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Anatomy Female Repro
| Question | Answer |
|---|---|
| What are the components of the upper genital tract? | Fallopian tubes, ovaries, uterus, upper third vagina |
| What does the upper genital tract arise from? | Paramesonephric or Mullerian ducts |
| What remnants of the mesonephric duct might persist? | Epoophoron, skenes gland, gartners duct |
| Which germ layer gives rise to the genital tract? | Mesoderm |
| What other tract is closely associated with the genital tract? | Urinary |
| Why are normal sized pelvic organs not palpable per abdomen? | Pelvic bones surrounding and bladder is more anterior |
| What name is given to the pouch anterior to the genital septum? | Vesicouterine pouch |
| What name is given to the pouch posterior to the genital septum? | Rectouterine pouch or pouch of Douglas |
| Which conditions can cause adhesions within the pelvis? | Endometriosis, pelvic inflammatory disease, appendicectomy |
| What is meant by version of the uterus? | Angle between longitudinal axis of cervix and vagina |
| What is meant by flexion of the uterus? | Angle between longitudinal axis of uterus and cervix |
| When is it clinically important to establish the version and flexion of the uterus? | IUD insertion and surgical uterine interventions to know where to place tenaculum to pull uterus in position. |
| What are the two subdivisions of the uterus? | Neck (cervix uteri) and body (corpus uteri) |
| Which structure separates the two subdivisions of the uterus? | Internal os |
| What is the fundus of the uterus? | Top part furthest from opening |
| Which structures arise anteriorly and posteriorly from the junction of the fundus and the uterine tubes? | Broad ligaments |
| What are the three component tissues of the uterus? | Endometrium, myometrium, perimetrium |
| Wht is excision of the uterus called a hysterectomy? | Hustera is greek for womb |
| How does the broad ligament form during development? | Fusion of the Mullerian ducts. |
| What other ligaments relate to the uterus? | Cardinal, sacrouterine, ovarian, suspensory, broad |
| What are the two subdivisions of the cervix? | Intravaginal and supravaginal |
| What surrounds the intravaginal part of the cervix? | Fornix of the vagina |
| What is the name given to the cervical opening into the vagina? | External os |
| Why would a GP/practice nurse be very familiar with external os? | Site for smear specimens |
| What is the blood supply to the uterus? | Uterine artery from anterior division of internal iliac artery |
| Which important structure is closely related to the uterine artery? | Ureters go under it |
| What is the clinical significance of the ureters and uterine artery crossing? | Must be careful not to damage ureters when clamping uterine arteries for surgery |
| What is the nerve supply to the uterus and at which spinal level do the afferent nerves enter? | Afferent T11/12 and sympathetic nerve supply from inferior hypogastric and ovarian plexus |
| What is the course of the round ligament? | Uterine horns -> deep inguinal ring -> inguinal canal -> labia majora -> fibres mix with mons pubis |
| The round and ovarian ligament are the homologue of which male structure? | Gubernaculum / scrotal ligament |
| At what gestation does the pregnant uterus become palpable per abdomen? | 12w |
| At what gestation does the pregnant uterus reach the umbilicus? | 20w |
| What is menorrhagia? | Heavy periods |
| What is metrorrhagia? | Irregular and heavy periods |
| What is dysmenorrhoea? | Painful periods |
| What is oligomenorrhpea? | Cycle of more than 35 days |
| What causes uterine prolapse? | Weakening of the ligaments supporting the uterus most commonly caused by multiple or complicated childbirth |
| How are uterine prolapses graded? | How far down the uterus has protruded |
| What are uterine fibroids? | Benign tumours of muscular and fibrous tissue |
| What is endometriosis? | Endometrium growth in other areas |
| What is the adnexa? | The structures between the pelvis and the lateral pelvic walls |
| What attaches the oviduct to the broad ligament? | Mesosalpinx |
| How long are the oviducts? | 4-5cm each |
| What are the five parts of the oviduct? | Intramural, isthmus, ampulla, infundibulum, fimbriae |
| Which part of the uterine tubes in narrowest? | Isthmus |
| Where does fertilisation usually take place? | Ampulla of uterine tubes |
| Which type of cells line the oviduct and what is their function? | Ciliated epithelium to waft the oocyte |
| What happens to the oviduct at ovulation? | Smooth muscle protrusion and ciliated epithelium help to move oocyte along the tube |
| Why are uterine tubes often associated with a medical emergency? | Ectopic pregnancy |
| What gives uterine tubes blood supply? | Uterine artery |
| What is salpingitis? | Inflammation of the uterine tubes usually caused by bacterial vaginal infection such as chlamydia or gonorrhea |
| What is a hydro-salpinx? | Oedematous fluid in the uterine tubes |
| What is a pyo-salpinx? | Pus in the uterine tubes |
| What is cervical excitation and how would you test for it? | Pain upon bimanual pelvic exam - chandelier test |
| From which germ cell layer of the embryo do the ovaries arise? | Mesoderm |
| Where do the ovaries begin developmentally? | High on the posterior abdominal wall |
| What vertebral level do the gonadal arteries arise from? | L2 from abdominal aorta |
| What is the infundibulopelvic or suspensory ligament of the ovary? | Peritoneum from ovaries to lateral wall of pelvis and it houses the ovarian artery and vein |
| Where do the ovarian veins drain to? | Right goes to IVC and left goes to renal vein |
| Where do the ovarian lymphatics drain to? | Para-aortic nodes |
| What is the clinical significance of the ovaries lymphatics? | In ovarian tumours, you have to check the para-aortic nodes for invasion |
| What attaches the medial pole of the ovary to the uterus? | Broad ligament |
| What attaches the ovary to the broad ligament? | Mesovarium |
| What is the anatomical difference in a postmenopausal woman compared to premenopausal? | Atrophy of uterus postmenopause |
| What is classed as premature ovarian failure? | Menopause before 40 |
| Why may ovarian pathology cause symptoms in medial thigh? | Anterior cutaneous nerve originates at L2-3 and so does ovarian artery |
| From a malignancy aspect, which 3 types of cell are found in the ovary? | Epithelial (carcinoma), stroma, germ cell |
| Which cell type most commonly gives rise to ovarian malignancy? | Epithelial |
| Why does ovarian cancer have such a poor prognosis? | No clear early detection or screening and so often picked up late after it has metastasised |
| What symptoms can ovarian cysts cause? | Abdominal pain, uterine bleeding, nausea, vomiting, change in ease of urination |
| What three cyst complications can occur causing acute pain? | Ovarian torsion, rupture, bleeding into cyst |
| What is the difference between PCOS and PCOD? | PCOD is just having cysts on the ovaries whereas PCOS is a specific disease |
| What are the components of the lower genital tract? | Vagina and vulva |
| How do male external genitalia develop from the indifferent stage? | Testosterone is converted to DHT in the testes and causes virilisation |
| How long is the vagina? | 8-10cm but the posterior wall is longer than the anterior |
| The vagina contains no glands so how is it lubricated? | Skene's glands behind vulva and Bartholins gland |
| What is the posterior relation to the posterior fornix? | Pouch of Douglas |
| What is the clinical significance of the pouch of Douglas being posterior to posterior fornix? | Access for culdocentesis (removal of fluid from pouch) and aids in removing eggs and vaginal hysterectomy |
| Which important structure is related to the lateral fornix? | Uterine artery and ureter |
| What is the opening at the lower end called and which plane is it in? | Introitus, transverse |
| What separates the vagina from the rectum? | Pouch of douglas |
| What are the relations of the vagina? | Bladder anteriorly and rectum posteriorly |
| What is the blood supply of the vagina? | Vaginal artery from the internal iliac artery |
| What happens when pelvic organ prolapse occurs? | Uterus falls through vagina |
| What is the hymen? | Membranous sheath - embryological remnance |
| Which gland opens below the hymen? | Bartholin's gland and it can get a cyst |
| What is meant by the vestibule? | Between labia minora |
| What is the blood and nerve supply of the vulva? | Pudendal nerve and pudendal artery from internal iliac artery |
| What is the lymphatic drainage of the vulva and its clinical significance? | Superficial and deep inguinal nodes and para-aortic nodes |
| What anatomical changes occur during sexual arousal? | Gland secretion from parasympathetic innervation |
Created by:
cherish.thorpe