Anatomy of the Female Reproductive Tract

Question 1

where does excess fluid in the peritoneal cavity collect

Answer 1

pouch of douglas

Question 2

what procedure can be performed to drain the pouch of douglas

Answer 2

culdocentesis - needle passed through pos fornix of vagina

Question 3

what is the broad ligament formed from

Answer 3

double layer of peritoneum

Question 4

what does the broad ligament attach to

Answer 4

the uterus, fallopian tubes and ovary

Question 5

what is the function of the broad ligament

Answer 5

to maintain the uterus in the correct midline position

Question 6

name the 3 parts of the broad ligament adn what they enclose

Answer 6

• mesometrium - largest section, surrounds uterus
• mesovarium - attaches to hilum of ovary, doesnt cover ovary surface
• mesosalpinx - encloses the fallopian tubes

Question 7

what structure are the round, ovarian and suspensory ligament all enclosed in

Answer 7

broad ligament

Question 8

what does the ovarian ligamenet run between

Answer 8

ovary and side of uterus - joint the uterus just below th eorigin of the fallopian tubes

Question 9

what is the ovarian ligament formed from structurally

Answer 9

fibrous band of tissue that lies wtihin the broad ligament

Question 10

what does the suspensory ligament of the ovary connect

Answer 10

ovary to lateral abdominal wall

Question 11

what does the suspensory ligament of the ovary contain

Answer 11

ovarian vessels and nerves

Question 12

whichb embryological structure is the round ligament a remnant of

Answer 12

gubernaculum

Question 13

outline the passage of the round ligament

Answer 13

originates at uterine horns

passes through inguinal canal

attaches to labia majora

Question 14

where is the fundus of the uterus

Answer 14

Question 15

where does implantation of the zygote normally occur in the uterus

Answer 15

body

Question 16

what structures hold hte uterus in position

Answer 16

ligaments - eg uterosacral ligaments

endopelvic fascia

muscles of pelvic floor

Question 17

what can cause uterine prolapse

Answer 17

weakness of the supporting structures of the uterus - eg damage to pelvic floor

Question 18

which angles do anteversion and anteflexion relate to in the position of the uterus

Answer 18

anteverted - the cervix is tipped anteriorly relative to the axis of the vagina

anteflexed - the uterus is tipped anteriorly relative to the axis of the cervix

Question 19

name abnormal positions of the uterus

Answer 19

retroverted or retroflexed

Question 20

what does abnormal positioning of the uterus predispose one to

Answer 20

uterine prolapse when there is inc intraabdominal pressure

Question 21

what epithelium is present in teh cervix

Answer 21

columnar epithelium

Question 22

are there glands in the vagina and cervix?

Answer 22

there are glands in the cervix - these secrete either a watery or thick secretion depending on menstrual time. secretion flows down and lubricates vagina (no glands here)

Question 23

what are the 4 histological layers of the vagina

Answer 23

non keratinized stratified squamous

lamina propria

fibromuscular layer

adventitia

Question 24

which layer of the vagina secretes glycogen, and what is the reason for this

Answer 24

the stratified squamous epithelium

it is metabolized by commensal bacteria (Lactobacillus spp) to form lactic acid - this maintain the low vaginal pH and inhibits the growth of pathogenic bacteria

Question 25

do the fimbriae touch the ovary

Answer 25

only one does - the great fimbriae the egg is released into the peritoneal cavity and then gathered up by the fimbriae

Question 26

what is found in the medulla and cortex of the ovaries

Answer 26

neurovascular structures in the medulla and developing follicles in the cortex

Question 27

what is the name of he dense connective tissue layer that surrounds the ovaries

Answer 27

tunica albuginea - covered by germinal epithelium (layer of cuboidal cells)

Question 28

at what positions can the ischial spines be palpated on bimanual examinatio

Answer 28

4 and 8 o clock positions

Question 29

what are the fornix of the uterus

Answer 29

Question 30

what 2 triangles can the perineum be divided up into

Answer 30

Question 31

what is the perineum separated from the pelvic cavity by

Answer 31

superiorly by the pelvic floor

Question 32

whta are the anatomical boundaries of the perineum

Answer 32

Question 33

what are the surface borders of the perineum

Answer 33

Question 34

is the levator ani one muscle?

Answer 34

no, it is made up of a number of smaller muscles

Question 35

which nerves supply the levator ani

Answer 35

nerve to levator ani (S345 of sacral plexus) and pudendeal nerve it is under skeletal control

Question 36

what is the perineal body made of

Answer 36

irregular fibromuscular mass - point of attachment of muscle fibres from pelvic floor and perineum

Question 37

where is the perineal body located in relation to the UG and anal triangles

Answer 37

at the junction

Question 38

how deep does the perineal body lie

Answer 38

just deep to the skin

Question 39

what function does the perineal body serve

Answer 39

point of attahcment of muscles - maintain pelvic floor strength and prevent prolapse

Question 40

wha structures is the perineal body located between in male and female

Answer 40

women - vagina and external anal sphincter male - bulb of penis and anus

Question 41

what is the function of Bartholin's gland

Answer 41

produces lubrication - erectile tissue

Question 42

what is the mons pubis formed from

Answer 42

skin with hair follicles overlying subcutaneous fat pad

Question 43

Answer 43

Question 44

whichb bony structure does the mons pubic overly

Answer 44

pubic symphysis

Question 45

which sweat glands are present in the perineum

Answer 45

apocrine and sebaceous

Question 46

compare the structure of the labia majora and minora

Answer 46

majora is an extension of the mons pubis, has glands, some smooth muscle, skinm subcut fat etc minora has no subcutaenous fat or hair follicles - rich in vasculature and sebaceous glands

Question 47

what is the erectile vascular tissue in teh clitoris called

Answer 47

corpora cavernosa

Question 48

what two openings are found in the vaginal vestibular

Answer 48

vaginal orifice and external urethral meatus

Question 49

describe the surface anatomy of the breast - where does it extend to and from horizontally, which muscles is it superficial to

Answer 49

located on ant thoracic wall extend horizontally from lateral border of sternum to mid axillary line superficail to pec major and serratus anterior

Question 50

what are nipples made of

Answer 50

mainly smooth muscle fibres

Question 51

what are the mammary glands and what are they drained by

Answer 51

ducts and secretory lobules (in pregnancy) drained by lactiferous ducts

Question 52

which ribs does the breast extend between

Answer 52

2 and 6

Question 53

name the 4 quadrants of the bresat

Answer 53

upper/lower outer/inner

Question 54

which position should a female stand in when examinig breast

Answer 54

inspect: * arms by sides * hands on hips - tense pec major * arms above head and then lean forward palpate with pt at 45 degree angle and arms above head

Question 55

outline the lymphatic drainage of the breast

Answer 55

75% axillary, 20% parasternal and 5% pos intercostal nodes

Question 56

where does lymph from the parasternal nodes drain

Answer 56

supraclavicular nodes

Question 57

can lymph from the breast drain to the abdominal lymph nodes?

Answer 57

yes

Question 58

why can axillary node clearance result in lymphoedema

Answer 58

upper limb lymph also drains to axillary nodes

Question 59

what are the 3 levels of axillary node clearance

Answer 59

1 - inferior and lateral to pec minor 2 - under pec minor 3 - superior and medial to pec minor

Question 60

what is the significance of the uterine tubes oepning into the peritoneal cavity

Answer 60

spread of infection eg PID can cause peritonitis ectopic pregnancy could develop in peritoneal cavity

Question 61

Answer 61

Question 62

Answer 62

Question 63

where does the ovarian artery arise from

Answer 63

abdominal aorta at L2

Question 64

where do the ovarian (gonadal) veins drain to

Answer 64

right - IVC left - left renal vein - IVC