Women's Health Anatomy & Physiology Flashcards

1
Q

What is the name of the anterior surface of the 1st sacral vertebra

A

sacral promontory

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2
Q

What is the name of the separation between the true pelvis and the false pelvis

A

linea terminalis

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3
Q

List the 3 conjugates and how they are measured

A
  • true conjugate: US
  • obstetric conjugate: US
  • diagonal conjugate: per vaginal
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4
Q

List the 4 types of pelvis shapes

A
  • gynecoid (favorable for vaginal delivery)
  • android
  • anthropoid
  • platypelloid
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5
Q

Which type of pelvis is this

A

Gynecoid

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6
Q

Which type of pelvis is this

A

Android

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7
Q

Which type of pelvis is this

A

Anthropoid

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8
Q

Which type of pelvis is this

A

Platypelloid

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9
Q

Name the 4 parts of the fallopian tube, distally to proximally

A
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10
Q

Name the 3 components of the broad ligament

A
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11
Q

Which structure delivers ovarian blood vessels

A

suspensory ligament

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12
Q

Which structure delivers uterine blood vessels

A

Mesometrium of the broad ligament

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13
Q

List the 3 components of the wall of the uterus, superficial to deep

A
  • perimetrium
  • myometrium
  • endometrium
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14
Q

Which structure is generally the culprit of low back pain during menstruation

A

the uterosacral ligament

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15
Q

Which structure anchors the ovary medially to the uterus

A

ovarian ligament

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16
Q

Which structure anchors the ovary laterally to the pelvic wall

A

suspensory ligament

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17
Q

Which structure suspends the ovary

A

mesoovarium of the broad ligament

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18
Q

What are the 2 major regions of the ovary

A

cortex: ovarian follicles
medulla: large blood vessels & nerves

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19
Q

Describe the 5 stages of a follicle

A
  1. primordial: single layer of squamous cells around oocyte
  2. primary: single layer of cuboidal cells around oocyte
  3. secondary: several layers of granulosa cells around oocyte
  4. late secondary: same as secondary but now with a few fluid cavities
  5. vesicular/Graafian: one large fluid filled cavity
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20
Q

Which cell type is a common nidus for tumors to arise

A

granulosa cells of a follicle

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21
Q

List the 4 major components of the uterus, superior to inferior

A
  • fundus
  • body
  • isthmus
  • cervix
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22
Q

Which suspensory ligament of the uterus does the uterine artery pass through

A

Transverse cervical ligament (aka Mackenrodt’s, aka Cardinal)

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23
Q

Which ligament of the uterus is commonly affected by endometriosis

A

uterosacral ligament

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24
Q

Describe blood flow to the uterus

A

Aorta - common iliac - internal iliac - uterine artery - spiral/radial/arcuate arteries

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25
Q

Describe the layers of the endomerium

A
  • Stratum basalis: replaces functionalis
  • Stratum functionalis (spongiosum & compactum): sheds every menstrual cycle
26
Q

Describe the histology of the cervix

A
  • Endocervix: single layer of columnar cells
  • Ectocervix: several layers of squamous cells
  • Squamocolumnar junction: most likely area for dysplasia (important to sample in pap)
27
Q

Locate the peritoneal pouches and fornices

A
28
Q

Where are the Skene’s glands located

A

Two directly inferiolaterally to the urethra

29
Q

Where are the Bartholin’s glands located

A

Two laterally to the vaginal opening
- susceptible to Bartholin Cysts: painful, palpable enlargement d/t blockage

30
Q

Describe the boundaries of the perineum

A

Diamond shaped area below the levator ani muscles
- pubic arch
- ischial tuberosities
- sacrotuberous ligaments
- coccyx

31
Q

Describe the divisions of the perineal triangles and the central point

A

Urogenital and Anal triangles, centered at the perineal body where all perineal muscles insert

32
Q

What is located within the anal triangle of the perineum that can result in rectal prolapse

A

Ischiorectal fossa containing fat - can atrophy and prolapse in severe malnutrition/diarrhea/etc.

33
Q

What is done to prevent a perineal tear in vaginal childbirth

A

Episiotomy
- mediolateral preferred
- midline avoided d/t risk of perineal body injury despite less blood vessels

34
Q

Describe the 4 degrees of perineal tear

A
  • 1st: limited to fourchette & superficial perineal skin
  • 2nd: extends to perineal muscle & fascia
  • 3rd: extends to anal sphincter
  • 4th: extends to rectal mucosa
35
Q

Describe the structure of a mammary gland

A

Modified sweat glands consisting of 15-25 pyramidal lobes
- extends from 2nd to 6th rib
- tail of spence/axillary tail extends into axilla

36
Q

What are tubercles of montgomery

A

modified sebaceous glands that enlarge during pregnancy/lactation

37
Q

What are suspensory ligaments of cooper

A

attach the breast to underlying muscle & contain lymphatics
- may be involved in malignancy & contract to produce peau d’orange

38
Q

Describe the flow of milk in lactation

A

Alveoli of lobule - lactiferous duct - lactiferous sinus - opening to nipple

39
Q

Describe how estrogen, progesterone, and placental hormones act on mammary glands

A
  • estrogen: stimulates growth & branching of the ducts
  • progesterone: stimulates alveolar formation
  • placental: forms true secretory alveoli during pregnancy
40
Q

Where does most of the lymphatic drainage of the breast go

A

75% drains to axillary nodes

41
Q

Describe the bloodflow of the mammary glands

A

Arterial supply & venous drainage from axillary & internal thoracic & intercostals

Intercostal nerves T4-6

42
Q

What is the role of GnRH

A

pulsatile release from the hypothalamus that stimulates pituitary to release FSH & LH

43
Q

Describe the role of prolactin-inhibitory hormone

A

decreases pituitary prolactin release (dopamine)

44
Q

What is the role of FSH

A

early & late follicle maturation

45
Q

What is the role of LH

A
  • late follicle maturation
  • causes estrogen spike midcycle which triggers ovulation & corpus luteum formation
  • stimulates progesterone release
46
Q

What is the role of PRL

A
  • breast milk secretion after primed by estrogen & progesterone
  • prevents ovulation during lactation
47
Q

What is the role of estrogen

A

Ovarian hormone
- synthesized by cholesterol & androgens stimulated by FSH & LH
- Estradiol>Estrone>Estriol

48
Q

What is the effect of estrogen on cervical mucus

A

causes it to be thin and water making it easy for sperm to traverse

49
Q

What is the role of progesterone

A

Ovarian hormone
- synthesized from cholesterol stimulated by LH in the corpus luteum & placenta
- increases basal body temp with timing of ovulation

50
Q

What is the effect on cervical mucus from progesterone

A

causes it to become thick, seals off uterus from further entry of sperm or bacteria

51
Q

Describe what happens during the follicular phase

A

(appx day 1-14)
- FSH secretion slightly elevated causing proliferation of granulosa cells & estrogen secretion
- single follicle secretes more estradiol & dominates
- remaining follicles synthesize androgens & become atretic

52
Q

Describe what happens in ovulation

A

(appx day 14)
- rupture & liberation of Graafian follicle
- dramatic rise in circulating estrogen which can no longer inhibit release of LH & FSH, this surge induces ovulation

53
Q

Describe what happens during the ovarian luteal phase

A
  • Mittelschmerz
  • FERTILIZATION: corpus luteum sticks around and produces progesterone
  • NO FERTILIZATION: ovum passes, corpus luteum sheds on day 24/4 days prior to next menstruation
54
Q

Describe what is happening during the uterine proliferative phase

A
  • under the influence of estrogen from maturing follicles
  • repair & growth of endometrium from previous menstruation
55
Q

Describe what happens during the uterine secretory phase

A
  • influenced by progesterone & estrogen of corpus luteum
  • endometrial glands coil & secrete fluid
  • FERTILIZATION: corpus luteum secrets progesterone & ripens/maintains endometrium
  • NO FERTILIZATION: corpus luteum regresses, less estro & progesterone, endometrial thinning, necrosis, vasospasm, menstruation
56
Q

______ is a passive process d/t lack kof gonadal sex steroids

A

menstruation

57
Q

Describe the difference between the fetal & maternal surfaces of the placenta

A
58
Q

Which hormone is tested in a pregnancy test

A

hCG

59
Q

Describe the types of placenta previa

A
60
Q

Describe the types/degrees of placental adhesion

A
61
Q

Describe placental abruption

A
  • placental prematurely separates from the uterus
  • MC pathologic cause of late pregnancy bleeding
  • usually after 20 weeks & before delivery