anatomy

Question 1

what separates the greater and lesser sciatic foramen

Answer 1

sacrospinous ligament

Question 2

what is the role of the greater sciatic foramen

Answer 2

passageway for structures to pass from the pelvis into the gluteal region

Question 3

what is the role of the lesser sciatic foramen

Answer 3

communication between the perineum of the pelvis and the gluteal region

Question 4

nervous supply to the perineal muscles

Answer 4

pudendal nerve

Question 5

what is the importance of the perineal body

Answer 5

important to pelvic floor strength

Question 6

what is the relationship between parietal peritoneum and the pelvic organs

Answer 6

inferior part of parietal peritoneum covers the superior aspect of the pelvic organs

Question 7

what is another name for the recto-uterine pouch

Answer 7

pouch of douglas

Question 8

where can the fusion of the 3 bones of the hip be seen

Answer 8

in the acetabulum

Question 9

where does the ovarian artery arise from

Answer 9

the abdominal aorta

Question 10

what is used to remember the relationship between the ureter and the uterine artery

Answer 10

water under the bridge

Question 11

what are the 3 bones that form the hip

Answer 11

ilium, pubis and ishium

Question 12

what does the bony pelvis consist of

Answer 12

2 hip bones, sacrum and coccyx

Question 13

what does the pelvic floor separate

Answer 13

the pelvic cavity from the perineum

Question 14

what are the 3 layers of the pelvic floor

Answer 14

pelvic diaphragm
muscles of perineal pouches
perineal membrane

Question 15

what is the pelvic diaphragm made of

Answer 15

levator ani and coccygeus muscles

Question 16

what is the structure of the levator ani

Answer 16

3 paired skeletal muscles: pubococcygeus, puborectalis and iliococcygeus

Question 17

what are the 2 gaps in the pelvic floor and what are their roles

Answer 17

urogenital hiatus - allows the passage of the urethra (and vagina in females)
rectal hiatus - allows passage of the anal canal

Question 18

what is a vaginal prolapse

Answer 18

herniation of urethra, bladder, rectum or rectouterine pouch through the supporting fascia

Question 19

how does a vaginal prolapse usually present

Answer 19

lump in the vaginal wall

Question 20

what embryonic layer do the urogenital and reproductive systems arise from

Answer 20

intermediate mesoderm

Question 21

what causes the development of male reproductive organs

Answer 21

sex determining region on Y chromosome causes primitive sex cords to form testis/medullary cords

Question 22

how long does spermatogenesis usually take

Answer 22

64-74 days

Question 23

when does spermatogenesis occur

Answer 23

starts at puberty and continues throughout life

Question 24

what regulates the descent of the testes

Answer 24

gubernaculum

Question 25

which genital ducts remain in men and women

Answer 25

mesonephric in males paramesonephric in females

Question 26

when does sexual differentiation occur in an embryo

Answer 26

from week 7

Question 27

what causes degeneration of the paramesonephric duct in males

Answer 27

sertoli cells secrete AMH

Question 28

what causes the development of mesonephric ducts in males

Answer 28

sertoli cells stimulate gonadal ridge cells to form leydig cells which secrete testosterone

Question 29

what causes the development of paramesonephric ducts in females

Answer 29

presence of oestrogen and the absence of testosterone and AMH

Question 30

what are the derivatives of vaginal development

Answer 30

superior vagina - paramesonephric ducts rest - urogenital sinus

Question 31

what causes the masculinisation of the external genetalia

Answer 31

dihydrotestosterone

Question 32

what are the 3 layers of the uterus from outside in and what are they made of

Answer 32

perimetrium - loose connective tissue myometrium - smooth muscle (+collagen and elastic tissue) endometrium - secretory mucosa

Question 33

what is the most common position of the uterus

Answer 33

anteverted and anteflexed

Question 34

what does it mean if a uterus is anteverted

Answer 34

cervix tipped anteriorly relative to the axis of the vagina

Question 35

what does it mean if a uterus is anteflexed

Answer 35

uterus tipped anteriorly relative to the axis of the cervix

Question 36

what are the 2 main ligaments of the uterus

Answer 36

broad and round

Question 37

what is the role of the broad ligament of the uterus

Answer 37

helps maintain the uterus in it's midline position

Question 38

what is the role of the round ligament of the uterus

Answer 38

just an embryological remnant

Question 39

what is another name for the uterine tubes

Answer 39

fallopian tubes

Question 40

where does fertilisation occur

Answer 40

ampulla

Question 41

what is the primary female reproductive organ

Answer 41

ovaries

Question 42

what are the 2 main functions of the ovaries

Answer 42

oogenesis produce steroids - mainly oestrogens and progestrogens

Question 43

what causes the ovary to secrete oestrogen and progesterone

Answer 43

response to LH and FSH from the anterior pituitary

Question 44

what are graafian follicles

Answer 44

mature follicles in the ovary prior to ovulation

Question 45

what is required to maintain the corpus luteum

Answer 45

LH (or HCG in pregnancy)

Question 46

where does lymph from the ovaries drain

Answer 46

para-aortic nodes

Question 47

venous drainage of the ovaries

Answer 47

L ovarian vein - left renal vein R ovarian vein - inferior vena cava

Question 48

what type of cells line the vagina

Answer 48

non-keratinised stratified squamous epithelium

Question 49

what examination can be used to palpate the position of the uterus

Answer 49

bimanual palpation

Question 50

where is the most common site for cervical cancer to occur

Answer 50

transition zone where stratified squamous epithelium turns into simple columnar epithelium

Question 51

how does the cervix facilitate the passage of sperm into the uterine cavity

Answer 51

dilation of the external and internal os

Question 52

what are bartholins glands and what is their role

Answer 52

glands on the side of the vaginal opening secrete fluid to help lubricate the vagina

Question 53

what kind of innervation controls pain from the perineum

Answer 53

somatic sensory

Question 54

describe innervation to the perineum

Answer 54

body wall so somatic sensation via pudendal nerve S2,3,4

Question 55

describe innervation of the superior aspect of the pelvic organs

Answer 55

TOUCHING THE PERITONEUM visceral afferents - run along sympathetic fibres enter spinal cord between T11-L2

Question 56

how is pain from the superior aspect of pelvic organs perceived

Answer 56

suprapubic pain

Question 57

describe innervation of the inferior aspects of pelvic organs

Answer 57

NOT TOUCHING THE PERITONEUM visceral afferents, run with parasympathetics enter spinal cord at S2,3,4

Question 58

how is pain from the inferior aspect of pelvic organs percieved

Answer 58

in the S2-4 dermatome = perineum

Question 59

at which vertebral level does the subarachnoid space end

Answer 59

S2

Question 60

where do we inject epidural anaesthetic

Answer 60

L3/4

Question 61

how can we estimate the level of the L4 spinous process

Answer 61

horizontal line for the most superior point of the iliac crests

Question 62

where does spinal anaesthetic get injected into

Answer 62

the subarachnoid space

Question 63

what can be a complication of a spinal anaesthetic and why

Answer 63

hypotension as causes vasodilation due to blockade of sympathetic tone

Question 64

what bony landmark can be used to identify the pudendal nerve

Answer 64

ischial spine

Question 65

what might be performed to help prevent perineal trauma during child birth

Answer 65

episiotomy

Question 66

what direction do the external obliques run in

Answer 66

anteroinferior direction - hands in pockets

Question 67

how does the linea alba form

Answer 67

interweaving of the muscle aponeurosis

Question 68

name the 2 main arterial supplies to the anterior abdominal wall

Answer 68

superior and inferior epigastric arteries

Question 69

arterial supply to the lateral abdominal wall

Answer 69

intercostal and subcostal arteries

Question 70

which layers are stitched closed following a caesarean

Answer 70

uterine wall + peritoneum rectus sheath skin

Question 71

incision for a laparotomy

Answer 71

vertical midline incision

Question 72

what incisions are usually made for a laparoscopy

Answer 72

subumbilical and lateral ports

Question 73

what do we need to make sure we avoid when inserting a lateral port for laparoscopy

Answer 73

inferior epigastric artery