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SBO5 > Reproductive System > Flashcards

Reproductive System Flashcards

1
Q

Introduce the ovaries

A

LOCATION

  • •Lie in a shallow fossa,in the angle between the internal and external iliac vessels on the obturator nerve

FUNCTIONS

  • •Production of female gametes (ova)
  • •Synthesis of female sex hormones:
  • •Oestrogens (oestradiolis the most abundant)
  • •Progesterone

STRUCTURE

  • paired shaped almond glands
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2
Q

What are the peritoneal ligaments of the ovaries?

A
  • Ovarian ligament (ligament of the ovary) – attachment to the uterus medially
  • Suspensory ligament – anchors laterally to pelvic wall (conveys neurovascular structures)
  • Mesovarium– suspends the ovary in between the ovarian and suspensory ligaments
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3
Q

What is the histology of the ovaries?

A
  • TUnica albuginea: germinal epithileum
  • Cortex
    • ovarian follicles
    • somatic cells: granulosa cell + theca cells
    • oogenesis: (Menstruation follicules x 3)
  • Medulla
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4
Q

Neurovascular supply to the ovaries?

A

ARTERIAL SUPPLY

  • •Ovarian arteries (from the abdominal aorta)
  • •Pass through the suspensory ligaments

VENOUS DRAINAGE

  • •A plexus of veins around the ovaries drain into the ovarian veins

LYMPHATIC DRAINAGE

  • •Lymphatics drain into the lumbar lymph nodes

NERVE SUPPLY

  • •Plexus of nerves called the ovarian plexus
  • •Parasympathetics:CNX (Vagus)
  • •Sympathetics:T9-11
  • •Visceral afferents: enter cord at T10 level
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5
Q

Introduce the uterine tubes

A

STRUCTURE: paired muscular 10cm tube embeded in uterine wall

LOCATION

  • •Extend laterally from the uterine horns and open into the peritoneal cavity near the ovaries
  • •Found in the upper free margin of the broad ligament

FUNCTIONS

  • •Receives oocyte from ovaries and provides a site for fertilisation
  • •Nourishes the fertilized ovum and transports it to the uterus
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6
Q

Label the parts of the uterine tube

A
  • INFUNDIBULUM(L.‘funnel’)

AMPULLA(L.‘flask’)

ISTHMUS(G. ‘narrow passage’)

UTERINE

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7
Q

Introduce the uterus

A

Structure: flattened pear shape organ 8x5x3 made from body and cervix

LOCATION

•Anterior to rectum, posterosuperior to the bladder

FUNCTION

•Site for reception, retention & nutrition of the fertilized ovum

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8
Q

Label the body of the uterus

A

•Fundus: regionof the uterus above where the uterine tubes enter

•

  • Body: flattened in an anterior /posterior direction
  • Cornu (‘horns’): where the uterus is joined by the uterine tubes
  • Vesical surface (anterior)
  • Related to the bladder
  • Intervening vesicouterine pouch
  • Intestinal surface(posterior)
  • Related to coils of small intestine and rectum
  • Rectouterine pouch (pouch of Douglas)
  • Isthmus
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9
Q

Name the parts of the neck of the uterus

A

Internal Os

External Os

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10
Q

What are the ligaments encompassing the uterus?

A

Round Ligament

Broad Ligament

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11
Q

What is the neurovascular supply to the uterus?

A

ARTERIAL

  • •Mainly from the uterine arteriess
  • •Additional supply from the Ovarian Arteries

VENOUS

  • •Uterine Veins = Enter the broad ligaments with the uterine aa
  • These veins drain into the Internal Iliac Veins

LYMPH

Three main routes:

  • •Most vessels from uterinetubes & fundus
  • •lumbar lymph nodes
  • •superficial inguinal nodes
  • •Vessels from the body
  • •external iliac lymph nodes
  • •Vessels from the cervix
  • •internal iliac and sacral lymph nodes

NERVE

  • Sympathetic:T12 -L1/2
  • Parasympathetic:S2-4
  • Visceral afferents
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12
Q

What are the 3 histology layers of the uterus?

A
  1. Endometrium
    • •Functional layer : Undergoes cyclical changes, shed during menstruation
    • Basal layer: Has stem cells that form a new functional layer
    • •Uterine glands: extend the length of the endometrium
  2. Myometrium
  3. Perimetrium
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13
Q

Introduce the vagina

A

Structure: muscular membranous tube

Location: from the cervical canal to the vestibule of the vagina

Function:

  • •Serves as an excretory duct for menstrual fluid
  • •Forms the inferior part of the birth canal
  • •Receives the penis and ejaculate during sexual intercourse
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14
Q

Neurovascular supply to the vagina?

A

ARTERIAL: vaginal artery

VENOUS: Vaginal vein + internal illiac vein via uterine vein

LYMPH:

  • •Internal and external iliac lymph nodes
  • •Sacral iliac nodes
  • •Superficial inguinal lymph nodes

NERVE

  • Uterovaginal plexus supply superior 3/4 vagina
    • •Sympathetics: T12-L1/2
    • •Parasympathetics: S2-4
    • •Visceral afferents
  • •Inferior ¼ vagina= somatic innervation
    • Pudendal nerve S2-4
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15
Q

WHat are the main female Hormones that regulate the female cycles and where are they located

A

GONADOTROPHIN-RELEASING HORMONE

•From the hypothalamus

THE GONADOTROPHINS

•From the anterior pituitary gland

  • •Follicle Stimulating Hormone
  • Luteinising Hormone

FEMALE SEX HORMONES

•From the ovaries*

  • •Oestrogens & Progesterone
  • The placenta produces most sex hormones during pregnancy – more on this next year!
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16
Q

What’s the function of the follicle stimulating hormone in women?

A
  • Stimulates ovarian follicle maturation
  • Ovarian production of oestrogen
17
Q

What’s the function of the luteinizing hormone in women?

A
  • Triggers ovulation & formation of corpus luteum
  • Ovarian production of progesterone & oestrogen
18
Q

WHat the role of oestrogen in women and how is it produced?

A

Oestrogen:

  • •Promote oogenesis, maintain the female reproductive tract, secondary sex characteristics
  • •Protective cardiovascular effect
  • •Maintain bone density
  • Theca cells formandrogens,which are converted to oestrogens by granulosa cells
  • Requires the enzyme aromatase
19
Q

WHat the role of progesterone in women and how is it produced?

A

Progesterone

  • Produced mainly by the corpus luteum
  • Prepares the endometrium for implantation
  • Forms a cervical mucous plug

made from cholesterol

20
Q

Describe the phases of the ovarian cycle and what hormones are produced?

A

FOLLICULAR PHASE

  • •FSH: a vesicular follicle is selected to be the dominant follicle
  • •LH: oestrogens produced in large amounts by granulosa cells

OVULATION

  • •High oestrogen levels a cause a spike in plasma levels of LH
  • •Dominant follicle releases an oocyte into the peritoneal cavity

LUTEAL PHASE

  • •Leftover granulosa & theca cells become the corpus luteum
  • •Produces large amounts of progesterone and some oestrogens
  • •Pregnancyvs. no pregnancy
21
Q

Describe the 3 phases of the uterine (menstrual) cycle

A

MENSTRUAL PHASE: Endometrium sheds functional layer

PROLIFERATIVE (PRE-OVULATORY) PHASE

  • •Stem cells in the basal layer generate a new functional layer
  • •In response to increasing oestrogen levels produced by the maturing follicle

SECRETORY (POST-OVULATORY) PHASE

  • •Begins immediately after ovulation
  • •Progesterone from the corpus luteum converts the functional layer into a secretory mucosa
  • •Glands enlarge and secrete nutrients to prepare endometrium for potential implantation
  • •If pregnancy doesn’t occur: progesterone levels decline (corpus luteum degenerates)
  • •Spiral arteries spasm:ischaemic endometrial cells undergo necrosis and slough off
22
Q

What is the classification of oral contraceptives?

A
  • Oestregen- progesterone combination
  • only progesterone
23
Q

How do contraceptive pills work?

A
  • •Interferes with the hormonal axis between the hypothalamus, anterior pituitary and ovaries
  • •OCP produces constant plasma levels of ovarian hormones that make the woman appear pregnant
  • •Mature follicles do not develop, ovulation ceases and menstrual flow is greatly reduced (or absent)
24
Q

Side effects of pills?

A

Common:

•nausea, breast enlargement or tenderness, weight gain, bloating and fluid retention, loss of libido, headache

Serious

thromboembolism

arterial thrombosis

25
Q

Label the external female genitalia

A
26
Q

Label the Vestibule

A
27
Q

Introduce the clitoris

A

STRUCTURE V-shaped erectile organ where the labia minora meet anteriorly

•Consists of a rootand body:

  • •Glans – most highly innervated, covered by a prepuce
  • Two corpora cavernosa
  • Two crura: connect the clitoris to the ischiopubic rami
  • Covered by the ischiocavernosus muscles

FUNCTION

  • •No functional relationship to the urethra
  • •Organ of sexual arousal, enlarges on tactile stimulation
28
Q

What is the neurovascular supply to the vulva?

A

ARTERIAL: External pudendal and internal pudendal artery

VENOUS: Labial veins + internal pudendal veins

LYMPH: superficial + deep inguinal nodes

NERVE:

•Sensory supply:

  • •Anterior labial nerves(ilioinguinal nerve, L1)
  • •Genital branch of genitofemoral nerve (L1,2)
  • •Perineal branch of the posterior femoral cutaneous nerve (S1,2,3)
  • •Posterior labial nerves (pudendal nerve, S2,3,4)

•Parasympathetic supply: (S2-4)

  • •Increased vaginal secretions
  • •Erection of clitoris & bulbs of vestibule
29
Q

Label the perineum region of the female genitalia.

identify the 2 triangles

A

•Diamond-shaped region located between:

  • •Pubic symphysis (anteriorly), ischial tuberosities (laterally), coccyx (posteriorly)

•Can be divided by a transverse line between the ischial tuberosities:

  • Urogenital triangle
  • anal triangle
30
Q

What are the layers of the female perineum ?

A

•From superficial to deep:

  • •Skin & external genitalia
  • •Superficial perineal pouch
  • •Perineal membrane
  • •Deep perineal pouch
  • •Pelvic diaphragm
31
Q

What is the content of the superficial peroneal pouch?

A
  • •Root of the clitoris & ischiocavernosus
  • •Bulbs of the vestibule & bulbospongiosus
  • •Greater vestibular glands
  • •Superficial transverse perineal muscles
  • •Related vessels & nerves
32
Q

What are the structures of the deep peroneal pouch?

A
  • Urethra & external urethral sphincter
  • Deep transverse perineal muscles
  • Related vessels & nerves
33
Q

What is the peroneal membrane?

A
  • A sheet of tough fascia that stretches between the two sides of the pubic arch
  • Covers the anterior part of the pelvic outlet
34
Q

What is the pelvic diaphragm and what does it consist of?

A

•Consists of:

  • levator ani muscle group
    • Pubococcygeus (PC)
    • Puborectalis (PR)
    • Illicoccygeus (IC)
  • coccygeusmuscles (C)
  • Forms the pelvic floor – separates the pelvic cavity from the perineum
  • Suspended like a funnel from the pubis, lateral pelvic walls and coccyx
35
Q

Describe the levator Ani muscle group?

A
  • Pubococcygeus: arises from the body of pubis and passes back to the coccyx
  • Puborectalis: a U-shaped sling that passes posterior to the anorectal junction
  • Iliococcygeus: arises from the ischial spine and fascia of obturator internus, passes to the coccyx

ACTIONS

  • Muscular sling that supports abdominopelvic viscera
  • Elevates the pelvic floor and resists increases in intra-abdominal pressure
  • Important during forced expiration, coughing/sneezing, heavy lifting
  • FUNCTION: Contributes to urinary and faecal continence
  • Nerve Supply:nerve to levator ani & coccygeus (S3, 4)
36
Q

Describe coccygeus muscle?

A

Location: Passes from the ischial spine to the sacrum and coccyx

Action: •Forms small part of pelvic diaphragm; flexes coccyx

Nerve: somatic nerve to levator ani & coccygeus (S3, 4)

37
Q

Introduce the male peroneum

A

SBO5 (16 decks)

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