Reproduction Flashcards
What bones make up the bony pelvis?
Sacrum
Coccyx
2 hip bones (fusion between ilium, ischium and pubis)
What bones make up the pelvic inlet?
Sarum promontory
Ilium
Superior pubic ramus
Pubic symphysis
What bones make up the pubic outlet?
Pubic symphysis Ischiopubic ramus Ischial tuberosity Sacrotuberous ligament Coccyx
What is the subpubic angle ?
The angle from the pubic arch between the ischial tuberosities
Is the pubic angle bigger or smaller in females than males
Pubic angle is GREATER in females
Name the three main joints with their type of joints in the pelvis
Hip joint (synovial) Pubic symphysis (secondary cartilaginous) Sacroiliac joint (synovial anteriroly but posteriorly syndemosus)
Where does the inguinal ligament extend from?
ASIS and pubic tubercle
On vaginal examination at what position would you find the ischial spines?
4 and 8oclock positions
What is the function of theh sacrotuberous and the sacrospinous ligaments?
Sacrotuberous help to stabilise the sacroiliac joint and hold the inferior part of the sacrum in place with weight
Where does the sacrotuberous ligament extend from
Sacrum and ischial tuberosity
Where does the sacrospinous ligament extend between?
Anteriorly between sacruma nd ischial spine
What structure overlies the obturator foramen that then forms the obturator canal?
The obturator membrane
What structures pass through the obturator canal?
Obturator vein
Obturator artery
Obturator nerve
What structures in the foetal skull allow moulding of the skull during childbirth?
Fontanelles (anterior and posterior)
What is the vertex in the foetal skull?
Triangle between parietal eminences and the fontanelles
What is the ‘station’ 0 during childbirth?
Where the head is at the level of the ischial spine
Above this point is a negative station, below this point is a positive station
Describe the orientation of the babies head as it undergoes childbirth
Will rotate to face laterally ( a leg)
Then as it descends through the the pelvis will rotate again to face medially posterior before exiting the other end
T/F the occipitofrontal diameter is longer than the biparietal diameter
TRUE hence why the baby faces laterally as it descends as this gives the most room for it in the pelvis
What are the three layers of the pelvic floor?
Pelvic diaphragm
Muscles of perineal pouches (transverse perineal, ischiocavernous, bulbocavernous)
Perineal membrane
What is the pelvic diaphragm and what muscles does it contain?
Deepest layer of pelvic floor (looks like a sling for the urethra and genitals openings)
Two muscle groups; levator ani and coccygeus
What ligaments help support the pelvic organs stay in their place in the female pelvis
Transverse cervical ligament Uterosacral ligament Lateral ligament of bladder Tendinous arch of pelvic fascia Tendinous arch of levator ani
(TULT)
What are the three parts to the levator ani? How it is innervated?
Puborectalis
Pubococcygeus
Iliococcygeus
Pudendal nerve
Where in the deep perineal pouch are the locations of
A. the perineal muscles
B. Perineal body
C. Bartholins glands
Deep perineal pouch lies above the perineal membrane and below fascia.
Perineal muscles Lie just posterior to the perineal membrane posterior to the urethra. It is a transverse muscles/ circles the urethra
Perineal body
When will the pelvic floor actively contract?
When coughing
Sneezing
Vomiting
How does the pelvic floor help maintaince continence both urianry and faecally
Compresses the urethra via external urethral sphincter and levator ani
Faceally has a tonic contraction of puborectalis bending the anorectum anteriorly so gives it a kink so stuff doesnt just drop out
What are some of the mechanisms to injure the pelvic floor?
Pregnancy Childbirth (stretching/tearing or pudendal nerve damage) Chronic constipation/cough/sneeze Obesity Heavy lifting Chronic Menopause
What structures can be involved in a prolapse of the pelvic organs
Uterus
Vagina
Bladder
Rectum
What is a
- urethrocele
- cystocele
- rectocele
- enterocele
Urethrocele (urethral prolapse) when it presses into vagina
Cystocele (bladder prolapse) when it presses into vagina
Rectocele (rectal prolapse) when rectum bulges into posterior vagina
Enterocele (small intestine prolapse) when small intestine bulges into superior vagina
What ligaments are contained in the lateral pelvic wall?
Obturator membrane
Sacrotuberous ligament
Sacrospinous ligament
What muscles are contained within the lateral pelvic wall?
Obturator internus
Coccygeus
Levator ani
All arteries of pelvis and perineum come from the internal ililac artery EXCEPT which ?
Gonadal artery (L2 abdo aorta) Superior rectal artery (from IMA)
Name some of the branches of the internal iliac artery in the male. From superior to inferior
Anterior division; obturator artery, superior vesical arteries
Posterior division; gluteal arteries, internal pudendal- middle rectal
Name some of the branches of the internal iliac artery in the female. From superior to inferior
Anterior division; obturator, superior vesical arteries
Posterior division; gluteal arteries, internal pudendal, middle rectal, uterine artery, vaginal artery
Where do most of the pelvic organs drain to?
Internal iliac vein
Except superior rectal into hepatic portal system, lateral sacral veins to internal vertebral venous plexus
What are the compound tubuoacinar glands?
The lactiferous ducts that transport the milk from the lobules to the nipple
During the follicular phase of the menstrual cycle what will happen to the ducts?
Their ducts will be shorter
During the luteal phase of the menstrual cycle what will happen to the ducts?
The ducts will increase in size, height and a small amount of secretions will occur
What cell type helps facilitate the pushing of milk out of the lobules and into the ducts?
Myoepithelial cells (they are contractile tissue that surrounds the lobules)
What is the lactiferous sinus?
It the widest part of the lactiferous ducts just below the areola used as a small reservoir for milk collection
Through what type of secretion do sebaceous glands on the nipple secrete their product?
Holocrine secretion
Where glands burst to rlease their fat droplets
What is merocrine secretion?
Packing the secretory product into a vacuole which is taken to the apical end of the membrane and released from its vacuole. So nothing else goes out with the product
What is apocrine secretion
Where the product buds off the membrane taking a bit of membrane with it
What hormones promote the proliferation of secretory tissue in the breast?
Oestrogen and progesterone
What occurs in the breast during menopause
Secretory cells degenerate leaving only ducts, fewer fibroblasts and reduction in collagen and elastic fibres
What ligaments have to weaken in order for a uterine prolapse to occur?
Uterosacral ligaments, endopelvic fasia and levator ani
What is the normal position of the uterus? (Ante/retro)
Anteverted and anteflexed e.g cervix anteriorly tipped and uterus flopped over the bladder
Where would you palpate the ischial spines during bimanual palpation of the vagina
4 oclock and 8 oclock
Where do the quadrants of the breast lymph drain to?
75% to ipsilateral axillary nodes then supraclavicular
Inner quads to parasternal
Lower inner to abdo
What is the arterial supply to the breast?
Axillary artery and internal thoracic artery
What hormones are in the combined contraceptive oral pill? How does it prevent pregnancy
Both oestrogen and progesteron
Prevents ovulation
