Reproductive Anatomy Flashcards
What are the component parts of the superior pelvic aperture/pelvic inlet/pelvic brim?
Sacral promontory Ala of the sacrum Arcuate line of ileum Pecten pubis Pubic tubercle Pubic crest Pubic symphysis
What are the component parts of the inferior pelvic aperture/pelvic outlet?
Inferior margin of pubic symphysis Inferior rami of pubis Sacrotuberous ligaments Tip of coccyx
How does the greater pelvis differ in females and males?
Females- shallow Males- deep
How does the lesser pelvis differ in females and males?
Females- Wide and shallow Males- Narrow and deep
How does the pelvic inlet differ in females and males?
Females- oval/rounded Males- heart-shaped
How does the pelvic outlet differ in females and males?
Females- Larger Males- Smaller
How does the subpubic angle differ in females and males?
Females- Obtuse Males- Acute
How does the obturator foramen differ in females and males?
Females- Oval Males- Round
How does the acetabulum differ in females and males?
Females- Small Males- Large
What type of joint is the sacroiliac joint?
Anteriorly- synovial plane Posteriorly- Syndesmosis
What type of joint is the pubic symphysis?
Secondary cartilaginous- symphysis
What makes up the anterior inferior wall of the pelvic cavity?
Bodies and rami of pubic bones and pubic symphysis
Which structures occupy the lateral pelvic wall?
Obturator internus muscles
What muscle is present in the posterior wall of the pelvis?
Piriformis
What nerve network lies on piriformis?
The sacral plexus
What are the functions of the pelvic floor muscles?
Support abdominopelvic viscera Urinary and fecal continence Resistance to increase of intra-abdominal/pelvic pressure
What are the perineal and anococcygeal bodies?
Ligaments
What are the major parts of the pelvic floor muscles?
Levator ani Coccygeus
What innervates the pelvic floor?
Sacral plexus
What is a cystoceole?
A prolapse of the upper anterior vaginal wall involving the bladder
What is a rectocoele?
A prolapse of the lower posterior wall of the vagina involving the rectum bulging forwards into the vagina
What arteries supply most of the pelvic viscera, and what organs do they not supply?
Right and left internal iliac arteries Do not supply testes, ovaries or upper part of rectum
What artery supplies the bladder, seminal gland and prostate?
Superior and inferior vesical arteries
What are the origins of the superior and inferior vesical arteries?
Superior vesical artery- patent part of umbilical artery Inferior vesical artery- anterior division of internal iliac artery
What artery supplies the pelvic ureter, uterus, ligament of uterus, uterine tube and vagina?
Uterine artery
What artery is the uterine artery a branch of?
Anterior division of internal iliac artery
What artery supplies the testes and ovaries?
Gonadal (testicular or ovarian)
What artery is the gonadal artery a branch of?
Abdominal aorta
What artery supplies the rectum?
Superior rectal artery
What artery is the superior rectal artery a branch of?
Anterior iliac artery
What artery supplies the seminal glands, prostate and rectum?
Middle and inferior rectal arteries
What artery are the middle and inferior rectal arteries a branch of?
Internal iliac artery
What artery supplies the vagina and inferior part of the bladder?
Vaginal artery
What artery is the vaginal artery a branch of?
Uterine artery
What is the main artery to the perineum?
Internal pudendal artery
What artery is the internal pudendal artery a branch of?
Anterior division of internal iliac artery
What artery supplies the pelvic muscles and head of femur?
Obturator artery
What artery is the obturator artery a branch of?
Intenral iliac artery
What do the superior and inferior vesical arteries supply?
Bladder Seminal glands Prostate
What does the uterine artery supply?
Pelvic ureter Uterus Ligaments of uterus Uterine tube Vagina
What do the gonadal arteries supply?
Testes or ovaries
What does the superior rectal artery supply?
Rectum
What do the middle and inferior rectal arteries supply?
Seminal glands Prostate Rectum
What does the vaginal artery supply?
Vagina Inferior part of urinary bladder
What does the internal pudendal artery supply?
Perineum
What does the obturator artery supply?
Pelvic muscles Head of femur
What are the five veins that drain the pelvis?
Internal iliac veins Superior rectal veins Median sacral vein Gonadal veins Internal vertebral venous plexus
Which rectal vein drains into the portal circulation?
Superior rectal vein
Which rectal veins drain into the systemic circulation?
Inferior and middle rectal veins
What is the clinical significance of the pelvic veins?
Haemorrhoids
With which venous plexus does the prostatic venous plexus communicate with on its posterior side?
Vertebral venous plexus (causes bone mets in prostate cancer)
What makes up the somatic component of the nerve supply to the reproductive organs?
Illioinguinal nerve + genitofemoral nerve
Where does the illioinguinal nerve originate?
L1
Where does the ilioinguinal nerve enter the inguinal canal?
At the superficial inguinal ring
What does the ilioinguinal nerve supply?
The skin at the root of the penis or the labia
Where does the genitofemoral nerve originate?
L1-L2
Where does the genitofemoral nerve enter the inguinal canal?
Deep inguinal ring
What structure is supplied by the genital branch of the genitofemoral nerve?
The anterior aspect of the scrotum
Where does the pudendal nerve arise from?
From S2-S4 via the sacral plexus
What is the sympathetic innervation of vas deferens, seminal vesicles, prostate and epididymis in males?
L1 and L2 via the hypogastric plexus
What is the sympathetic innervation of the female genital tract?
Ovarian and pelvic plexuses
What is the parasympathetic innervation of the female genital tract?
Pelvic splanchnic nerves (S2-4)
What is the innervation of male and female erectile tissues?
Parasympathetic fibres from S2-S4 via the hypogastric plexus
What region do the external iliac lymph nodes drain?
Pelvic viscera (especially superior parts of anterior pelvic organs)
What region do the internal iliac lymph nodes drain?
Gluteal region, deep perineum and inferior pelvic viscera
What region do the sacral lymph nodes drain?
Postero-inferior pelvic viscera
What nodes do the common iliac lymph nodes drain?
External iliac nodes Internal iliac nodes Sacral nodes
Why are the testicles located outside of the abdominopelvic cavity?
For temperature regulation
What are the main contents of the spermatic cord?
Ductus deferens Testicular artery Artery of ductus deferens Cremasteric artery Pampiniform venous plexus Lymphatic vessels Sympathetic nerve fibres Genital branch of genitofemoral nerve
What is the tough outer layer of the testis called?
Tunica albuginea
What is the name of the peritoneal sac covering the testis?
Tunica vaginalis
What are the two divisions of tunica vaginalis?
Visceral layer Parietal layer
What is present between the two layers of tunica vaginalis?
Fluid
What artery do the testicular arteries arise from? At what vertebral level does this happen?
From the abdominal aorta at L2
What structures do the testicular arteries cross before reaching the inguinal canal?
Ureters External iliac arteries
What veins drain the testis>
The pampiniform venous plexus
What is the function of the pampiniform venous plexus
Involved in thermoregulation of testes
Into which vein does the right testicular vein drain?
Inferior vena cava
Into which vein does the left testicular vein drain?
Left renal vein
Which lymph node groups receive lymph from the testis?
Right/left lumbar Para-aortic
What is the course of the vas deferens
Arises from the tail of the epididymis Traverses inguinal canal Enters the pelvis by crossing the external iliac vessels Terminates by joining the duct of the seminal gland to form the ejaculatory duct
What is produced by the seminal vesicles?
Seminal fluid
What are the anatomical relations of the prostate?
Fused to the neck of the bladder Surrounds the prostatic urethra
What is produced by the prostate?
Prostatic fluid
Where do the bublourethral glands empty in to?
The penile urethra
What is secreted by the bulbourethral glands?
Cowper’s fluid
What is the lymphatic drainage of the prostate?
Internal iliac and sacral nodes
What is the lymphatic drainage of the seminal vesicles?
Iliac lymph nodes Superior part of vesicles to external iliac nodes, inferior to internal
What is the lymphatic drainage of the scrotum?
Superficial inguinal nodes
What is the lymphatic drainage of the penis?
Superficial inguinal nodes
What structures constitute the birth canal?
Vulva Cervix Vagina
What are the layers of the uterus, from outermost to innermost?
Perimetrium Myometrium Endometrium
From what area of the uterine body does the lower segment develop from during pregnancy?
The isthmus
How does the round ligament appear?
Fibrous appearance
Where does the ovarian ligament run between?
Ovaries and uterus
What is the appearance of the ovarian suspensory ligaements?
Hollow with ovarian vessels inside
Where is the round ligament of the uterus found?
Between the two sheets of the broad ligament
What is the normal position of the uterus?
Anteflexed Anteverted
What can happen if the uterus is retroverted and retroflexed, especially in early pregnancy?
Urinary incontinence Miscarriage
Why is it important to know the position of the uterus prior to instrumental delivery?
To avoid perforation of the uterus with instrumentation
Where does the rectouterine space lie?
Between the rectum and the uterus
Where does the uterovesical space lie?
Between the bladder and the uterus
What are the fornices of the vagina?
Anterior Posterior Lateral
Through which vaginal fornix can the rectouterine puch be accessed?
Posterior vaginal fornix
What structures support the uterus?
Pelvic fascia Muscles of pelvic floor
What is the cardinal ligament of the uterus?
Transverse cervical ligament
What are the parts of the uterine tubes?
Infundibulum Ampulla Isthmus Intramural/uterine part
Which is the longest and widest part of the uterine tubes?
Ampulla
Where does fertilisation occur?
In the ampulla of the uterine tubes
What are the ligaments associated with the ovaries?
Ligament of ovary Suspensory ovarian ligament
Where does the ligament of the ovary run between?
From the uterus to ovaries
Where does the suspensory ovarian ligament run between?
From ovaries to lateral pelvic wall
What branches of the abdominal aorta supply the gonads and genitalia?
Gonadal and internal iliac arteries
At what vertebral level do the gonadal arteries originate?
L2
In what structure does the ovarian artery descend?
Within the suspensory ligament and supplies ovarie via broad ligament
Into what vein does the left ovarian vein drain?
Left renal vein
Into what vein does the right ovarian vein drain?
Inferior vena cava
Where does the uterine artery cross over the ureter?
At the level of the ischial spine at the junction of the cervix and lateral part of the fornix of the vagina
Which group of lymph nodes receive lymph from the ovaries?
Lumbar lymph nodes
Where is lymph from the external orifice of the vagina drained to?
Superficial inguinal lymph nodes
What lymph nodes drain the fundus and upper uterine body?
Pre-aortic group
What lymph nodes drain the bulk of the uterine body?
Internal iliac group
What lymph nodes drain the lower part of the uterine body?
Ecternal iliac group
What lymph nodes drain the uterine cervix and upper vagina?
Internal iliac and sacral lymph nodes
What lymph nodes drain the lower vagina?
Sacral and common iliac
How many lobes are in each breast?
15-25
What are the boundaries of the breasts?
2nd rib 6th rib Lateral border of sternum Anterior axillary line
What muscles are the deep surface of the breasts related to?
Pectoralis major Pectoralis minor Serratus anterior
Branches of which arteries supply the mammary gland?
Branches of subclavian and axillary arteries
What are the main lymph node groups draining the breasts?
Axillary lymph nodes (75%, lateral quadrants) Pectoral Parasternal Supraclavicular lymph nodes
What is the appearance of the fetal surface of the placenta?
Smooth and bears the attachment of the umbilical cord
What is the appearance of the maternal surface of the placenta?
Rough and spongy
What are the functions of the placenta?
Gaseous exchange Attaches fetus to uterine wall Provides nutrients Produces hormones
When does the placenta separate from the uterine wall?
During the third stage of labour following delivery of the baby
How many umbilical arteries are there in a cross section of the umbilical cord?
Two
How many umbilical veins are there in a cross section of the umbilical cord?
One
What else is present in the umbilical cord asides from vessels?
Whorton’s jelly
What are the contents of the male perineum?
External genitalia Perineal muscles Anal canal
What are the contents of the female perineum?
Female external genitalia Perineal muscles Anal canal
What are the subdivisions of the perineum?
Urogenital triangle Anal triangle
Where is the line separating the urogenital and anal triangles?
Line between two ischial tuberosities transversley
Which perineal triangle lies inferior to the pubic symphysis?
Anal triangle
Which perineal triangle lies anteroinferior to the coccyx?
Urogenital triangle
Where does the perineal membrane run?
Between the right and left sides of the pubic arch, below the pubic symphysis
What is the innervation of the external anal sphincter?
Branch of pudendal nerve
What are the main actions of the external anal sphincter?
Constricts anal sphincter during peristalsis
What is the innervation of the bulbospongiosus muscle?
Muscular/deep branch of perineal nerve Branch of pudendal nerve
What is the innervation of the ischiocavernous muscle?
Muscular/deep branch of perineal nerve Branch of pudendal nerve
What is the innervation of the superifical transverse perineal muscle?
Muscular/deep branch of perineal nerve Branch of pudendal nerve Dorsal nerve of penis/clitoris Terminal branch of pudendal nerve
What is the innervation of the deep transverse perineal muscle?
Muscular/deep branch of perineal nerve Branch of pudendal nerve Dorsal nerve of penis/clitoris Terminal branch of pudendal nerve
What is the innervation of the external urethral sphincter?
Muscular/deep branch of perineal nerve Branch of pudendal nerve Dorsal nerve of penis/clitoris Terminal branch of pudendal nerve
What are the main actions of the bulbospongiosus muscle?
Support and fixes perineal body/ pelvic floor
What are the main actions of the ischiocavernosus muscle?
Maintains erection of penis/ clitoris
What are the main actions of the superficial transverse perineal muscle?
Support and fix perineal body to support abdomino-pelvic viscera Resist intra-abdominal pressure increases
What are the main actions of the deep transverse perineal muscle?
Support and fix perineal body to support abdomino-pelvic viscera Resist intra-abdominal pressure increases
What are the main actions of the external urethral sphincter?
Compresses urethra to maintain urinary continence
What is the perineal body?
A fibro-muscular mass
What is the clinical significance of the perineal body?
If damaged can get prolapse of pelvic viscera
What muscles converge towards the perineal body?
Bulbospongiosus External anal sphincter Superficial and deep transverse perineal muscles Muscles from external urethral sphincter Levator ani
Which space is the external urethral sphincter found in?
Deep perineal pouch
What is the innervation of the external urethral sphincter?
Branch of pudendal nerve
What are the parts of the male urethra?
Prostatic Membranous Spongy/penile
What is the widest part of the male urethra?
Prostatic
What is the narrowest part of the male urethra?
Membranous
Where do the ischio-anal fossae lie?
Inferior to the pelvic floor, lateral to the anal canal
What is the function of the ischio-anal fossae?
Allow the anal canal to expand during defacation
What is the major content of the ischio-anal fossae?
Fat and vessels
Where does the neurovascular bundle enter the ischio-anal fossae?
Through the lesser sciatic foramen
What structures are present in the neurovascular bundle that enters the ischio-anal fossae?
Pundendal nerve Obturator internus nerve
What structures does the neurovascular bundle that enters the ischio-anal fossae supply?
Obturator internus Pelvic floor Perineum
