Applied anatomy live session

Question 1

What is the uterus divided into?

Answer 1

2 main parts

Body of uterus is superior 2/3

Cervix is lower 1/3

Question 2

Uterus is divided by the vaginal attachment into what?

Answer 2

• Supra vaginal part (between the isthmus and vagina) which is only separated from the bladder anteriorly only by loose connective tissue and from the rectum posteriorly by recto-uterine pouch. (Pouch of Douglas)
• Vaginal part (which protrudes to the vagina):that is visible during speculum examination

Question 3

What are the reationships of the supravaginal uterus?

Answer 3

• Anteriorly: Urinary bladder.
• Posteriorly:Forms the anterior wall of Douglas pouch.
• Laterally:1/2 an inch lateral to the internal os the ureter is crossed by the uterine artery (i.e. ureter below the uterine artery)(Water under the bridge)

Question 4

What is the vasculature of the uterus?

Answer 4

•Shared between the uterine and the vaginal artery à anterior division of internal iliac artery

Question 5

How is the ovarian artery enclosed?

Answer 5

Enclosed in the infundibulo-pelvis ligaments; direct branch from Aorta

Question 6

What does the ovarian vein drain into?

Answer 6

• right side drains into IVC
• Left Ovarian vein: drains into left renal vein.

Question 7

What is the lymphatic drainage of the uterus?

Answer 7

Along the uterine vessels within the transverse cervical ligament to the internal and external iliac lymph nodes and along uterosacral to the sacral lymph nodes

Question 8

What is the innervation of the female reporudctive tract?

Answer 8

Superior hypogastric plexus

Inferior hypogastric plexus

Pelvic splanchnic nerve

Question 9

What is the superior hypogastric plexus?

Answer 9

•In front of sacral promontory; Contains sympathetic nerve fibres; divides into right and left hypogastric nerves

Question 10

What is the inferior hypogastric plexus?

Answer 10

The right and left hypogastric nerves + preganglionic parasympathetic fibres from the pelvic splanchnic nerves. Located on each side of rectum and base of the bladder; contains both sympathetic and parasympathetic fibres.

Question 11

What are the pelvic splanchnic nerves?

Answer 11

S2/3/4; preganglionic parasympathetic fibers that originate from the 2nd, 3rd, and 4th sacral spinal segments. They join the hypogastric nerves to form the inferior hypogastric plexuses

Question 12

What is the function of the sympathetic nerves in the pelvis?

Answer 12

Question 13

What is the function of the pudneal nerves in the pelvis?

Answer 13

Question 14

What does the pudneal nerve supply?

Answer 14

Question 15

What are the true ligaments?

Answer 15

Transverse cervical ligaments

Uterosacral ligaments

Pubocervical ligament

Question 16

What is the transverse cervical ligament?

Answer 16

•From the Cx and lateral part of the vagina to the lateral wall of the pelvis

Question 17

Where does the uterosacral ligament pass?

Answer 17

Superioly and posterioly from the side of the Cx to the middle of the sacrum.

Question 18

When is the pubocervical ligament relevant?

Answer 18

Relevant in prolapse surgery. Ligaemnt is weak

Question 19

Answer 19

Question 20

What are the types of hysterectomy?

Answer 20

Total

Subtotal

Radical

Question 21

What kind of incisions are these?

Answer 21