Week 1- Anatomy and development of reproductive system Flashcards
where is the pelvic cavity?
the pelvic cavity is between the inlet and outlet of the bony pelvis
where do the ossa coxae articulate?
posteriorly: with sacrum at the sacroiliac joint
anteriorly: at the pubic symphysis
what are the three parts of the os coxae?
ilium, ischium, pubis
what are the borders of the pelvic inlet
posterior: sacral promotory and ala
lateral: arcuate and pectineal line
anterior: pubic symphysis
what are the borders of the pelvic outlet?
posterior: tip of coccyx
lateral: ischial tuberosities
posterolateral: sacrotuberous ligament
anterior: pubic arch
what are the differences between the male and female pelvis?
male: deep and narrow; heart shaped, narrow pelvic inlet; smaller subpubic angle- <70
female- wide and shallow; oval, wide pelvic inlet; bigger subpubic angle- 80-90
what are the layers of the uterus and their function?
endometrium- innermost layer, lines uterus, shed during menstruation
myometrium- middle smooth muscle, contains blood vessels and nerves, contracts during childbirth
perimetrium- layer of peritoneum overlying uterus
what is the internal and external os of the cervix?
the internal os is the opening of the cervix into the uterine cavity
the external os is the opening into the vaginal cavity
what are vaginal fornices?
gutters around the margin of the cervix and wall of the vagina created where the cervix bulges into the vagina
what are the angles of the uterus?
angle of anteversion: angle between the axis of the vagina and the axis of the cervix
angle of anteflexion: angle between the axis of the uterine body and the axis of the cervix
the uterine angles are maintained by …
cardinal ligaments- cervix to iliac vessels
uterosacral ligaments- cervix to sacrum
what are the parts of the uterine tube?
from medial to lateral: isthmus, ampulla, infundibulum and the fimbriae
what is the function of the fimbriae of the uterine tube?
the fimbriae sweep the ovum into the uterine tube
where does fertilisation usually take place?
in the ampulla of the uterine tube
ovarian vessels and nerves are found within….
the suspensory ligament of the ovary
true/ false- the urethra is fused to the anterior wall of the vagina
true
which peritoneal pouch is the posterior vaginal fornix closely associated with?
the recto-uterine pouch
what is the vestibule of the perineum?
the vestibule is the region between the labia minor where the vagina opens into
describe the route of sperm through the male reproductive tract?
sperm is produced in the testes and moves to the epididymis to mature before entering the ductus deferens. the ductus deferens enters the abdominal cavity via the inguinal canal and then passes posteriorly and medially to the pelvic brim into the pelvic cavity. it unites with the seminal vesicle and forms the ejaculatory duct which passes into the prostate and joins with the urethra. the urethra then travels down the penis
what is the function of seminal vesicles?
seminal vesicles contribute seminal fluid (containing fructose, prostaglandins, coagulants, etc.) to the semen.
where is sperm stored prior to ejaculation?
the sperm is stored first in the epididymis and then in the ampulla of the ductus deferens just prior to ejaculation
what are the lobes of the prostate and their composition?
isthmus (anterior)- anterior to urethra, fribromuscular
right and left- glandular ( can be subdivided into 4 indistinct lobes: inferoposterior, inferolateral, anteromedial, superomedial)
what is the arterial supply of the prostate?
mainly inferior vesicle artery, also middle rectal and pudendal artery
what is the venous drainage of the prostate?
prostate venous plexus drains into the internal iliac veins
what is the innervation of the prostate?
sympathetic- T12-L3
parasympathetic- S2-S3
what are the glands within the prostate called?
inner periurethral- open directly into the urethra outer periurethral (submucosal glands)- ducts transfer secretion into urethra external/ peripheral zone glands- open into urethra via long ducts.
what is the epithelium of the glands and ducts of the prostate?
glands- tall/ cuboidal columnar epitheilium
ducts- columnar or cuboidal, get more cuboidal and transitional closer to the urethra.
what are the signs and symptoms of a malignant prostate?
signs- enlarged with irregular nodules
symptoms- urination difficulties
what is a mesentery, momentum and ligament?
they are double folds of peritoneum arising from peritoneal reflections
mesentery- between viscera and abdominal wall
momentum- between viscera and other viscera
ligament- can be either
are pelvic viscera intraperitoneal, retroperitoneal or subperitoneal?
pelvic viscera are subperitoneal- they only have peritoneum on their superior surface
what are the peritoneal pouches in a male pelvis?
there is the rectovesical pouch between the bladder and rectum
what are the peritoneal pouches in a female pelvis?
vesicle-uterine pouch- anterior, between bladder and uterus
recto-uterine pouch- posterior, between uterus and rectum
what is a culdocentesis?
drainage of a fluid from recto-uterine pouch through an incision in the posterior vaginal fornix
what is the broad ligament?
a double layer of peritoneum (mesentery) extending from the sides of uterus to the lateral walls and floor of pelvis
what are the subdivisions of the broad ligament?
mesometrium- between lateral pelvic walls and body of uterus
mesoalpinx- most superior pair, suspends the uterine tube
mesovarium- posterior extension of the broad ligament attached to the ovary
what is the ovarian ligament and the suspensory ligament of the ovary?
suspensory ligament of the ovary- connects ovary to the wall of pelvis, contains ovarian nerves and vessels.
ovarian ligament- connects ovary to uterus (joins at uterotubal junction)
what is the round ligament and what is its function?
this runs from the uterotubal junction through the inguinal canal to the labia major. it is continuous with the ovarian ligament. it is an embryological remnant of the gubernaculum. function- maintains position of uterus in pregnancy
where do the gonadal arteries branch from?
the abdominal aorta
what do the gonadal arteries supply?
the gonads (ovaries and testes) and the lateral half of the uterine tube in females.
which division of the internal iliac artery supplies the pelvic viscera?
the anterior division
what are the branches of the anterior division of the internal iliac and what do they supply?
- umbilical artery branches into superior vesicle artery which supplies the bladder and urethra
- obturator- moves towards obturator foramen
- vaginal (female) or inferior vesicle (male)
- uterine artery (female)
- middle rectal- supplies rectum
- inferior gluteal- supplies gluteal region
- internal pudendal- supplies perineum (external genitalia)
what does the ascending and descending branch of the uterine artery supply?
ascending branch- uterine body
descending branch- cervix and vagina
what does the uterine artery anastomose with, where does it happen and what does it supply?
the uterine artery anastomoses with the ovarian artery in the broad ligament to contribute to uterine tube supply.
what is a fistula?
an abnormal connection between two hollow spaces
what is an internal and external fistula and give an example.
external- one of the spaces is the skin. example- anal fistula (usually after draining of an anal abscess)
internal- between 2 hollow organs. example- colo-vesical or recto vaginal (during labour)
what is a bimanual exam?
fingers inserted into vagina and other hand pressed above pelvic brim to palpate the cervix (pain) and to check if the uterus is palpable above the pelvic brim (pregnancy, large fibroids, large cancers)
what are the steps of a rectal examination?
- inspection- for haemorrhoids, anal fissure/fistula, prolapse
- neuromuscular function- superficial anal reflex (L1/2), levator ani, external anal sphincter and internal anal sphincter
- digital examination- rectum palpated for masses, prostate and rectovesical pouch (men), rectouterine pouch (women)
at what stage do primordial follicles appear in the ovary of a foetus?
32 weeks
where does follicular development take place in the adult ovary?
the cellular stroma of the outer cortex
what are the steps of fertilisation?
- sperm capacitation
- penetration of corona radiata
- attachment to zone pellucida
- activation: acrosome reaction, penetration of zone pellucida
- sperm fuses to plasma membrane and entry
- blocks to polyspermy
what happens to the follicle after ovulation?
luteinisation of granulose and thecal cells by LH. this produces granulosa lutein cells and theca lutein cells which secret progesterone and a small amount of oestrogen. the follicle is now a corpus luteum. this shrinks and stops producing hormones becoming a corpus albicans
what is capacitation and where does it occur?
capacitation is the removal of glycoproteins and sterols from plasma membrane. it occurs post ejaculation in the female genital tract
what is sperm activation?
morphological event. includes acrosome reaction: release of hydrolytic enzymes from the acrosome
what are the two blocks to polyspermy?
fast block- electrical depolarisation of plasma membrane of the ovum, prevents sperm fusing to membrane
slow block- oocyte secretes lysozymes ceasing the cortical reaction- formation of impenetrable membrane and zone reaction- structural changes which prevent sperm binding
what is the pre- embryo
preimplantation embryo- fertilisation to day 11/12
define the term embryo
phase of gastrulation, neuralation, folding and organogenesis- day 11/12 to week 8
define the term fetus
growth phase- week 9 till birth
what are the pre-implatation stages of development?
cleavage- says 1-2 morula, 16 cells- day 3 blastocyst- day 4 hatching (removal of zone pellucida for implntation)- day 5 implantation- day 5-7
what does the inner cell mass of the blastocyst become
the fetus
what do the trophoblast cells become?
the placenta
what is the blastocyst cavity called?
blastocoele
what do syncytiotrophoblast cells do?
invade maternal blood vessels forming lacunae and produce hCG