Session 5 - Female Reproductive System

Question 1

Where do the gonads develop initially and where do they end up?

Answer 1

Gonads develop within mesonephric ridge and then descend through the abdomen before stopping gin the pelvis

Question 2

What embryological structures fuse to form the uterus?

Answer 2

ParaMesonephric ducts

Question 3

What is the CT capsule of the ovary?

Answer 3

tunica albuginea of ovary

Question 4

What is the arterial supply of the ovaries?

Answer 4

Ovarian arteries come directly off abdominal aorta just below renal arteries

Question 5

What is the venous drainage of the ovaries?

Answer 5

• Right ovarian vein comes off IVC
• Left ovarian vein comes off left renal vein which itself comes from IVC

Question 6

What is the lymphatic drainage of the ovaries?

Answer 6

para aortic nodes

Question 7

What are the 4 parts the uterus is made up of?

Answer 7

Fundus
Body
Uterine tubes
Cervix

Question 8

Answer 8

Question 9

Answer 9

Question 10

Answer 10

Question 11

Answer 11

Question 12

Answer 12

Question 13

Answer 13

Question 14

What is the smooth muscle of the uterus called?

Answer 14

myometrium

Question 15

What is the internal lining of the uterus called? Which layer is subject to growth and shedding?

Answer 15

endometrium

Stratum functionalis

Question 16

What changes occur in the uterus to prepare it duringpregnancy?

Answer 16

myometrium undergoes hypertrophy

Question 17

What are the 3 phases of the endometrium? What occurs to hormone secretion during each stage?

Answer 17

1. Proliferative phase of endometrium – oestrogen secreted during folliculogenesis
2. Secretory phase of endometrium – corpus luteum secretes progesterone which stimulates endometrial glands to secrete glycogen and encriching vascular supply to mucous membrane
3. Menstrual phase – conceptus failes to implant. Withdrawal of hormones. Changes in vascular supply of endometrium and degeneration of bulk of upper endometrium

Question 18

What is the position of the uterus in relation to the vagina and cervix?

Answer 18

AnteVerted – In relation to Vagina
AntifleXed – In relation to the cerviX

Question 19

What are the 3 parts of the broad ligament?

Answer 19

mesovarium, mesosalpinx, mesometrium

Question 20

What is the round ligament a remnant of? What canal does it travel through?

Answer 20

• Remnant of gubernaculum
• Travels through inguinal canal

Question 21

What is the lining of the endocervix and exocervix?

Answer 21

Endocervix:

Lined by columnar epithelium

Exocervix:

Stratified squamous non keratinised epithelium.

Question 22

Give the pathway of blood vessels that leads to the uterine artery

Answer 22

Abdominal aorta –> common iliac –> internal iliac –> anterior divison of internal iliac –> uterine

Question 23

Give the venous drainage of the uterus. What is the pathway?

Answer 23

Uterine venous plexus –> uterine –> internal iliac –> common iliac –> IVC

Question 24

Which lymphatic nodes drain the fundus, body and cervix?

Answer 24

Fundus: aortic nodes
Body: external iliac nodes
Cervix: External and internal iliac nodes and sacral nodes

Question 25

What is the epithelium of the vagina?

Answer 25

Stratified squamous epithelia

Question 26

What is the venous drainage of the vagina? State the pathway

Answer 26

Vaginal Plexus --\> Vaginal --\> Uterine --\> Internal Iliac --\> Common Iliac --\> IVC

Question 27

What innervates the uterus and vagina?

Answer 27

Inferior 1/5th of vagina receives somatic innervation from pudendal nerve S2-S4 Superior 4/5ths of vagina and uterus receives innervation from uterovaginal plexus

Question 28

Where does the pain refer in vaginal/uteral injuries?

Answer 28

Above pelvic pain line – pain refers back up Below pelvic pain line – pain refers locally

Question 29

What are ovarian cysts derived from?

Answer 29

Follicles

Question 30

What is salpingitis? What can it lead to and how? How can it result in ectopic pregnancies?

Answer 30

* Inflammation of uterine tube caused by MOs * Causes fusions or adhesions of mucosa and can block its lumen leading to infertility * Blocked or dysfunctional tubes may result in ectopic pregnancies

Question 31

What is endometriosis? What are the symptoms?

Answer 31

* Ectopic endometrial tissue is dispersed to various sites along the peritoneal cavity and beyond * Associated with severe period pain and/or infertility

Question 32

Where is an endoetrial carcinoma likely to occur? What is a symptom?

Answer 32

* Junction between columnar cells of endocervix and squamous cells of exocervix is wher emost neoplasma form * Major symptom Is abnormal uterine bleeding

Question 33

What is bartholinitis?

Answer 33

infection or inflammation of greater vestibular glands (Bartholin glands)

Question 34

What is vaginismus?

Answer 34

Reflex of pubococcygeus muscle makes vaginal penetration painful or impossible

Question 35

What is the false and true pelvis?

Answer 35

False pelvis = greater pelvis – no obstetric relevance True pelvis = lesser pelvis – bony canal

Question 36

Where is the obstetric conjugate measured from?

Answer 36

measured from sacral promontory to midpoint of pubic symphysis

Question 37

Where is the diagonal conjugate measured from?

Answer 37

measured from sacral promontory to inferior border of pubic symphysis

Question 38

Answer 38

Question 39

What are the two ligaments of the pelvis?

Answer 39

Sacrospinous ligament Sacrotuberous ligament

Question 40

Answer 40

Question 41

Where are the common sites of ectopic pregnancy?

Answer 41

ampullary, fimbrial, isthmic, interstitial

Question 42

What are the 3 layers of the uterus?

Answer 42

endometrium, myometrium, perimetrium