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MB3 Obstetrics and Gynaecology > Anatomy > Flashcards

Anatomy Flashcards

(79 cards)

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1
Q

what aspects of female reproductive tract are located in pelvic cavity

A

ovaries
uterine tubes
uterus
superior portion vagina

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2
Q

what aspect of female repro tract are located in perineum

A 
inferior vagina
perineal muscles 
bartholins glands 
clitoris 
labia
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3
Q

what two pouches does the inferior parietal peritoneum form in females

A

rectouterine pouch of douglas

vesicouterine

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4
Q

what pouch does the inferior parietal peritoneum form in males

A

rectovesical

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5
Q

what is the borad ligament of the uterus, what does it do and what does it contain

A

double layer peritoneu from uterus to lateral walls/floor pelvis
keeps uterus midline
contains prox broad ligament and uterine tubes

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6
Q

what is the round ligament of uterus, what does it attach

A

embryological remnant

lateral aspect uterus, through deep inguinal ring to superficial tissue perineum

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7
Q

most common uterine position

A

anteflexed
cervix tipped anterior to vagina
uterus tipped anterior to cervix

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8
Q

true/false - the most common uterine position is retroverted

A

false - it is normal variation however

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9
Q

during a cervical smear, what aspect of the cervix is smeared

A 
squamocolumnar junction (transition zone)
external cervical os sampled
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10
Q

the fact that the uterine tubes are open ended is clinically relevant for what 2 reasons

A

potential for ectopic pregnancy

potential for infection spread

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11
Q

sections of uterine tube?

A

infundibulum
ampulla
isthmus

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12
Q

what are the 4 fornix?

A

anterior
posterior
lateral right/left

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13
Q

nerve to levator ani has what nerve roots?

A

S3,4,5

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14
Q

surface anatomy of the perineum

A 
mons pubis 
labia majora 
labia minora 
clitoris 
external urethral meatus 
vaginal orifice 
vestibule 
anus
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15
Q

what do the greater vestibular glands secrete

A

lubricating fluid

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16
Q

what is the perineal body

A

bundle of collagenous and elastic tissue where perineal muscles attach
can be damaged by labour

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17
Q

what nerve innervates all muscles of perineum

A

pudendal

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18
Q

describe how the perineum can be diamond shaped and what triangles it is split into

A

diamond shaped with points from pubic symphysis to ischial spines, to coccyx
anal triangle and urogenital triangle

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19
Q

on what fascia does the breast lie

A

deep fascia of pec major and serratus anterior

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20
Q

what ribs do the breast extend from

A

2-6

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21
Q

what space is between breast and deep fascia

A

retromammary space

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22
Q

quadrants of the breast?

A 
upper outer
upper inner
lower outer
lower inner
axillary tail
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23
Q

if a lump is felt in breast and is fixed it is attached to

A

deep fascia

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24
Q

if a lump is felt in breast and is mobile it is attached to

A

breast tissue

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25
lymph drainage of the breast
most are to ipsilateral axillary nodes then onto supraclavicular inner quadrants can drain parasternal lower can drain abdominal
26
if lymph nodes are removed due to breast cancer what upper limb condition can this cause and why
lymphoedema of upper limb as lymph from upper limb can also drain to axillary lymph nodes
27
level I axillary lymph nodes ?
inferolateral to pec minor
28
level II axillary lymph nodes?
deep to pec minor
29
level III axillary lymph nodes?
superomedial to pec minor
30
blood supply to breast
internal thoracic makes up most lateral aspect supplied by thoracic, thoracoacromial, lateral mammary branches by posterior intercostals
31
venous drainage from breast
axillary vein mainly but also internal thoracic
32
functions of the pelvic floor
seperates pelvic cavity from perineum supports organs continence
33
what is the urogenital hiatus
gap in pelvic diaphragm to allow passage of urethra and vagina
34
segments of levator ani and nerve innervation
iliococcygeus puborectalis pubococcygeus
35
levator ani attachments
ichial spines, pubic bones, tendinous arch levator ani perineal body, coccyx, walls of midline organs nerve to levator ani and pudendal nerve
36
what is endopelvic fascia
loose tissue with collagen and elastic fibres
37
what ligaments support organs within perineum
``` fibrous endopelvic fascia uterosacral transverse cervical/cardinal lateral ligament of bladder lateral rectal ligaments ```
38
what is the deep perineal pouch
lies below fascia covering inferior pelvic diaphragm | above perineal membrane
39
what structures are found in the deep perineal pouch
part of urethra and vagina bulbourethral glands (M), neurovascular bundle for penis/clitoris extension of ischioanal fat pads
40
what muscles are found in deep perineal pouch
external urethral sphincter compressor urethrae deep transverse perineal muscle in men smooth muscle to replace DTPM in females
41
what is the perineal membrane
superficial to deep perineal pouch and thin sheet of tough deep fascia
42
contents of the superficial perineal pouch in females
``` corpus cavernosum - clitoris and crura - erectile bulbs of vestibule bulbospongiosus and ischiocavernosus bartholins glands superficial transverse perineal muscle pudendal nerve and vessels ```
43
contents of the superficial perineal pouch in males
root of penis corpus spongiosum, corpus cavernosum bulbospongiosus ischiocavernosus
44
perineal support from deep to superficial
``` pelvic diaphragm deep perineal pouch perineal membrane erectile tissue superficial perineal pouch muscles superficial perineal pouch ```
45
what links layers of perineal support
perineal body
46
muscles maintaining urinary continence?
external urethral sphincter, compressor urethrae, levator ani
47
muscles maintaining faecal continence?
tonic contraction of puborectalis beds anorectum anterior | active contraction after rectal filling
48
cause of injury to pelvic floor?
``` pregnancy childbirth constipation obesity heavy lifting chronic cough previous injury menopause ```
49
what is a vaginal prolapse
herniation of urethra, bladder, rectum or rectouterine pouch through fascia
50
what is a uterine prolapse
descent of cervix/uterus to vaginal wall
51
1st degree uterine prolapse
cervix dropping to vagina
52
2nd degree uterine prolapse
cervix drops deeper to vagina but not external
53
3rd degree uterine prolapse
cervix visible from external and uterus telescoped into vagina
54
4th degree uterine prolapse
entire uterus present externally
55
mechanism of repair for uterine prolapse?
sacrospinous fixation | risks injury to sciatic nerve or pudendal NV bundle
56
what surgery can be given for incontinence
transobturator mesh surgery | very controversial
57
attachments of the sacrospinous ligament
sacrum | ischial spine
58
attachments of the sacrotuberous ligament
sacrum | ischial tuberosity
59
what foramen do the sacrospinous/sacrotuberous ligaments form
greater/lesser sciatic foramen
60
what covers the obturator foramen
obturator membrane, with gap for obturator NV bundle
61
tendinous arch of levator ani is made up of what muscle
obturator internus
62
what is the main arterial supply to the pelvis and what are the main exception
internal iliac gonadal arteries direct from abdo aorta superior rectal as continuation of IMA
63
what are the two main anastomoses in females in the pelvis
uterine artery and ovarian artery | uterine artery and vaginal artery
64
what does the posterior division of internal iliac supply
body wall | blood to gluteal arteries
65
what is the significance of the median umbilical ligament
embryological remnant of the umbilical artery which supplied foetus with blood during pregnancy
66
what are the main divisions of the anterior division of the internal iliac
``` obturator artery superior vesicle arteries uterine artery/vas deferens internal pudendal artery middle rectal ```
67
branches of internal pudendal in females and what else contributes to blood supply to perineum
inferior rectal dorsal artery clitoris perineal artery external iliac
68
branches of internal pudendal in males
perineal artery deep artery dorsal artery penis anterior scrotal - from external iliac
69
true/false - hysterectomy can often lead to damage of the ureter
true
70
what vein does most perineal blood drain to
internal iliac
71
what are the 2 plexuses that perineal blood can drain to that is of clinical relevance
via superior rectal to hepatic portal lateral sacral into internal vertebral venous plexus can be clinically relevant in metastatic disease
72
nerve roots of obturator nerve and passage through gluteal/perineal area
L2-4 | passes on extraperitoneal fatty tissue and into medial thigh by obturator membrane
73
nerve roots of pudendal nerve and passage through gluteal/perineal area
S2-4 | passes through greater sciatic foramen, loops round sacrospinous and back through lesser sciatic foramen
74
main groups of lymph nodes associated with the pelvis
``` lumbar inferior mesenteric common iliac internal/external iliac superficial/deep inguinal sacral pararectal ```
75
where do the ovaries/testes lymph drain to
lumbar nodes as per embryological origin
76
where does superficial perineal lymph drain to
superficial inguinal
77
where does superior pelvic viscera lymph drain to
external iliac nodes, to common iliac, to aortic and to thoracic duct
78
where does lower pelvic viscera lymph drain to
internal iliac nodes, common iliac, aortic, thoracic duct
79
what is transperitoneal spread of malignancy
disease penetration of peritoneal layer, leading to dissemination of disease in the peritoneal cavity

MB3 Obstetrics and Gynaecology (12 decks)

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