Repro 5 Flashcards
Describe the arterial supply and venous drainage of the ovaries.
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.
What lymph nodes drain the ovaries?
Para aortic nodes.
Name and describe with respect to other organs, the pouches in the female.
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.
What is the ovarian ligament a remnant of, and what does it do?
It’s a remnant of the superior portion of the gubernaculum
It attaches the ovaries to the uterus.
It’s contained within the mesovarium.
What is the name of the connective tissue of the ovaries?
Describe its appearance over the course of life.
This is the Tunica Albuginea.
It its greyish in colour.
It becomes scarred and distorted over life due to repeated ovulations.
In which structure is the neurovascular supply of the uterus carried through?
Through the broad ligament.
- not a true ligament in the MSK sense.
What two structures does the round ligament of the uterus attach to?
What is its embryonic origin?
It attaches the ovaries to the labia majora
It’s the remnant of the gubernaculum.
It travels through the inguinal canal.
Describe the position of the uterus
Antiverted with respect to the vagina
Antiflexed with respect to the cervix.
What does the broad ligament of the uterus consist of?
Where is it located?
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
Name the different sections of the Fallopian tubes
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.
What is ‘different’ about the abdominal ostium and its relationship with the peritoneum?
The ostium opens up into the peritoneal cavity.
Where is the endocervical canal?
In between the internal and external os.
What exactly is the cervix? Describe its location.
The cervix of the uterus is a fibromuscular structure which is similar to a neck. It protrudes into the vagina.
Describe the arterial supply, venous drainage and the lymphatics of the uterus.
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
What structure can become damaged during a hysterectomy? (Non reproductive structure)
Ureters.
These pass below the uterine artery
‘Water under the bridge’
Where are the vaginal fornices located?
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.
Describe the nerve supply to the vagina
Superior 4/5th - uterovaginal plexus
Inferior 1/5th - pudendal
What happens to pain above and below the pelvic pain line?
Above this, the back is referred
Below, the pain is localised.
Describe the blood supply to the vagina
Superior portion
- AA
- common Ileac
- internal Ileac
- anterior division
- vaginal artery
Middle and Inferior portion
- AA
- common Ileac
- internal Ileac
- anterior division
- pudendal artery
Describe the venous drainage of the vagina
- vaginal plexus
- vaginal vein
- uterine vein
- internal Ileac
- IVC
Describe the drainage of the testes starting from the capsule
- capsule
- seminiferous tubules
- rete testes
- efferent ducts
- epididymis (H B and T)
- vas deferens
What two types of cells constitute the seminiferous epithelium?
Sertoli cells, which also form the blood-testes barrier
Cells of the germ cell lineage.
What is the action of the efferent duct ?
Contribute to sperm transport via ciliary action and myoid contraction.
What is the epithelium of the epididymis ? The function?
Pseudostratified non keratinized with stereocilia
Involved in absorption mainly, not so much about movement.
How many layers constitute the vas deferens? What are these called?
4 layers
- epithelium X1
- smooth muscle x 3
- longitudinal, circular and then longitudinal again
What is the function of the vas deferens?
They connect the epididymis to the ejaculatory ducts
They contract forcefully during ejaculation.
What contributes the majorly of the ejaculate volume?
The seminal vesicles, which receive sympathetic innervation.
Where does benign prostatic hyperplasia occur and how does a patient often present
Occurs in the transition zone of the prostate
This hyperplasia eventually impinges and begins to occlude the prostatic urethra, causing difficulty in micturating.
Where does prostatic carcinoma occur and why is it often at an advanced stage upon presentation?
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.
What is the name of the structure that suspends each ovary?
The mesovarium. This is a mesentry.
