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Reproduction > Clinically Relevant Anatomy - Female reproductive system and Breasts > Flashcards

Clinically Relevant Anatomy - Female reproductive system and Breasts Flashcards

1
Q

Which female reproductive organs are located in the true pelvic cavity?

A 
Above the levator ani muscle: 
Ovaries
Uterine tubes
Uterus
Superior part of vagina
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2
Q

Which organs in the female reproductive system are located in the perineum?

A 
Inferior part of vagina
Perineal muscles
Bartholin's glands
Clitoris
Labia
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3
Q

What is the primary organ of female reproduction?

A

Ovaries

Everything else is accessory

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4
Q

What is the pelvic floor muscle?

A

Levator ani

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5
Q

What is the peritoneum?

A

Very thin serous membrane layer

Completely covers the superior aspect of viscera

Drapes itself over the pelvic organs and forms little pouches

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6
Q

What is the most important peritoneal pouch?

A

Recto-uterine pouch/Pouch of Douglas

Most inferior part of the peritoneum in anatomic position - excess fluid collets here

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7
Q

What is the location of recto uterine pouch?

A

B/w rectum and posterior wall of uterus

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8
Q

Name another peritoneal pouch

A

Vesico-uterine pouch

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9
Q

What are para rectal pouches?

A

Technically the most inferior portion where fluid drains

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10
Q

How to drain fluid from pouch of douglas?

A

Via a needle passed through the posterior fornix of the vagina

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11
Q

Which are the only true intra-peritoneal organs of the pelvic cavity?

A

Uterine tubes

Completely covered by the peritoneum

Fimbriated end is open

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12
Q

Name the ligament formed from double layer of peritoneum

A

Broad ligament

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13
Q

Describe the borders of the broad ligament

A

Extends between the uterus and the lateral walls & floor of the pelvis

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14
Q

What is the function of broad ligament?

A

helps maintain the uterus in its correct midline position

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15
Q

What are the contents of the broad ligament

A

uterine tubes and (the proximal part of) the round ligament

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16
Q

Name the ligament that is an embryological remnant on the lateral aspect of the uterus

A

Round ligament/teres ligament

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17
Q

Describe the course of round ligament

A

From uterus, through anterior abdo wall and inguinal canal and down into labia in the perineum.

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18
Q

Which ligament contains the gubernaculum?

A

Round ligament

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19
Q

What are the 3 layers of the uterine body

A

perimetrium
myometrium
endometrium

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20
Q

Where does implantation occur?

A

Body of the uterus

Ectopic pregnancy if it implants anywhere else

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21
Q

What is the most common location of ectopic pregnancy?

A

Uterine tubes

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22
Q

What are the less common sites of ectopic pregnancy?

A

Ovary

Abdomen: due to connection b/w uterine tube and peritoneum

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23
Q

What are the 3 levels of support for the uterus

A
  1. uterosacral ligament: runs from cervix to sacrum (not uterus)
  2. Endopelvic Fascia
  3. Muscles of the pelvic floor
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24
Q

How does uterine prolapse occur?

A

Weaking of the levels of support of the uterus causes posterior movement of the uterus

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25
Q

What is the most common position of the uterus

A

Anteverted and Anteflexed

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26
Q

Define anteverted

A

Cervix tipped anteriorly relative to the axis of the vagina

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27
Q

Define anteflexed

A

Uterus tipped anteriorly relative to the axis of the cervix (the mass of the uterus lies over the bladder)

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28
Q

Normal variation of the position of uterus

A

Retroverted and retroflexed

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29
Q

Why is a speculum used during cervical smear?

A

Vaginal walls are usually collapsed, hence speculum needed to spread it apart to get a good view of cervix

30
Q

Which area of cervix is to be sampled during smear?

A

Squamo columnar junction

31
Q

Which factors affect appearance of cervix?

A

Age
Stage of menstrual cycle
Parity

32
Q

What is the significance of uterine tubes?

A

Fertilisation occurs here

Specific location: Ampulla

33
Q

Name the process of removing both uterine tubes and ovaries

A

bilateral salpingo-oophrectomy

34
Q

What is the clinical significance of fimbriated ends of uterine tubes opening into peritoneal cavity?

A

Communication between the genital tract and the peritoneal cavity

Infection could pass between the two areas.
Pelvic Inflammatory Disease can cause peritonitis

Ectopic pregnancy can develop in peritoneal cavity

35
Q

What is the appearance of a hysterosapingogram (HSG) when tubes are patent and not blocked?

A

Radiopaque dye spills out of the end of the uterine tube and into the peritoneal cavity

36
Q

Name the fossa located on lateral wall of the uterus

A

Ovarian fossa - location of the ovaries

37
Q

What structures of the ovaries develop on the posterior abdominal wall

A

Arterial supply, venous and lymphatic drainage

38
Q

Lateral vaginal fornices are used to palpate which structures?

A

Ischial spines can be palpated

  • laterally
  • 4 and 8 o’clock positions
39
Q

Bimanual palpation during vaginal exam assesses what?

A

Position of uterus

40
Q

Hormones secreted by ovaries

A

oestrogen

progesterone

41
Q

Ovum is released into peritoneal cavity- true or false?

A

True

42
Q

List fornices of vagina

A

anterior
posterior
lateral - 2X

43
Q

How to palpate adnenxae in vaginal exam

A

adnexae: uterine tubes and ovaries
place examining fingers into lateral fornix
press deeply with other hand in the iliac fossa of the same side
repeat on other side
can detect large masses or tenderness affecting these structures.

44
Q

Which part of the levator ani muscle is made of skeletal muscle and under voluntary control?

A

Lateral aspect (majority)

45
Q

Which aspect of levator ani is under autonomic control and is made of SM

A

Medial aspect

46
Q

Weakened levator ani leads to ____?

A

uterine (& other organs) prolapse
urinary incontinence
Fecal incontinence

47
Q

Function of levator ani

A

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

48
Q

Nerve supply of levator ani

A

“nerve to levator ani” - S3,4,5

Pudendal nerve - S2,3,4

49
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

located just deep to skin

50
Q

What are the contents of the perinuem

A

Perineal muscles

Perineal body

51
Q

Nerve supply to perineal muscles

A

Pudendal nerve

52
Q

Other name for bartholin glands

A

Greater vestibular glands

Secrete lubrication into vagina

53
Q

What is the perineum?

A

shallow space between pelvic diaphragm and the skin

pelvic diaphragm forms floor of pelvis, but roof of perineum

54
Q

What are the openings of the pelvic floor?

A

passage of distal parts of alimentary, renal and reproductive tracts from pelvis to perineum

55
Q

Borders of the bed of breast tissue

A

from ribs 2-6

lateral border of sternum to mid-axillary line

56
Q

Name the fatty tissue of the breast that extends to axilla?

A

Axillary tail of spence

57
Q

Name the muscles on which the breast lies

A

lies on deep fascia covering pec major and serratus anterior

58
Q

What is the retromammary space?

A

Potential space b/w breast and pectoral fascia

Contains small amount of fat - allows movement between breast and muscles

59
Q

What attaches breast to skin?

A

suspensory ligaments

60
Q

There is only one opening on nipple for lactation - T or F

A

F.

Multiple openings

61
Q

What is the significance of a “fixed” lump?

A

Lump has invaded the deep fascia and has attached to muscle

62
Q

Lymphatic drainage of the breast

A

lateral parts of the breast (75-80% - ipsilateral) - axillary lymph node

Medial quadrants - parasternal lymph node
- can easily cross to contralateral side to parasaternal lymph node

Inferior quadrant - abdominal lymph node

From upper limb: axillary lymph nodes
- lymphedema if axillary nodes are removed

63
Q

Function of axilla

A

pyramidal passageway between arm and chest

64
Q

Contents of axilla

A

brachial plexus branches
axillary artery (& branches) and axillary vein (& tributaries)
axillary lymph nodes
all embedded in axillary fat

65
Q

Significance of levels of axillary nodes

A

Breast surgeons use “levels” of axillary nodes to describe the extent of “axillary node clearance”. The position of each level can be described in relation to pectoralis minor

66
Q

Level I axillary nodes

A

inferior and lateral to pectoralis minor

67
Q

Level II axillary nodes

A

Deep to pec minor

68
Q

Level III axillary nodes

A

Superior and medial to pec minor

69
Q

Blood supply to breast

A

axillary artery

Internal thoracic/internal mammary

70
Q

Function of Levator Ani

A

provides continual support for the pelvic organs.

  • tonic contraction
  • reflexively contracts further during situations of increased intra-abdominal pressure
  • weakness can be a factor in the development of prolapse of the pelvic organs

Reproduction (32 decks)

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