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SA reproductive > S2) The Woman > Flashcards

S2) The Woman Flashcards

1
Q

Identify the following structures in the female reproductive system:

A
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2
Q

Describe the clinical basis for a sharp pain at ovulation

A
  • Mittelschmerz pain is pelvic/lower abdominal pain felt during ovulation
  • Exact cause is unknown
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3
Q

Why do nuns tend to get ovarian cancer?

A

They have the maximum number of follicular ruptures, thus get repeated healing/scarring which predisposes them to cancer

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4
Q

What are ovarian cysts?

A

Ovarian cysts are large fluid filled lesions on the ovary

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5
Q

How might a patient with an ovarian cyst present?

A
  • Lower abdominal pain (stretching of perineum, rupture / torsion of ovary)
  • Bloating
  • Back pain
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6
Q

Identify the following structures on the uterus:

  • Uterine tube
  • Fundus
  • Vagina
  • Cervix
  • Body
A
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7
Q

What sort of structure is the cervix?

Fibrous or muscular?

A

Fibrous structure

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8
Q

Distinguish between the external Os of a cervix that has had a baby passed through and one that hasn’t

A
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9
Q

Why do pregnant women experience the following symptoms:

  • Acid reflux
  • Constipation
  • Polyuria
A
  • Acid reflux: uterus pushes on stomach from below
  • Constipation: uterus pushes backwards onto large intestine
  • Polyuria: uterus pushes downwards onto bladder
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10
Q

In terms of fertilisation, what is the clinical significance of the uterine tubes?

A

Site of fertilisation

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11
Q

What is notable about the ampulla region of the fallopian tube?

A

Most common site for ectopic pregnancies

  • normally places that aren’t in the uterus wall
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12
Q

What is the most important investigation in women of reproductive age with abdominal pain?

A

Pregnancy test

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13
Q

Identify the peritoneal ligaments

A
  • Broad ligament
  • Round ligament
  • Ovarian ligament
  • Suspensory ligament of the ovary
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14
Q

Describe the structure of the broad ligament

A

Broad ligament – peritoneal fold, covers uterus, fallopian tube and ovary like a vacuum

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15
Q

Describe the structure of the suspensory ligament of the ovary

A

Suspensory ligament of the ovary – neurovascular pathway bulging into peritoneum supplies the ovaries

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16
Q

Describe the origins of the round ligament and the ligament of ovary

A

Round ligament and ligament of ovary – remnants of the gubernaculum, helps keep uterus anteverted and anti flexed

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17
Q

What is the mesovarium?

A

Mesovarium is the portion of the broad ligament of the uterus that suspends the ovaries

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18
Q

What is the mesosalpinx?

A

Mesosalpinx is the portion of the broad ligament that stretches from the ovary to the level of the uterine tube

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19
Q

What is the mesometrium?

A

Mesometrium is the mesentery of the uterus, composing most of the broad ligament of the uterus, excluding only the mesosalpinx and the mesovarium

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20
Q

How does the uterus get its blood supply?

A
  • Uterine artery
  • Ovarian artery
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21
Q

What is significant about the axis of cervix?

A
  • Axis of cervix to axis of vagina < 180o = cervix is anteverted (most common)
  • Axis of cervix to axis of vagina >180o = cervix is retroverted
22
Q

What is significant about the axis of uterine body?

A
  • Axis of uterine body to axis of vagina < 180o = uterus is anteflexed (most common)
  • Axis of uterine body to axis of vagina > 180o = uterus is retroflexed
23
Q

How is anteversion/anteflexion maintained?

A

Peritoneal ligaments

24
Q

Describe the three different types of vaginal mutilation

A
  • Removal of clitoris
  • Removal of all except urethra and vagina
  • Everything is removed, sewn up and leaving a tiny opening for urine
25
Q

What is the origin of the blood supply to the ovary?

A

The ovarian artery arises from the abdominal aorta

26
Q

Describe the venous drainage of the left and right ovaries

A
  • Left ovarian vein (LOV) drains into left renal vein
  • Right ovarian vein (ROV) drains into the inferior vena cava
27
Q

To which lymph nodes does the ovary drain?

A

Para-aortic lymph nodes

28
Q

Identify the following areas in the fallopian tube:

  • Fimbriae
  • Ampulla
  • Isthmus
A
  • fimbriae transport the egg from the ovary to the Fallopian tube
29
Q

How might infection spread to the peritoneum from the female reproductive tract?

A

Via the fimbrae, there is a gap in the abdomen where potential infection could spread to

30
Q

Describe how the tissue structure of the Fallopian tube facilitates the transport of the ovum towards the uterus

A
  • Peristalsis: muscular tube moves ovum in peristaltic waves
  • Cilliary sweeps: unidirectional movement of ovum
31
Q

What may be the consequence of infection in the uterine tubes?

A
  • Scarring
  • Ectopic pregnancy
  • Infection could spread to peritoneum (peritonitis)
32
Q

Where would pain be felt with an ectopic pregnancy implanted in the ampulla of the uterine tubes?

A

Iliac fossa

33
Q

Why is shoulder tip pain associated with the rupture of an ectopic pregnancy?

A

Blood runs up paracolic recesses (spaces between abdominal wall and colon) which compresses the phrenic nerve

34
Q

Describe the arterial supply to the uterine tubes

A
  • Uterine arteries
  • Ovarian arteries
35
Q

Be able to identify the following structures:

  • Ovarian artery
  • Uterine artery
  • Vagina artery
  • Internal pudendal artery
36
Q

Why is the ureter at risk of being damaged during a hysterectomy?

A
  • When removing the uterus, the uterine artery is clamped
  • The ureter is closely associated to the uterine artery (water under the bridge)
  • can feel the difference between the ureter and artery because ureter will undergo peristalsis and you can feel it
37
Q

What are the posterior anatomical relations of the vagina?

A
  • Rectum
  • Anus
38
Q

What are the anterior anatomical relations of the vagina?

A
  • Bladder
  • Urethra
39
Q

What are the lateral anatomical relations of the vagina?

A
  • Ureter
  • Uterine artery
40
Q

In terms of lymphatic drainage, identify the structures below:

41
Q

In terms of the vulva, label the following structures:

  • Mons pubis
  • Labia majora & minora
  • Clitoris
  • Vestibule of the vagina
  • External urethral orifice
  • Anus
42
Q

Describe the structure of the recto-uterine pouch

A
  • Aka pouch of Douglas
  • It is an extension of peritoneum between the posterior wall of uterus and the rectum in females
43
Q

Describe the structure of the vesico-uterine pouch

A

Vesico-uterine pouch is a second but shallower pouch formed from the peritoneum over the uterus and bladder

44
Q

In a bimanual/pelvic examination, which structure can be palpated anteriorly from the fornix?

A

Vesico-uterine pouch

45
Q

In a bimanual / pelvic examination, what structures can be palpated from the posterior fornix?

A

Recto-uterine pouch

46
Q

peg cells

A
  • found in the ampulla
  • secrete nutrients and supportive factors for sperm to gain more energy to reach the egg cells
47
Q

pouch of Douglas relevance

A
  • lowest part of the abdomen
  • fluid can collect containing infections
48
Q

which lymph nodes do the lymphs of the uterus drain

A

internal iliac

49
Q

which lymph nodes does the lower third of the vagina drain

A

superficial inguinal

50
Q

which tissue do the gonads develop

A

intermediate mesoderm in the abdomen

51
Q

what structure does the uterus develop

A

paramesonephric duct

SA reproductive (22 decks)

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