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Year Three Anatomy > Reproductive Anatomy > Flashcards

Reproductive Anatomy Flashcards

1
Q

Name the structures that define the superior pelvic aperture

A
  • Sacral promontory
  • Ala of the sacrum
  • Arcurate line of the ilium
  • Pecten pubis (ridge on the superior rams of the pubic bone)
  • Pubic tubercle
  • Pubic crest
  • Pubic symphysis
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2
Q

What is the sexual diamorphism of the greater pelvis?

A

Females have a shallow greater pelvis

Males have a deep greater pelvis

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3
Q

What is the sexual diamorphism of the lesser pelvis?

A

Females have a wide lesser pelvis

Males have a narrow lesser pelvis

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4
Q

What shape is the pelvic inlet in both sexes?

A

Females have an oval/rounded shaped pelvic inlet

Males have a heart shaped one

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5
Q

What is the difference in relative size of the pelvic outlet between the two sexes?

A

Female relatively large

Male relatively smaller

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6
Q

What is the sexual diamorphism of the suprapubic angle?

A

Female - Obtuse: greater than 90 degrees

Male - Acute: less than 90 degrees

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7
Q

What is the difference in shape of the obturator foramen in men and women?

A

Female - oval

Male - round

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8
Q

What is the sexual diamorphism of the relative size of the acetabulum?

A

Female relatively small

Male relatively large

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9
Q

What are the two types of joints found in the pelvis?

A

Planar synovial e.g. sacroiliac joint

Pubic symphysis e.g. secondary cartilaginous

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10
Q

What is the pelvic brim?

A

The edge of the superior pelvic aperture - anything superior to this point is known as the greater (false) pelvis and inferior to this point, the lesser (true) pelvis

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11
Q

Why is the greater pelvis known as the false pelvis?

A

Contains the inferior part of the peritoneal cavity (i.e. intestines and other abdominal organs)

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12
Q

Why is the lesser pelvis known as the true pelvis?

A

Contains true pelvic organs (i.e. reproductive systems)

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13
Q

What walls does the pelvic cavity have?

A

Antero-inferior wall, two lateral walls and a posterior wall

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14
Q

What is the antero-inferior wall made of?

A

Bodies and rami of the pubic bones and the pubic symphysis

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15
Q

What is the lateral walls made of?

A

Obturator internus and the piriformis muscles

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16
Q

What is the posterior wall made of?

A

Coccygeus muscle

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17
Q

What is the pelvic floor?

A

Funnel-shaped ‘hammock’ of muscles and fascia that separates the pelvic cavity from the perineum, inferior to which the genitalia and anus sit

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18
Q

How does the pelvic floor allow for defaection and urination?

A

Hiatuses for the anal and urethral canal

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19
Q

Between anal and urethral hiatuses lies a fibrous node of connective tissue known as what?

A

Perineal body

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20
Q

What are the functions of the pelvic floor?

A
  • Support of abdomen-pelvic viscera
  • Resistance to increases in intra-pelvic/abdominal pressure
  • Urinary and faecal incontinence
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21
Q

What are the muscles of the pelvic floor?

A
  • Levator ani muscles
  • Coccygeus muscle
  • Fascia covering the muscles
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22
Q

What muscles form the elevator ani muscles?

A

Puborectalis, pubococcygeus and the iliococcygeus

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23
Q

How does the puborectalis maintain continence?

A

Originates at the pubic bone and form muscular slings around the anal canal and urethra respectively

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24
Q

What is the only true levator muscle of the levator ani muscles?

A

Iliococcygeus - elevating the pelvic floor and ano-rectal canal

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25
Q

How is the levator ani muscle innervated?

A

Pudendal nerve (roots S2, S3, S4)

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26
Q

Describe the course of the coccygeus muscle

A

Originates from the ischial spines and runs posteriorly attaching to the lateral aspect of the sacrum and coccyx along the sacrospinous ligament

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27
Q

What is the blood supply to the pelvis?

A

Branches of the internal iliac artery supply everything except for the testes/ovaries (gonadal artery) and the upper rectum (superior rectal artery from the Inferior Mesenteric Artery)

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28
Q

What structures do the superior and inferior vesicle arteries supply?

A

Bladder, seminal glands, prostate

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29
Q

What structures do the uterine arteries supply?

A

Uterus, ovaries, Fallopian tubes

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30
Q

From where do the gonadal arteries arise?

A

Abdomain aorta

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31
Q

From where do the middle and inferior rectal arteries arise?

A

Internal iliac a.

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32
Q

What structures does the vaginal artery supply?

A

Vagina/base of bladder

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33
Q

What is the vaginal artery a branch of?

A

Uterine artery

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34
Q

What is the main artery to the perineum?

A

Internal pudendal artery

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35
Q

What does the obturator artery supply?

A

Thigh adductors

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36
Q

Five different veins drain the pelvis; name them.

A
  1. Internal iliac veins
  2. Superior rectal veins
  3. Median sacral veins
  4. Gonadal veins
  5. Internal vertebral arteries (Batson’s plexus)
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37
Q

What veins do the rectal veins drain into? Think about types of venous drainage

A

Superior - portal circulation

Middle and inferior - systemic circulation

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38
Q

What is the clinical significance of the rectal veins?

A

Suppositories bypass portal circulation, potentially giving better bioavailability

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39
Q

What is the significance of the prostatic venous plexus?

A

Freely communicates with Batson’s plexus; significant in metastasis of cancers

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40
Q

What are the four components of innervation to he pelvis?

A
  • Ilioinguinal nerve
  • Genitofemoral nerve
  • Pudendal nerve
  • Autonomic components
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41
Q

Describe the ilioinguinal nerve

A

Originate from L1 and enters the inguinal canal at the superficial ring to supply the skin at the root of the penis and labia

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42
Q

Describe the genitofemoral nerve

A

Originates from L1-L2 and enters at the deep inguinal ring, supplying the cremaster muscle and is tested via the cremasteric reflex

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43
Q

Describe the pudendal nerve

A

Arises form the sacral plexus (L4-S4) and follows the course of the pudendal artery to innervate the sin and the muscles of the perineum

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44
Q

What bony landmark is used to locate the pudendal nerve or nerve block during forceps delivery?

A

Ischial spine

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45
Q

What effect do symapthetic fibres have in the pelvis?

A

From L1-L2, via the hypogastric plexus supply the vas deferens, vesicles and epididymis

Fibres from the pelvic and ovarian plexuses and parasympathetic nerve fibres from the pelvic splanchnic (S2-S4) nerve supply the female genital tract

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46
Q

What effect doe parasymptahtic fibres have in the pelvis?

A

Fibres from S2-S4 form the hypogastric plexus innervate the erectile tissue

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47
Q

How many lymph node groups are there in the pelvis

A

Four primary

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48
Q

What are the groups of lymph nodes in the pelvis called?

A

Extrernal iliac
Internal iliac
Sacral
Common iliac

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49
Q

What structures are drained by the external iliac nodes?

A

External genitalia, rectal viscera, abdominal wall (inferior to umbilicus)

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50
Q

What structures are drained by the internal iliac nodes?

A

Gluteal region, deep perineum and inferior pelvic viscera

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51
Q

What structures are drained by the sacral nodes?

A

Pelvic, perineal nad gluteal regions

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52
Q

What structures are drained by the common iliac nodes?

A

Receive drainage from the other groups of lymph nodes in the pelvis and lower limbs

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53
Q

Reproductive organs can be classified into four categories in males; what are they?

A
  • External genitalia
  • Gonads
  • Tubal systems
  • Accessory glands
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54
Q

What are the male reproductive organs?

A

Testes, ductus deferens/vas deferens, seminal glands, prostate, epididymis, bulbourethral glands

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55
Q

What is the function of the counter-current heat exchange system in the testes?

A

Testes optimal temperature is two degrees below core body temperature. the testicular artery is surrounded by the pampiniferous venous network to draw out heat

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56
Q

What are the fascial coverings of the testes?

A
  1. Skin
  2. Dartos muscles and superficial fascia
  3. External spermatic fascia
  4. Cremasteric fascia
  5. Internal spermatic fascia
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57
Q

Describe the structure of the testes

A

Tough fibrous outer layer called tunica albugeniea

Tunica vaginalis is a peritoneal sac covering the testes. It has two layers: visceral and parietal and between them exists serous fluid

58
Q

What spinal level do the testicular arteries arise?

A

L1/L2

59
Q

What is the peritonisation fo the testicular arteries?

A

Retroperitoneal

60
Q

What structures do the testicular arteries cross before entering the inguinal canal?

A

Psoas major and IVC

61
Q

What is the pampiniferous venous plexus?

A

A network of 8-12 anastomosing veins surrounding the testicular artery in the scrotum that are important in the heat transfer

62
Q

Where do the testicular veins drain into?

A

Left - Left Renal Vein

Right - Inferior Vena Cava

63
Q

What two groups of lymph nodes drain the testes?

A

Para-aortic and inguinal nodes

64
Q

What is the vas deferens?

A

Muscular tube which arises from the caudal epididymis and enters the pelvis over the external iliac vessels

65
Q

Where does the vas deferens terminate?

A

Joining the duct of the seminal gland to forth ejaculatory process

66
Q

What are seminal glands?

A

Paired structures on the posterior aspect of the bladder

67
Q

What is the funciton of the seminal glands?

A

Secrete a thick, yellow, alkaline fluid which comprises of protein, sugar and semen

68
Q

Where is the prostate anchored?

A

To the inferior neck of the bladder and surrounds the prostatic urethra

69
Q

What does the prostate secrete?

A

A thick milky and slightly acidic fluid

70
Q

What are the bulbourethral glands (also known as Cowper’s glands)?

A

Small, paired structures located in the urogenital diaphragm which empty in to the penile/spongy urethra

71
Q

What lymph node group drains the prostate?

A

Internal iliac and sacral

72
Q

What lymph node group drains the seminal glands?

A

Internal and eternal iliac nodes

73
Q

What lymph node group drains the scrotum?

A

Superficial inguinal nodes

74
Q

What lymph node group drains the penis?

A

Superficial inguinal nodes

75
Q

What are the histological features of a testis sample?

A

Convoluted tubules in various planes
4-8 layers of celss
Spermatozoa in the lumen
Leydig cells in the interstitium

76
Q

What are the histological features of a prostate sample?

A

Serous alveoli with infolding epithelium
Trabeculae of muscular stroma
Amorphous eosinophilic masses called corpora amylacae in the alveoli in older men

77
Q

What are the histological features of a seminal vesicle sample?

A

No sperm in lumen
Highly recessed and irregular lumen forming crypts and cavities giving a honey-combed appearance
Well-developed muscular externa

78
Q

What are the histological features of a ductus deferens sample?

A

Lumen stellate in shape
A thick walled muscular tube
Epithelial lining and its supporting lamina propriety are thrown into longitudinal folds

79
Q

What reproductive organs comprise the female reproductive system?

A

Uterus, ovaries, fallopian tubes, vagina

80
Q

What comprises the birth canal?

A

Vagina, cervix and vulva

81
Q

What are the three layers f the uterus?

A

Perimetrium, myometrium, endometrium

82
Q

As pregnancy advances, the uterus has what two sections?

A

Upper and a lower

83
Q

What is the normal position of the uterus?

A

Anteverted and antiflexed

84
Q

What is anteversion?

A

Refers to the positions of the uterus in which its long axis is bent forward on the long axis of the vagina

85
Q

What is anteflexion?

A

Refers to the position in which the long axis of the body of the uterus is bent forward along the axis of the vagina at the internal os

86
Q

What are the fornices of the vagina?

A

Superior portions of the vagia extending into recesses

87
Q

Why is the posterior fornix clinically relevant?

A

It is an important surgical route into the rectouterine pouch and can be a common site of metastasis

88
Q

What is the main ligamentous support of the uterus?

A

Cardinal ligament (lateral cervical ligament)

89
Q

Apart from the pelvic fascia, what other structure provides important support of the uterus?

A

Bladder

90
Q

What are the sections of the Fallopian tube called?

A

Starting at the ovarian end:

Fimbriae
Infundibulum
Ampulla
Isthmus

91
Q

The ovary is held in place by which two ligaments?

A

Suspensory ligament - from ovary to pelvic wall

Ovarian ligament - from uterus to ovary

92
Q

The ovarian ligament is covered by what flat ligament?

A

Broad ligament

93
Q

What two major branches of the abdominal aorta supply the gonads and genitalia?

A

Internal iliac and Gonadal arteries

94
Q

Where do the gonadal arteries originate?

A

L2 level

95
Q

In females, the ovarian artery descends within what structure and freely communicates with what other major pelvic artery?

A

Suspensory ligament; uterine artery

96
Q

Where does the uterine artery cross over the ureter?

A

Lower level of the ischial spine at the junction of the cervix and lateral part of the fornix of the vagina

97
Q

Lymph from the labia and distal vagina drain into which nodes?

A

Deep inguinal and external iliac nodes

98
Q

Lymphatic drainage of the ovaries is achieved by what nodes?

A

Para-aortic

99
Q

Describe the lymphatic drainage of the uterus

A

Fundus and upper part - para-aortic
Body - internal iliac
Uterine cervix - internal iliac and sacral

100
Q

Describe the structure of the breast

A

Each breast contains 15-25 lobes with tubule-acinar glands (parenchyma) and stroma (connective tissue)

101
Q

Describe the position of the breasts anatomically

A

Extend vertically from the 1st to the 6/7th rib and horizontally from the lateral border of the sternum to the mid-axillary line

102
Q

What are the deep surface relations of the breast?

A

Pec. major, serrates ant., intercostal muscles, rectus abdomens, external oblique

103
Q

What arteries supply the breast?

A

Branches of the subclavian/axillary (internal and lateral thoracic arteries)

104
Q

What lymph groups drain the breast?

A

Lateral quadrants - axillary nodes
Medial quadrants - parasternal nodes
Superior quadrants - supraclavicular nodes

105
Q

What is the clinical significance about lymph drainage of the breast?

A

Lymph from the medial side of one breast can drain into nodes on the medial side of the contralateral breast - thus providing a route for infection/cancer

106
Q

What are the three distinct phases of uterine histology?

A

Proliferative and secretory and menses

107
Q

What hormone facilitates the proliferative phase of the uterus; what are its features histologically?

A

Follicle Stimulating Hormone (oestrogen for vascularisation)

Thick endometrium, renewed connective tissue, glandular structure and ehlicrine arteries

108
Q

What hormone facilities the secretory phage and what are its features?

A

Luteinising Hormone

Cork-screw endometrial glands, filled with glycogen

109
Q

What hormones are responsible for the beginning of menses?

A

Decreasing levels of Luteinising Hormone and progesterone

110
Q

What feature are histologically recognisable in menses?

A

Lumen, degeneration of the endometrium and ears of blood leakage as spiral arterioles degenerate

111
Q

What ype of organ is the placenta?

A

Foetomaternal (common to both the foetus and the mother)

112
Q

What embryological structure does the placenta develop from?

A

The placenta develops from the trophoblast following implantation of the blastocyst

113
Q

What are the features of the maternal side of the placenta?

A

Rough and spongy

114
Q

What are the features of the foetal side of the placenta?

A

Smooth and bears the attachment of the umbilical cord

115
Q

What are the four main functions of the placenta?

A

Gaseous exchange
Excretion of waste
Immunity
Endocrine

116
Q

Describe the structure of the umbilical cord

A

Two umbilical arteires, one vein, one allantoic duct and surrounded by Wharton’s jelly

117
Q

What type of blood do the umbilical arteries and vein transmit?

A

Vein - oxygenated

Arteries - deoxygenated

118
Q

Where does the perineum lie?

A

Inferior to the pelvic diaphragm

119
Q

What are the structures of the perineum?

A

Exrtenal genitalia, perineal muscles, anal canal

120
Q

The perineum is divided into what two triangles? What demarcates these?

A

Urogenital triangle and the anal triangle; the imaginary line between the two ischial tuberosities

121
Q

What are the four main muscles of the perineum?

A

External anal sphincter
Transverse perineal muscles
Bulbospongiosus
Ischiocavernosus

122
Q

What are the action and innervation of the external anal sphincter?

A

Continence (faecal); branch of the pedundal nerve

123
Q

What are the action and innervation of the bulbospongiosus?

A

Males: empties urethra

Female: clenches vagina; pudendal nerve

124
Q

What are the action and innervation of the ischiocavernosus?

A

Assists bulbospongiosus; pudendal nerve

125
Q

What are the action and innervation of the superficial and deep transverse perineal muscle

A

Fixation of the perineal body; pudendal nerve

126
Q

What are the action and innervation of the external urethral sphincter?

A

Continence (urinary); pudendal nerve

127
Q

What is the perineal body?

A

The raphe of fibromuscle which denotes the boundary between the anal and urogenital triangle

128
Q

Which muscles converge towards the perineal body?

A

External anal sphincter, bulbospongiosus, elevator ani, transverse perineal

129
Q

What are the perineal pouches?

A

Superficial and deep perineal pouches are fascia-limited, potential spaces traversed by the urethra

130
Q

What is the clinical significance of the perineal pouches?

A

They can become infiltrated following traumatic surgical injury of the urethra

131
Q

What urethral sphincter is found in the deep perineal pouch?

A

Internal

132
Q

What urethral sphincter is found in the superficial perineal pouch?

A

External

133
Q

How does the superficial perineal pouch relate to the urogenital membrane?

A

Antero-inferior and surround the external genitalia

134
Q

How does the deep perineal pouch relate to the perineal muscle?

A

Surrounds it

135
Q

What are the three main parts of the urethra?

A

Prostatic, membranous, spongy

136
Q

Which is the widest part of the urethra? Which is the narrowest?

A

Prostatic; membranous

137
Q

What is the function of the ischio-anal fossa?

A

Allows room for the anal canal to expand during defaecation

138
Q

What characteristic of the ischia-anal fossa makes it susceptible to pathology? What lifestyle can predispose you to this?

A

Fatty tissue is susceptible to abscess and can result in fistulae; sedentary lifestyle

139
Q

What neurovascular bundle enters the ischio-anal fossa?

A

The pudendal nerve and vessels (artery and vein)

140
Q

What foramen does the pudendal bundle enter the ischia-anal fossa through?

A

Lesser sciatic foramen

141
Q

What structures do the pudendal neurovasculature supply?

A

Sensory external genitals and motor supply to the pelvic muscles

Year Three Anatomy (5 decks)

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