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
What is the nerve supply to the scrotum
Anterior and posterior scrotal nerves
26
What are the two main roles of the penis
Sexual intercourse Micturition
27
What are the anatomical parts of the penis
Root Body Glans
28
What does the root of the penis contain
Three erectile tissue - two crura - bulb of the penis Two muscles - ischiocavernous - bulbospongiosum
29
What does the body of the penis contain
Three cylinders of erectile tissue Two corpora cavernosa Corpus spongiosum
30
What is the role of corpus spongiosum
Prevent the urethra from becoming occluded during erection
31
What is the role of the ischiocavernous
Helps maintain erection
32
What are the fascial coverings of the penis
Deep fascia of the penis - buck's fascia Underneath deep fascia - tubica albunginea
33
What ligaments support the root of the penis
Suspensory ligament Fundiform ligament
34
What is the innervation of the penis
S2-S4 Spinal ganglia Pudendal nerve
35
Where is spermatozoa produced
Seminiferous tubules
36
Where does developing sperm travel through and collect in
Travels through the tubules Collects in the rete testes
37
What does the epididymis consist of
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
38
What is the main artery supply of the testes and the epididymis
Paired testicular arteries
39
What is the anatomical course of the spermatic cord
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
What does the spermatic cord contain
Blood vessels including testicular artery and cremasteric artery Nerves Vas deferens Lymph vessels
41
What is the pampiniform plexus
Network of veins responsible for the drainage of the testes
42
What is the role of the vas deferens
Straight, thick muscular tube - coveys sperm from the epididymis to the ampulla Microvilli
43
Describe the anatomical course of the vas deferens
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
What is the largest accessory gland in the male reproductive system
Prostate
45
What is the role of the prostate
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
Describe the anatomical structure of the prostate
Size of a walnut 2/3 glandular, 1/3 fibromuscular Three histological divisions - central zone - transitional zone - peripheral zone
47
What is the arterial supply to the prostate
Prostatic arteries Mainly arise from the internal iliac arteries
48
What is another name for the bulbourethral glands
Cowper's glands
49
What are the bulbourethral glands
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
What is the function of the bulbourethral glands
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
What is the arterial supply to the bulbourethral glands
Derived from the arteries to the bulb of the penis
52
What % of the total volume of semen do seminal vesicles provide
70%
53
Describe the seminal vesicles
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
What does the fluid from the seminal vesicles contain
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
What does vulva refer to
External female genitalia
56
What are the functions of the vulva
Acts as sensory tissue during sexual intercourse Assists micturition by directing flow of urine Protects the internal female reproductive tract from infection
57
What are the anatomical structures of the vulva
Mons pubis Labia majora Labia minora Vestibule Bartholin's gland Clitoris
58
Describe the mons pubis
Formed by the fusion of the labia majora
59
Describe the labia majora
Hair-bearing
60
Describe labia minora
Hairless
61
Describe vestibule
Area enclosed by the labia minora Contains the opening of the vagina and urethra
62
Describe Bartholin's glands
Secrete lubricating mucus from small ducts during sexual arousal Located either side of the vaginal orifice
63
Describe clitoris
Under the clitoral hood Formed of erectile corpora cavernosa tissue - becomes engorged with blood during sexual intercourse
64
What is the arterial supply to the vulva
Paired internal and external pudendal arteries
65
What are the functions of the vagina
Sexual intercourse Childbirth Mensuration
66
What is the vagina closely related to
Anterior - bladder and urethra Posterior - rectouterine pouch, rectum and anal canal Lateral - ureters and levator ani muscle
67
Describe the anatomical structure of the vagina
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
What is the arterial supply to the vagina
Uterine and vaginal arteries Both branches of the internal iliac artery
69
What is the venous drainage of the vagina
Vaginal venous plexus - internal iliac veins
70
What are the two regions of the cervix
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
What are the functions of the cervix
Passage of sperm into the uterine cavity Maintains sterility
72
What organ is the uterus
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
What is the role of secondary sex organs
Maintenance and transportation of gametes
74
Describe the uterus
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
What does the anatomical location of the uterus depend upon
Varies to the degree of distension of the bladder
76
Define anteverted
Uterus rotated forwards, towards anterior surface of the body
77
Define anteflexed
Uterus flexed, towards anterior surface of the body
78
What ligaments support the uterus
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
Describe the uterine tubes
Muscular 'J' shaped tubes Lie in upper border of the broad ligament
80
What are the main functions of the uterine tubes
Assist transfer and transport of the ovum from the ovary to the uterus
81
Describe the anatomical structure of the uterine tubes
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
Where does fertilisation usually occur
Ampulla
83
What is the innervation of the fallopian tubes
T11-L1
84
What are the female gonads
Ovaries
85
Describe the ovaries
Paired, oval organs Attached to the posterior surface of the broad ligament of the uterus
86
What are the main functions of the ovaries
Produce oocytes in preparation for fertilisation Produce sex steroid hormones oestrogen and progesterone in response to pituitary gonadotrophins
87
What are the ligament of the ovaries
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
What are the ligaments of the female reproductive tract divided into
Broad ligament Uterine ligament Ovarian ligament
89
Describe the broad ligament
Sheet of peritoneum - associated with both the uterus and ovaries
90
Describe the uterine ligaments
Ligaments primarily associated with the uterus
91
Describe the ovarian ligaments
Ligaments primarily associated with the ovaries
92
What is the collective role of the ligaments of the female reproductive tract
Support female viscera Provide a conduit for neurovascular structures
93
What can the broad ligament be divided into
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
Define perineum
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
What is the role of the posterior fornix
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
What are the muscles of the pelvic floor
Funnel shaped Levator ani - puborectalis - pubococcygeus - iliococcygeus Coccygeus muscle Fascia coverings of the muscle
97
What is the role of the puborectalis
Maintain faecal continence U-shaped sling around the anal canal - attaches to the pubis on the contralateral side