Applied Anatomy of the Female Reproductive System Flashcards

1
Q

What is the pelvis floor?

A

Divides main pelvis cavity above and perineum below

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2
Q

What forms pelvic floor?

A

Levator ani muscles
Coccygeus muscles
Covering fascia

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3
Q

What is the function of pelvic floor?

A

Maintains pelvis viscera in position

Resist intrapelvic pressure and expulsive efforts of abdominal muscles

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4
Q

What are gaps in muscular pelvis floor?

A

Urethra
Vagina
Rectum

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5
Q

Where does puborectalis start and end?

A

Pubic symphysis to rectum

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6
Q

What does puborectalis do?

A

Form sling around anal canal

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7
Q

What does sphincter vaginae do?

A

Form sling around urogenital hiatus

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8
Q

What is pubococcygeus start and end?

A

From pubic to annococcygeal body

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9
Q

What is annococcygeal body?

A

Fibrous mass between tip of coccyx and anal canal

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10
Q

Where does iliococcygeus start and finish?

A

Ischial spines anococcygeal body and coccyx

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11
Q

Where does coccygeus start and finish?

A

Ischial spine to coccyx/sacrum

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12
Q

Where does perineal membrane lie?

A

Beneath the anterior urogenital triangle

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13
Q

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

A

Obturator Ex

Obturator Int

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14
Q

What is the deep perineal pouch?

A

Bounded by obturator ext, levator ani and perineal membrane

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15
Q

What is in the urogenital diaphragm?

A

External urethral sphincter

deep perineal muscles

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16
Q

What is the lower space beneath the perineal membrane?

A

Superficial perineal pouch

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17
Q

What is beneath the superficial perineal pouch?

A

Colles fascia

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18
Q

What is inferior to colles fascia?

A

Skin

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19
Q

What is within superficial perineal pouch?

A

Erectile tissue/muscles + glands

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20
Q

Where is bartholin’s gland?

A

Superficial perineal pouch

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21
Q

Where is urogenital diaphragm located?

A

Deep perineal pouch

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22
Q

What is urogenital diaphragm formed by?

A

EUS,
sphincter urethrovaginalis
Compressor urethrae
Deep transverse perineal muscles

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23
Q

What are the 3 masses of erectile tissue?

A

Bulb of vestibule

Crura or clitoris

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24
Q

What is bulb of vestibule attached to?

A

Urogenital diaphragm

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25
Q

What 3 muscles are in SPP?

A

Bulbospongiosus
Ischiocavernosus
Superficial transverse perineal muscle

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26
Q

What does the bulbospongiosus surround?

A

Vaginal orifice and covers vestibular bulbs

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27
Q

What does Bartholin’s gland do?

A

Secretes mucus into vestibule area

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28
Q

What does pelvis floor do during child birth?

A

Supports foetal head while cervix is dilating

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29
Q

Which parts of levator ani are most often torn?

A

Pubococcygeus

Puborectalis

30
Q

What can happen if muscles pubococcygeus and puborectalis are torn?

A

Incontinence

31
Q

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

A

Controlled episiotomy

Prenatal (e.g. Lamaze) classes

32
Q

What is episiotomy?

A

If labour is prolonged, may have posterolateral incision

33
Q

What is the broad ligament?

A

Double fold of peritoneum which attaches internal genitalia to pelvis

34
Q

What are mesosalpinx?

A

Fallopian tubes

35
Q

What do mesovarium do?

A

Ovaries o broad ligament

36
Q

What do mesometrium do?

A

Ovaries to uterus

37
Q

What does suspensory ligament do?

A

Ovary to wall of pelvis

38
Q

What do ligament of ovary do?

A

Ovary to lateral uterus

39
Q

Where does round ligament (caudal gubernaculum) originate?

A

Uterine horns

40
Q

Where does round ligament exit

A

abdominal cavity

41
Q

Where does round ligament pass through

A

inguinal canal

42
Q

Where does round ligament end?

A

Labium majora

43
Q

Where do ovaries lie?

A

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

44
Q

What supports superior aspect of uterus?

A

Ovarian + round ligaments

45
Q

What supports vagina?

A

Levator ani

Perineal body

46
Q

What supports middle aspect of uterus?

A

Uterosacral ligaments
Transverse cervical ligaments
Pubocervical ligaments

47
Q

Where does uterosacral ligaments start and end?

A

Cervix to sacrum

48
Q

Where does transverse cervical ligaments start and end?

A

Cervix/vagina to lateral pelvic wall

49
Q

Where do pubocervical ligaments start and end?

A

Cervix to pubis (either side of bladder)

50
Q

What is the normal position of the uterus?

A

Anteverted

Anteflexed

51
Q

What can retroverted uterus cause?

A

Vaginal prolapse

52
Q

When is uterus prolapse most common?

A

After menopause when pelvis viscera tend to atrophy

53
Q

What happens in rectouterine pouch?

A

Accumulation of blood or pus

Commonly violated by instruments that pierce the post fornix

54
Q

What is the vesicouterine pouch?

A

Formed from peritoneum over uterus and bladder

55
Q

Where does vagina extend?

A

Vulva to uterus

56
Q

What pierces upper end of vagina?

A

Cervix

57
Q

How many fornices are formed in vagina?

A

4
1x Anterior
1x Posterior
2x lateral

58
Q

What is anterior to vagina?

A

Bladder

urethra

59
Q

What is posterior to vagina

A

Pouch to douglas
ampulla of rectum
perineal body

60
Q

what is lateral to vagina?

A

Ureters
lecator ani
urogenital diaphragm
bulb of vestibule

61
Q

What plexus is mixed of parasympathetic and sympathetic?

A

Inferior hypogastric plexus

62
Q

What supplies IHP (parasympathetic)?

A

S2, S3, S4 (pelvic splanchic nerves)

63
Q

What supplies IHP (sympathetic)

A

Superior hypogastric plexus (lies around L3, L4)

64
Q

What feeds into SHP?

A

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

65
Q

What comes off SHP?

A

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

66
Q

What also originates from S2, S3, S4?

A

Pudendal nerve (somatic)

67
Q

What innervates levator ani?

A

Branches from S4

68
Q

What are obstetric anaesthetic options?

A

Spinal anaestheia
Caudal epidural block
Pudendal nerve block

69
Q

What is spinal anaesthia?

A

Subarachnoid space L4-5

Complete anaesthia below waist

70
Q

What is caudal epidural block?

A

Anaesthetic administered to catheter in sacral canal

71
Q

What happens in pudendal nerve block?

A

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

72
Q

What is landmark for issuing pudendal nerve block?

A

Ischial spine