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Reproductive System > Session 2 - Female reproductive anatomy and Development of tracts > Flashcards

Session 2 - Female reproductive anatomy and Development of tracts Flashcards

1
Q

What surrounds the ovaries?

A

A layer of peritoneum, fully enclosing the ovaries.

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2
Q

Why do some women get a sharp pain at ovulation?

A

During ovulation, oocyte must breach the surface of the ovary, rupturing the follicle.

  • In rupturing the follicle breaches the peritoneum (parietal).
  • This causes sharp pain, as parietal peritoneum is somatically innervated.
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3
Q

Why do nuns have a tendency to get ovarian cancer?

A
  • Celibacy
  • No pregnancy
  • Means they will have the maximum number of ovulations possible, causing more trauma to ovarian capsule.
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4
Q

What is an ovarian cyst?

A
  • Fluid filled cyst associated with ovary.
  • Can be benign or malignant.
    Often go unnoticed.
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5
Q

What would symptoms of a large ovarian cyst be?

A
  • Pain: direct pressure, stretch of peritoneum.
  • Torsion: extremely painful.
  • Bloating.
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6
Q

Why is it important not to rupture an ovarian cyst when operating?

A

In case the cyst is malignant.

The rupture could cause cancer cells to disseminate, causing metastases.

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7
Q

What is the outer opening to the cervix called?

A

The external os.

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8
Q

What is the difference between the external os in different women?

A

Not had child = small circular os.

Had child = slit like os (wider)

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9
Q

Why may the inner part (of cerical canal) be visualised during speculum? What is this called?

A
  • Transitional zone
  • Between external os and internal epithelium of cervix.
    (can be due to oestrogen pill) os unfurls a bit.
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10
Q

How would a cervical cancer appear?

A

Redness on os, due to blood vessels.

Unfurled os.

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11
Q

What happens to the contents of the abdomen during late pregnancy?
What are some symptoms?

A

Pushes on stomach, diaphragm, colon and bladder.
Can cause reflux, constipation, frequent urination etc.

  • Round ligament stretches (on uterus) can be painful.
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12
Q

What is the most common site for ectopic pregnancy?

A

The ampulla of the uterine tube.

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13
Q

Why can ectopic pregnancies occur in many different parts of the body?

A

Due to the oocyte rupturing into the peritoneum briefly before moving into fimbriae.
Could potentially move anywhere within the peritoneal cavity (but rare)

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14
Q

What is an important factor when a female of reproductive age presents with abdominal pain?

A

PREGNANCY TEST!

Could be ruptured ectopic, which if not discovered can cause internal bleeding and death quickly!

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15
Q

Which two main types of cell are present in the uterine tubes? What do they do?

A
  • Ciliated cells: waft egg toward uterus.

- Peg cells (secretory): secrete factors which maintain the egg.

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16
Q

What is special about the female peritoneal cavity?

A

There is a communication between the peritoneum and the outside word (at the uterine tubes)
- Air could very possibly enter the the peritoneum, blowing into vagina etc

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17
Q

What is the relationship between the uterus/ female reproductive system and the peritoneum?

A 
Covered in parietal peritoneum, not within the peritoneum.
Below it (no term for it)
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18
Q

Which structure does the uterine artery pass through before reaching the uterus?

A

Broad ligament.

Runs in the double fold of peritoneum.

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19
Q

What is the vesico-uterine pouch?

A

The pouch formed by peritoneum between the bladder and the anterior of the uterus.

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20
Q

What is the recto-uterine pouch (pouch of douglas).

A

The pouch formed by peritoneum between the posterior uterus and the rectum.

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21
Q

Which three parts make up the broad ligament?

A
  1. Mesovarium - peritoneum covering the overy.
  2. Mesosalpinx - double folded peritoneum hanging down from uterine tube, to ligament of ovary.
  3. Mesometrium - forms majority of broad ligament, inferior to the overies and ligament of ovary. (ureter goes through here)
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22
Q

Where does the uterus get its blood supply from?

A

Branch of the internal iliac artery.
The uterine artery goes over the ureter.
(original water under the bridge)

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23
Q

Why is the anastomosis between the uterine and ovarian arteries important?

A

Need to be properly clipped in hysterectomy, otherwise profuse bleeding could occur.

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24
Q

What is the normal position of the uterus?

A

Anteverted and Anteflexed - sits over the bladder.

see diagrams for different positions

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25
Q

Why may a uterus not be anteverted and anteflexed?

A

Due to genetic factors - can be normal

Due to child-birth etc.

26
Q

What sort of epithelium lines the uterus?

A

Stratified squamous epithelium.

27
Q

Why does the uterus contain lots of glycogen?

A
  • Main food for lacto-bacilli

- Turn it into lactic acid, which helps maintain the acidic pH of the uterus.

28
Q

Why is it important not to use a douche to clean the vagina?

A

Can cause serious imbalances of the normal flora in the vagina.
This can cause candidiasis/ thrush.
Should just use water.

29
Q

What is the vulva?

A

The external part of the femal genitals (outer part)

30
Q

What are the labia majora?

A

The large lips of the vulva, which enclose everything during normal function of the vagina.

31
Q

What are the labia minora?

A

Internal lips of vagina, normally enclose in labia majora in normal function.

32
Q

What is the function of the labia?

A

They protect the internal structures of the vagina.

33
Q

What is the vestibule of the vulva?

A

The part of the vulva between the two labia minora, containing the entrance to the vagina, and the external urethral orifice.

34
Q

What is the fourchette? Why is it important?

A

The tense skin at the bottom of the vulva.

Can tear in pregnancy!

35
Q

What is an episiotomy?

A

An incision in the perineum and posterior vagina.
This is to prevent a tear, and damage to the anal sphincter/ rectum.
The cut is repaired by suture.

36
Q

What are the three types of genital mutilation?

A
  1. Clitoridectomy - removal of clitoris.
  2. Removal of labia majora, minora, and clitoris.
  3. Everything is removed, sewn up, leaving only a hole for urine.
37
Q

What are the three main germ layers in embryonic development?

A

Ectoderm, Mesoderm and Endoderm

38
Q

Which part of the developing germ disc will form the reproductive system?

A

The intermediate mesoderm.

39
Q

What is the cloaca?

A

The blind ending of at the caudal end of the embryo, where the hindgut, and genito-urinary system initially all meet. (has no mesoderm).

40
Q

In basic terms, how is the reproductive system made?

A
  • XX or XY
  • An indifferent gonad forms.
  • Indifferent duct system forms (mesonephric and paramesonephric ducts)
  • If testis present: Epididymis + Vas deferens form
  • If testis not present: Uterus, tubes + part of vagina form.
41
Q

What is the uro-genital ridge?

A

Region of intermediate mesoderm giving rise to both embryonic kidney, and gonad.

42
Q

Which structures is the indifferent gonad derived from?

A
  • Intermediate mesoderm

- and primordial germ cells

43
Q

What are the primordial germ cells?

A

Special population of Pluripotent stem cells, derived from the yolk sac, and migrate into the retroperitoneum (along dorsal mesentery)

44
Q

Which gene is responsible for driving male development in the primordial germ cells?

A

Y chromosome carries SRY gene.

  • Gonad - testis
  • Testicular hormones
  • Male duct system
45
Q

How do the duct systems develop in the embryo before differentiation?

A 
Both Mesonephric (wolffian) and Paramesonephric (mullerian) ducts form.
Both end at the urogenital sinus in the cloaca.
46
Q

What is the mesonephric duct?

A

Duct which carries urine for the mesonephros (embryonic kidney), which becomes no longer required.

47
Q

How does differentiation of the internal genitalia occur in males?

A
  • Functional testis present
    thus:
    1) Testis produces Mullerian inhibiting hormone, which suppresses mullerian (paramesonephric) duct development.
    2) Testis produces androgens (testosterone) which supports wolffian (mesonephric) duct development.
48
Q

How does differentiation of the duct system occur in a female embryo?

A
  • No tesits present.
    thus. ..
  • No mullerian inhibiting hormone, so no suppression of mullerian duct development.
  • No testis producing androgen, so wolffian duct degenerates.
49
Q

What is Androgen insensitivity syndrome?

A

(In a MALE)
The receptors for testosterone do not work.
thus
- Wolffian ducts do not survive
- But Mullerian inhibiting hormone is still present (testis), so Mullerian ducts degenerate.
(No duct system at all)

50
Q

What happens in development of a female embryo with exogenous androgen present?

A

Female (no testis)
- exogenous androgen will support the wolffian duct.
- No mullerian inhibiting hormone, so mullerian ducts will develop too.
Has BOTH wolffian and mullerian duct systems.

51
Q

What happens to the mesonephric duct in males, under androgen stimulation?

A

Converted to vas deferens and epididymis.

Migrates with testis as it descends.

52
Q

How do the paramesonephric ducts develop into the female internal genitalia?

A
  • Appear as invaginations of epithelium of urogenital ridge.
  • Caudally: Make contact with cloaca
  • Cranially: Open into abdominal cavity
    The two ducts aim towards each other, and fuse, to form one tube, the Uterus
    (diagrams)
53
Q

Which structures form part of the vagina?

A
  • Endoderm tissue from urogenital sinus forms distal vagina, and hymen.
  • Paramesonephric duct forms proximal vagina (just before cervix) and uterus.
54
Q

What are the basic components of the indifferent External genitalia?

A

Genital tubercle
Genital folds
Genital swellings

55
Q

How do external genitalia differentiate in male?

A

The genital tubercle elongates to and the genital folds fuse, to form the spongy urethra.
The genital tubercle develops into the glans.
Influenced by dihydrotestosterone.

56
Q

How do the indifferent external genitalia develop in females?

A

No fusion occurs in females.
Labia minora and majora develop.
The genital tubercle forms the clitoris.
The urethra opens into the vestibule.

57
Q

What happens to the testis in the embryo as the male develops?

A 
Testis descend, pulled by gubernaculum, through the inguinal canal, becoming external (taking the layers with them)
Processus vaginalis (covering of peritoneum)
Becomes tunica vaginalis (separates)
58
Q

What happens to the primordial germ cells and the indifferent gonad in the male and female?

A

Male - Development of seminiferous epithelium, containing primordial germ cells in medulla.

Female - No medulla development, outer cortex becomes studded with primordial germ cells (primordial follicles)

59
Q

How do the ovaries end up in their final position?

A
  • Gubernaculum attaches inferiorly to labio-scrotal folds.
  • Ovaries descend to pelvis.
  • Uterus has developed, which blocks/ prevents further descent!
60
Q

What is the round ligament remnants of?

A

Remnants of the gubernaculum, goes into inguinal canal and labia (followed by lymphatics).

Reproductive System (6 decks)

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