Women's Health Anatomy Flashcards
3 bones of the pelvis
- ilium
- pubis
- ischium
What is the iliac crest?
the top ridge of the ilium
What are the two prominences on the ilium?
- post. superior iliac spine (PSIS)
- ant. superior iliac spine (ASIS)
Describe the pelvic brim.
the inner circle of the pelvis that extends from the superior pubic crest of the pubic bone then posteriorly to the sacral promontory
What are the boundaries of the pelvic brim?
superior pubic crest and sacral promontory
What is the acetabulum?
area where we have articulation with the hip joint
What is the obturator?
opening within the ischium
What is the pubic symphysis?
the cartilaginous tissue that connects the pubic bones anteriorly
What happens to the pubic symphysis during childbirth
it stretches to allow for enlargement of the pelvic brim to allow for baby to pass
What is the pelvic brim (pelvic inlet)?
continuous oval ridge that runs from pubic crest posterior to sacrum
What makes up the pelvic brim?
false pelvis & true pelvis
Location of the false pelvis
superior to pelvic brim
Location of true pelvis
inferior to pelvic brim; defines birth canal
What is the pelvic outlet?
inferior margin of the true pelvis
What bones make up the pelvic brim?
- pubis
- ischium
- ilium
- sacrum
- coccyx
How does the female pelvis differ from the male pelvis?
wider, shallower, lighter, rounder
What is superior to the pelvic brim?
false pelvis
The false pelvis essentially sits in the….
abdominal cavity
What is inferior to the pelvic brim?
true pelvis
The true pelvis is also what we call the…
birth canal
The inferior margin of true pelvis aka
pelvic outlet
The pelvic outlet is defined by the…
pubic arch, ischial spines & coccyx
What sits below the pelvic outlet?
perineum
- what we see during vag exams
- location of roots of female genitalia (anchor external genitalia)
NOTE
False pelvis–> true pelvis–> pelvic inlet–> Pelvic outlet–> perineum
What makes up the pelvic diaphragm?
- 3 parts of the levator ani
- coccygeus
What are the 3 muscle of the levator ani?
- iliococcygeus
- pubococcygeus
- puborectalis
What do all 3 muscles of the levator ani converge?
tendinous arch
What is the function of the levator ani muscles?
prevent pelvic organs from falling out
What structures pass through the levator ani?
- rectum
- vagina
- urethra
What innervates the pelvic floor/wall muscles?
Sacral Plexus (L4 - S4)
What are the nerves of the sacral plexus?
- sciatic nerve
- gluteal nerve
- pudendal nerve
Sciatic nerve supplies the…
leg & foot
Gluteal nerve supplies the…
posterior glute muscles
Pudendal nerve supplies the…
perineum
Function of the pelvic splanchnic nerves (S2 - S4)
Parasympathetic to hindgut, bladder & genitalia
When is a pudendal nerve block done?
In ppl who are having perineal pain; this nerve supplies sensation to the genitalia, perineum, & anal region
–> episiotomy after childbirth
Arterial supply to the pelvis & perineum comes from the…
internal iliac arteries
What does the anterior trunk supply?
pelvic organs
–> uterus, vaginal, etc
perineum
What does the anterior trunk supply?
- lumbar
- iliac
- sacral
- gluteal regions
Do the internal iliac arteries supply the gonads?
NO
What do the gonadal arteries arise from?
directly from the abdominal aorta
Anterior internal iliac artery give rise to these arteries: (6)
- Patent umbilical artery (give rise to vesicle artery (bladder)
- Obturator artery
- Uterine artery
- Vaginal artery
- Middle rectal artery
- Internal pudendal artery (feeds external genitalia)
What is the venous drainage of the pelvis?
- pelvic plexus
- hepatic portal or caval drainage
Describe the pelvic plexus
a bunch of anastomoses of veins that drain eventually into the hepatic portal system or into the inferior vena cava
The superficial tissue/pelvic cavity lymph fluid drains into the…
internal & external iliac nodes–> lateral aortic nodes
The testes & ovaries lymph fluid drains into the…
lateral aortic nodes
List the parts of the vulva
- Mons pubis
- Labia majora
- Labia minora (Vesitbule)
- Clitoris = glans + clitoral hood (prepuce)
- Bartholian glands
- Skene’s gland
Describe the mons pubis
- Rounded fatty area that overlies the pubic bone.
- Post puberty females, covered by hair
Describe the labia majora
- 2 large fleshy folds of skin that extend from the mons pubis down the perineum posteriorly towards the rectum
- Outer surface is covered by pubic hair; the inner surface is smooth & some sebaceous oi/sweat glands
- Main function is to protect the inner structures of the vulva
Describe the labia minora
There are kind of two portions: two smaller hairless folds of skin that surround the vagina & urethral openings
Describe the vestibule
the area within the labia minora where there are some smaller inner folds of the vulva; contain ureteral and vaginal openings; also called the introdis
Describe the Bartholin glands
glands that sits on either side of the vaginal opening & they secrete mucus to lubricate the vagina; prone to abscess/cyst
Describe the Skene’s glands
Periurethral glands; around the urethral opening; also help with lubrication
What is the erectile tissue for the female?
glans
What is the corpora cavernosa?
crura attached along pubic arch
What are the bulbs of the vestible
anchored along the perineal membrane
What is the perineal body?
CT structure to which pelvic floor muscles & perineal membrane attach
–> site of episiotomy
Where is the perineal body located?
just b/t the vaginal opening & rectal sphincter
What are the organs of the female reproductive system?
- vagina
- cervix
- uterus
- uterine tubes
- ovaries
What are the parts of the cervix?
- external os
- internal os
–> posterior fornix
What makes up the uterine adnexa?
uterine tubes + ovaries
What is the pathway of female organs from external to internal?
Vagina–> Cervix–> Uterus–> Uterine tubes (fallopian tubes)–> ovaries
Describe the cervix
opening of the uterus; non muscular cartilaginous tissue that separates the uterus & vagina
The anterior part of the vagina is connected to the…
bladder
–> & the uterus also articulates w/ the bladder
What articulates with the rectum?
posterior part of the vagina & some of the uterus
What are the fornixes?
areas around the cervix
What is the posterior fornix?
–> area where we can enter surgically (minimally invasive)
–> where we can enter the abdo cavity;
pelvic mass cyst, or pain (drainage, lyse adhesions)
What are the parts of the uterus?
body and fundus
What are the 3 possible positions of the uterus?
- anteflexed
- retroverted
- retroflexed
What is the most common position of the uterus?
anteflexed
Describe a anteflexed uterus
uterus lays against bladder
Describe a retroverted uterus
uterus sits more upward toward spine
Describe a retroflexed uterus
uterus is flexed toward the rectum
What supplies blood supply to & from the uterus?
uterine arteries & veins
What are the 3 layers of the uterus?
- perimetrium
- myometrium
- endometrium
Describe the perimetrium (serosa)
visceral peritoneum
Describe the myometrium
thick smooth muscular layer; will contract during childbirth
Describe the endometrium
inner layer; the mucosal lining of uterus; where fertilized eggs burrow during development
Describe the functional layer of the endometrium.
changes in response to ovarian hormone cycles; sheds during you period
Describe the basal layer of the endometrium.
forms a new functional layer after menstruation; base renewal
Uterine tubes aka
fallopian tubes
What are parts of the uterine tubes?
- Isthmus
- Ampulla
- Infundibulum
- Fimbriae
Describe the isthmus
the area of the tube that connects to the uterus
What is the location of a tubal ligation?
isthmus
Describe the ampulla
the widened portion of the tube
Describe the infundibulum
the largest part that articulates with the ovary
Describe the fimbriae
fingerlike extension; collect & sweep up eggs for ovulation
NOTE
The ovaries have an outer cortex & inner medulla
What is contained w/n the ovaries?
ovarian follicles
What are ovary follicles?
tiny sac-like structures that are usually embedded in the outer cortex & contain immature eggs or oocytes
What happens to the immature eggs during menstruation?
they will ripen or mature & be ejected from the ovary.
–> ovulation
What happens once the egg is ejected?
fimbriae will pick up the egg–> sweep it into the fallopian tube–> enter the uterus for potential fertilization
List the ligaments of the uterus
- Broad ligament (intraperitoneal)
- Round ligament
- Suspensory ligament
- Ovarian ligament
- Cardinal (transverse cervical) ligament
- Uterosacral & pubocervical
Location of the ovaries
lateral wall of the true pelvis
Describe the broad ligament
drape-like ligament of double-layer peritoneum that drapes over the uterus, uterine tubes & ovaries
Describe the round ligament
fibrous cord that runs from the area where the fallopian tubes enter the uterus (isthmus) through the inguinal canal & anchors to the labia majora
What does the round ligament cause during pregnancy?
causes pain from overstretching & can be felt on the labia majora
What does the suspensory ligament contain?
ovarian artery & vein
Function of the ovarian ligament.
helps attach the ovaries to the uterus
Describe the cardinal ligament.
thick band of CT that extends from the cervix to the lateral parts of the vagina & pelvic wall
What other 2 ligaments work in conjunction with the cardinal ligament?
Uterosacral ligament & pubocervical ligaments
Boundaries of the uterosacral ligament.
extend from the cervix and upper vagina up to the sacrum
Boundaries of the pubocervical ligament.
extend from the cervix up to the posterior pubic symphysis
Function of the cardinal, uterosacral & pubocervical ligaments.
- maintain positioning of the uterus & other structures of the pelvic cavity
- prevent displacement esp. during childbirth.
- help protect the uterus.
Dysfunction of the cardinal, uterosacral & pubocervical ligaments can cause…
uterine prolapse
Describe the areola.
pigmented skin surrounding nipple
Function of suspensory ligaments
attach breast to underlying muscles
Lobes–> lobules–> glandular alveoli… these alveoli produce….?
milk
Describe the passage way of milk in the breast.
lactiferous ducts–> lactiferous sinuses–> open to outside at nipple
Describe glandular tissue in non-nursing women.
undeveloped
Describe mammary glands.
modified sweat glands that are made of different lobes & fat tissue
Breast CA can arise from what parts of the breast & what do we call this type of CA?
- arises from lactiferous ducts & sinuses
- ductal CA
Function mammary glands in women
milk production & feeding of babies
Function of mammary glands in men
- galactorrhea: non-milk discharge from nipple as a SE of some meds
- gynecomastia: enlargement of breast tissue as a SE of some meds
