Repro Anatomy 3 Flashcards

1
Q

The female reproductive organs include what?

A

the uterus, fallopian tubes, vagina and ovaries

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2
Q

The duct system for the transference of gametes is _____, and leads from the ovaries to the uterus, where implantation and development of the zygote occurs

This then communicates with the exterior via the _____ _____

A

short

birth canal

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3
Q

What three structures constitute the birth canal?

A

womb, cervix and vagina

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4
Q

A

A

Rectum

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5
Q

B

A

Round lig. of uterus

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6
Q

C

A

Bladder

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7
Q

D

A

Rectouterine pouch (pouch of Douglas)

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8
Q

E

A

Uterovesical Pouch

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9
Q

F

A

Uterus

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10
Q

G

A

Fallopian Tube

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11
Q

H

A

Broad ligament

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12
Q

I

A

Ovary

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13
Q

What are the 3 layers of the uterus?

A

perimetrium (outer)

myometrium (middle)

endometrium (inner)

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14
Q

As pregnancy advances the uterus physiologically has an ‘upper’ segment and a ‘lower segment’ – what area of the uterine body does the lower segment develop from?

A

isthmus of the uterine tube and the cervix

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15
Q

When a caesarean delivery is done which part of the uterus is opened to deliver the baby?

A

the lowest part of the uterus, which is thinner so results in less bleeding

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16
Q

what is the normal position of the uterus?

A

The normal position of the uterus is ‘anteflexed’ and ‘anteverted’

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17
Q

What could happen if the position of the uterus is very retroverted and retroflexed, particularly in early pregnancy?

A

Think of the position of the other organs…

may create more pressure on bladder (can cause incontinence), baby can be obstructed and a normal vaginal birth can be limited so may need to think about a c section as baby can’t pass down the pelvic inlet and outlet, constipation

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18
Q

At any surgical management of miscarriage why might it be important to know prior to instrumentation of the uterine cavity whether the uterus is anteverted or retroverted?

A

as there is many organs around it could damage them, aware of where the implantation to take place, changes angle required of where the instruments are required to go

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19
Q

What are the fornices of the vagina? How many are they?

A

Definition - superior portions of vagina extending into recesses created by vaginal portion of cervix

1) one posterior fornix
2) one anterior fornix
3) two lateral fornix

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20
Q

Through which vaginal fornix you can access the rectouterine pouch? What is the clinical significance of this?

A

posterior fornix – procedures of the rectouterine pouch can be reached through the posterior fornix e.g. to drain fluid

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21
Q

The uterus and cervix are firmly anchored in position in the pelvis by a number of ligamentous attachments.

what are they?

A

Ligament of ovary

Suspensory ligament of ovary

Round ligament of uterus

Broad ligament

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22
Q

Which ligament (part of the pelvic fascia, which is one of the main supports of the uterus) is called the cardinal ligament of the uterus?

A

transverse cervical – attaches to the cervix

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23
Q

Apart from pelvic fascia, what other structure in the pelvis is also an important support of the uterus?

A

Pelvic diaphragm, perineal body

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24
Q

In the pelvis the cervix is a fixed structure, supported by strong ligaments to _______ movement. The uterus is supported, but has ability to ____, especially when increasing in size during pregnancy.

A

prevent

move

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25
Q

what are the 4 parts of the uterine tubes?

A

1) Infundibulum
2) Ampulla
3) Isthmus
4) Intramural or uterine part

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26
Q

Which part of the uterine tube is longest and widest?

A

ampulla

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27
Q

Fertilization occurs in which part of the uterine tube?

A

ampulla

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28
Q

Clinical – Ectopic Pregnancy

What is meant by tubal (ectopic) pregnancy?

A

when a fertilised egg implants itself outside the womb

An ectopic pregnancy is an uncommon, but important clinical diagnosis to be aware of an requires urgent surgery due to the risk of blood loss

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29
Q

What might a cornual ectopic pregnancy be?

A

implantation occurs in the cavity of a rudimentary horn of the uterus

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30
Q

The ovaries are located in the lateral walls of the pelvis, supported by 2 ligaments.

What are the two ligaments associated with the ovary?

A
  1. From uterus to ovary - ovarian ligament
  2. Ovary to lateral pelvic wall - suspensory ligament of ovary
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31
Q

As discussed in Part 1 the blood supply to the gonads and genitalia is via two major branches from the aorta - what are they?

A

the ovarian (gonadal) and internal iliac arteries

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32
Q

The ovarian artery corresponds to the male testicular artery, in that they are branches directly from the abdominal aorta

At what vertebral level do the ovarian arteries originate?

A

L2

As it descends the artery passes within the suspensory ligament to supply the ovaries via the broad ligament. Note that this vessel freely anastomoses with the uterine artery.

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33
Q

ovarian veins - note that the ascending course of the left and right are different – into which vessels do these paired vessels drain?

A

Left - left renal vein

Right - inferior vena cava

34
Q

The uterine artery crosses over the ______ at the level of ischial spine, junction of cervix and lateral part of fornix of vagina.

A

ureter

The expression “water under the bridge” reminds us of an important anatomical relation to remember during the ligation of uterine artery.

35
Q

A

A

Ovarian artery

36
Q

B

A

Ureter

37
Q

C

A

Ovary

38
Q

D

A

Uterine artery

39
Q

Clinical – Pelvic Surgery

Due to the close proximity of the ureter and bladder to the female reproductive organs, it is not uncommon that either can be _______ during a caesarean section or hysterectomy (removal of the uterus)

A

damaged

40
Q

The lymphatic drainage of the internal pelvic organs largely follows the arterial supply and venous drainage described above.

Which group of lymph nodes drains the ovary?

A

para-aortic nodes

41
Q

Area of Reproductive System - Fundus and upper uterine body

What is its Lymphatic Drainage (Nodes)?

A

Pre-aortic group of lymph nodes

42
Q

Area of Reproductive System - Most part of uterine body

What is its Lymphatic Drainage (Nodes)?

A

External iliac and lumbar nodes

43
Q

Area of Reproductive System - Uterine cervix and upper vagina

What is its Lymphatic Drainage (Nodes)?

A

Internal iliac and sacral lymph nodes

44
Q

Area of Reproductive System - Lower vagina

What is its Lymphatic Drainage (Nodes)?

A

Inguinal and femoral lymph nodes

Superficial inguinal, perirectal lymph nodes

45
Q

The breasts are highly modified exocrine glands lying in the superficial fascia of the pectoral region. They form important accessory organs of the female reproductive system and provide nutrition to the new-born in the form of milk.

Each breast consists of 15-25 lobes with tubulo-acinar glands (parenchyma) and stroma (connective tissue).

Breast extends vertically from the ___ rib to the ___ rib and horizontally from the lateral border of sternum to the mid-_______ line.

A

2nd

6th

axillary

46
Q

Breast - Its deep surface is related to what following muscles?

A

pectoralis major

pectoralis minor

serratus anterior

47
Q

what is the axillary tail of the breast

A

The axillary tail of the breast is an extension of the breast tissue into the axilla, and is important to appreciate in the spread of breast cancer (more on this later)

48
Q

The mammary gland is extremely vascular. They are supplied by what?

49
Q

A

A

Lateral thoracic artery

50
Q

B

A

Posterior intercostal artery

51
Q

C

A

Right subclavian artery

52
Q

D

A

Medial mammary artery, internal thoracic

53
Q

Lymphatic drainage of the breast assumes great importance to the surgeon because cancer of the breast spreads mostly along lymphatics to the regional nodes and beyond.

lymph nodes draining the breast tissue and their area of drainage - what is 1?

A

internal mammory

54
Q

Lymphatic drainage of the breast assumes great importance to the surgeon because cancer of the breast spreads mostly along lymphatics to the regional nodes and beyond.

lymph nodes draining the breast tissue and their area of drainage - what is 2?

A

supraclavicular

55
Q

Lymphatic drainage of the breast assumes great importance to the surgeon because cancer of the breast spreads mostly along lymphatics to the regional nodes and beyond.

lymph nodes draining the breast tissue and their area of drainage - what is 3?

A

subscapular

56
Q

Lymphatic drainage of the breast assumes great importance to the surgeon because cancer of the breast spreads mostly along lymphatics to the regional nodes and beyond.

lymph nodes draining the breast tissue and their area of drainage - what is 4?

A

axillary

57
Q

Lymphatic drainage of the breast assumes great importance to the surgeon because cancer of the breast spreads mostly along lymphatics to the regional nodes and beyond.

lymph nodes draining the breast tissue and their area of drainage - what is 5?

A

pectoral group

58
Q

Which group of lymph nodes first receives lymph from the lateral part (quadrant) of the breast tissue?

A

axillary

59
Q

Clinical - Breast Cancer:

Due to the vascularity and good lymphatic drainage of the breast, malignant cells can what?

A

quickly spread either to the opposite breast, or to other sites in the body (bone, lung, brain)

60
Q

what are the treatment options in breast cancer?

A

1) Chemotherapy +/- Hormone Treatment (depending on the sub-type of breast cancer)

2) “Lumpectomy” + lymph node Biopsy (removal of suspicious lump, with surrounding biopsy of cancerous ‘hot’ lymph nodes – these are tagged using radioactive dye

3) Mastectomy + Axillary Clearance – Removal of breast + axillary tail

61
Q

Breast tissue undergoes cyclical changes in activity, controlled by hormones involved with the ovarian cycle

is this inactive, lactation or pregnancy?

A

inactive

62
Q

Breast tissue undergoes cyclical changes in activity, controlled by hormones involved with the ovarian cycle

is this inactive, lactation or pregnancy?

A

lactation

63
Q

Breast tissue undergoes cyclical changes in activity, controlled by hormones involved with the ovarian cycle

is this inactive, lactation or pregnancy?

A

pregnancy

64
Q

Which image is from the late proliferative or secretary phase of the uterus?

A

Left - Proliferative phase

Right - Secretary phase

65
Q

Identify the different muscular layers of the uterine tubes on the image below

A

A

Serosa

66
Q

Identify the different muscular layers of the uterine tubes on the image below

B

A

Epithelium (mucosa)

67
Q

Identify the different muscular layers of the uterine tubes on the image below

C

A

Lumen

68
Q

Identify the different muscular layers of the uterine tubes on the image below

D

A

Muscularis mucosae

69
Q

what are the types of follicles?

A

Primordial follicle

Primary follicle

Secondary follicle

Tertiary follicle

Graafian follicle

70
Q

what is 1 and 2?

A
  1. primary oocyte
  2. follicular fluid
71
Q

what is 1-4?

A
  1. Secondary oocyte
  2. Zona granulosa
  3. follicular cells
  4. follicular fluid
72
Q

what is 1-5?

A
  1. oocyte
  2. zona pellutida
  3. follicular fluid, follicular antrum
  4. zona granulosa
  5. theca interna
73
Q

what is the placenta?

A

The placenta is a feto-maternal organ. It develops from the trophoblast following implantation of the blastocyst into the uterine endometrium.

It forms a link for physiological exchange between maternal and foetal circulation

74
Q

Examine the specimens of the placenta below and note that one surface of the placenta is disc shaped and the structure is rough and spongy - the maternal side.

The reverse side - foetal side, is smooth and bears the attachment of the umbilical cord.

which is which below?

A

left = foetal

right = maternal

75
Q

what are the functions of the placenta?

A
  1. Gaseous Exchange
  2. metabolic transfer
  3. hormone secretion
  4. fetal proteciton
76
Q

At what stage of labour does the placenta physiologically separate from the uterine wall?

A

third stage

77
Q

Look carefully at the cut-end of the umbilical cord, you should be able to see at least three structures, what are they?

A

these are the two umbilical arteries and single umbilical vein

Whartons jelly = W

78
Q

What is the function of umbilical arteries in the foetal circulation?

A

carry deoxygenated, nutrient depleted blood form the fetus to the placenta

79
Q

What structure (ligament) does the umbilical vein persist as?

A

round ligament of the liver, (ligament teres)

80
Q

What is the function of umbilical veins in the foetal circulation?

A

carry oxygenated, nutrient rich blood from the placenta to the fetus

81
Q

What is structure labelled W in the cross section above?

A

Whartons jelly/umbilical cord matrix