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repro and sexual health > clinical anatomy > Flashcards

clinical anatomy Flashcards

1
Q

what is pouch of douglas

A

recto-uterine pouch
most inferior point in the peritoneal cavity in an upright woman

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2
Q

what does the broad ligament do

A

extends between the uterus and the lateral walls and floor of the pelvis
helps maintain the uterus in its correct midline position

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3
Q

what is the round ligament

A

embryological remnant
attaches to the lateral aspect of the uterus
passes through the deep inguinal ring to attach to the superficial tissue to the female perineum

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4
Q

3 layers of the body of the uterus

A

perimetrium
myometrium
endometrium

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5
Q

where does implantation of zygote occur

A

body of the uterus

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6
Q

most common position of the uterus

A

anteverted and anteflexed
anteverted- cervix tipped anteriorly relative to the axis of the vangina
anteflexed- uterus tipped anteriorly relative to the axis of the cervix

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7
Q

normal variation position of the uterus

A

retroverted and reftroflexed

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8
Q

3 levels of support for holding the uterus in position

A

number of strong ligaments (uterosacral ligaments)
endopelvic fascia
muscles of the pelvic floor

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9
Q

what happens when there is weakness in uterine support

A

uterine prolapse

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10
Q

where does fertilisation occur

A

ampulla

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11
Q

how to check if the fimbriated end of the uterine tubes are open

A

HSG
- radiopaque dye spilling out of the end of the uterine tube and into peritoneal cavity

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12
Q

what area is sampled in cervical screening

A

squamo columnar junction- transformation zone

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13
Q

what type of muscle is levator ani

A

skeletal
- voluntary control

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14
Q

what is the function of levator ani muscle

A

provides continual support for the pelvic organs
- tonic contractions
- reflexively contracts further during situations of increased intra-abdominal pressure

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15
Q

innervation of levator ani muscle

A

S3,4,5 sacral plexus

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16
Q

perineal body

A

bundle of collagenous and elastic tissue into which the perineal muscles attach
important to pelvic floor strength
can be disrupted during labour

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17
Q

bartholins gland

A

secrete lubricating fluid

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18
Q

where does most of the lymph of the breast drain

A

most lymph drains to ipsilateral axillary lymph nodes and then the supraclavicular nodes

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19
Q

where can lymph from the inner breast drain

A

parasternal lymph nodes

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20
Q

where can lymph from the lower inner breast drain

A

abdominal lymph nodes

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21
Q

where can lymph from the upper limb drain

A

axillary lymph nodes

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22
Q

blood supply of the breast tissue

A

axillary
internal thoracic (internal mammary)

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23
Q

bony pelvis consists of

A

2 hip bones
sacrum
coccyx

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24
Q

bony points of the pelvic inlet

A

sacral promontory
ilium
superior pubic ramus
pubic symphysis

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25
Q

bony points of pelvic outlet

A

pubic symphysis
ischiopubic ramus
ischial tuberosities
sacrotuberous ligaments
coccyx

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26
Q

where does the inguinal ligament attach

A

between the ASIS and the pubic tubercle

27
Q

where are the ischial spines palpable

A

on vaginal examination
- approx 4 and 8 o clock

28
Q

where does the sacrospinous ligament attach

A

sacrum and ischial spine

29
Q

where does the sacrotuberous ligament attach

A

sacrum and ischial tuberosity

30
Q

in what ways is a females pelvis different to a mans

A

the AP and transverse diameters of the female pelvis are larger than the male
the subpubic angle and pubic arch in the female is wider than the male
the pelvic cavity is more shallow in the female

31
Q

what is moulding

A

the movement of one bone over another to allow the fetal head to pass through the pelvis during labour

32
Q

what is the vertex

A

an area of the fetal skull
outlined by the anterior and posterior fontanelles and the parietal eminences

33
Q

which is longer the occipitofrontal diameter or the biparietal diameter

A

the occipitofrontal diameter

34
Q

what is the station? in context of labour

A

the distance if the fetal head from the ischial spines

35
Q

what does a negative or positive station mean

A

a positive number means the head is inferior to the spines
and a negative number means the head is superior

36
Q

what position should the fetal head be at the pelvic inlet

A

transverse

37
Q

control of uterine cramping (menstruation)

A

hormonal (sympathetic/parasympathetic)

38
Q

control of uterine contraction (during labour)

A

hormonal (sympathetic/parasympathetic)

39
Q

what type of gland is the breast

A

subcutaneous gland

40
Q

what is the secretory tissue made up of

A

15-25 lobes
each consisting of a compound tubulo-acinar gland which drains via a series of ducts leading to the nipple

41
Q

what are suspensory ligaments

A

larger condensations that extend from the dermis of the skin to the deep fascia overlying the muscle
they support breast tissue

42
Q

what is the duct system in a non-lactating breast

A

the terminal duct lobular unit is the basic functional secretory unit of the breast
terminal ductules lead into an intralobular collecting duct which leads into the lactiferous duct for that lobe
the lactiferous duct leads to the nipple, passing through an expanded duct region near the nipple (lactiferous sinus)

43
Q

within the lobule what cells line the accini

A

secretory epithelial cells (vary from cuboidal and columnar)

44
Q

what cells surround the secretory cells of acinus

A

myoepithelial cells
- contractile epithelial cells which in turn are surrounded by the basal lamina

45
Q

what cells line the larger ducts of the breast

A

epithelium that varies from thin stratified squamous to stratified cuboidal

46
Q

what cells cover the nipple

A

thin, highly pigmented keratinized stratified squamous epithelium

47
Q

changes to the breast during the menstrual cycle

A

during the luteal phase the epithelial cells increase in height, the lumina of the ducts becomes enlarged and small amounts of secretion appear in the ducts

48
Q

changes to the breasts during pregnancy

A
  • In the first trimester there is elongation and branching of the smaller ducts, combined with proliferation of the epithelial cells of the glands and the myoepithelial cells.
  • In the second trimester glandular tissue continues to develop with differentiation of secretory alveoli. Also, plasma cells and lymphocytes infiltrate the nearby connective tissue.
  • In the third trimester secretory alveoli continue to mature, with development of extensive rER
49
Q

composition of human milk

A

88% water
1.5% protein mainly lactalbumin and casein
7% carbohydrate mainly lactose
3.5% lipid
small quantities of: ions, vitamins and IgA antibodies

50
Q

how are lipid droplets secreted from the breast

A

they are secreted surrounded by membrane and carrying a small amount of cytoplasm
apocrine secretion

51
Q

how is the protein in milk made

A

in the rER in the golgi apparatus and secreted via vesicles which merge with the apical membraane to release only their contents into the duct system
merocrine secretion

52
Q

changes to the breasts after menopause

A

the secretory cells of the TDLU’s degenerate leaving only ducts
are fewer fibroblasts and reduced collagen and elastic fiibres in the connective tissues

53
Q

what is the blood supply of the breast

A

lateral mammary branches from the lateral thoracic
medial mammary branches from the internal thoracic

54
Q

what is the venous drainage of the breast

A

by medial and lateral mammary veins

55
Q

how to palpate the ischial spines

A

laterally at 4 and 8oclock position

56
Q

location of retromammary space

A

lies between fascia and breast

57
Q

how is the breast attached to the skin

A

suspensory ligaments

58
Q

location of level I axillary nodes

A

inferior and lateral to pectoralis minor

59
Q

location of level II axillary nodes

A

deep to pectoralis minor

60
Q

location of level III axillary nodes

A

superior and medial to pectoralis minor

61
Q

paramesonephric (mullerian) ducts give rise to

A

uterine tubes
uterus
superior vagina

62
Q

majority of arteries of the pelvis and perineum arise from what artery

A

the internal iliac artery

63
Q

which arteries of the pelvis and perineum do not arise from the internal iliac artery

A

gonadal artery
superior rectal artery

64
Q

superficial perineum drains to

A

the superficial inguinal nodes

repro and sexual health (21 decks)

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