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ESA 4 > Session 5 : Reproduction > Flashcards

Session 5 : Reproduction Flashcards

1
Q

What is the remnant of the gubernaculum in females?

A

The vestigial remnant of the gubernaculum is the :
Ovarian ligament
The round ligament of the uterus.

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2
Q

What is the ovarian ligament ?

A

This connects the inferior pole of the ovary to the fundus of the uterus

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3
Q

What is the round ligament of the uterus ?

A

This is the continuation of the ovarian ligament which reflects off itself to become the round ligament. This connects the uterus to the labia majora, the ligament will run in the inguinal canal.

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4
Q

What are the layers of the ovary ?

A

The outer surface of the ovary is covered in germinal epithelium (simple cuboidal)
The cortex has lots of connective tissue and houses the germ cells (primordial follicle - oocyte + simply squamous follicular cells)
The medulla has the majority of the nerves, b/v & connective tissue.

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5
Q

Comment on the arteries and veins of the ovary?

A

The ovarian arteries arise from the abdominal aorta inferior to the origin of the renal arteries.
The ovarian veins will drain differently according to which side they are on :
LHS -> left renal vein -> IVC
RHS -> IVC

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6
Q

What is the suspensory ligament of the ovary ?

A

This ligament connects the lateral pelvic wall to the upper pole of the ovary and the infundibulum, and is continous with the board ligament.
It conducts the nerves & blood vessels.

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7
Q

Comment on the lymphatic drainage of the ovary?

A

Drainage occurs in to the para- aortic lymph nodes and can therefore Travel into the body (if there is a cancer here)

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8
Q

What is the board ligament of the uterus ?

A

This ligament will connect the organs of the female reproductive tract ( the ovaries, uterus and Fallopian tubes) to the lateral pelvic wall.
It acts like a mesentry & will conduct arteries and veins within it.

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9
Q

How is the broad ligament formed?

A

It is formed when the paramesonephric ducts which were posterolateral push forward and bring along with it the periotoneum.

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10
Q

What are the anatomical regions of the broad ligament ?

A

Mesoalpinx - around the Fallopian tubes (upper border of the ligament) superior to the ovaries
Mesovarium - from the posterior surface of the ligament and will connect to the ovaries & is continous with the hilium of the ovary.
Mesometrium - around the uterus, the largest part of the bora ligament.

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11
Q

What is the contents of the broad ligament ?

A

Other ligaments - round ligament of uterus , ovarian ligament and suspensory ligament of ovary
Vasculature - ovarian and uterine artery
Organs- ovary, Fallopian tubes & uterus

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12
Q

What is the function of the open ended Fallopian tube and why is this potentially dangerous?

A

This open end of the tube is near to the ovary to catch the developing oocyte to then travel down the Fallopian tubes.
It is a potential rout of infection into the abdominal cavity. This is one of the main reasons why pelvic inflammatory disease is more common in females.

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13
Q

What are the components of the Fallopian tube?

A

The fimbriae - cilliated projections which extend from the :
The infundibulum
The ampulla - widest part of the tube
The isthmus - connects to the cornua of the uterus.

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14
Q

What are the layers of the Fallopian tube ?

A

Outermost serosal lining
Muscular layer - differs upon the region, most prominent in the isthmus (3 layers here) in ampulla (2) - inner circular and outer longitudinal.
Lamina propria
Epithelium - Columnar cells, cilliated and peg cells.

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15
Q

What cells are present in the ampulla and why?

A

Peg cells- nutritive to the oocyte, and a lot of
Cilliated cells - to move the oocyte along
Lots of glands and supportive tissue to allow for fertilisation.
Region has many folds.

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16
Q

Where does fertilisation most likely occur in the female repro tract?

A

In the ampulla

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17
Q

What cell types are common in the isthmus?

A

The muscle cell layers are more prominent here, to aid the propulsion of the zygote/ovum into the uterus.

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18
Q

What are the common sites for ectopic pregnancy?

A

The ampulla

Isthmus, infubdibulum, and the cornua

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19
Q

What are the dangers of an ectopic pregnancy ?

A

The epithelium is not supportive for the invasive process of implantation therefore cannot accomodate for the growing fetus which will cause the tube to rupture and haemorrhage.
Life threatening for the mother and a non-viable pregnancy.

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20
Q

What are some common reasons for ectopic pregnancys ?

A

Any problem which damages the layer of peg and cilliated cells will impair the process of the zygote reaching the uterus :
Chronic infection leading to scarring or adhesions, atrophy of cells, polyps in this region.

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21
Q

What is salpangitis?

A

The inflammation of the uterine tubes

Can cause infertility or ectopic pregnancy.

22
Q

Comment on n/v/l of the uterine tube?

A

Vasculature : ovarian and uterine artery (& veins)
Lymphatics : Iliac, aortic & inguinal nodes.
Innervation : uterine and ovarian plexus
Sensory afferents from T11- L1

23
Q

In relation to the uterus where are the two peritoneal pouches located ?

A

Anteriorly : uterovesical pouch
This is located between the anterior surface of the uterus and the posterior surface of the bladder.
Posteriorly : pouch of Douglas
This is located between the posterior surface of the uterus and the anterior surface of the rectum.

24
Q

What is a culdocentesis ?

A

The process of testing the fluid from the pouch of Douglas. This is located in next to the posterior fornix of the vagina.

25
Q

What is the position of the uterus in the body?

A

Anteverted - rotated forward and anterior in reference to the axis of the vagina
Anteflexed - flexed toward anterior surface in reference to the axis of the cervix.

26
Q

What other positions of the uterus are common ?

A

Excessive anteflexion
Anteflexed and retroinverted
Retroinverted and retroflexed - this increases the risk of prolapse as the increase in abdominal pressure can push the organs into the vestibule of the vagina.

27
Q

What are the basic components of the uterus?

A

Fundus - (superior part - palpable in pregnancy)
Body - posterior uterine wall ideal implantation site
Cervix - anatomically functionally distinct.

28
Q

What layers and cells make up the uterus ?

A

This will differ according to the menstruation cycle but :
Perimetrium
Myometrium (4* muscle layers)
Endometrium : Stratum basale & Stratum functionalis (outer compact and inner spongey)
Cells of the stratum functionalis are sensitive to the steroids.

29
Q

Comment on the components of the cervix?

A

Internal opening - from uterus into cervix
Endocervical canal
External openings -into vagina

Simple columnar epithelium which becomes non keratinised stratified squamous from the external os. Although with time the transition osf cell occurs more proximally.

30
Q

Which ligaments are important in the stabilisation of the uterus?

A 
Broad ligament 
Ovarian ligament 
Uterosacral ligament 
Cardinal / transverse cervical ligament 
Round ligament
31
Q

How does the uterosacral support the uterus ?

A

The ligament runs from the cervix to the sacrum

It opposes the anterior pull of the round ligament, to maintain the uterus in the anteverted position.

32
Q

What is the role of the transverse cervical ligament in the uterus?

A

Lateral stability of the pelvic organs
This is the base of the broad ligament which runs to the ischial spines.
Contains the uterine artery.

33
Q

How does the round ligament of the uterus maintain the position of the uterus?

A

This will maintain the anteverted position of the uterus 9tipped forward)

34
Q

Comment of the vasculature of the uterus ?

A

Vasculature :
Ovarian artery
Uterine & internal pudendal artery -> branches of the anterior division of the internal Iliac artery.

35
Q

What is cervictis and which common organisms cause it ?

A

Inflammation and infection of the cervix
N.gonorhoea & C. Trochamitis.
Can cause pelvic pain ,post coital bleeding, vaginal discharge and dyspareunia
Can lead to PID

36
Q

What is the function of the cervix?

A

The cervix produces mucus which :
Maintains the sterility of the environment
Dilates internal and external os to facilitate the movement of sperm

37
Q

What maintains the sterility of the female repro tract?

A

The mucus from the cervix
The narrow external and internal os
Shedding of the endometrium with each cycle

38
Q

What are the two cancers associated with the cervix?

A

Adenocarcinoma

Squamous cell carcinoma (effect the ectocervix)

39
Q

What are the two cell types of the cervix ?

A

Non keratinised squamous cell (often in the ectocervix)

Glandular : simple columnar epithelium.

40
Q

What are the main components of the female external genetila?

A

The labia minora & majora
The vestibule which contains the orifices of the vagina and the urethra : the greater and lesser vestibular glands. (Bartholin)
The clitoris

41
Q

What does the labia minora & majora enclose?

A

Labia majora - the pudendal cleft

Labia minora - the vestibule , the clitoris and the bulbs of vestibule.

42
Q

What are the main functions of the vagina?

A

Channel of delivery for the newborn and in menstruation

Recieves the penis and ejaculate to aid conception.

43
Q

What are the layers of the vagina ?

A

Outer surface of adventitia
Muscular layer : inner circular and outer longitudinal (fibromuscular)
Elastic lamina propria
Epithelium : non keratinised stratified squamous
Secretes glycogen for the lactobacillus.

44
Q

What effect does oestrogen have on the cells in the vagina?

A

The cells (non keratinised stratified squamous) will secrete glycogen which will then be used by the lactobacillus vaginalis. This organism is a commensal which will maintain the low ph of the vagina to limit infections from other organisms.

45
Q

What can commonly cause vaginal infections?

A

Antibiotic treatment (can destroy the normal flora of the body)
When the body is in a low oestrogen state:
Diabetic, pregnancy, post menopause

46
Q

What are vaginal fistulaes and what commonly causes them?

A

It is the result of a long and traumatic childbirth.
Blood supply can be cut off in certain regions resulting in necrosis of the vagina can lead to an open communication with :
Bladder - urine constantly in the vagina
Urethra- urine in vagina when peeing
Rectum- foecal mater in the vagina

47
Q

What is the function of the bartholin glands? And what pathologies are associated with these glands?

A

These glands secrete mucus to lubricate the vagina.
They are pea sized glands.
They can be infected in : bartholinitis
They can fill and accumulate with fluid : bartholin cyst.

This can be extremely painful and if there is a cyst it should be drained.

48
Q

What conditions can commonly effect the urterus ?

A

Endometriosis - ectopic endometrial tissue in regions other than the uterus -> this can cause bleeding (dysmenorrhea)
Endometrial carcinoma
Fibroids -> benign growths which are oestrogen dependent.

49
Q

What is a hysterectomy ?

A

Removal of the uterus :

Commonly done due to : Menorhagia, cancer treatment

50
Q

Which examinations are done to check the uterus?

A

Cervical examination :
Speculum placed between the fornices of the vagina to open the cervix, then cervix is smeared
Bimanual examination :
Two fingers are inserted into the vagina and are used to test the cervical motion tenderness (indicative of PID) & the other hand paplates on the surface of the px for the superior border of the uterus(fundus)

51
Q

What are nabuthian cysts and where are they found ?

A

These cysts are formed in the cervix.

The stratified squamous epithelium of the ectocervix grows over the simple columnar epithelium.

52
Q

What are the anatomical regions of the vagina ?

A

Anteriorly : bladder and urethra
Posteriorly : rectum and the pouch of Douglas
Laterally : ureter and uterine artery

ESA 4 (15 decks)

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