Anatomy of Female Reproductive System

Question 1

What are the Female Reproductive Organs?

Answer 1

Uterus
Uterine Tubes x2
Ovaries
Vagina

Question 2

What is the Uterus and what does it contain?

Answer 2

Muscular organ -
Fundus (above level of entry uterine tube)
Body (flattened anteroposteriorly)
Cervix (opens into vault of vagina)

Question 3

What are the 3 Layers of the Uterus?

Answer 3

Epimetrium (derived from peritoneum)
Myometrium (smooth muscle)
Endometrium (inner mucous coat, menstrutation)

Question 4

What gives the Female Reproductive system Structural Support?

Answer 4

Pelvic Diaphragm (active)
Perineal body
Broad ligament (double layer of peritoneum)
Uterosacral Ligament (cervix to sacram)
Cardinal Ligament (cervix to ischial spine)
Round Ligament

Question 5

What are the 3 Types of Broad Ligaments?

Answer 5

Mesomentrium (mesentery uterus)
Mesosalphinx (uterine tuber)
Mesovarium (overies)

Question 6

What is the normal position of the Uterus?

Answer 6

Anteverted and slightly Anteflexed

Question 7

Why would the Uterus Change Position?

Answer 7

Bladder and Rectum fill up

Question 8

What are the 3 Anatomical Variants?

Answer 8

Anteflexed (left) , Normal, Retroflexed (right)

Question 9

What are Fibroids?

Answer 9

Uterine Leiomyomas - bening tumours from myometrium

Question 10

What are the Symptons for Fibroids?

Answer 10

Cyclic - hormone sensitive
if large can cause heavy periods, painful intercourse, back pain
Common in middle to later age groups

Question 11

What are the Treatment Options for Fibroids?

Answer 11

Pharmacological Intervention - reduce oestrogen
Invasive Uterine Artery Embolisation - reduce blood supply to fibroids
Hysteroscopic resection - resctoscope
Myomectomoy - Laparoscopic, Open laparotomy
Hysterectomy - Transvaginal, laporoscopic

Question 12

What are the Uterine Tubes?

Answer 12

Fallopian tubes or Oviducts that project laterally from Uterus

Question 13

What are the 3 Segments of the Uterine Tubes?

Answer 13

Isthmus - narrow portion joins uterus
Ampulla - dilated lateral portion
Infundibulum - Surrounds fimbriae

Question 14

What are the purpose of the Segments of the Uterine Tubes?

Answer 14

Opens into peritoneal cavity at distal ostium, receive eggs from ovaries

Question 15

What is the difference between Uterine Artery and Ureter?

Answer 15

Uterine artery passes ABOVE ureter ‘water under the bridge’

Surgically Important as Ureter is at risk of damage (2%)

Question 16

What is the Round Ligament?

Answer 16

Vestige of female Gubernaculum - fibrous cord connecting ovary and uterus to labium majora
Upper part = ovarian ligament
Lower part = round ligament

Question 17

Where does the Round Ligament pass?

Answer 17

Through Inguinal canal and maintain anteversion in pregnancy

Question 18

Describe the Ovary?

Answer 18

Almond shaped and Female gonad
Develops Ova (eggs)
Endocrine gland produces hormones, covered by layer of cuboidal cells
Connected by Uterus

Question 19

How does Ovary change when you get older?

Answer 19

Shrinks and Becomes Pitted

Question 20

How does Blood Supply reach Ovaries and Uterus?

Answer 20

Left and Right Ovarian arteries originate from Abdominal Aorta
At pelvic brim cross External Iliac arteries and enter Suspensory ligaments, Splits at ampulla into ovarian and tubul branches originate from internal iliac artery

Question 21

What are the Problems with Uterine Artery Embolisation?

Answer 21

Microsphere migration to Ovaries leads to loss of function or Infertility

Question 22

Where are the Nerves in Relation to Ovaries?

Answer 22

Obturator nerve is lateral to ovary seperated by peritoneum

Question 23

What are the Symptons of Cysts and Tumours in the Ovaries?

Answer 23

Compresses nerve - cause pain and weakness in medial thigh

Question 24

Describe the Vagina?

Answer 24

Flattened Muscular Tube, Runs upwards and Backwards from opening of perineum, Cervix protrudes upper part creating fornix, Birth canal

Question 25

How can a Vaginal Examination be carried out?

Answer 25

Digital VE
Cervix, OS, fornices palpated by 2nd,3rd fingers
Using Bimanual approach - uterus anteriorly
adnexa lateral fornix
abnormalities in doughlas pouch posteriorlyy
Rectovaginal used for posterior structures