Reproduction BABY Flashcards
Why might haemorrhoids be associated with cirrhosis of the liver?
Congestion of portal circulation
What is the function of the superficial transverse perineal?
Fixation and stabilisation of the perineal body
When does the placenta physiologically separate from the uterine wall?
Thirsd stage of labour after delivery of the foetus
Where do the bulbourethral glands empty?
Empty into the penile/spongy urethra
What is the tough outer layer of the testis?
Tunica vaginalis
At what vertebral level does the testicular artery arise from the abdominal aorta?
L2
What artery supplies the uterus?
Uterine artery (branch of the anterior trunk of the internal iliac)
Which nerve pireces the psoas major muscle?
Genitofemoral nerve
Give two functions of the pelvic diaphragm
Supports abdominopelvic viscera
Fecal continence
What is the innervation of erectile tissues in both men and women?
S2,3,4 from hypogastric plexus
Why is a mediolateral episiotomy preferable to a midline episiotomy?
Reduces chance of damage to the rectum and the anal spincter
What forms the ejaculatory duct?
Vas deferens joining the duct of the seminal gland
What are the layers of the muscle and fascia that contribute to the inguinal canal?
External oblique
Internal oblique
Transversus abdominis
Transversalis fascia
Where is the cardinal ligament found?
Located at the base of the broad ligament of the uterus
(attaches the cervix to the lateral pelvic wall)
What can be a complication of ischia-anal abscesses?
Can burst into nearby spaces / passageways generating fistula
Make sure you can locate the uterine tube
Ovarian ligament
Round ligament
Suspensory ligament and the broad ligament
What is the blood supply to the breast?
Supplied by branches of the subclavian and axillary arteries
(lateral thoracic, internal thoracic, lateral mammary, medial mammary)
What drains most of the uterine body?
External iliac and lumbar nodes
Which area develops into the lower segment of the uterus?
The area between the cervix and the uteus
For C section th uterus is opened at the lower segment
What is the main component of the ischio-anal fossae?
Fat
Into which vein does the left and right testicular vein drain?
RIght vein drains into the IVC
Left testicular vein drains into the left renal vein
Compare acetabulum
Female = large
Male = small
What is the risk of having a retroverted and retrofelxed pelvis in early pregnancy?
Uterus may become trapped in the pelvis - incarcerated uterus
Which ligament does the uterine artery travel within?
Cardinal ligament
After rectal surgery why are some men not able to ejaculate?
Damage to pudendal nerve
What are the two triangles of the perineum?
Urogenital
Anal
What are the features of the ductus defrerens on histology?
Stellate shaped lumen
Thicked walled muscular tube
Sompare lesser pelvis?
Female = wide and shallow
Male = narrow and deep
What ligament attaches the ovary to the lateral pelvic wall?
Suspensory ligament of ovary
What nerve supplies the skin and muscles of the perineum?
Pudendal nerve - arises from the sacral plexus
What is a rectocele?
Prolapse of the wall between the rectum and the vagina
What is a varicocele?
A mass of varicose veins in the spermatic cord
What three structures constitue the birth canal?
Cervix
Vulva
Vagina
What is the main artery into the perineum?
Internal pudendal
What drains the lower vagina?
Inguinal lymph nodes
With which venous plexus does the prostatic venous plexus communicate on its posterior side?
Vesical plexus
(potential spread of bone mets)
What is the nerve supply of the female genital tract?
Sympathetic nerve fibres from the pelvic and ovarian plexuses and parasympathetic fibres from the pelvic splanchnic nerves (S2,3,4)
What is the lymphatic drainage of the scrotum?
Superficial inguinal nodes
What is the name of the fascia that stretches between right and left sides of the pubic arch?
Perineal fascia
What is the appearance of testis on histology?
Convoluted tubules sectioned in various planes
Spermatozoa in the lumen
Leydig cells in the interstitial spaces between tubules
What does the left umbilical vein form?
Forms the round ligament of the liver
What inenrvates the external urethral sphincter?
Pudendal nerve
What is the perineal body?
It is a fibromuscular bundle
Secures the pelvic floor
Compare pelvic inlet
Women = oval and rounded
Male = heart shape
Parts of the urethra
Look
What secretions are produced by the prostate?
Alkaline fluid - helps neutralise the acidity of the vaginal tract
What is the venous drainage of the pelvic structures?
5 different veins
- Internal iliac veins
- Superior rectal veins
- Medial sacral vein
- Gonadal veins
- Internal vertebral venous plexua
(prostatic venous plexus is clinically significant)
What is the supply of the vagina?
Uterine artery
Compare greater pelvis
Female = shallow
Male = deep
What is the purpose of the panpiniform plexus of veins?
Temperature regulation and venous returm from the testes
Where does the genitofemoral nerve originate?
L1-2
Where does the ilioinguinal nerve enter the inguinal canal?
Superficial inguinal ring
What are the structures of the male perineum?
External genitalia (urethra, scrotum and penis)
Perineal muscles
Anal canal
Which part of the rectum drains into systemic circulation?
Middle and inferior rectal veins
What is the lymphatic drainage of the penis?
Superficial inguinal (skin)
Internal iliac (deep structures)
What are the main contents of the spermatic cord?
Ductus deferens
Testicular artery
Pampinoform plexus of veins
Genital branch of the genitofemoral nerve
Which group of lymph nodes first receives lymph from the lateral part of the breast tissue?
Axillary
What is the main blood supply to the pelvic organs?
Internal iliac
Ovary, testes and upper part of rectum has different blood supply
What nerve network lies on the piriformis?
Sacral plexus
Which segmental level does the pudendal nerve arise from ?
S2-S4
What do the sacral lymph nodes drain?
Wall of pelvis, parts of the rectum and the signoid colon
What is a cystocele?
Prolapse of the bladder (bladder bulges into the vagina)
What do the common iliac lymph nodes drain?
Drainage from the three main groups
What is the epithelium of epididymus?
Pseudostratified?
What is the function of the Ischiocavernosus?
Compression fo the corpus cavernosum
What supplies the rectum?
Superior rectal artery - branch of the inferior mesentaric artery
Middle and inferior rectal artery (these are suplied by the internal iliac anterior trunk)
What do the external iliac lymph nodes drain?
Inguinal nodes
Deep lymphatics of abdominal
Lymphatics from glans penis, glans clitoris, membranous urethra and prostate
What is the structure of each breast?
Each breast consists of 15-25 lobes with tubulo-acinar gland (parenchyma) and stroma (connective tissue)
What is the origin of the ilioinguinal nerve?
L1
What is the function of the external urethral sphincter?
Compress urethrato maintain urinary continence
Which part of the uterine tube is the longest and widest?
Ampulla
What are the structures of the cross section of the umbilical cord?
Two uterine arteries
One uterine vein
Wharton’s jelly
Which two lymph node groups receive lymph from the testis?
Paraaortic and inguinal
Which nerve supplies the skin at the root of the penis and the labia?
Ilioinguinal nerve
Compare subpubic angle
Female = greater than 90 degreees (obtuse)
Male = less than 90 degrees (acute)
Revise histology of the uterus and the follicles
Make sure you know where the bulbourethral gland and the seminal vesicle glands are
What do the internal iliac nodes drain?
Gluteal region
Deep perineum
Inferior pelvic viscera
What muscle is present on the posterior wall of the pelvis?
Piriformis
What is the clinical significance of the perineal body?
Ruptures during childbirth
Where does the round ligamet travel to and from?
Originates at the uterine horns in the parametrium
Round ligament exits the pelvis at the deep inguinal ring, passes through the inguinal canal and continues on to the labia majora where its fibres spread and mix with the tissue of the mons pubis
What type of joint is the sacroiliac joint?
Synovial plane
What is the appearance of the seminal vesicles on histology?
No sperms in lumen
Highly recessed and irregular lumen forming crypts and cavities giving a honeycombed appearance
Well developed muscular externa
Why do haemorrhoids form in the wall of the anal canal?
Anastomosis between the portal and systemic veins are located in the wall of the anal canal, making this a site of portocaval anastomosis
What drains the uterine cervix and upper vagina?
Internal iliac and sacral lymph nodes
What is the blood supply of the bladder, seminal gland and prostate?
Superior and inferior vesicular artery
(anterior trunbk of internal iliac)
What is the innervation and function of the external anal sphincter?
Innervated by a branch of the pudendal nerve
Main action is to relax from tonic contraction
Voluntary defacation
What is the function of the secretions produced by the bulbourethral glands?
Clear fluid rich in mucoproteins that help lubricate the distal urethra and neutrlise acidic urine which remains in the urethra
What does the placenta develop from?
The trophoblast
(following implantation of the blastocyst into the uterine endometrium)
What is the lymphatic drainaige of the prostate?
Internal iliac and sacral nodes
What is the appearance of the prostate on histology?
Serous alveoli with infolding epithelium
Trabeculae of muscular stroma
Amorphous eosinophilic masses called corpora amylacea in the alveoli in older men
What supplies the deep transverse perineal?
Pudendal nerve
Which muscles converge towards the perineal body?
Bulbospongiosus
Superficial transverse perineal
External anal sphincter
Levator ani
Compare pelvic outlet
Female = comparitively larg
Male = somparitively small
What drains the fundus and upper part of the uterin body?
Pre-aortic group of lymph nodes
What are the divisions of the uterine tube?
Infundibulum
Isthmus
Ampulla
Intramural or uterine part
What is the mnemoic for remembering the parts of the inguinal canal?
MALT
M (superior) - Internal oblique, transversus abdominis
A (anterior)- External oblique aponeurosis
L (inferior) - Lacunar ligament, inguinal ligament
T (posterior) - Conjoint tendon, transversalis fascia
compare obturator foramen
Female = oval
Male = round
What is the function of umbilical arteries in fetal circulation?
Carries deoxygenated blood to the mother
What is the nerve supply of the vas deferens, seminal vesicle, prostate and epididymis?
Supplied by sympathetic fibres frmo L1 and L2 of the hypogastric plexus
What is the anococcygeal body?
Strong fibrous body that joins the coccyx to the fibres of levator ani muscle and external anal sphincter
What type of joint is the pubic symphysis?
Secondary cartilagenous
Which artery might replace the ovarian artery?
Uterine artery
The ovarian artery freely anastamoses with the uterine artery
Which group of lymph nodes receives lymph from the ovary?
Para-aortic nodes
What is the lhympatic drainage from the distal part of the vagina?
Inguinal lymph nodes
Where is the external urethral sphincter found?
Superficial perineal space
What is the supply of the testes and ovary?
Gonadal artery (testicular or ovarian)
Arises from the abdominal aorta
What is the lymphatic drainaige of the seminal vesicle?
Internal iliac nodes or external iliac nodes
What is the action of the bulbospongiosus?
Compress bulb of penis and spongy urethra
OR
Compress vestibular bulb and constricts the spongy urethra
What structures does the testicular artery cross before entering the inguinal canal?
Crosses the ureter and lowe part of the external iliac
What structures in the male are supplied by the genital branch of the genitofemoral nerve?
Cremaster muscle and the scrotal skin
(nerve can be used for nerve block in the repair of inguinal hernias)
Look for external anal sphincter
Superficial transverse perineal
Bulbospongiosus
Ischiocavernosus
Where is the internal urethra found?
Subperitoneal space
What does the pudendal nerve supply?
Pelvic floor and the perineum
What ligament attaches the ovary to the uterus?
Ligament of ovary
What is the innervation of the pelvic diaphragm/floor?
Levator ani muscles = pudendal nerve (S2,S3,S4)
Coccygeus = anterior rami of S4 and S5
What is a cornual ectopic?
A cornual pregnancy is an ectopic pregnancy that develops in the interstitialportion of the fallopian tube invading through the uterine wall. Cornual pregnanciesoften rupture later than other tubal pregnancies because the myometrium is more distensible than the fallopian tube.
What is the function of the deep transverse perineal?
Fixation and stability of the pelvic floor (expulsion of semen in males)
Expulsion of the last drops of urine in males and females
What ligaments are associated with the ovarian artery?
Ovarian artery descends with the suspensory ligament to supply the ovaries via the broad ligament
What are the landmarks of the breast?
Breast extends vertically from the 2nd rib to the 6th rib and horizontally from lateral border of the sternum to the mid-axillary line
What does the obturator artery supply?
Hip and medial thigh
What are the three layers of the uterus?
Endometrium
Myometrium
Perimetrium
Whata re the four lymph node gorups of the pelvis?
External iliac
Intenal iliac
Sacral lymph nodes
Common iliac
What is contained in the neurovascular bundle that enters the ischio-anal fossae through the lesser sciatic foramen?
Pudendal vein artery and nerve
What secretions are produced by the seminal vesicles?
Semenal fluid
Proteins
Enzymes
Fructose
Mucous
Vitamin C
Flavins
Phosphorylcholine
Prostaglandins
What is the function of the epididymus?
Accumulation, storage and maturation of spermatozoa
What is the normal position of the uterus?
Anteverted and anteflexed
Make yourself aware of the different positions of the uterus
Which muscle occupies the lateral pelvic wall?
Obturator internus
What is meant by hydrocele?
Collection of clear fluid in the tunica vaginalis
What does the perineal nerve supply?
Bulbospongiosus
Ischiocavernosus
Superficial perineal nerve supplies the superficial transverse perineal muscle
What are the two layers of the tunica vaginalis?
Parietal layer
Viceral layer
(fluid present between the two layers)
What is the structure that allows the anal canal to expand during defaecation?
Ischio-anal fossae
Where does the genitofemoral nerve enter the inguinal canal?
Deep inguinal ring
What is a haemoatocele?
Collection of blood in the tunica vaginalis
What are the functions of the placenta?
Gaseous exchange
Nutrition
Attach foetus to uterina wall
Immunity
Secretes hormones
Breaks down food
Removes waste
What is the appearance of epididymus?
Look it up
What muscles are deep to the breast?
Pec major
Pec minor
Serratus anterior
What are the erectile tissues?
Corpora cavernosa of the penis, Clitoris, bubls of vestibule
Which part of the rectum drains into portal circulation?
Superior rectal vein
What is the appearance of the placenta?
Fetal side = tubey
Maternal side = rough
Why might an episiotomy minimise long term damage?
Prevents tears and directs tear awya from anal sphincter
What does the ductus venosus obliterate to form?
Forms the ligamentum venosum
What is contained in the female perineum?
Female external genitalia
Perineal muscles
Anal canal
