Session 5 - Female reproductive anatomy Flashcards
Where do the gonads develop?
Within the mesonephric ridge
How is the inferior pole of the ovary connected to the external genitalia?
By the gubernaculuym to the labioscrotal folds
How does the uterus form?
Mesonephric ducts fuse
What are the two main functions of the ovaries?
Endocrine glands
Oocyte released
What are the connections of the ovaries?
By the mesovarium to the abdominal wall and the by the ovarian ligament to the uterus
What is the ovarian ligament derived from?
Gubernaculum
What is the arterial supply of the ovary?
The Ovarian Arteries come directly off the Abdominal Aorta, just below the Renal Arteries.
Abdominal Aorta -> Ovarian Artery
What is the venous drainage of the ovaries?
Right ovarian vein -> Inferior vena cava
Left ovarian vein -> Left renal vein -> Inferior vena cava
What is the lymphatic drainage of the ovaries?
Para-aortic nodes
What is the relationship of the uterus anteriorly?
Uterovesical pocuh
What is the relationship of the uterus posteriorly?
Rectouterine pouch
What are the three layers of the uterus?
- The perimetrium
- The myometrium
- The endometrium
What is the most superficial part of the endometrium called?
Stratum functionalis
What is the deepest part of the endometrium caled?
Stratus basalis
What are the three phases of the uterus?
THe proliferative phase, the secretory phase and the menstrual phase
What occurs in the proliferative phase?
Oestrogen secreted during folliculogenesis stimulates growth and proliferation of the endometrium
What occurs in the secretory phase of the uterus?
After ovulation, corpus luteum secretes progesterone which stimulates the endometrial glands to secrete glycogen and causes their extensive coiling, enriching the vascular supply to the mucous membrane. These changes in the endometrium are in preparation for the receipt of embedding (implantation) of the conceptus following fertilisation.
What is the menstrual phase of the uterus?
Brought about by luteolysis of corpus luteum, removing supportive effect of progesterone and causing decrease in vascular supply of the endometrium. This results in the breakdown and degeneration of the bulk of the upper endometrium (stratum functionalis, bleeding and shedding of tissues.
What is the broad ligament?
Double layer of peritoneum that extends from the sides of the uterus to the lateral walls and floor of the pelvis.
What is the round ligament of the uterus?
The embryological remmnant of the gubernaculum which is attached to the ovary and labium majus and well as travelling through the inguinal canal.
What is the structure of the uterine tubes?
Fimbrae next to the ovary
Then infuindibulum
Tnen ampulla
Then isthmus and opening into uteriune cavity
What is the cervic?
The fubromuscular neck of the uterus which protrudes into the upper vagina and contain the endocervical canal linking the uterine cavity with the vagina
What are the two main regions of the cervix?
The endocervic and the exocervix.
Outine the structure of the enodcervix
The endocervix is lined by tall columnar epithelium with basally placed nuclei and the greater part of the cytoplasm filled with mucus. The mucosa contains numerous large glands that are also lined with tall, mucus-secreting columnar cells.
What is the structure of the exocervix?
. The exocervix is covered with a stratified squamous non-keratinised epitheium (as of the vagina). The change from the columnar to stratified squamous epithelium, at the transformation zone, is abrupt. The remainder of the cervix is composed of circularly arranged smooth muscle fibres lying abundant dense connective tissue.
What is the arterial supply of the uterus?
Abdominal Aorta -> Common Iliac -> Internal Iliac -> Anterior Division of Internal Iliac -> Uterine
What is the venous drainage of the uterus?
Uterine venous plexus which merges to form the uterine veins, which are tributaries of the internal iliac vein
Uterine Venous Plexus -> Uterine -> Internal Iliac -> Common Iliac -> IVC
What is the lymphatic drainage of the uterus
plex:
o Fundus Aortic nodes
o Body External iliac nodes
o Cervix External and internal iliac nodes and sacral nodes
What are the three layers of the vagina?
Mucous membrane
Muscular coat
Adventitia
What does the mucous membrane of the vagina consist of?
Stratified squamous epithelium with underlying lamina propria composed of dense conective tissue
Describe the muscle layer of the vagina
Smooth muscle bundles arranged circularly and longitudinally
What are the vaginal fornices?
Recesses of the vagina around the cervix
What is the arterial supply of the vagina?
Superior part supplies by the uterine artery
Middle and inferior supplies by
Abdominal Aorta Common Iliac Internal Iliac Anterior Division of Internal Iliac Uterine Vaginal
Abdominal Aorta Common Iliac Internal Iliac Anterior Division of Internal Iliac Pudendal
Outline the venous drainage of the vagina
Vaginal Plexus Vaginal Uterine Internal Iliac Common Iliac IVC
Outline the innervation of the vagina
o Inferior 1/5th of the Vagina receives somatic innervation from the Pudendal Nerve (S2-4)
o Superior 4/5th of the Vagina and Uterus receives innervation from the Uterovaginal plexus
What is the pelvic pain line?
o Pain afferents vary depending on the pelvic pain line. Considered to be above the pelvic pain line if touches visceral peritoneum – EXCEPT in sigmoid colon, where it is located about midway.
Above line – Pain refers back up, follows sympathetic fibres.
Below line – Local pain, follows parasympathetic fibres.
What are the three main parts of the female external genitalia?
o Labia Majora Enclosing the pudendal cleft o Labia Minora Enclosing the vestibule of the vagina Bulbs of vestibule Clitoris o Vestibule Orifices of urethra, vagina and greater (Bartholin) and lesser vestibular glands
What do ovarian cysts develop from?
Follicles
What do ovarian tumours arise from?
Epithelial components or germ cells
Give two conditions of the uterus
Salpinigitis
Endometriosis
What is salpingitis
Inflammation of the uterine tube caused by microorganisms
Causes fusions or adhesions of the mucosa and thus can partially or completely block its lumen – leading to infertility
Blocked or dysfunctional tubes may result in ectopic (tubal) pregnancy or implantation outside of the uterus
What is endometriosis?
A condition in which ectopic endometrial tissue is dispersed to various sites along the peritoneal cavity and beyond (e.g. near to the umbilicus).
May be associated with the ovaries or attachments of the uterus
Associated with severe period pain (Dysmenorrhoea), infertility or both
What is an endometrial carcinoma?
Malignancy of the endometrium
Usually occurs in postmenopausal women
Junction between columnar cells of endovervix and squamous cells of exocervix (Transformation zone) is where the majority of neoplasms form
Major symptom is abnormal uterine bleeding
What is the difference between cervical examination and bimanual examination?
Cervical - Use of a speculum to isolate the external os of the cervix
Bimanual - Two fingers are inserted into the vagina until they isolate the cervix.
Test of cervical motion tenderness (Sign of PID)
o Examiner palpates the uterus
What can go wrong witth the greater vestibular glands (Bartholin glands) of the vagina
Bartholinitis
Bartholin gland cyst
What is vaginitis?
Inflammation of the vagina
What is vagnismus?
A condition making any sort of vaginal penetration (sexual intercourse, insertion of tampons) painful or impossible
Reflex of the pubococcygeus muscle.
What is an ectopic pregnancy?
Implantation anywhere except for the uterine body