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3rd Year Anatomy > Week 2 - The Female Reproductive System and Breast > Flashcards

Week 2 - The Female Reproductive System and Breast Flashcards

1
Q

The female reproductive system lies within which two areas of the body?

A

The pelvic cavity and perineum

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2
Q

Which aspects of the female reproductive system lie within the pelvic cavity?

A

Ovaries, uterine tubes, uterus and superior part of vagina

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3
Q

Which aspects of the female reproductive system lie within the perineum?

A

Inferior part of the vagina, perineal muscles, Bartholin’s glands, clitoris and labia

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4
Q

The inferior part of the parietal peritoneum forms what?

A

The floor of the peritoneal cavity and the roof over the superior pelvic organs

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5
Q

The inferior part of the parietal perineum forming a roof over the pelvic organs allows the formation of what structures?

A

Vesico-uterine and recto-uterine pouches

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6
Q

Excess (abnormal) fluid in the peritoneal cavity tends to collect where? Why?

A

The pouch of Douglas (rectouterine pouch) - this is the most inferior part of the peritoneal cavity in the anatomical position

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7
Q

Fluid collection in the pouch of Douglas can be drained how? What is this process known as?

A

A needle gets passed through the posterior fornix of the vagina, this is known as culdocentesis

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8
Q

What is the broad ligament of the uterus formed of?

A

A double layer of peritoneum

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9
Q

Where does the broad ligament extend between?

A

The uterus, and the lateral walls and floor of the pelvis

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10
Q

What is the function of the broad ligament?

A

Helps to maintain the uterus in its correct midline position

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11
Q

What is contained within the broad ligament?

A

The uterine tubes and the proximal part of the round ligament

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12
Q

The broad ligament is divided into 3 parts. What is the part that covers the uterine tubes known as?

A

Mesosalpinx

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13
Q

The broad ligament is divided into 3 parts. What is the part that covers the ovary known as?

A

Mesovarium

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14
Q

The broad ligament is divided into 3 parts. What is the part that covers the uterus known as?

A

Mesometrium

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15
Q

Which ligament of the uterus is an embryological remnant?

A

Round ligament

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16
Q

Which aspect of the uterus does the round ligament attach to?

A

Lateral

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17
Q

The round ligament passes through which structure to attach to the superficial tissue of the female perineum?

A

Deep inguinal ring

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18
Q

Proximally, the round ligament is contained within what?

A

The broad ligament

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19
Q

What are the 3 layers of the uterus from outer to inner?

A

Perimetrium, myometrium, endometrium

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20
Q

Implantation of a zygote occurs where?

A

In the body of the uterus

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21
Q

What are the 3 structures which form the support to hold the uterus in place?

A

Strong ligaments, endopelvic fascia, muscles of the pelvic floor

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22
Q

What is the most common position for the uterus to be in?

A

Anteverted (cervix tipped anterior relative to the axis of the vagina) and anteflexed (uterus tipped anterior relative to the axis of the cervix)

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23
Q

If the uterus is in the correct position, the mass of the uterus should be lying over what structure?

A

The bladder

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24
Q

Is it normal for the uterus to be retroverted and retroflexed?

A

Yes, this is a form of normal variation

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25
Q

What specific area of the cervix must always be sampled during a cervical smear?

A

The squamo-columnar junction (transformation zone)

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26
Q

Where in the uterine tubes does fertilisation occur?

A

The ampulla

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27
Q

The fimbriae at the ends of the uterine tubes open into where? What is the clinical significance of this?

A

They open into the peritoneal cavity, meaning that infection can pass between the two areas

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28
Q

Which hormones do the ovaries secrete?

A

Oestrogen and progesterone

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29
Q

Where do the ovaries develop? Where do they move to after this?

A

They develop on the posterior abdominal wall and then move onto the lateral wall of the pelvis

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30
Q

The descent of the ovaries during development leads to the formation of what structure?

A

Round ligament

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31
Q

Which structures of the female reproductive tract, located in the pelvis are not covered in peritoneum?

A

The ovaries and the fimbriae of the uterine tubes

32
Q

The walls of the vagina are usually collapsed, apart from where? What does this form?

A

Superiorly, the cervix holds them apart forming a fornix

33
Q

What are the 4 parts of vaginal fornix?

A

Anterior, posterior and 2 lateral

34
Q

On vaginal examination, what bony structures can be palpated at the 4 and 8 o clock positions?

A

Ischial spines

35
Q

How do you feel the ovaries and uterine tubes on vaginal examination?

A

By placing fingers into the lateral fornix and the pressing deeply on the iliac fossa of the same side with the other hand

36
Q

What is the perineum?

A

The shallow space between the pelvic diaphragm and the skin

37
Q

Perineal muscles are divided into superficial and deep and are supplied by what nerve?

A

Pudendal nerve

38
Q

What is the perineal body?

A

A bundle of collagenous and elastic tissue into which the perineal muscles attach

39
Q

What is the function of Bartholin’s gland?

A

Produces mucus for lubrication

40
Q

What type of muscle is levator ani?

A

Skeletal (voluntary)

41
Q

What is the function of levator ani?

A

Provides support for pelvic organs, contracting during situations of raised intra-abdominal pressure

42
Q

What nerve supplies the levator ani?

A

Nerve to levator ani (S3, 4, 5)

43
Q

The bed of the breast extends to and from where in a superior-inferior direction?

A

Rib 2 - rib 6

44
Q

The bed of the breast extends to and from where in a medial-lateral direction?

A

Lateral border of the sternum to the mid-axillary line

45
Q

The breast lies on deep fascia which covers which muscles?

A

Pectoralis major and serratus anterior

46
Q

What are the spaces which lie between the fascia and breast known as?

A

Retromammary spaces

47
Q

The breast is firmly attached to the skin via what? These structures are orientated towards where?

A

Suspensory ligaments, orientated towards the areola

48
Q

Which hormone produces breast milk? Which hormone ejects breast milk?

A

Prolactin / oxytocin

49
Q

What are the 4 quadrants of the breast known as?

A

Upper outer, upper inner, lower outer and lower inner

50
Q

To assess whether or not a breast lump is fixed, you should get the patient to place their hands on their hips to contract which muscle group?

A

Pectoral muscles

51
Q

Most lymph from the breasts drains to where? And then where?

A

Ipsilateral axillary nodes and then to supraclavicular nodes

52
Q

Lymph from which breast quadrants can drain ipsilaterally or contralaterally?

A

Inner quadrants

53
Q

Lymph from the lower inner breast quadrant can also drain to where?

A

Abdominal nodes

54
Q

Level 1 axillary nodes are found where?

A

Inferior and lateral to the pectorals minor

55
Q

Level 2 axillary nodes are found where?

A

Deep to the pectorals minor

56
Q

Level 3 axillary nodes are found where?

A

Superior and medial to the pectoralis minor

57
Q

What separates the pelvic cavity from the perineum?

A

Levator ani

58
Q

What is removed in a bilateral salpingo-oophorectomy?

A

Both uterine tubes and ovaries

59
Q

What is removed in a unilateral salpingectomy?

A

One uterine tube

60
Q

What is the anal triangle filled with?

A

Fat and blood vessels

61
Q

What vessel supplies the medial aspect of the breast?

A

Internal thoracic (mammary) artery

62
Q

What vessel supplies the lateral aspect of the breast? What is this a branch of?

A

Lateral thoracic artery, a branch of the axillary artery

63
Q

What vessels supply the deep aspects of the breast?

A

Intercostal arteries

64
Q

What vessels are responsible for draining blood from the breast?

A

Internal thoracic (mammary), lateral thoracic and intercostal veins

65
Q

What is significant about intercostal veins draining blood from the breast when there is a cancer?

A

These veins go back to the thorax and so can cause cancer to spread into the thoracic spine

66
Q

How many lactiferous ducts are in each breast

A

15-25

67
Q

What ribs to the breasts form on

A

2-6

68
Q

What arteries supply the breasts

A

Laterally - vessels from axillary artery - superior thoracic, thoracoacromial, lateral thoracic, subscapular arteries

Medially - branches from internal thoracic artery

The 2-4 intercostal arteries via branches that perforate the thoracic wall and overlying muscle

69
Q

What veins drain the breast

A

Follows arteries and drains into the axillary, internal thoracic and intercostal veins

70
Q

What innervates the breasts

A

anterior and lateral cutaneous branches of the second to sixth intercostal nerves.

The nipple is innervated by the fourth intercostal nerve

71
Q
A
72
Q

What is the lymphatic drainage of the breast

A

75% - axillary lymph nodes (especially lateral quadrants)

most lymph drains through the pectoral (anterior axillary nodes) first and then drains to the other ones. Sometimes it drains directly to the other axillary nodes

Medial breast drain into the parasternal lymph nodes or to the opposite breast

Lymph from the inferior breast quadrants may pass deeply to abdominal lymph nodes (inferior phrenic nodes)

73
Q

Where does lymph to the axillary lymph nodes drain

A

Infra clavicular and supra clavicular nodes and then onto the subclavian lymphatic trunk

74
Q

Where does lymph to the parasternal lymph nodes drain

A

enters bronchomediastinal trunks and then drains into the thoracic or right lymphatic duct

75
Q

Discuss the histology of the breast

A

Each of the 15-25 lobes is a compound tubular acinar gland. The acini empty into ducts, that are lined by cuboidal, or low columnar epithelial cells, and surrounded by myoepithelial cells. The ducts from each lobule empty into a lactiferous duct that empties onto the surface of the nipple. These ducts are surrounded by smooth muscle in the region of the nipple, contraction of which makes the nipple become erect.

3rd Year Anatomy (21 decks)

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