The Woman

Question 1

What is the fibrous outer structure of the ovary called?

Answer 1

Tunica Albuginea

Question 2

What is the ovary enclosed in?

What happens to the follicles an ovary contains when stimulated by FSH

Answer 2

Parietal Peritoneum

Produce a primary follicle which will mature to release an ovum

Question 3

The ovary may develop ovarian cysts derived from what?

They can be asymptomatic or lead to torsion/ rupture/ other complications.

What is a common cause of infertility?

Answer 3

From follicles

Polycystic ovaries (more than 10 cysts)

Question 4

What does the Suspensory ligament of the ovary do?

Answer 4

Allows passage of ovarian artery and vein to ovary

Question 5

What is the origin of the ovarian artery?

What about the veinous and lymphatic drainage of ovaries

Answer 5

Directly from abdominal aorta

Same as testes

Question 6

The Fallopian Tubes allow passage of ovum to uterus.

Describe the tubes and how they transport an ovum

Answer 6

• Female reproductive tract opens into peritoneal cavity, so tubes have Fimbriae to increase SA to catch the ovum
• Ovum channelled into Infundibulum, continues to ampulla (most common site of fertilisation)
• Continues into Isthmus then into uterus

Question 7

What are the Fallopian tubes lined with?

Suggest 1 cause of these tubes being blocked and 1 outcome

Answer 7

Cilia

• Scarring in chronic infection
• Infertility

Question 8

What are the 3 parts of the uterus?

What does the cervix empty into?

Answer 8

• Fundus (top)
• Body
• Cervix

The vagina

Question 9

Where is the uterus relative to bladder?

Answer 9

Behind and above

Question 10

What happens to Fundus of Uterus during pregnancy?

What is it covered by?

Answer 10

Enlarges

Parietal peritoneum

Question 11

What is Cervical Ectropion?

Is this abnormal?

Answer 11

When the cells lining the inner cervical canal spread to the outer surface

Not abnormal, not uncommon

Question 12

Name 3 ligaments around uterus

Answer 12

• Round ligament (Remnant of gubernaculum)
• Ovarian ligament (continuous with round, remnant of “”)
• Broad ligament (double fold of peritoneum, connects uterus to lateral pelvic wall)

Question 13

Describe the 3 subdivisions of the broad ligament

Answer 13

• Mesovarium: Surrounding ovary
• Mesometrium: Between uterus and pelvic wall
• Mesosalpinx: Surrounding Fallopian tubes

Question 14

What does the uterine artery originate from?

What does it run between?

Answer 14

Internal iliac artery, runs between layers of broad ligament

Question 15

What are the vesicouterine and rectouterine pouch?

Why are they important clinically?

Answer 15

Vesicouterine: Peritoneum pouch between uterus and bladder anteriorly

Rectouterine: Peritoneum pouch between uterus and rectum posteriorly

Can be a site of fluid collection (Blood/ pus)

Question 16

What is Endometriosis?

What is it often associated with?

Answer 16

Ectopic endometrial tissue is dispersed to various sites along peritoneal cavity and beyond

Infertility, severe period pain or both

Question 17

What is the External Os?

What is internal os?

Answer 17

E: Opening of cervix into vagina

I: Opening of uterus into cervix

Question 19

What is the function of the Simple Columnar epithelia lining the cervix?

Answer 19

Produce mucus (which changes in pH and consistency according to menstrual cycle) to help facilitate/ prevent sperm entry

Question 20

What is the region close to the external os called?
What changes here?

What is this region most at risk of?

Answer 20

• Transitional zone
• Cervical to vaginal epithelium
• most at risk of malignant changes (if early can be identified through cervical screening)

Question 21

What is the normal angle between cervix and vagina called?

What is the normal angle between cervix and uterus called?

Answer 21

• Anteversion (C and V)

- Anteflexion (C and U)

Question 22

What is the vagina lined with?

What bacteria does it contain? Why?

Answer 22

Stratified squamous

Contains lactobacilli to regulate pH and keep environment acidic (to prevent infections)

Question 23

What is the vagina adapted to do during birth and intercourse?

What about lubrication?

Answer 23

Birth- expand

Intercourse- epithelia designed to resist friction

• Can’t provide its own lubrication, reliant on cervix secretions

Question 24

What do vaginal bacteria use as a metabolic substrate?

Answer 24

Glycogen

Question 25

What is the vulva?

What is it comprised of?

Can tumours occur here?

Answer 25

External genitalia, comprised of Labia Majora and Minora

Yes (vulval tumours)

Question 26

What is one fatal outcome of an ectopic pregnancy?

Answer 26

Haemorrhage

Question 27

How are Uterine and Vagina artery related?

Answer 27

Anatomose with each other

Question 28

Describe the Venous drainage of the Uterus and Vagina (including cervix)

Answer 28

Uterine veinous plexus each side of cervix, drain into internal iliac veins

Vaginal veinous plexus drains into uterine veins into internal iliac veins

Question 29

Describe the lymph drainage of the uterus including the cervix

Answer 29

Superior: Drains to Internal Iliac nodes

Inferior: Drains to Sacral nodes

Question 30

Describe the lymphatic drainage of the vagina

Answer 30

Superior aspect: External iliac nodes

Middle aspect: Internal iliac nodes

Inferior aspect: Superficial inguinal nodes

Question 38

What epithelia line the inside of the cervical canal and the outside?

Answer 38

Inside: Simple Columnar
Outside: Stratified squamous

Question 39

What is the Mons Pubis?

What is its function?

Answer 39

Rounded mass of fatty tissue lying over joint of pubic bones, present in both men and women, but more prominent in women

Acts as a source of cushioning during intercourse

Question 40

Beyond what angle do Anterversion and Anteflexion become Retroversion and Retroflexion

Answer 40

180 degrees