Anatomy L.5 Flashcards
(26 cards)
What is the clinical significance of the Douglas pouch?
During digital rectal and vaginal examination, enlargement of the uterus, uterine tubes, and ovaries can be felt in Douglas pouch.
What attaches the ovary to the posterior aspect of the broad ligament?
Mesovarium
What is the anterior relation of the ovarian fossa?
Obliterated umbilical artery.
FYI:
Ant -> obliterated umbilical artery
Posteriorly -> ureter and internal iliac artery
Laterally -> obterator internus muscle
What can a long mesovarium or suspensory ligament of the ovary cause?
Torsion of the ovary; can compress the blood vessels and cause severe abdominal pain
Where is pain felt in disease of the ovary when it adheres to ovarian fossa, and why?
The obturator nerve is related to the lateral surface of the ovary, so pain is felt in the obturator region of the thigh
What is the arterial supply to the ovaries?
Ovarian artery
Branch of uterine artery
What is the venous supply to the ovaries?
Ovarian veins accompany ovarian artery and drain into inferior vena cava on the right side and left renal vein on the left side
What is the lymphatic drainage of the ovaries?
Pre and para-aortic group of lymph nodes
What is the nerve supply of the ovaries?
The sympathetic fibers are derived from T11-L1 segment of SC which carry pain sensation, hence why pain is felt at pubic and lower abdominal region.
What is the arterial supply to the uterine tubes?
Uterine and ovarian arteries
Medial 2/3 -> uterine artery
Lateral 1/3 -> ovarian artery
What is the nerve supply of the fallopian tubes?
Sympathetic -> T10-L2
Parasympathetic -> vagus and pelvic splanchnic nerves
What is the normal position of the uterus?
Anteverted and anteflexed
What is the angle of anteversion of the uterus?
It is forward angulation of uterus between the long axis of cervix and vagina. It is 90°
What is the angle of anteflexion of the uterus?
It is the forward angulation between the body and cervix of the uterus. It is 125°
What is the lymphatic drainage of the uterus?
Fundus and upper part of the body -> pre and para-aortic lymph nodes
Angle of the uterus -> superficial inguinal lymph nodes
Lower part of the body and upper cervix -> External iliac lymph nodes
Cervix also drains into internal iliac, sacral, and paracervical gp of lymph nodes
What is the nerve supply to the uterus?
Sympathetic = T12-L1 segment of SC
Parasympathetic = pelvic splanchnic nerve (S2,3,4)
What conveys pain fibers from cervix and vagina?
Parasympathetic pelvic splanchnic nerve (S2,3,4)
What conveys pain fibers from fundus and body of the uterus?
Sympathetic nerves T11-L1
What causes the severe pain during childbirth when there is passage of fetus through lower birth canal?
Somatic nerve- pudendal nerve
Enormous stretching of vaginal wall, pelvic diaphragm, and muscles of perineum
What causes the perineal body to be torn, and what can be caused if it’s not properly repaired?
Vaginal delivery or during episiotomy causes the perineal body to be torn. If it’s not properly repaired it can cause prolapse of the uterus
What condensation of pelvic fascia maintains normal axis of the pelvic wall?
Ueterosacral ligament
How is the axis pf uterus maintained?
By both the round ligament of uterus and the uterosacral ligament
The round ligament of uterus -> pulls fundus forwards
The uterosacral ligament -> pulls cervix backwards
What is the portion between the uterine tube and attachment of mesovarium?
Mesosalpinx
What is the part of broad ligament below the attachment of mesovarium?
Mesometrium
