Applied Female Anatomy

Question 1

What is the most important blood supply to the pelvis?

Answer 1

Internal iliac artery

Question 2

Where do all the arteries exiting the pelvis pass through?

Answer 2

Greater sciatic foramen

Question 3

What muscles does the superior gluteal artery supply?

Answer 3

Gluteus medius and minimus

Question 4

What muscle does the inferior gluteal artery supply?

Answer 4

Gluteus maximus

Question 5

What branches does the inferior pudendal artery give rise to?

Answer 5

Perineum arteries:
> Inferior rectal
> Perineal
> Dorsal clitoris/penis

Question 6

Name the branches from the internal iliac artery that go to the pelvic viscera

Answer 6

> Superior vesical artery
> Inferior vesical artery 
> Obturator artery
> Uterine artery
> Vaginal artery
> Middle rectal artery

Question 7

What is an ectopic pregnancy?

Answer 7

A pregnancy in which the fetus develops outside the uterus, typically in a fallopian tube

Question 8

Where may an ectopic pregnancy occur?

Answer 8

Ampulla (most common), isthmus, ovary, cervix or in the wall (cornual)

Question 9

What are the signs/symptoms of an ectopic pregnancy?

Answer 9

Light vaginal bleeding, lower abdominal pain, sharp abdominal cramps, pain on one side of the body

Question 10

What structures are involved in supporting the uterus?

Answer 10

Levator ani, transverse/cardinal ligament, pubocervical ligament, sacrocervical ligaments

Question 11

How are the transverse/cardinal cervical ligaments involved in supporting the uterus?

Answer 11

Band of fibromuscular fibres that connect the lateral pelvic wall to the cervix and upper vagina

Question 12

How are the pubocervical ligaments involved in supporting the uterus?

Answer 12

Two firm bands of connective tissue which connect the pubis to the cervix either side of the bladder

Question 13

How are the sacrocervical ligaments involved in supporting the uterus?

Answer 13

Fibromuscular bands that connect the cervix to the sacrum

Question 14

What is the fimbriae of the fallopian tube?

Answer 14

‘Hairs’ at the very end of the fallopian tube

Question 15

What is the infundibulum of the fallopian tube?

Answer 15

The head of the fallopian tube

Question 16

What is the ampulla of the fallopian tube?

Answer 16

The main segment of the tube as a pipe to the uterus

Question 17

What is the isthmus of the fallopian tube?

Answer 17

The small portion of tube before the opening into the uterus (narrowest portion of fallopian tube)

Question 18

What is the normal positioning of the uterus?

Answer 18

Anteverted and ante flexed

Question 19

Which structures form the pelvic floor?

Answer 19

Levator ani and coccygeus muscles and their covering fascia

Question 20

Which muscles make up levator ani?

Answer 20

Sphincter vaginae, puborectalis, pubococcygeus and iliococcygeus

Question 21

What is likely to cause injury to the pelvic floor/levator ani?

Answer 21

Difficult childbirth where levator ani fails to recoil, or atrophy of pelvic viscera after menopause

Question 22

What are the contents of the female superficial pouch?

Answer 22

Two bulbs of vestibule, crura of clitoris, bulbospongious, ischiocavernosus and superficial transverse perineal muscles, greater vestibular (Bartholin’s gland) and the perineal body

Question 23

What is the function of the bulbospongiosus muscle in the female superficial pouch?

Answer 23

Reduces the size of the vaginal orifice and compresses the dorsal vein of the clitoris to aid in engorgement

Question 24

What is the function of the ischiocavernosus muscle in the female superficial pouch?

Answer 24

Assists clitoral erection

Question 25

Which structures pass through the pudendal canal?

Answer 25

Pudendal nerve (S2-S4), internal pudendal artery and vein

Question 26

Describe the path of the pudendal canal

Answer 26

Leaves the pelvis through the greater sciatic formate and enters the perineum via the lesser sciatic foramen

Question 27

Describe the sensory supply to the pelvis above the pelvic pain line

Answer 27

Visceral general afferents travel in the sympathetic nervous system from T5-L2

Question 28

Describe the sensory supply to the pelvis below the pelvic pain line

Answer 28

Visceral general afferents travel in the parasympathetic nervous system (S2-S4)

Question 29

Outline spinal block by lumbar puncture as anaesthesia in childbirth

Answer 29

Anaesthesia is given in the subarachnoid space between L4 and L5 which results in complete anaesthesia below the waist (no motor or sensory capacity)

Question 30

Outline pudendal nerve block as anaesthesia in childbirth

Answer 30

Anaesthesia administered between S2-S4 and provides anaesthesia to the perineum and lower 1/4 of the vagina but the mother can still feel and assist in contractions

Question 31

Outline caudal epidural block as anaesthesia in childbirth

Answer 31

Where anaesthetic is administered via a catheter to the sacral canal (must be done in advance) but the limbs will remain unaffected