2-1.5%)
lower segmentVertical incision-KRONIGS incision (1-7%)
Upper segment vertical incision-CLASSICAL incision (4-9%)—WEAKEST
28
Weakest incision for LSCS
Classical
29
Indications of classical incision for LSCS
Only indication (absolute) for classical : Ca cervix
Others
-dense adhesions b/w L.S and bladder
-very preterm LS
-post mortem CS
-anterior located placenta previa (only if a not trained doctor )
Ans : for ant. PP
30
Technique of LSCS
| Advantage
Joel Cohen : blunt dissection technique (only small incision with scalpel on LUS and layers are separated by fingers
1. Less blood loss
2. Less time to reach
3. Less operative time
4. Less post op. Pain
31
3 structures attached to upper part of uterus and their ant.-post. Relations + sup.-inferior relations with each other
MC mistake made here is what and occurs due to what
```
Round ligament
Fallopian tube
Ovarian ligament
- ant.-post. R
RL FT OL
(Ant) (Post.)
-sup.-inf.R
FT- superior
RL/OL:same level below FT
-failure of sterilisation
-occurs due to ligation of the wrong structure
```
32
Structures derived form GUBERNACULUM
Proximal part - ovarian ligament
| Distal part - round ligament
33
Canal of nuck
+ in foetus only
| It is a fold of peritoneum in foetus that contains round ligament and extends into inguinal canal
34
What pulled the uterus anteriorly in its opinion
Round ligament
35
What attaches uterus to ovaries
Ovarian ligament
36
Main supports of uterus
1. Mackendrodt
2. Broad ligament
3. Cardinal ligament
4. Pubocervical
5. levator ani
6. Uterosacral
7. Round ligament
1. Mackendordt
2. Cardinal
3. Levator ani
37
Supports of uterus
Ant- pubocervical
Post- uterosacral
Lateral- mackenrodt aka cardinal ligament aka transverse cervical ligament
Inferiorly- levator ani
38
Main ligament or support of uterus
Main ligament :cardinal ligament/transverse cervical / mackendrodt
39
Triradiate ligament
Illiococygeous
Pucococcygeous (mainly this one )
Puborectalis
40
Muscles attached to perineal body
```
Sup. And deep transverse perinei
Bulbospongious
Levator ani
External anal sphincter
External urinary sphincter
```
41
Antevered and antiflexed explain
Angle b/t cx and vagina -90degree : anteverted
| Angle b/t long axis of uterus and cx : anteflexed :120degree(approx120-170)
42
If fundus is towards bladder it is known as
| If fundus towards sacrum known as
Antiflexed
| Acute retro flexion
43
Main ligament for antiversion and anti flexion
```
Round ligament (mainly )
(Round ligament+pubocervical)
```
44
Which ligament prevents retroversion
Uterosacral
45
Which layer is known as the living ligature of uterus
Middle myometrium layer arranged in crisis cross fashion is called the living ligature of uterus
46
Which of the following is false
1. Uterus is a muscular organ
2. Uterus mainly made of myometrium:2.5cm thick
3. Fundus is part which lies above the attachment of Fallopian tube
4. Antiversion and anti flexion present in 80% of the female
5. Their are 2 layers in the myometrium (Criss cross and circular)
```
5th is false
Their are 3 layers in the myometrium
Outer : longitudinal
Middle : Criss cross (living ligature )
Inner : circular (sphincteric action )
```
47
3 areas of sphenteric action of inner layer
2cornu or Ostia and 1 internal os
48
Blood supply Of uterus
Uterine A. Which is a br. Of anterior internal iliac A.
Uterine A. Gives the rest of the br.
Arcuate A. — supply outer 2/3 rd of myometrium
Radial A.-2 branches (basal and spiral)— supply inner 1/3 rd of myometrium
Basal A.-supply basal endometrium (take part in regeneration)
Spiral A. - supply superficial endometrium (shed off during menstrual cycle )(aka functional)
49
What is water under bridge
Uterine artery runs parallel to the ureter
| Therefore horizontal position of uterine artery runs above the peristaltic movements of ureter
50
Mc site of ureteric injury
| 2nd mc site of ureteric injury
Water under bridge
| Pelvic brim - where it is crossed over by ovarian vessels
51
Location of water under bridge
2cm lateral to cervix or 1.5cm lateral to fornix
52
Artery suppling round ligament
Uterine artery gives a special br. Samson’s A.
53
Blood supply of cervix
Descending cx artery which is a br of uterine A.
54
Blood supply of upper 1/3rd of vagina
Descending vaginal branch of uterine artery
55
Nerve supply of uterus
| Ganglion for uterus nerve supply
```
T10
T11
T12
L1
Responsible for pain sensation during uterine contractions
Franken hauser ganglion
```
56
Epidural analgesia
Level of block
Type of block
Mc drug used
Aka labour analgesia (cause painless labour)
T10
Sensory block
Bupivacaine 0.25%
57
M.c anaesthesia used for LSCS
Location
Why t4
Spinal anaesthesia
T4
To block nerve supply of peritoneum (sensory block )
58
Anaesthesia used in force
| Done when
Pudendal nerve block
Only when complete dilatation (head at +3 station )
Q
59
Pudendal nerve is present where
Pierce which ligament
Direction
Present in pudendal canal present behind ischial spine
Saccrospinous ligament
Posterio medial
60
Lymphatic drainage of uterus
Internal iliac L.N (mainly )
External lilac
Superficial iliac
Fundus - para aortic LN
61
```
Cervix -
Gross shape
Canal
Length
Opens into vagina at what level
```
Conical shape
Fusiform /spindle shape
3-4cms
At external os
62
Shape of cervix in nulliparous and in multiparous
Nulliparous : circular
| Multiparous : transverse slit
63
Uterus is made of
| Cervix is made of
```
Muscle
Connective tissue (mainly collagen) and only 10% is made of muscle
```
64
Lining epthileum of the following
Uterine endometrium
Endo cx
Ecto cx
Single layer of columnar epithelium
Tall columnar epithelium
Stratified squamous epithelium
65
Glands in the following
Uterine endometrium
Endo cx
Simple tubular glands
| Compound racemose glands
66
Arbor vitae
Characteristic feature os Cx
| Represents branching of glands in endo Cx
67
Mc site for both premalignant and malignant lesions of Cx
Transformation zone
68
```
What is the thickness of uterine endometrium in the following stages
On day 5 or immediately after menses
Periovulatory phase
Secretory phase
At time of implanatation
```
On day 5 or immediately after menses :0.5mm
Periovulatory : 2-3mm
Secretory phase : 6mm
At time of implanatation : 10-12mm
69
```
What is the change in the ratio that occurs b/t cervix : corpus
At birth
Before puberty
After puberty
Reproductive life
Menopause
```
```
Cervix : corpus(body of uterus)
At birth 1:1
Before puberty 2:1
After puberty 1:2
Reproductive life 1:3
Menopause 1:1
```
70
Nerve roots for pudendal nerve
S2
S3
S4
71
Which nerve block is given for uterine endometrium
Paracervical block
Can be given at 2 and 10 o’clock
Or 4 and 8 o’clock
***never give at 3 and 9 o’clock position
72
Fallopian tube size
10cm
73
Medial most part of Fallopian tube
Interstitial (intra mural )
Size 1-2cm
Fallopian tube opens through Cornu /Ostia
74
Size of Fallopian tube (length )
Interstitial -1 to 2cm
Isthmus - 3cm
Ampulla- 6cm
Fimbrial end (infundibulum)
75
Widest part of Fallopian tube
Ampulla
| It is also the longest part of ft 6cm
76
Narrowest part of Fallopian tube
Interstitial (0.7mm) >isthmus (1mm)
77
Fallopian tube epithelium
Single layer of ciliated columnar epithelium
78
Site of fertilisation
| Mc site of ectopic
In Fallopian tube in ampulla
| Ampulla because it is the site of fertilisation and it has max. No. Of PLICAE (mucosal folds - crypts)
79
How many days after fertilisation , conceptus remains in F.T
3 days
80
Which part of Fallopian tube acts as anatomical sphincter
Interstitial part due to circular muscles
81
Which part acts as physiological sphincter
Isthmus
82
Is ciliated epithelium present throught the Fallopian tube
```
No
Their are other cells also like
Secretory cells
Ciliated cells
Peg cells : resting cells of Fallopian tube
```
83
Direction of ciliary muscles
Towards uterus
84
Important reason of conceptus movement
Peristalsis of Fallopian tube main reason for transport of conceptus
85
Blood supply of Fallopian tube
Medial 2/3 rd uterine A
| Lateral 1/3 rd ovarian A
86
Lymph node of Fallopian tube
Para aortic
| *ostia / intramural part drains into superficial inguinal LN
87
Nerve supply of Fallopian tube
| Why even unruptured ectopic is painful
T11
T12
L1
Reason of Pain is due to stretching f Fallopian tube (t11 ,t12, l1)
88
Total how many recess are their in vagina
4 fornix=recess
89
Length of vagina
7-10cm
90
Vagina has how many walls
```
4 walls
Ant.
Post.
2lateral
*post wall longer then ant wall by 2cm
```
91
Deepest fornix of vagina
Post. Fornix
92
Lining of vagina
Stratified squamous non keratinised
93
Most dependent part of peritoneum
Pouch of Douglas
94
Embryological development of vagina
Upper 2/3rd :Müllerian duct (mesoderm)
| Lower 1/3rd :urogenital sinus (endoderm)
95
Through which part of vagian peritoneal cavity can be reached
Pouch of Douglas (rectouterine fold )
96
Which of the following statement is true
1. Vagina has no glands
2. Vagina has no secretions
3. Natural ph of vagina is acidic q
1 is true
But vagian has so many secretions
- they come as Transudative secertions across vagianl wall
-as cervical secretions
- bartholin’s gland (only during colitis)
Natural ph of vagina is acidic as it acts as natural defence against infection where as cervical secretions which are alkaline becomes acidic in vagina
97
Cervical secretions are alkaline which becomes acidic in vagina how ?
1.Due to commensal bacteria i.e lactobacillus (doderleins bacilli)
And 2. Due to presence of glycogen brought about by estrogen
Imbalance in these causes acidic imbalance
For e.g in bacterial vaginosis - lactobacilli are decreased
98
```
Significance of pH change with estrogen in vagina
During menstruation
Before puberty and after menopause
In pregnant female
New born
```
During menstruation - 3.5 to 4.5 (approx 4 to 4.5 )
Before puberty and after menopause - 6.5 to 7.5 (d/t lack of estrogen )
PH in pregnant female -4
In new born vaginal pH 5.5 to 6 (less acidic ) becoz lining epithelium of vagina is transitional
99
Vagina is made up of 3 types of cells name them
1. Parabasal - seen in menopausal women (predominantly)
2. Intermediate - predominant under progesterone
3. Superficial - predominant under estrogen
It is used to calculate menstruation index ( parabasal : intermediate : superficial )
100
```
Calculate the mensturation index of the following
Pregnancy
Ovulation
Post partum
Children
Menopause
Atrophic `
```
1. 0:95:5
2. 0:30:70
3. 100:0:0
4. 80:20:0
5. 50:50:0
6. 100:0:0
101
Blood supply of vagina
Upper 1/3 rd : descending vaginal artery of uterine
Middle 1/3rd : inferior vesicle
Lower 1/3rd : middle rectal
102
Lymphatic drainage of vagina
Upper 1/3rd : external iliac LN
Middle 1/3rd : internal iliac LN
Lower 1/3rd : superficial inguinal LN
103
The following in female external genitalia gives rise to
Genital tubercle
Genital fold
Genital swelling
Genital tubercle - clitoris (appears in the flouts at 6th weeks )
Genital fold - Labia minora
Genital swelling - labia Majora
104
What in female body the following parts are homologous to which part of male body
1. Clitoris
2. penile urethra
3. scrotum
4. prostate
5. bartholin’s glands
1. clitoris - penis
2. penile urethra - labia minora
3. Scrotum - labia majora
4. Prostate - glands of skene (para urethral glands)
5. bartholins gland - bulbourethral glands in female aka COWPER’S GLAND
105
Lymphatic drainage of clitoris
Lymphatic drainage of glans clitoris
Clitoris + majora drains into
Glans + minora
Superficial inguinal L.N
Drains into deep inguinal L.N aka L.N of cloquet
Superficial
106
Are bartholin’s glands present in males
Yes , the are present deeply in males
107
Location of bartholin’s glands in female
+ in superficial perineal pouch
Anterior 2/3rd and posterior 1/3rd in the groove b/w majora and minora
* ducts travel forward and medially to open in the vagina outside the hymen
They are pea sized
108
Bartholin’s can give rise to 3 types of cancers . True or false ?
True bartholin’s can give rise to all 3 types of cancer due to the lining epithelium it has
Their is different epithelium in the gland -columnar epithelium
Different in the duct - transitional epithelium
And different at opening - squamous epithelium
109
What will be the course of treatment in a pt. with bartholin’s cyst and following condition
1. Asymptomatic cyst
2. Asymptomatic cyst + >40 yrs
3. Symptomatic cyst +<40 yrs
1. Asymptomatic cyst - no Rx
2. Asymptomatic cyst +>40 yrs - excision ( high risk of cancer)
3. Symptomatic cyst + <40 yrs - marsupilization (exteriorisation of opening)
110
Mc organism causing bartholin’s gland abscess
Rx
What perevents recurrence
E.coli>gonorrhoea
I and D
Word catheter
111
The gonads i.e testis and ovaries arise from
Gonadal ridge / genital ridge
112
Why gonads become testis or ovaries
D/t presence of Y Chr. —SRY (short arm of Y chr on distal part) if this is absent the foetus has tendency to become female foetus
113
What gene is required for the gonads to become testis
| Or to become ovaries
Testis - SRY gene
| Ovaries - WNT4
114
Which of the following is false
Testis are formed at 7 weeks
Ovary are formed at 8 weeks
Internal genitalia differentiate at 10 weeks
External genitalia differentiate at 12 weeks
All are true
115
Differentiation of male and female at what period of gestation
If nothing mentioned 12 weeks
116
Boundaries of ovarian fossa
Sup: external iliac vessels
Inferior:levator ani
Medial:ovarian ligament
Lateral:obturator nr. And vessels
Posterior:ureter and internal iliac vessels
Anterior:posterior leaf of broad ligament and obliterated umbilical artery
117
Infundibulo pelvic ligament attaches ovary to ....
| It carries what
It attaches ovary to lateral pelvic wall
| It carries ovarian artery and vein
118
Are bartholin’s glands present in males
Yes , the are present deeply in males
119
Location of bartholin’s glands in female
+ in superficial perineal pouch
Anterior 2/3rd and posterior 1/3rd in the groove b/w majora and minora
* ducts travel forward and medially to open in the vagina outside the hymen
They are pea sized
120
Bartholin’s can give rise to 3 types of cancers . True or false ?
True bartholin’s can give rise to all 3 types of cancer due to the lining epithelium it has
Their is different epithelium in the gland -columnar epithelium
Different in the duct - transitional epithelium
And different at opening - squamous epithelium
121
What will be the course of treatment in a pt. with bartholin’s cyst and following condition
1. Asymptomatic cyst
2. Asymptomatic cyst + >40 yrs
3. Symptomatic cyst +<40 yrs
1. Asymptomatic cyst - no Rx
2. Asymptomatic cyst +>40 yrs - excision ( high risk of cancer)
3. Symptomatic cyst + <40 yrs - marsupilization (exteriorisation of opening)
122
Mc organism causing bartholin’s gland abscess
Rx
What perevents recurrence
E.coli>gonorrhoea
I and D
Word catheter
123
The gonads i.e testis and ovaries arise from
Gonadal ridge / genital ridge
124
Why gonads become testis or ovaries
D/t presence of Y Chr. —SRY (short arm of Y chr on distal part) if this is absent the foetus has tendency to become female foetus
125
What gene is required for the gonads to become testis
| Or to become ovaries
Testis - SRY gene
| Ovaries - WNT4
126
Which of the following is false
Testis are formed at 7 weeks
Ovary are formed at 8 weeks
Internal genitalia differentiate at 10 weeks
External genitalia differentiate at 12 weeks
All are true
127
Differentiation of male and female at what period of gestation
If nothing mentioned 12 weeks
128
Boundaries of ovarian fossa
Sup: external iliac vessels
Inferior:levator ani
Medial:ovarian ligament
Lateral:obturator nr. And vessels
Posterior:ureter and internal iliac vessels
Anterior:posterior leaf of broad ligament and obliterated umbilical artery
129
Infundibulo pelvic ligament attaches ovary to ....
| It carries what
It attaches ovary to lateral pelvic wall
It carries ovarian artery and vein
*ovarian artery br. Of abdominal aorta (at L2)
Ovarian vein
-Rt. Side o.vein : IVC
-left side o.vein :left renal vein then IVC
130
Reason for Varicocele
| Mc side
Left testicular vein joins left renal vein at 90 degree
| Left side mc
131
Referred pain of ovary is seen where
| Occurs d/t
Felt at medial aspect of thighs
| Cutaneous br. Of obturator Nr
132
Lymphatic drainage of the ovary
Para aortic LN
133
Primordial germ cells are derived from
Epiblast (ectoderm)-older days yolk sac
134
Does ovary has capsule
Yes ovary has capsule......it is nothing but germinal layer i.e epithelium only
It has single layer cuboidal epithelium ,germ cells are formed here
135
Which of the following are true
1. No. Of oocytes decrease as age increases
2. Max. No. Of oocyte are found at 20 weeks of IUL (5month) i.e 7 million
3. At birth :2 million (1-2million)
4. At puberty :4,00,000
5. 400 ovulate in female , 1000 undergo atresia every month
All of the following are true
136
What is the sequence of completion of follicular formation and at what weeks
Epiblast - yolk sac (at 3weeks)- genital ridge (6weeks) -oogonia (9weeks) - primary oocyte (12 weeks) - follicle formation begins (14 weeks) - follicle formation completes (24 weeks)
137
Oogenesis begins when
Intra uterine life
138
Oogonia is diploid or haploid
It is diploid which undergoes mitosis
139
When is meiosis completed
Just before ovulation ( 3-4 Hours before ovulation )
140
1st meiotic division is arrested in which stage of oogenesis
Dictyotene
| Prophase - diplotene - dictyotene**
141
Features of 2 degree oocyte are
1. Genetic material equally divided
2. Less cytoplasm
3. Ovum contains 2 degree oocyte
4. It is haploid (n)
1,3,4 all are features of 2 degree oocyte
But less cytoplasm is a feature of 1st polar body
2 degree oocyte has more cytoplasm
142
2nd meiotic division is arrested in which stage of oogenesis
Metaphase
143
2nd meiotic division is finished / completed when and what is formed
After fertilisation
| Female pronucleus and 2nd polar body is formed
144
Size of mature ovum
120 micro m in diameter
145
Size of mature follicle
18-20 mm
146
Fertilisable life span of ovum
24 hrs
147
When does the following process begin
Oogenesis
Spermatogenesis
Intrauterine life
| Puberty
148
Which stage is absent in spermatogenesis which is present in oogenesis
Spermatogenesis does not have any arrest i.e dictyotene
149
1 primary spermatocyte gives birth to how many spermatid
4 sperm / spermatid
150
1 spermatogonia gives rise to how many primary spermatocytes
16 primary spermatocyte = 64 sperms
151
In 1 day how many spermatid are formed
100 million
152
Fertilisable life span of sperm
3 days
153
Length of mature sperm
55micron (smaller then ovum 120 micro m )
154
Duration of spermatogenesis
72 days
155
Time taken by spermatogenesis
14 days
156
Achieve maturity and motility at which part of male reproductive system
Epididymus
| Specific- tail /caudal part of epididymus
157
```
Following organelles make what part of sperm
Nucleus
Golgibodies
Mitochondria
Microtubules
```
Nucleus - head of sperm
Golgibodies - acrosomal cap
Mitochondria - middle piece (power house of sperm)
Microtubules - tail (arrangement 9+2)
158
Which organelle is absent in sperm
Endoplasmic reticulum (rough E.R)
159
Ion which is responsible for motility of sperm
Calcium
