Repro - Female Flashcards
What structures constitute the birth canal?
Cervix
Vagina
Vulva
What are the layers of the uterus?
Endometrium
Myometrium
Perimetrium
Describe the ligaments around the uterus?
Fascial Ligaments:
- Pubocervical
- Sacrocervical
- Cardinal aka transverse cervical
Broad ligament
(The above ones support the uterus)
Round ligament travels through broad ligament
Ovarian ligament connects ovary to uterus
What is the normal position of the uterus?
Anteflexed
Anteverted
What happens if the uterus is very retroverted or retroflexed?
Prolapse during early pregnancy
Why is it important to know the position of the uterus during surgical management of miscarriage?
To minimise risk of perforation of the uterus with instrumentation
What do we call the peritoneal pouches ant and post to the uterus?
Rectouterine pouch and uterovesical pouch
What are the fornixes of the vagina?
Arches found just distal to the cervix
What links the fornixes and peritoneal pouches clinically?
The posterior fornix can access the rectouterine pouch.
Pathologies can spread this way such as pus, tumours or endometriosis
What does the cardinal or transverse cervical ligament connect?
Cervix to the lateral pelvic wall
Name the sections of the fallopian tube?
From ovary –> Uterus:
- Infundibulum
- Ampullary Region
- Isthmus
- Intramural or Uterine part
What parts of the fallopian tube are longest and widest?
Ampullary region
Where does fertilization occur in the fallopian tube?
Ampullary region
What is an ectopic or tubal pregnancy?
Embryo implants & grows outside the uterus
What is a cornual ectopic pregnancy?
Pregnancy in the intramural fallopian tube, the part that traverse the uterine muscular wall
What ligaments are associated with the ovary?
Ovarian ligament from uterus -> ovary
Suspensory Ligament of ovary from lateral pelvic wall -> Ovary
Where does the ovarian artery arise and travel?
From the Abdominal Aorta at L2
Descends within the suspensory ligament and supplies the ovaries via the broad ligament
(Anastomoses with the uterine artery and is sometimes replaced by it)
Where do the ovarian veins drain?
Left into Left Renal Vein
Right into IVC
Describe the passage of the uterine artery?
Crosses over ureter at the level of ischial spine at junction of cervix & lateral part of the vagina’s fornix.
Why is the passes of the uterine artery important to understand?
Iatrogenic injury of the ureter is not uncommon when ligating the uterine artery during hysterectomy
Where does lymph from the labia and distal vagina go?
To the inguinal nodes
Where does lymph from the ovaries go?
To the Paraaortic nodes at L2
Where does lymph from the fundus and upper uterine body go?
To the pre-aortic lymph nodes
Where does lymph from most of the uterine body go?
Internal Iliac lymph nodes
Where does lymph from the uterine cervix & upper vagina go?
Internal Iliac and Sacral lymph nodes
Where does lymph from the lower vagina go?
Iliac and superficial inguinal nodes
What is breast tissue?
A highly modified sweat gland in the superficial fascia of the pectoral region
Each breast contains 15-25 lobes of tubulo-acinar glands and connective tissue
What surface landmarks do we use to mark the extent of the breast?
Vertically from 2nd -> 6th rib
Horizonally from lateral sternal border to midaxillary line
What muscle are associated with the deep surface of the breast?
Pectoralis Major
Pectoralis Minor
Serratus Anterior
What arteries supply the breast?
Branches of the subclavian and axillary:
- Internal thoracic
- Thoraco-acromial
- Lateral Thoracic
What are the main lymph node groups draining the breast?
Axillary (first receives lymph from the lateral quadrant of the breast tissue)
Parasternal
Supraclavicular lymph nodes
Lymph can drain from the medial side of one breast to the other side allowing spread of breast cancer
How does breast tissue change during pregnancy and lactation? (histologically)
Inactive breast tissue is dominated by fat
Active tissue (late pregnancy) has adiposity replaced by glandular tissue (with trabeculae of stroma & smooth muscle)
When lactating you can see the duct contains secretions and the glands hypertrophy
How does endometrium look histologically during the proliferative phase?
Like long streaky glands
How does the endometrium look during the secretory phase?
glands look infolded with lotsof crypts, kinda spiky
Describe a cross-section of the fallopian tube on histology?
Looks like brain but smooshed into a tube
How can you tell an ovary on histology?
Look for a mess of cells containing folicles
How do you tell the different stages of follicle on histology?
Young follicles are small and round with a single layer of cells
Secondary follicles have more layers and a visible oocyte
A mature graafian follicle contains a white antrum in a c-shape around the oocyte
From where does the placenta develop?
The trophoblast after the blastocyst has implanted into the uterine endometrium
Describe the surfaces of the placenta
Maternal side is rough and spongy
Foetal side is smooth and bears umbilical cord attachment
What are the functions of the placenta?
1) Gaseous Exchange
2) Metabolism (Specifically glycogen synthesis)
3) Endocrine secretion (Specfically HCG)
4) Nutrient Transport
What stage of labour does the placenta seperate from the uterine wall?
Third stage
After the fetus is delivered
What vessels travel within the umbilical cord?
Two umbilical arteries carrying deoxygenated blood from foetus -> Placenta
one umbilical vein carry oxygenated blood from placenta -> foetus
What happens to the umbilical vein after birth?
Persists as the round ligament of the liver, remember?
Other than the veins/arteries what makes up the rest of the umbilical cord?
Wharton’s Jelly
