Applied Anatomy of the Female Reproductive System

Question 1

What is the pelvis floor?

Answer 1

Divides main pelvis cavity above and perineum below

Question 2

What forms pelvic floor?

Answer 2

Levator ani muscles
Coccygeus muscles
Covering fascia

Question 3

What is the function of pelvic floor?

Answer 3

Maintains pelvis viscera in position

Resist intrapelvic pressure and expulsive efforts of abdominal muscles

Question 4

What are gaps in muscular pelvis floor?

Answer 4

Urethra
Vagina
Rectum

Question 5

Where does puborectalis start and end?

Answer 5

Pubic symphysis to rectum

Question 6

What does puborectalis do?

Answer 6

Form sling around anal canal

Question 7

What does sphincter vaginae do?

Answer 7

Form sling around urogenital hiatus

Question 8

What is pubococcygeus start and end?

Answer 8

From pubic to annococcygeal body

Question 9

What is annococcygeal body?

Answer 9

Fibrous mass between tip of coccyx and anal canal

Question 10

Where does iliococcygeus start and finish?

Answer 10

Ischial spines anococcygeal body and coccyx

Question 11

Where does coccygeus start and finish?

Answer 11

Ischial spine to coccyx/sacrum

Question 12

Where does perineal membrane lie?

Answer 12

Beneath the anterior urogenital triangle

Question 13

What is between the superior pubic ramus and inferior pubic ramus?

Answer 13

Obturator Ex

Obturator Int

Question 14

What is the deep perineal pouch?

Answer 14

Bounded by obturator ext, levator ani and perineal membrane

Question 15

What is in the urogenital diaphragm?

Answer 15

External urethral sphincter

deep perineal muscles

Question 16

What is the lower space beneath the perineal membrane?

Answer 16

Superficial perineal pouch

Question 17

What is beneath the superficial perineal pouch?

Answer 17

Colles fascia

Question 18

What is inferior to colles fascia?

Answer 18

Skin

Question 19

What is within superficial perineal pouch?

Answer 19

Erectile tissue/muscles + glands

Question 20

Where is bartholin’s gland?

Answer 20

Superficial perineal pouch

Question 21

Where is urogenital diaphragm located?

Answer 21

Deep perineal pouch

Question 22

What is urogenital diaphragm formed by?

Answer 22

EUS,
sphincter urethrovaginalis
Compressor urethrae
Deep transverse perineal muscles

Question 23

What are the 3 masses of erectile tissue?

Answer 23

Bulb of vestibule

Crura or clitoris

Question 24

What is bulb of vestibule attached to?

Answer 24

Urogenital diaphragm

Question 25

What 3 muscles are in SPP?

Answer 25

Bulbospongiosus Ischiocavernosus Superficial transverse perineal muscle

Question 26

What does the bulbospongiosus surround?

Answer 26

Vaginal orifice and covers vestibular bulbs

Question 27

What does Bartholin's gland do?

Answer 27

Secretes mucus into vestibule area

Question 28

What does pelvis floor do during child birth?

Answer 28

Supports foetal head while cervix is dilating

Question 29

Which parts of levator ani are most often torn?

Answer 29

Pubococcygeus | Puborectalis

Question 30

What can happen if muscles pubococcygeus and puborectalis are torn?

Answer 30

Incontinence

Question 31

What can be used to help prevent injury to pelvic floor?

Answer 31

Controlled episiotomy | Prenatal (e.g. Lamaze) classes

Question 32

What is episiotomy?

Answer 32

If labour is prolonged, may have posterolateral incision

Question 33

What is the broad ligament?

Answer 33

Double fold of peritoneum which attaches internal genitalia to pelvis

Question 34

What are mesosalpinx?

Answer 34

Fallopian tubes

Question 35

What do mesovarium do?

Answer 35

Ovaries o broad ligament

Question 36

What do mesometrium do?

Answer 36

Ovaries to uterus

Question 37

What does suspensory ligament do?

Answer 37

Ovary to wall of pelvis

Question 38

What do ligament of ovary do?

Answer 38

Ovary to lateral uterus

Question 39

Where does round ligament (caudal gubernaculum) originate?

Answer 39

Uterine horns

Question 40

Where does round ligament exit

Answer 40

abdominal cavity

Question 41

Where does round ligament pass through

Answer 41

inguinal canal

Question 42

Where does round ligament end?

Answer 42

Labium majora

Question 43

Where do ovaries lie?

Answer 43

Lateral wall of pelvis in ovarian fossa (may also be found in pouch to Douglas)

Question 44

What supports superior aspect of uterus?

Answer 44

Ovarian + round ligaments

Question 45

What supports vagina?

Answer 45

Levator ani | Perineal body

Question 46

What supports middle aspect of uterus?

Answer 46

Uterosacral ligaments Transverse cervical ligaments Pubocervical ligaments

Question 47

Where does uterosacral ligaments start and end?

Answer 47

Cervix to sacrum

Question 48

Where does transverse cervical ligaments start and end?

Answer 48

Cervix/vagina to lateral pelvic wall

Question 49

Where do pubocervical ligaments start and end?

Answer 49

Cervix to pubis (either side of bladder)

Question 50

What is the normal position of the uterus?

Answer 50

Anteverted | Anteflexed

Question 51

What can retroverted uterus cause?

Answer 51

Vaginal prolapse

Question 52

When is uterus prolapse most common?

Answer 52

After menopause when pelvis viscera tend to atrophy

Question 53

What happens in rectouterine pouch?

Answer 53

Accumulation of blood or pus | Commonly violated by instruments that pierce the post fornix

Question 54

What is the vesicouterine pouch?

Answer 54

Formed from peritoneum over uterus and bladder

Question 55

Where does vagina extend?

Answer 55

Vulva to uterus

Question 56

What pierces upper end of vagina?

Answer 56

Cervix

Question 57

How many fornices are formed in vagina?

Answer 57

4 1x Anterior 1x Posterior 2x lateral

Question 58

What is anterior to vagina?

Answer 58

Bladder | urethra

Question 59

What is posterior to vagina

Answer 59

Pouch to douglas ampulla of rectum perineal body

Question 60

what is lateral to vagina?

Answer 60

Ureters lecator ani urogenital diaphragm bulb of vestibule

Question 61

What plexus is mixed of parasympathetic and sympathetic?

Answer 61

Inferior hypogastric plexus

Question 62

What supplies IHP (parasympathetic)?

Answer 62

S2, S3, S4 (pelvic splanchic nerves)

Question 63

What supplies IHP (sympathetic)

Answer 63

Superior hypogastric plexus (lies around L3, L4)

Question 64

What feeds into SHP?

Answer 64

Thoracic (greater,lesser + least)/ lumbar splanchic nerves

Question 65

What comes off SHP?

Answer 65

Right and left hypogastric nerves (follow pathway of common iliac arteries)

Question 66

What also originates from S2, S3, S4?

Answer 66

Pudendal nerve (somatic)

Question 67

What innervates levator ani?

Answer 67

Branches from S4

Question 68

What are obstetric anaesthetic options?

Answer 68

Spinal anaestheia Caudal epidural block Pudendal nerve block

Question 69

What is spinal anaesthia?

Answer 69

Subarachnoid space L4-5 | Complete anaesthia below waist

Question 70

What is caudal epidural block?

Answer 70

Anaesthetic administered to catheter in sacral canal

Question 71

What happens in pudendal nerve block?

Answer 71

Peripheral nerve block S2-4 Perineum and lower 1/4 vaginal Mother can still feel contractions

Question 72

What is landmark for issuing pudendal nerve block?

Answer 72

Ischial spine