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ESA 4 > Repro: The Female Repro Tract > Flashcards

Repro: The Female Repro Tract Flashcards

1
Q

What is the function of Bartholins glands?

Where are they located?

A

Located either side of the vaginal orifice

They secrete lubricating mucus during sexual arousal

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2
Q

What is the erectile tissue in the clitoris?

A

Corpora cavernosa tissue

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3
Q

What is the lymphatic drainage of the vulva?

A

Drains into the superficial inguinal lymph nodes

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4
Q

What is the vascular supply to the vulva?

A

Supplied by paired pudendal arteries (mostly the internal branch)
And drained by the pudendal veins with smaller labial veins as tributaries

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5
Q

What is the sensory innervation of the vulva?

A

Anterior vulva - ilioinguinal nerve and genital branch of the genitofemoral nerve
Posterior vulva - pudendal nerve and posterior cutaneous nerve of the thigh

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6
Q

What is a vaginal fistula?

A

Occurs as a result of a traumatic birth where a caesarian is not available (seen as a disease of poverty)
The foetus cuts off the blood supply so there is necrosis - a fistula forms between the vagina and adjacent structure
Eg vesicovaginal, urethrovaginal, rectovaginal

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7
Q

What is the lymphatic drainage of the vagina?

A

Via the iliac and superficial inguinal lymph nodes

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8
Q

What is the vascular supply to the vagina?

A

Uterine and vaginal arteries which are branches of the internal iliac artery
The venous drainage is via the vaginal venous plexus which drains into the internal iliac veins via the uterine vein

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9
Q

What is the innervation of the vagina?

A

The parasympathetic and sympathetic nerves are derived from the uterovaginal nerve plexus which is located at the base of the broad ligament

  • The inferior fibres of the plexus supply the superior vagina (these are derived from the inferior hypogastric plexus and pelvic splanchnic nerves
  • the inferior vagin is supplied by the deep perineal nerve which is a branch of the pudendal nerve
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10
Q

What epithelium lines the ectocervix and endocervix?

A

The ectocervix is the part that projects into the vagina and is lines by stratified squamous.
The external os is the region of transition to the endocervix which is lines by simple columnar epithelium which secretes mucus.

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11
Q

What are the 2 main functions of the cervix?

A
  • facilitates passage of sperm into the uterine cavity
  • maintains sterility of the upper repro tract by preventing bacterial invasion. This is due to frequent shedding of the endometrium, thick cervical mucus and narrow external os
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12
Q

What is the lymphatic drainage of the uterus?

A

The iliac, sacral, aortic and inguinal lymph nodes

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13
Q

What is the vascular supply of the uterus?

A

Blood supply is via the uterine artery

Venous drainage is via a plexus in the broad ligament which drains into the uterine veins

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14
Q

What is cervicitis?

What are the symptoms?

A

Chronic inflammation and infection of the cervix - often caused by chlamydia trachomatis or neisseria gonorrhoeae

Often asymptomatic but can present as pelvic pain, discharge, postcoital bleeding or painful intercourse.

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15
Q

What are the 2 main types of cervical cancer?

A
  • squamous cell carcinoma (ectocervix)

- adenocarcinoma (of the glands in the endocervix)

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16
Q

Where is the ideal site of implantation?

A

High up in the posterior wall of the uterus

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17
Q

Describe the anatomical position of the uterus

A

Anterverted with respect to the vagina - eg rotated forward
Anteflexed with respect to the cervix - eg flexed forwards

Therefore the uterus in immediately posterosuperior to the bladder and anterior to the rectum.

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18
Q

What are the 3 tissue layers of the uterus?

A

Peritoneum - double layered and continuous with the abdo peritoneum. Also known as perimetrum.

Myometrium - thick smooth muscle layer, undergoes hypertrophy and hyperplasia during pregnancy

Endometrium - inner mucous lining, and is further subdivided into the stratum basilis and stratum functionalis.

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19
Q

What is the innervation to the uterus?

A

Sympathetic: arise from the uterovaginal plexus which is mainly anterior and intermediate parts of the inferior hypogastric plexus
Parasympathetic: pelvic splanchnic nerves S234

20
Q

What is endometriosis?

A

Ectopic endometrial tissue, most commonly in the ovaries and ligaments of the uterus. The tissue still responds to oestrogen so bleeding can occur, often forming a cyst. Condition an cause dysmenorrhea or infertility

21
Q

What are fibroids?

A

Benign tumours of the endometrium. Present in 20% of post menopausal women. They are oestrogen dependent.
Most are asymptomatic but if large enough can cause menorrhagia, pelvic pain or infertility.

22
Q

What is endometrial carcinoma?

A

Most common malignancy of the female repro tract
Often found during or after menopause and is characterised by abnormal bleeding.
The majority are find in the transition zone between the ectocervix and endocervix.

23
Q

What features of the fallopian tubes assist in the transport of the ovum to the uterus?

A
  • the inner mucosa is lines with ciliated columnar epithelium and peg cells which waft the ovum and supply it with nutrients
  • the smooth muscle layer contracts to assist transport, the muscle is sensitive to oestrogen so peristalsis is greatest when oestrogen is high
24
Q

Name the different regions of the uterine tube

A

The fimbrae: finger like projections which sweep over the ovary to catch the ovum
The infundibulum: funnel shape opening near the ovary
The ampulla: site of fertilisation
The isthmus: narrow section where the tube connects to the uterine cavity

25
Q

What is the lymphatic drainage of the uterine tubes?

A

Via the iliac, sacral and aortic lymph nodes

26
Q

What is the vascular supply of the uterine tubes?

A

Arterial supply via the uterine and ovarian arteries

Drainage is via the uterine and ovarian veins

27
Q

What is the innervation of the uterine tubes?

A

Receive parasympathetic and sympathetic innervation via nerve fibres from the ovarian and uterine plexuses. Sensory fibres run from T11-L1

28
Q

What is salpingitis?

A

Inflammation of the fallopian tubes, often caused by a bacterial infection. It can cause adhesions which can partially or completely occlude the tube.
This can result in infertility or ectopic pregnancy

29
Q

What is an ectopic pregnancy?

A

Where the blastocyst implants in the uterine tube. This may be caused by a partially occluded tube.
This is a MEDICAL EMERGENCY, the implanted blastocyst can cause rupture and haemorrhage of the tube (implantation is an invasive process)

30
Q

What are the 2 methods of ligation of the uterine tubes?

A

Open abdominal: carried out via a suprapubic incision

Laparoscopic: carried out via a fibre optic laparoscope via a small incision near the umbilicus

31
Q

Why does the descent of the ovaries stop in the pelvis? (Unlike the testis)

A

They are prevented from descending further by the broad ligament

32
Q

What are the 3 areas of the ovary?

A

The surface: formed by simple cuboidal epithelium (germinal epithelium)
The cortex: mostly connective tissue stroma, contains ovarian follicles
The medulla: composed of supporting stroma with a rich neurovascular network

33
Q

What is the lymphatic drainage of the ovaries?

A

Drain into the para-aortic nodes

34
Q

What is the vascular supply of the ovary?

A

Receive blood from the ovarian arteries which branch directly off the aorta
The venous drainage is via the ovarian veins - the left drains into the left renal vein and the right drains into the IVC

35
Q

What is the innervation of the ovaries?

A

The nerve supply runs via the suspensory ligament

Receive sympathetic innervation from the ovarian plexus and parasympathetic innervation from the uterine plexus

36
Q

What does the broad ligament cover?

A

Its a flat sheet of peritoneum that extends from the lateral pelvic walls and folds over the uterus, Fallopian tubes and ovaries anteriorly and posteriorly

37
Q

What are the 3 divisions that the broad ligament can be divided into?

A

Mesometrium: the largest section, surrounds the uterus, proximal part of the round ligament and folds over the external iliac vessels
Mesovarium: projects from posterior and attaches to hilum of ovary to protect the vasculature (doesnt cover the ovary itself)
Mesosalpinx: superior to mesovarium and encloses the fallopian tubes

38
Q

Which arteries and ligaments are located within the broad ligament?

A

The ovarian and uterine arteries
The ovarian ligament
The round ligament of uterus
The suspensory ligament of ovary

39
Q

What are the attachments of the ovarian ligament?

A

The ovarian ligament connects the inferior part of the ovary to the side of the uterus (just below the origin of the fallopian tubes)

40
Q

What are the attachments of the suspensory ligament of the ovary?
What is its function?

A

The suspensory ligament (fold of peritoneum) extends from the ovary to the lateral abdo wall
Its function is to contain the ovarian artery, vein, nerve plexus and lymphatics)

41
Q

What is the embryological derivative of the round ligament?

A

Its a remnant of the gubernaculum

42
Q

What are the attachments of the round ligament?

A

Originates at the uterine horns (where the fallopian tubes enter the uterus) and attaches to the labia majora - passing through the inguinal canal

It can be painful during pregnancy due to the increased force of the expanding uterus

43
Q

What are the attachments of the cardinal ligaments? (Also known as the transverse cervical)

A

Arise from the side of the cervix and the lateral fornix and attach extensively to the lateral pelvic wall at the level of the ischial spines

44
Q

What are the attachments of the pubocervical ligaments?

Whats the function?

A

Attach the cervix to the posterior pubic symphysis

Function is to support the uterus within the pelvic cavity

45
Q

What are the attachments of the uterosacral ligaments?

A

Bilateral fibrous bands which attach cervix to the sacrum

46
Q

How can infection spread from the uterus into the peritoneum?

A

Via the ostium of the fallopian tube (where the oocyte enters)

ESA 4 (39 decks)

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