Repro 5

Question 1

Describe the arterial supply and venous drainage of the ovaries.

Answer 1

Ovarian artery - direct branch of the abdominal aorta, inferior to renals.

R+L ovarian veins

• right drains into inferior vena cava
• left drains into the left renal vein and that drains into IVC.

Question 2

What lymph nodes drain the ovaries?

Answer 2

Para aortic nodes.

Question 3

Name and describe with respect to other organs, the pouches in the female.

Answer 3

Rectouterine pouch - posterior

• aka pouch of Douglas
• between the uterus and rectum
• access to this is via the posterior fornix of the vagina

Uterovesical pouch - anterior
- between bladder and uterus.

Question 4

What is the ovarian ligament a remnant of, and what does it do?

Answer 4

It’s a remnant of the superior portion of the gubernaculum
It attaches the ovaries to the uterus.
It’s contained within the mesovarium.

Question 5

What is the name of the connective tissue of the ovaries?

Describe its appearance over the course of life.

Answer 5

This is the Tunica Albuginea.
It its greyish in colour.
It becomes scarred and distorted over life due to repeated ovulations.

Question 6

In which structure is the neurovascular supply of the uterus carried through?

Answer 6

Through the broad ligament.

- not a true ligament in the MSK sense.

Question 7

What two structures does the round ligament of the uterus attach to?
What is its embryonic origin?

Answer 7

It attaches the ovaries to the labia majora
It’s the remnant of the gubernaculum.
It travels through the inguinal canal.

Question 8

Describe the position of the uterus

Answer 8

Antiverted with respect to the vagina

Antiflexed with respect to the cervix.

Question 9

What does the broad ligament of the uterus consist of?

Where is it located?

Answer 9

The broad ligament is found extending from the sides of the uterus to the lateral walls and the pelvis floor.

Mesovarium - mesentry that suspends the ovaries
Mesosalpinx - attaches Fallopian tubes to the broad ligament
Mesometrium

Question 10

Name the different sections of the Fallopian tubes

Answer 10

From proximal to distal:

• isthmus
• ampulla (fertilisation occurs here)
• infundibulum
• fimbriae
• abdominal ostium

Conducts the oocyte into the uterus.

• lining of the uterus and Fallopian tubes is different
  
  • Ectopic pregnancy here can cause haemorrhage easily.

Question 11

What is ‘different’ about the abdominal ostium and its relationship with the peritoneum?

Answer 11

The ostium opens up into the peritoneal cavity.

Question 12

Where is the endocervical canal?

Answer 12

In between the internal and external os.

Question 13

What exactly is the cervix? Describe its location.

Answer 13

The cervix of the uterus is a fibromuscular structure which is similar to a neck. It protrudes into the vagina.

Question 14

Describe the arterial supply, venous drainage and the lymphatics of the uterus.

Answer 14

Arterial - uterine artery. Below are branches leading to the uterine artery

• AA
• common Ileac
• internal Ileac
• anterior division
• uterine artery

Venous - via the uterine venous plexus.

• uterine venous plexus
• uterine vein
• internal Ileac
• IVC

Lymph nodes - different parts have different drainage

• fundus - aortic nodes
• body - external Ileac
• cervix - internal/external Ileac and sacral nodes

Question 15

What structure can become damaged during a hysterectomy? (Non reproductive structure)

Answer 15

Ureters.
These pass below the uterine artery
‘Water under the bridge’

Question 16

Where are the vaginal fornices located?

Answer 16

These are the recesses in the vagina of the cervix.

- IE where the cervix protrudes into the vagina, it creates small pockets either side. These are the vaginal fornices.

Question 17

Describe the nerve supply to the vagina

Answer 17

Superior 4/5th - uterovaginal plexus

Inferior 1/5th - pudendal

Question 18

What happens to pain above and below the pelvic pain line?

Answer 18

Above this, the back is referred

Below, the pain is localised.

Question 19

Describe the blood supply to the vagina

Answer 19

Superior portion

• AA
• common Ileac
• internal Ileac
• anterior division
• vaginal artery

Middle and Inferior portion

• AA
• common Ileac
• internal Ileac
• anterior division
• pudendal artery

Question 20

Describe the venous drainage of the vagina

Answer 20

• vaginal plexus
• vaginal vein
• uterine vein
• internal Ileac
• IVC

Question 21

Describe the drainage of the testes starting from the capsule

Answer 21

• capsule
• seminiferous tubules
• rete testes
• efferent ducts
• epididymis (H B and T)
• vas deferens

Question 22

What two types of cells constitute the seminiferous epithelium?

Answer 22

Sertoli cells, which also form the blood-testes barrier

Cells of the germ cell lineage.

Question 23

What is the action of the efferent duct ?

Answer 23

Contribute to sperm transport via ciliary action and myoid contraction.

Question 24

What is the epithelium of the epididymis ? The function?

Answer 24

Pseudostratified non keratinized with stereocilia

Involved in absorption mainly, not so much about movement.

Question 25

How many layers constitute the vas deferens? What are these called?

Answer 25

4 layers

• epithelium X1
• smooth muscle x 3
  
  • longitudinal, circular and then longitudinal again

Question 26

What is the function of the vas deferens?

Answer 26

They connect the epididymis to the ejaculatory ducts

They contract forcefully during ejaculation.

Question 27

What contributes the majorly of the ejaculate volume?

Answer 27

The seminal vesicles, which receive sympathetic innervation.

Question 28

Where does benign prostatic hyperplasia occur and how does a patient often present

Answer 28

Occurs in the transition zone of the prostate

This hyperplasia eventually impinges and begins to occlude the prostatic urethra, causing difficulty in micturating.

Question 29

Where does prostatic carcinoma occur and why is it often at an advanced stage upon presentation?

Answer 29

Occurs in the peripheral zone of the prostate.
For there to be any signs, the prostatic urethra must be compressed. The peripheral zone is on the periphery of the prostate, and so it takes longer to compress the prostatic urethra. Once it does, it must have been there for a long time and so therefore it is at an advanced stage.

Question 30

What is the name of the structure that suspends each ovary?

Answer 30

The mesovarium. This is a mesentry.