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LSS 2 - Abdomen, Alimentary and Urinary systems > Lecture 6 - Female Pelvis and Perineum > Flashcards

Lecture 6 - Female Pelvis and Perineum Flashcards

1
Q

What are the female pelvic organs?

A

Ovary, uterine tubes, uterus, cervix, vagina, ureter, bladder, urethra, rectum, caecum, appendix, sigmoid colon and ileum, vessels, nerves and lymphatics

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2
Q

What is the structure of the female pelvic organs?

A
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3
Q

What are the boundaries of the peritoneum and pelvic fascia?

A

Parietal peritoneum continues into pelvic cavity without touching the pelvic floor; uterine tubes are completely enveloped by peritoneum (broad ligament). Pelvic fascial condensation form ‘ligaments’ supporting viscera (cervix, vagina)

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4
Q

How are the ovaries suspended?

A

By the mesovarium from posterior of broad ligament

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5
Q

How are the broad ligament, uterus, uterine tubes and ovary organised?

A
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6
Q

What are the broad ligaments?

A

Transverse mesentries joining the uterus to the pelvic walls -> contain the uterine tubes and uterine arteries

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7
Q

How are the ligaments arranged around the uterus?

A
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8
Q

How is the cervix and vagina maintained stable?

A

3 sets of fibrous bands (cervical ligaments) anchor the cervix in position with the pelvis -> prevent uterus from prolapsing through the vagina

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9
Q

What is the structure of the uterus and uterine tube?

A

Uterus consists of fundus, body, lower segment and cervix. Uterine tubes consist of infundibulum, ampulla, isthmus and uterine parts

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10
Q

Where is there potential communication between peritoneal cavity and exterior?

A

Via the reproductive passage -> abdominal ostium of uterine tube and vaginal opening

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11
Q

How is the uterus arranged?

A
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12
Q

How does the uterus change size in pregnancy?

A
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13
Q

What is the cervix?

A

Fibro-muscular cylinder with internal/external os -> projects into anterior vaginal wall at right angle to vaginal axis

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14
Q

What lines the cervical canal?

A

Mucus secreting simple columnar epithelium

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15
Q

What cells line the vaginal surface of the cervix?

A

Covered in stratified squamous non-keratinized epithelium -> no glands in vaginal wall

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16
Q

How is the cervix held up?

A

By strong cervical ligaments attached to the pelvis and sacrum -> part of pelvic fascia

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17
Q

What is the vagina?

A

Fibromuscular canal -> 7-9cm; vaginal fornices at upper end -> posterior fornix is important clinically and urethra is fused with the anterior wall

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18
Q

What structures can be palpated via the vagina wall?

A

Cervix, ischial spine, sacral promontory, uterine arterial pulse (lateral fornix), ovary [some can be felt through rectal examination]

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19
Q

What is the arterial supply to the female pelvic viscera?

A

Superior vesicle, uterine and middle rectal

20
Q

What is the arterial blood supply to the walls of the pelvis?

A

Sacral, gluteal and obturator branches

21
Q

What does the pudendal artery supply?

A

Perineum and recto-anal region (via inferior rectal branch)

22
Q

How does the internal iliac artery divide to supply the pelvis in the female?

A
23
Q

What does the uterine artery supply?

A

Main blood supply to the uterus and enlarges during pregnancy

24
Q

Where does the uterine artery run from and close to?

A

Runs medially to cervix and crosses ureter about 1cm from cervix -> uterine segment runs close to uterus in broad ligament

25
Q

What does the ascending branch of the uterine artery supply?

A

Uterine tubes and ovary (ovary also has ovarian artery from abdominal aorta)

26
Q

What does the descending branch of the uterine artery supply?

A

Vagina

27
Q

Where do the ovaries lie?

A

Close to openings of the uterine tubes into the peritoneal cavity; on the posterior surface of broad ligament facing into the peritoneal cavity into which eggs are first released -> supplied by ovarian artey

28
Q

What is the structure of the ovaries?

A
29
Q

What are the superficial perineal structures of the female?

A

Perineal membrane fills the urogenital triangle -> erectile tissues and associated skeletal muscles are anchored to this

30
Q

What are the deep perineal structures of the female?

A
31
Q

How do the urethral sphincters differ in females and males?

A

Females don’t have a well organised IUS but the EUS is more intricate in women than men and is crucial for maintaining urinary continence in women

32
Q

What are the 3 perineal spaces or pouches present in females?

A

Perineal membrane, deep perineal space and superficial perineal space -> Potential spaces and are real only when fluid leaks into them

33
Q

What is the perineal membrane?

A

Thick triangular fascial structure attached to pubic arch -> posteriorly free margin and a small gap anteriorly

34
Q

What is the deep/superficial perineal space?

A

Deep: above the perineal membrane and below the fascia of pelvic diaphragm. Superficial: Below perineal membrane and perineal fascia (subcutaneous tissue)

35
Q

What is in the superficial perineal pouch?

A

Median erectile tissue masses, lateral erectile tissue masses -> these erectile tissues within perineum are surrounded by skeletal muscles

36
Q

What are median erectile tissue masses in females?

A

Corpus spongiosum -> divides around the vestibule to form 2 vestibular bulbs, surrounding the lower vestibule and vagina -> derives the glans of clitoris

37
Q

What are the lateral erectile tissue masses in females?

A

Corpora cavernosum -> Paired cylinders, attached to ischipubic rami -> derives the body of clitoris

38
Q

What is the vulva?

A

Collective name for female external genitalia -> mons pubis, labia majora/minora, clitoris, vestibule of vagina, vestibular bulbs and vestibular glands

39
Q

What is the hymen?

A

The vaginal orifice in a virgin possesses a thin mucosal fold (hymen) which is normally perforated at the centre. Following intercourse and child birth the hymen is torn and only a few tags may remain

40
Q

What is the arrangement of the urethra in a female?

A
41
Q

What nerves supply the pelvis in females?

A

Autonomic nerves only -> SNS from lower thoracic and upper lumbar segments via hypogastric plexus; PSNS from S2-4 outflow; pudendal (somatic) S2-4

42
Q

Where is pelvic pain referred to?

A

Visceral and poorly localised -> referred to suprapubic region and perineum

43
Q

What does the pudendal nerve innervate?

A

Motor: to perineal muscles, anal/urethral sphincters, levator ani. Sensory: External genitalia (vestibule, labia minora and part of labia majora), lower vagina, clitoris, lower anal canal

44
Q

How are the external genitalia of the female innervated?

A
45
Q

How is the pelvic lymphatic drainage organised?

A

Pelvic organs: mainly to external/internal iliac nodes. Ovary/Testis: para-aortic nodes. Perineum (inc. anal canal) and external genitalia: superficial inguinal nodes [subcutaneous below inguinal ligament]

46
Q

Fill in the blanks

A
47
Q

Fill in the blanks

A

LSS 2 - Abdomen, Alimentary and Urinary systems (29 decks)

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