Repro Session 5 Flashcards
4 component parts of female reproductive system?
paired ovaries- produce ova and sex hormones
fallopian (uterine) tubes- provide site for sperm and ovum to come into contact with 1 another, and convey product of fertilisation to uterus
uterus- desired area of implantation of conceptus= posterior uterine wall
vagina and external genitalia
how are the ovaries attached to the posterior surface of the broad ligament of the uterus?
by the mesovarium
name given to inflammation of uterine tubes due to microorganisms?
salpingitis
what occurs as a result of inflammation of the uterine tubes?
fusions or adhesions of mucosa occurs, that can cause partial or complete blockage of lumen of uterine tube, leading to infertility.
blocked or dysfunctional tubes may result in ectopic pregnancy (tubal) or implantation outside the uterus
function of cervix?
allow sperms deposited in vagina at coitus to enter uterine cavity and proceed to site of fertilisation, and, at other times, to protect the uterus and upper genital tract from bacterial invasion
epithelial lining of exocervix?
stratified squamous non-keratinized
lining of endocervix?
tall columnar epithelium with basally positioned nuclei and greater part of cytoplasm filled with mucus. Mucosa has numerous large glands also lined with tall, mucus-secreting columnar cells
in which condition is ectopic endometrial tissue dispersed to various sites along the peritoneal cavity and beyond e.g. near to umbilicus?
endometriosis
what might endometriosis be associated with?
ovaries or attachments of uterus, and often associated with dysmenorrhoea, infertility, or both.
major symptom of endometrial carcinoma?
abnormal uterine bleeding
at which site of uterus and cervix due majority of neoplasms form?
junction between columnar cells of endocervix and squamous cells of exocervix
what is the pelvic inlet demarcated by?
broad ‘wings’ of iliac bones, sacrum and pubic symphysis
what is the pelvic outlet demarcated by?
paired inferior pubic rami, ischial bones, ischial spines, and the coccyx
how can male and female pelves be distinguished on X-rays?
pelvic inlet oval in female and heart shaped in male subpubic angle (between inferior pubic rami) narrow in male, wide in female soft tissue shadow of penis and scrotum can usuallt be seen when not shielded by a lead screen
composition of pelvic floor?
pelvic diaphragm- levator ani and coccygeus, and related fascial coverings
superficial muscles and structures: anterior (urogenital) perineum and posterior (anal) perineum
how is the uterus tethered to the pelvic wall?
via the broad ligament
what name is given to the opening of the uterine tubes into the periotneal cavity?
the abdominal ostium
what is the bulb of the vestibule surrounded by in the female?
the bulbospongiosus muscles
Why must an ectopic pregnancy be operated on?
risk of rupture of site of implantation e.g. ampulla of fallopian tube, resulting in severe haemorrhage, fluid and blood can collect in the Pouch of Douglas between the rectum and uterus, and spread within the peritoneum, causing an acute abdomen- may feel rigid and painful. Loss of blood may mean patient goes into SHOCK.
Other than the abdomen, where else is pain felt in an ectopic pregnancy and why?
Shoulder
blood from rupture can spread within the greater sac via the paracolic gutters to the subphrenic space below the diaphragm, causing diaphragmatic irritation, and as the diaphragm is innervated by the phrenic nerve with nerve roots C3-C5 which supply dermatomes over shoulder, pain is referred to the shoulder
why is endometrial cancer currently on the increase?
OBESITY
fat is a site for androgen conversion to oestrogens so in an obese patient, there is is increased oestrogen production which stimulates the proliferation of endometrial cells, increasing risk of endometrial cancer
outer covering of uterus?
perimetrium
gubernaculum remnants?
ovarian ligament and round ligament of uterus
importance of L ovarian vein drainage in pregnancy?
increased susceptibility to obstruction of vein and thrombus formation
3 key sections of fallopian tube?
infundibulum, ampulla, isthmus
origin of uterine arteries?
anterior divison of internal iliac arteries
what stops ovaries descending?
uterus- formed by fusion of paramesonephric ducts
blood supply of ovaries?
ovarian arteries from abdominal aorta, just below renal arteries
venous drainage of ovaries?
R ovarian vein to IVC
L to L renal vein
how are ovaries suspended?
mesovarium- short peritoneal fold which is a division of the broad ligament of the uterus- larger mesentery
how do ovarian vessels, lymphatics and nerves pass to and from ovaries?
via suspensory ligament of ovary- becomes continuous with broad ligament
why does cervix project partly into vagina?
as cervix formed from mullerian ducts which contact the urogenital sinus and open into it, with further modification then forming the vagina
how is the deepest part of the pouch of Douglas reflected?
by the posterior fornix= part of vagina posterior to cervix
how is broad ligament of uterus formed?
fusion of paramesonephric ducts in midline as grow towards each other, pushing into peritoneal cavity and taking peritoneum with them
what does broad ligament assist with?
keeping uterus in position
what does broad ligament enclose?
uterus, uterine tube and ovary, and their NV supply
importance of round ligament travelling through inguinal canal for lymphatic drainage?
ligament lies anteroinferiorly between layers of broad ligament, and as runs through inguinal canal to labia majora, some drainage from fundus of uterus is to superficial inguinal LNs
which part of the broad ligament encloses the uterine tubes?
mesosalpinx
how does round ligament assist anatom positon of uterus?
due to tethering to labia majora
describe position of uterus within pelvic cavity
anteverted with respect to vagina, and antiflexed with respect to cervix
what is retroversion?
uterus tilted posteriorly with respect to vagina
what is retroflexion?
uterus tilted posteriorly with respect to cervix
where does the oocyte expelled at ovulation pass into?
peritoneal cavity, but then trapped by fimbriae of infundiblum, and so passes into uterine tube via abdominal ostium, and is then carried into ampulla
contrast lining of uterine cavity and uterine tubes, and explain clinical significance of this
tubes= simple columnar ciliated and non-ciliated cells
cavity= endometrium
lining of tubes specialised for movement on non-motile gamete, and NOT implantation, so consequence for ectopic implantation