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SUGER > Reproduction > Flashcards

Reproduction Flashcards

1
Q

Describe the uterus

A

Hollow muscular organ

7.5cm in length

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2
Q

How is the uterus supported

A

Broad ligament
Round ligament
Cardinal ligament

Rectouterine (relating to rectum and uterus)
Vesicouterine (relating to the bladder and uterus) folds and ligaments

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3
Q

Describe ultrasound

A

Sound wave strikes an object, it bounces back or echoes

Measures these echo waves it is possible to determine how far away the object is and its size, consistency (whether the object is solid, filled with fluid, or both)

Transducer both sends the sound waves and records the echoing waves

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4
Q

What is the doppler ultrasound

A

Measures direction and speed of blood cells as they move through vessels

Movement of blood cells causes a change in pitch of reflected sound waves

Computer collects and processes the sounds and creates graphs or colour pictures that represent the flow of blood through the blood vessels

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5
Q

Describe transvaginal ultrasound

A

Performed to view the endometrium or the lining of the uterus - including thickness and the ovaries

Can evaluate the muscular walls of uterus - myometrium

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6
Q

What is a sonohysterography

A

Allows for a more in-depth investigation of the uterine cavity

  • uterine anomalies
  • uterine scars
  • endometrial polyps
  • fibroids
  • cancers - especially in patients with abnormal uterine bleeding
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7
Q

What is a hysterosalpingography

A

Catheter inserted into the uterine cavity

Contrast injected into the cavity under pressure

Contrast track along the fallopian tubes

X-ray image obtained

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8
Q

When do you pregnancy scan

A

12 week dating scan and nuchal thickness

20 week anomaly scan

Additional scans depending on clinical need

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9
Q

What is the nucal

A

Thickness on the back of the skin of a fetus - check

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10
Q

What happens that the 12 week dating scan

A

Heart beat to assess viability

Crown rump length to date the pregnancy

Number of fetuses

Nuchal translucency

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11
Q

What happens at the 20 week scan

A

Anomaly scan

Detect any abnormality
- detailed whole body scan

Assess the nature of the abnormality
- viable or not

Assess the extent of the abnormality
- referral to fetal maternal specialists

Assess placenta and its location

Femur and head measured
- if abnormality nature will protect the head

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12
Q

Describe the fetal maternal scan

A

Issue with scan or mother with a condition (e.g. diabetes)

Second detailed ultrasound

Counselling by qualified staff

Additional investigation
- blood test
- amniocentesis
- further ultrasound
- magnetic resonance imaging

Depends on parental choice

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13
Q

Describe amniocentesis

A

Sample of the amniotic fluid - under ultrasound

DNA/genetic analysis - skin cells

Small risk of mischarge by approx. 0.5%

Depends on parental choice

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14
Q

Describe magnetic resonance imaging

A

No radiation

Thought to be safe

Not in first trimester

Only following tertiary referral ultrasound opinion

Limited availability in the UK

Sheffield centre of excellence

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15
Q

Describe MRI

A

Expensive

Limited availability

Limited experience

Still developing

not routine on NHS

Images easier for parents to understand

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16
Q

What are the issues of the MRI

A

Mums often have claustrophobia

Movement problems

20 slices in 20 seconds

30-40 mins in scanner, longer in twins

Better definition of brain and soft tissue

Worse for limbs, heart, movement

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17
Q

What can be seen in MRI to check baby formation

A

Folds in the brain happen at a set time - can be able to see if this is at the correct time

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18
Q

What is post mortem imaging

A

Importance of the autopsy

Imaging as an adjunct

Imaging as an alternative

e.g. conjoined twins - MRI can be used to see where to cut and high areas of abnormalities

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19
Q

What is the scrotum composed of

A

Testis

Epididymis

Spermatic cord

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20
Q

Where is the site of sperm production

A

Testis

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21
Q

Where is the storage reservoir for sperm

A

Epididymis

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22
Q

What is spermatic cord

A

Collection of muscle fibres, vessels and nerves and ducts that run to and from the testes

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23
Q

What is the dartos muscle

A

Sheet of smooth muscle - situated immediately underneath the skin

Regulates the temperature of the scrotum by wrinkling the skin - decreases surface area = reduces heat loss

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24
Q

What arteries supply the scrotum

A

Anterior and posterior scrotal arteries

Anterior scrotal artery - arises from the external pudendal artery

Posterior scrotal artery - arises from the internal pudendal artery

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25
Q

What is the nerve supply to the scrotum

A

Anterior and posterior scrotal nerves

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26
Q

What are the two main roles of the penis

A

Sexual intercourse

Micturition

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27
Q

What are the anatomical parts of the penis

A

Root

Body

Glans

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28
Q

What does the root of the penis contain

A

Three erectile tissue
- two crura
- bulb of the penis

Two muscles
- ischiocavernous
- bulbospongiosum

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29
Q

What does the body of the penis contain

A

Three cylinders of erectile tissue

Two corpora cavernosa
Corpus spongiosum

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30
Q

What is the role of corpus spongiosum

A

Prevent the urethra from becoming occluded during erection

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31
Q

What is the role of the ischiocavernous

A

Helps maintain erection

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32
Q

What are the fascial coverings of the penis

A

Deep fascia of the penis - buckā€™s fascia

Underneath deep fascia - tubica albunginea

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33
Q

What ligaments support the root of the penis

A

Suspensory ligament

Fundiform ligament

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34
Q

What is the innervation of the penis

A

S2-S4

Spinal ganglia

Pudendal nerve

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35
Q

Where is spermatozoa produced

A

Seminiferous tubules

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36
Q

Where does developing sperm travel through and collect in

A

Travels through the tubules

Collects in the rete testes

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37
Q

What does the epididymis consist of

A

Head - contains efferent tubules of the testes, transport sperm from testes to the epididymis

Body - formed by the heavily coiled duct of the epidiymis

Tail - marks the origin of the vas deferens, transports sperm to the prostatic portion of the urethra for ejaculation

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38
Q

What is the main artery supply of the testes and the epididymis

A

Paired testicular arteries

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39
Q

What is the anatomical course of the spermatic cord

A

Begins at inferior abdomen - formed at the opening of the inguinal canal

Passes through the inguinal canal

Enters the scrotum via the superficial inguinal ring

Continue into the scrotum - ends at the posterior border of the testes

40
Q

What does the spermatic cord contain

A

Blood vessels including testicular artery and cremasteric artery

Nerves

Vas deferens
Lymph vessels

41
Q

What is the pampiniform plexus

A

Network of veins responsible for the drainage of the testes

42
Q

What is the role of the vas deferens

A

Straight, thick muscular tube - coveys sperm from the epididymis to the ampulla

Microvilli

43
Q

Describe the anatomical course of the vas deferens

A

Continuous with the tail of the epididymis

Travels through the inguinal canal - as part of the spermatic cord

Moves down the lateral pelvic wall close to the ischial spine

Turns medially to pass between the bladder and ureter and then travels downward on the posterior surface of the bladder

Inferior narrow part of the ampulla joints the duct from the seminal vesicles to form the ejaculatory duct

44
Q

What is the largest accessory gland in the male reproductive system

A

Prostate

45
Q

What is the role of the prostate

A

Secretes proteolytic enzymes in the semen - act to break down clotting factors in the ejaculate - allows semen to remain in a fluid state

Proteolytic enzymes leave via the prostatic ducts
- these open into the prostatic portion of the urethra, through 10-12 openings each side of the seminal colliculus

Secretes enzymes immediately before ejaculation

46
Q

Describe the anatomical structure of the prostate

A

Size of a walnut

2/3 glandular, 1/3 fibromuscular

Three histological divisions
- central zone
- transitional zone
- peripheral zone

47
Q

What is the arterial supply to the prostate

A

Prostatic arteries

Mainly arise from the internal iliac arteries

48
Q

What is another name for the bulbourethral glands

A

Cowperā€™s glands

49
Q

What are the bulbourethral glands

A

Pair of pea shaped exocrine glands located posterolateral to the membranous urethra

Contribute to the final volume of semen by producing lubricating mucus secretion

50
Q

What is the function of the bulbourethral glands

A

During sexual arousal - produce mucus secretion containing glycoproteins

Substance has three main purposes
- lubricant medium for the urethra and tip of penis
- expels any residue of urine, dead cells or mucous through the urethral meatus, preparing a clean and lubricated pathway for ejaculation
- helps neutralise residual acidity in the male urethra (secretions are alkaline)

51
Q

What is the arterial supply to the bulbourethral glands

A

Derived from the arteries to the bulb of the penis

52
Q

What % of the total volume of semen do seminal vesicles provide

A

70%

53
Q

Describe the seminal vesicles

A

Pair of 5cm long tubular glands

Located between bladder fundus and rectum

Combine with vas deferens to form the ejaculatory duct

Pseudostratified columnar epithelium

54
Q

What does the fluid from the seminal vesicles contain

A

Alkaline fluid - neutralise the acidity of the male urethra and vagina

Fructose - energy source for spermatozoa

Prostaglandins - role in supressing the female immune response to foreign semen

Clotting factors - designed to keep semen in the female reproductive tract post-ejaculation

55
Q

What does vulva refer to

A

External female genitalia

56
Q

What are the functions of the vulva

A

Acts as sensory tissue during sexual intercourse

Assists micturition by directing flow of urine

Protects the internal female reproductive tract from infection

57
Q

What are the anatomical structures of the vulva

A

Mons pubis

Labia majora

Labia minora

Vestibule

Bartholinā€™s gland

Clitoris

58
Q

Describe the mons pubis

A

Formed by the fusion of the labia majora

59
Q

Describe the labia majora

A

Hair-bearing

60
Q

Describe labia minora

A

Hairless

61
Q

Describe vestibule

A

Area enclosed by the labia minora

Contains the opening of the vagina and urethra

62
Q

Describe Bartholinā€™s glands

A

Secrete lubricating mucus from small ducts during sexual arousal

Located either side of the vaginal orifice

63
Q

Describe clitoris

A

Under the clitoral hood

Formed of erectile corpora cavernosa tissue - becomes engorged with blood during sexual intercourse

64
Q

What is the arterial supply to the vulva

A

Paired internal and external pudendal arteries

65
Q

What are the functions of the vagina

A

Sexual intercourse

Childbirth

Mensuration

66
Q

What is the vagina closely related to

A

Anterior - bladder and urethra

Posterior - rectouterine pouch, rectum and anal canal

Lateral - ureters and levator ani muscle

67
Q

Describe the anatomical structure of the vagina

A

Fibromuscular tube with anterior and posterior walls

H lying on its side

Posterior fornix acts as a natural reservoir for semen after intravaginal ejaculation

68
Q

What is the arterial supply to the vagina

A

Uterine and vaginal arteries

Both branches of the internal iliac artery

69
Q

What is the venous drainage of the vagina

A

Vaginal venous plexus - internal iliac veins

70
Q

What are the two regions of the cervix

A

Ectocervix - cervix that projects into the vagina
- lined by stratified squamous non-keratinised epithelium

Endocervical canal - inner part of cervix
- lined by mucus-secreting simple columnar epithelium

71
Q

What are the functions of the cervix

A

Passage of sperm into the uterine cavity

Maintains sterility

72
Q

What organ is the uterus

A

Secondary sex organ

Secondary sex organ - components that mature curing puberty under influence of sex hormones produced from primary sex organs (ovaries in females and testes in males)

73
Q

What is the role of secondary sex organs

A

Maintenance and transportation of gametes

74
Q

Describe the uterus

A

Thick-walled muscular organ capable of expansion to accommodate growing fetus

Three parts

Fundus - entry point for uterine tubes
Body - site for implantation of the blastocyst
Cervix

75
Q

What does the anatomical location of the uterus depend upon

A

Varies to the degree of distension of the bladder

76
Q

Define anteverted

A

Uterus rotated forwards, towards anterior surface of the body

77
Q

Define anteflexed

A

Uterus flexed, towards anterior surface of the body

78
Q

What ligaments support the uterus

A

Broad ligament - attaches sides of the uterus to the pelvis. Acts as a mesentery to the uterus. Contributes to maintaining its position

Round ligament - maintains the anteverted position of the uterus

Ovarian ligament - joints the ovaries to the uterus

Cardinal ligament - located at the base of the broad ligament. Extends from the cervix to the lateral pelvic walls. Contains uterine artery and vein. Provides support to the uterus

Uterosacral ligament - extends from the cervix to the sacrum. Provides support to the uterus

79
Q

Describe the uterine tubes

A

Muscular ā€˜Jā€™ shaped tubes

Lie in upper border of the broad ligament

80
Q

What are the main functions of the uterine tubes

A

Assist transfer and transport of the ovum from the ovary to the uterus

81
Q

Describe the anatomical structure of the uterine tubes

A

Lateral to medial

Fimbriae - finger-like, ciliated projections which capture the ovum from the surface of the ovary

Infundibulum - funnel-shaped opening near the ovary to which fimbriae are attached

Ampulla - Widest section of the uterine tubes. Fertilisation usually occurs here

Isthmus - narrow section of the uterine tubes connecting the ampulla to the uterine cavity

82
Q

Where does fertilisation usually occur

A

Ampulla

83
Q

What is the innervation of the fallopian tubes

A

T11-L1

84
Q

What are the female gonads

A

Ovaries

85
Q

Describe the ovaries

A

Paired, oval organs

Attached to the posterior surface of the broad ligament of the uterus

86
Q

What are the main functions of the ovaries

A

Produce oocytes in preparation for fertilisation

Produce sex steroid hormones oestrogen and progesterone in response to pituitary gonadotrophins

87
Q

What are the ligament of the ovaries

A

Suspensory ligament of the ovary - fold of peritoneum extending from the mesovarium to the pelvic wall. Contains neurovascular structures

Ligament of ovary - extends from the ovary to the fundus of the uterus. Then continues to the connect tissue of the labium majus, as the round ligament of the uterus

88
Q

What are the ligaments of the female reproductive tract divided into

A

Broad ligament

Uterine ligament

Ovarian ligament

89
Q

Describe the broad ligament

A

Sheet of peritoneum - associated with both the uterus and ovaries

90
Q

Describe the uterine ligaments

A

Ligaments primarily associated with the uterus

91
Q

Describe the ovarian ligaments

A

Ligaments primarily associated with the ovaries

92
Q

What is the collective role of the ligaments of the female reproductive tract

A

Support female viscera

Provide a conduit for neurovascular structures

93
Q

What can the broad ligament be divided into

A

Mesometrium - surrounds the uterus. Runs laterally to cover the external iliac vessels. Encloses the proximal part of the round ligament of the uterus

Mesovarium - associated with the ovaries. Projects from the posterior surface of the broad ligament and attaches to the hilum of the ovary, enclosing its neurovascular supply

Mesoalpinx - originates superiorly to the mesovarium, enclosing the fallopian tubes

94
Q

Define perineum

A

The space between the anus and scrotum in the male, or between the anus and the vulva in the female

Between the coccyx and the pubic symphysis

95
Q

What is the role of the posterior fornix

A

Acts like a natural reservoir for semen after intravaginal ejaculation

Semen retained in the fornix liquifies in the next 20-30 minutes allows for easier permeation through the cervical canal

96
Q

What are the muscles of the pelvic floor

A

Funnel shaped

Levator ani
- puborectalis
- pubococcygeus
- iliococcygeus

Coccygeus muscle

Fascia coverings of the muscle

97
Q

What is the role of the puborectalis

A

Maintain faecal continence

U-shaped sling around the anal canal - attaches to the pubis on the contralateral side

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