Reproduction 2 Flashcards
What are the internal female reproductive organs?
Uterus, fallopian tubes, vagina and ovaries
In females the duct system for the transference of _______ is _______ and leads to the ______ which is the site of ____________ and ___________ of the zygote.
In females the duct system for the transference of gametes is short and leads to the uterus which is the site of implantation and development of the zygote.
What three structures constitute the birth canal?
Cervix, vagina, vulva
What are the three layers of the uterus?
Perimetrium: outer serous coat, peritoneum & connective tissue
Myometrium: middle smooth muscle coat
Endometrium: inner mucosa coat (blastocyst implants here)
What two layers of the uterus are adhered firmly together?
Endometrium firmly adhered to the myometrium.
As pregnancy progresses, the uterus physiologically splits into two segments. What are these called? What do these segments develop from?
Upper and lower segments
Upper - body of uterus
Lower - isthmus and cervix
What is the normal position of the uterus?
Anteflexed and anteverted
Anteflexion = tipping forward uterine body in comparison to the cervix
Anteversion = tipping forward of whole organ compared to the vagina
What could happen in early pregnancy if the uterus is retroverted and retroflexed?
Uterine incarceration is an obstetrical complication whereby a growing retroverted uterus becomes wedged into the pelvis after the first trimester of pregnancy
At any surgical management of miscarriage why might it be important to know prior to instrumentation of the uterine cavity whether the uterus is anteverted or retroverted?
To minimise risk of perforation of the uterus
What are the fornices of the vagina?
Recess around the protruding cervix
Split into anterior, posterior and lateral parts
Through which vaginal fornix can you access the rectouterine pouch?
Posterior fornix
Why is it important to be able to reach the rectouterine pouch (Pouch of Douglas) via the posterior fornix)?
Pouch of Douglas is commonly a site where fluid collects and if you can gain access to it via the posterior fornix you will be able to drain it
What ligaments firmly anchor the uterus and cervix in place?
Ligament of the ovary
Suspensory ligament of the ovary
Round ligament of the uterus
Broad ligament
Which ligament (part of the pelvic fascia) is called the cardinal ligament of the uterus?
Cardinal ligament (attaches cervix to the lateral pelvic walls)
Apart from pelvic fascia, what other structure in the pelvis is also an important support of the uterus?
The tone of the pelvic floor
Give a description of the four parts of the uterine tubes?
Infundibulum - funnel shaped distal end that opens into peritoneal cavity
Ampulla - widest and longest part
Isthmus - thick walled part that enters the uterine horn
Intramural/uterine part - short segment that passes through the wall of the uterus & opens into uterine cavity
Where does fertilisation usually occur?
Ampulla of the uterine tube
What is an ectopic pregnancy?
Pregnancy in which the ovum implants outside the endometrium of the uterine cavity (most commonly in the uterine tube)
What is cornual ectopic?
Rare type of ectopic pregnancy where the pregnancy implants in the cornua of the uterus
In which fossa to the ovaries fit?
Ovarian fossa
Repeated pregnancies may do what to the ovaries?
Displace their position
How do the ovaries appear after menopause?
Atrophied and fibrous
What ligament stretches from the ovary to the uterus?
Ligament of the ovary
what ligament stretches from the ovary to the lateral pelvic wall?
Suspensory ligament of the ovary
What are the two major arteries supplying the gonads and genitalia?
Gonadal arteries and internal iliac arteries
Where do the gonadal arteries originate?
Abdominal aorta at L2
Where does the ovarian artery travel?
Within the suspensory ligament to supply the ovaries via the broad ligament
With which artery does the ovarian artery freely anastomose with?
The uterine artery
Which vein does the left ovarian vein drain into?
Left renal vein
What vein does the right ovarian vein drain into?
Right renal vein
Where does the uterine artery cross the ureter?
At the level of the ischial spine at the junction b.w. the cervix and lateral part of the fornix of the vagina
What is commonly injured during hysterectomy?
Ureter
Lymph from labia and the distal part of the vagina drain into which group of lymph nodes?
Superficial inguinal lymph nodes
Which group of lymph nodes receives lymph from the ovary?
Right and let lumbar/aortic lymph nodes
Which group of lymph nodes receives lymph from the upper uterine body and fundus?
Pre-aortic group of lymph nodes
Which group of lymph nodes receives lymph from most of the uterine body?
External iliac lymph nodes
Which group of lymph nodes receives lymph from the uterine cervix and upper vagina?
Internal iliac and sacral lymph nodes
Which group of lymph nodes receives lymph from the lower vagina?
Superficial inguinal lymph nodes
What kind of glands are in the breast?
Mammary glands - modified sweat glands
In which fascia do the breast lie?
Superficial fascia of the pectoral region
What is the structure of the breasts?
15-20 lobules with tubule-acinar gland (parenchyma) and stroma (connective tissue)
Where do the breasts extend from horizontally and vertically?
Vertically: 2nd to 6th rib
Horizontally: border of sternum to midaxillary line
What three muscles is the deep surface of the breast related to?
Pectoralis major and minor and serratus anterior
What is the main blood supply of the breasts?
Medial mammary branches from the subclavian artery
Mammary branches from the lateral thoracic and thoracocacromial arteries (from axillary artery)
Posterior i.c. arteries
What are the main groups of lymph nodes draining the breasts?
Axillary lymph nodes (lat. quadrants, 75% of lymph)
Parasternal lymph nodes (medial quadrants)
Supraclavicular lymph nodes
Which group of lymph nodes first receives from the lateral quadrants of the breast?
Anterior pectoral lymph nodes (axillary group)
Is it possible for lymph from medial side of one breast to drain to the opposite breast?
Yes
Breast tissue undergoes cyclical changes in activity, which is controlled by what?
Hormones of the ovarian cycle
What does lactating breast tissue look like histologically?
Acini distended with milk
V. thin septa
What does inactive breast tissue look like histologically?
Extensive, branching duct system
Fibrous interlobular tissue
Ducts lined with luminal epithelium and myoepithelium
What does pregnant breast tissue look like histologically?
Enlarged lobules
Acini dilated
What does the uterus look like histologically during the proliferative phase (where oestrogen causes the endometrium to grow)?
Few, thin, straight glands
What does the uterus look like histologically during the secretory phase (where progresterone increases blood flow to the uterus to make it mores suitable for implantation)?
Corkscrew glands
What does the oviduct look like histologically?
Highly folded mucosa protruding into lumen
Muscularis mucosae layer with surrounding serosa
What does the ovary appear like histologically?
Follicles present
What does a primary follicle appear like histologically?
2 layers of surrounding cells
What does a Graffian follicle appear like histologically?
Surrounded by loads of granulosa cells and single antrum containing follicular fluid
What does the placenta develop from?
Trophoblasts following implantation of the blastocyst into uterine endometrium
What side of the placenta appears rough and spongey?
Maternal side
Which side of the placenta appears smooth and bears the attachment of the umbilical cord?
Foetal side
List 4 functions of the placenta
Gaseous exchange
Allows for transport of nutrients to foetus
Removal of waste products from foetus (urea, uric acid ,creatinine)
Produces hormones (e.g. hCG, progesterone, oestrogen…)
When does the placenta physiologically separate from the uterine wall?
Third stage of labour after delivery of the foetus
What does the umbilical cord contain?
Two umbilical arteries and one umbilical vein
What is the function of the umbilical arteries in the fetal circulation?
Carry deoxygenated, nutrient-depleted blood away
What is the function of the umbilical vein in the fetal circulation?
Carry oxygenated, nutrient-rich blood to foetus
What is also in the umbilical cord with the vessels? What is it’s purpose?
Wharton’s jelly
It protects the BVs
