The Female Reproductive System Flashcards
What does ‘water under the bridge’ refer to in women?
Ureter passes under the uterine artery
Where is fluid most likely to accumulate in the pelvic cavity of a woman?
Rectouterine pouch
What is the angle of anteversion?
Position of cervix in relation to vagina
Vagina - Version
How do you clinically test the angle of anteversion?
What are the results?
Insert fingers into the vagina + feel for a cervix:
- cervix is anteverted: cervix felt on fingertips
- cervix is retroverted: cervix felt on fingernails
How do you work out the angle of anteversion in a cross section specimen?
What are the results?
Draw long axis of vagina + cervical canal
- cervix is anteverted: <180°
- cervix is retroverted: >180°
What is the angle of anteflexion?
Position of uterus compared to cervix
How do you clinically test the angle of anteflexion?
What are the results?
Place hand on abdominal wall, insert other fingers in vagina + press uterus:
- uterus is anteflexed: can feel fundus of uterus
- uterus is retroflexed:cannot feel fundus of uterus
How do you work out the angle of anteflexion in a cross section specimen?
What are the results?
Draw long axis of cervical canal and uterus?
- uterus is anteflexed: <180°
- uterus is retroflexed: >180°
Why is it important to know the angle of anteversion?
Insertion of IUD
- to prevent perforation of any structures + causing bleeding
What is the venous drainage of the ovaries?
- right ovary: right ovarian vein > IVC
- left ovary: left ovarian vein > left renal vein > IVC
Why do some women get a sharp pain during ovulation?
The egg bursts out of the ovary
What can happen to a ovary with a cyst?
- can twist > ovarian torsion
- can disrupt the blood supply > ischaemia
What are the fornices?
- the upper end of the vagina where it meets the cervix
- ‘bulges around the cervix’
What is cervical ectropion?
- it is a normal occurrence in which the cells that line the cervical canal spread out onto the surface on the cervix
- can appear red as the cells in the canal are thinner
What can cause cervical ectropion?
Hormonal contraceptions
What cells are in the uterine tubes?
- Ciliated cells
- Peg cells
Function of ciliated cells in the uterine tubes
Cilia waft the egg down the tube
Function of peg cells in the uterine tubes
- nutrition for sperm + egg
- secrete mucus which aids the movement of the egg and sperm
What is the vesicouterine pouch?
A fold of peritoneum over the bladder and the uterus forming a pelvic recess
What is the rectouterine pouch?
What is its other name?
- A fold of peritoneum over the rectum and the uterus forming a pelvic recess
- pouch of Douglas
What are the 4 peritoneal ligaments?
- broad ligament
- round ligament
- ligaments of ovary
- suspensory ligament of ovary
What is the round ligament between?
- from the uterus to the labia majora through the inguinal canal (deep inguinal ring)
- sits under the peritoneal sheath
What is the round ligament a remnant of?
Gubernaculum
What is the ligament of ovary between?
Ovary and uterus
What is the suspensory ligament of the ovary?
- attaches each ovary to the pelvic sidewall
- the neurovascular pathway bulging into peritoneum
What is the broad ligament?
A two layered fold of peritoneum that extends from the lateral pelvic walls + folds over the internal genitalia
What is the ligament of ovary a remnant of?
Gubernaculum
What is the remnant of the Gubernaculum in women?
- Round ligament
- ligament of ovary
What are the subdivisions of the broad ligament?
- mesometrium
- mesovarium
- mesosalpinx
What are the divisions of the uterine tubes?
- fimbriae
- infundibulum
- ampulla
- isthmus
What is the lymphatic drainage of the ovaries?
Para-aortic nodes
What is type of epithelia is inside the vagina?
Stratified squamous epithelium (withstands friction)
What is the mesosalpinx?
A subdivision of the broad ligament which covers the fallopian tubes
What is the mesovarian?
- a subdivision of the broad ligament which attaches to the hilum of the ovary + encloses the neurovascular bundle
- does NOT cover the ovary
What is the mesometrium?
- a subdivision of the broad ligament which surround the uterus + external iliac vessels
- also encloses proximal part of the round ligament
What is the most common location of a ectopic pregnancy?
Ampulla
Compare the cervical os before and after childbirth
- pre-childbirth: small dot .
- post-childbirth: linear shape -
Where do the ovarian arteries arise from?
Abdominal aorta
What is the blood supply to the vagina?
- vaginal arteries
- branches of the internal iliac artery
What does the vaginal artery arise from?
Internal iliac artery
Why are there large granules of glycogen in the vagina?
For the natural bacteria (lactobacilli) which keep the vagina acidic
What can a disruption in the natural bacteria of the vagina cause?
Bacterial vaginosis
Thrush
What is the venous drainage of the uterus?
Into the uterine vein via a plexus in the broad ligament > drains into the internal iliac vein
What is the venous drainage of the vagina?
into the vaginal vein via a plexus > drains into internal iliac vein
What is the lymphatic drainage of the uterus?
- body: external iliac
- fundus: paraaortic + inguinal
- cervix: external + internal iliac + sacral
What is the lymphatic drainage of the vagina?
- superior 1/3: external iliac
- middle 1/3: internal iliac
- inferior 1/3: superficial inguinal
EIS in alphabetic order
What are the 4 types of FGM?
1- partial/total removal of clitoris
2- partial/total removal of clitoris + labia minora
3- removal of labia minora + sewing labia majora together only leaving a small hole for urine + menstrual blood
4- any other harmful procedure e.g. piercing, cutting
What is type 1 FGM?
Partial or total removal of clitoris
What is type 2 FGM?
Partial or total removal of clitoris + labia minora
What is type 3 FGM?
removal of labia minora + sewing labia majora together only leaving a small hole for urine + menstrual blood
What needs to be considering in transgender women?
They normally have a prostate so they could suffer from BPH or prostate cancer
What are polycystic ovaries?
What is it a common cause of?
> 10 cysts
Infertility
What type of peritoneum covers the ovaries?
Parietal peritoneum
What is endometriosis?
Ectopic endometrial tissue is dispersed to various sites along the peritoneal cavity
What is the most common site of pelvic endometriosis?
Pound of Douglas
Recto-uterine pouch
