Repro 5.1 female anatomy Flashcards
1
Q
What are the main components of the female reproductive tract?
A
- ovaries
- uterus
- uterine tubes
- cervix
- vagina
- external genitalia (labia majora/minora, clitoris, etc)
2
Q
where do the ovaries develop originally?
A
the mesonephric ridge (urogenital ridge)
3
Q
Where are the ovaries situated?
A
Within the pelvis, not descended outside the body like the testes.
4
Q
What are the main funtions of the ovaries?
A
- to produce oocytes
- to produce sex steroids progesterone and oestrogen.
5
Q
What are the 2 main anatomical components of the ovary?
A
medulla
cortex
6
Q
Whats the function of the cortex?
A
Made of connective tissue stroma and many primordial follicles.
7
Q
What’s the function/make up of the medulla?
A
Made of supporting stroma and rich vasculature.
8
Q
How does neurvasculature enter the ovaries?
A
Via the mesovarium.
9
Q
What is the mesovarium?
A
a fold of peritoneum which is continuous with the outer surface of the ovaries.
IT connects the ovaries to the posterior uterine wall.
10
Q
What is the epithelial layer of the surface of the ovaries?
A
simple cuboidal epithelium, also known as germinal epithelium.
11
Q
What are ovarian cysts?
A
Fluid filled masses on the surface of the ovary, commonly from follicles.
Can grow up to 2.5cm.
12
Q
What are some complications of ovarian cysts and how would you deal with them?
A
bleeding, pain
would surgically remove them
13
Q
How is PCOS characterised?
whats the criteria?
A
10+ ovarian cysts
hormonal dysfunction
(often associated infertility)
14
Q
What are the common cells involved in ovarian tumours?
A
- epithelial cells (ovarian adenocarcinoma)
- germ cells (teratoma- usually benign)
15
Q
What are the 2 ligaments associated with the ovaries?
A
-suspensory ligament of the ovary- attaches it from the mesovarium to the pelvic wall.
Ligament of the ovary- from the ovary to the fundus of the uterus. (continues as the round ligament of the uterus)
16
Q
Where do the ovaries recieve their blood from?
A
ovarian artery (direct branch from the abdominal aorta)
17
Q
What’s the venous drainage of the ovaries?
A
-left and right ovarian veins.
left drains into the left renal vein, right drains striaght into the IVC
18
Q
Where does the lymph from the ovaries drain?
A
Para-aortic lymph nodes.
19
Q
from where do the ovaries receive their nervous supply:
a) sympathetic
b) parasympathetic
A
a) ovarian plexus
b) pelvic plexus.
20
Q
What is the location of the uterine ducts?
A
run within the upper border of the broad ligament.
extend from the lateral uterus and open into the abdominal cavity near tot he ovaries.
21
Q
What’s the main function of the uterine tubes?
A
to transport the ovum from the ovaries to the uterus.
22
Q
What factors aid the uterine tube in moving the ovum?
A
- cillia on the inner mucosa
- peg cells (non-ciliated secretory cells) to provide the ovum with nutrients,
- smooth msucle layer undergoes peristalsis.
23
Q
What are the 4 sections of the uterine tube>
A
Fimbria (finger like projections)
infundibulum (funnel shaped)
ampulla (widest section, where fertilisation usually occurs)
isthmus (connection to uterine cavity)
24
Q
Where do the uterine tubes receive their blood supply from?
A
uterine and ovarian arteries.
25
What is the venous drainage of the uterine tubes?
uterine and ovarian veins
26
What is the lymphatic drainage of the uterine tubes?
- sacral
- iliac
- para-aortic lymph nodes
27
What's the innervation of the uterine tubes?
sympathetic- from the ovarian plexus
parasympathetic- from the pelvic plexus
Sensory fibres from T11-L1.
28
What's the name given to inflammation of the uterine tubes?
Salpingitis.
29
What's the common cause of salpingitis?
Bacterial infections, eg ghonorrhoea
30
What are the complications associated with salpingitis?
adhesions of the mucosa which can cause blockages of the lumen. This can cause infertility or an ectopic pregnancy.
31
How can a partially obstructed uterine tube lead to an ectopic pregnancy?
The sperm can pass the occlusion to fertilise the egg, but the fertilised egg cannot pass, so will stay and try to grow wihtin the uterine tubes.
32
Why are ectopic pregnancys classed as a medical emergency?
the tissue of the uterine tube isn't made for implantation, so can rupture leading to haemorrhage.
33
What is ligation of the uterine tubes?
Cutting of them, used to sterilise someone so they can not longer get pregnant.
The oocyte cannot pass to the uterus.
34
What are the 2 methods of ligation?
- open abdominal (via a suprapubic incision)
| - laparoscopic (using a small incision near the umbillicus and a laparoscope).
35
What are the 2 connections of the uterus?
laterally-uterine tubes
distally- vagina
36
What are the 3 parts of the uterus?
- fundus (located above the opening of the uterine tubes)
- body
- cervix
37
Describe the anatomical position of the uterus in the average adult
- anterverted with respect tot he vagina
| - anteflexed wtih respect to the cervix.
38
Where does the uterus lie with respect to the bladder?
Posteriosuperiorly.
39
What are the common abnormal positions of the uterus?
- excessively anteflexed
- anterflexed and retroverted
- retrofelxed and retroverted.
40
What problems can an abnormally positioned uterus cause?
Normally doesn't cause any problems
a retroverted uterus lies directly above the vagina so is more likely to prolapse when there is increased abdominal pressure.
41
What are the 3 histological layers of the uterus?
- peritoneum (known as perimetrium)
- myometrium (smooth muscle layer, undergoes hyperplasia and hypertrophy to help expell the foetus at birth)
- endometrium-further subdivided.
42
What are the 2 distinctive layers fo the endometrium?
(deep) stratum basalis
| (sueprfiical) statum functionalis
43
Which layer of the uterus is shed during menstruation?
The startum functionalis.
Also responds to the oestrogens to proliferate, and becomes secretory in response to the progesterones.
44
What are the main ligaments of the uterus?
- broad ligament
- round ligament
- ovarian ligament
- cardinal ligament
- uterosacral ligament
45
Describe features of the broad ligament.
attaches the sides of the uterus to the pelvis.
| Double layer of peritoneum which acts as the mesentery of the uterus.
46
Describe the round ligament of the uterus.
Remenant of the gubernaculum, and an extension of the ovarian ligament.
Connects the uterine horns to the labia majora (via inguinal canal)
Maintains anteverted position of the uterus.
47
What does the cardinal ligament of the uterus do?
attached the lateral cervix to the lateral pelvic walls.
48
What does the cardinal ligament of the uterus contain and where is it found?
Uterine artery and vein.
Found in the base of the broad ligament.
49
what does the uterosacral ligament do?
Connects the cervix to the sacrum.
50
What is the blood supply to the uterus?
Uterine artery
51
What is the venous return of the uterus?
a venous plexus found wihthin the broad ligament, which drains into the uterine ligament.
52
What's the lymphatic drainage of the uterus?
- illiac
- sacral
- aortic
- inguinal lymph nodes
53
What is a hysterectomy?
Surgical removal of the uterus.
54
When is a hysterectomy performed?
Usually following a uterine or cervical cancer.
Sometimes as a last resort for menstrual dysfunction.
55
What is endometriosis?
Ectopic uterine tissue. (usually ovaries or ligaments)
still responsive to hormones so often forms cysts.
Can lead to irregular bleeding, and/or fertility.
56
What are fibroids?
benign growths of the endometrium.
OEstrogen dependant (grow in response to pregnancy/contraceptive pill, regress after menopause)
57
What can be some symptoms of fibroids?
menorrhagia
pelvic pain
infertility
58
What is the name given to malignancy of the endometium?
endometrial carcinoma
59
Where is endometrial cancer most often found?
in the transfromation zone between the collumnar epithelium of the endocervix and the stratified squamous epithelium of the ectocervix.
60
What are the 2 portions of the cervix?
Endocervix
| Ectocervix
61
What is the ectocervix?
| What's its lining
The portion that projects into the vagina,
It's opening is the external os
it is lined by stratified squmoaus non keratinised epithelia.
62
What is the portion of the cervix between the endocervix and the ectocervix called?
Endocervical canal.
63
What is the lining of the endocervical canal?
simple collumnar epithelium.
It is mucus secreting.
64
What is the point at which the uterus becomes the endocervix called?
Internal os.
65
What are the functions of the cervix?
- to help the passage of sperm by dilation of the external and internal os.
- to help keep the upper female reproductive tract sterile. (aided by frequent shedding of the endometrium)
66
What's the arterial supply of the cervix?
Uterine artery
67
What's the venous drainage of the cervix?
Via a uterine plexus within the broad ligament which drains into the uterine vein.
68
What is the lymphatic drainage of the cervix?
iliac
sacral
aortis
inguinal lymph nodes
69
What is cervicits?
| What are the common causes?
Chronic inflammation of the cervix,
| Commonly caused by neisseria ghornorrhoea, and Chlamydia trachomatis.
70
What are some symptoms of cervicitis?
usually asymptomatic
pevic pain,
vaginal discharge
postcoital bleeding
pain during sex
71
What is the medical name given to pain during sex?
dysparuenia.
72
What are the main complications of cericitis?
PID.
| Infertility (due to increased hostility for sperm, blockage of mucus ducts etc)
73
What is the main known cause of cervical cancer?
Human papilloma virus. (HPV)
74
What are the 2 types of cervical cancer you can get?
squmaous cell carcinoma (ectocervix)
cervical adenocarcinoma (endocervix)
75
How long is the vagina?
~9cm
76
What are the functions of the vagina?
intercourse
delivery channel for newborns
exit for menstrual fluid and tissue
77
What are the anatomical relations of the vagina?
-anteiorly- bladder and urethra
-laterally- ureter and uterine artery
posterior- rectum and anus
78
Give examples of vaginal fistulae.
- rectovaginal fistulae
- vesicovaginal fistulae
- urethrovaginal fistuale
79
What are some complications of vaginal fistulae?
- bacterial from the rectum and anus could lead to infections
- urine can enter vagina
80
What's the usual cause of vaginal fistuale and why?
Long traumatic child birth.
Foetus cuts of blood supply to the vaginal wall and necrosis occurs. Can lead to open communication with nearby structures.
81
What are the layers of the vagina?
- epithelia (stratified squamous)
- lamina propria
- fibromuscular layer (2 SM layers, inner circular, outer longitudinal)
- adventitia
82
The epithelium of the vagina responds to which hormone?
| What is the relevance of the response?
Oestrogen, responds by producing glycogen.
This is nutrients for the lactobacillus microbiota, which convert glycogen to lactate, and produce the acidic pH of the vagina.
83
What is the normal pH of the vagina?
| Why is this relevant?
around 4.5
prevents colonisation by other bacteria.
84
what can lead to vaginal infections?
Depletion of lactobacilli by antibiotics,
low oestrogen levels, eg diabetes, during pregnancy
85
What are common vaginal infections?
Candida albicans--> Trush,
| bacterial vaginosis
86
What is the arterial supply to the vagina?
Uterine and vaginal arteries (branches of the internal iliac artery)
87
What is the venous return of the vagina?
vaginal venous plexus, which drains into the uterine vein then the internal iliac vein.
88
What is the lymphatic drainage of the vagina?
iliac and superficial inguinal nodes.
89
Whats the difference in innervation of the superior and inferior vagina?
Superior- via the inferior fibres of the uterovaginal plexus
inferior- via the pudendal nerve.
90
What is the name given to the external genital organs of the female?
Vulva
91
What is the function of the vulva?
- sensation during intercourse
- assist micturition (direction)
- defend internal female against infections
92
What components make up the vulva?
- labia majora
- labia minora
- clitoris
- mons pubis
- bartholins glands
- vestibule
93
What is the vestibule?
The area between and surrounding the labia.
| The vaginal oriface and urethral opening open here.
94
What is the function of bartholins glands and where are they located?
either side of the vaginal orriface, they secrete lubricating mucus for sexual intercourse.
95
What's the embryological origin of the labia minora?
genital folds
96
What's the embryological origin of the clitoris?
genital tubercle
97
What's the emrbyological origin of the labia majora?
labioscrotal swellings.
98
What tissue is the clitoris made of?
Corpora cavernosa erectile tissue- it engorges with blood when stimulated.
99
What is some pathology affecting Bartholins glands?
bartholinitis (infection resulting in inflammation)
Bartholins cysts (when they get blocked but theres no infection)
100
What is the arterial and venous blood supply of the vulva?
Pudendal arteries and pudendal veins (which engorge with blood during sexual stimulation)
101
What is the lymphatic drainage of the vulva?
Superficial inguinal nodes
102
What 2 types of innervation does the vulva recieve?
Sensory
| parasympathetic
103
Describe the sensory innervation of the vulva.
anteriorly- via the illioinguinal nerve and the genital branch of the genitofemoral nerve.
Posteriorly- by the pudendal nerve and the posterior cutaneous nerve of thigh.
104
What are the subdivisions of the borad ligament?
Mesometrium
mesosalpinx
mesovarium
105
Describe features of the mesometrium.
A subdivison of the broad ligament.
Covers the external iliac vessels.
Encloses proximal part of the round ligament of the uterus.
106
Describe features of the mesovarium?
It doesnt actually cover the surface of the ovaries themselves, but attaches to the hilum of them instead and encloses the neurovascular supply.
107
What ligaments are located within the broad ligament?
- ovariean ligament
- round ligament of the uterus
- suspensory ligament of ovary
108
What is the anatomical relationships of the suspensory ligament of the ovary?
- connects ovary to lateral abdominal wall.
| - contains the ovarian artery, vein, nerve plexus and lymphatic vessel)
109
What 3 ligaments support the cervix?
- cardinal ligaments
- pubocervical ligament
- uterosacral ligament
110
What structures support the inferior uterus?
The pelvic floor muscles.
111
Where do the pubocervical ligaments attach?
The anterior cervix to the posterior pubic symphesis
