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ESP 2023 OBGYN > Chapter 1 — Female Reproductive Anatomy > Flashcards

Chapter 1 — Female Reproductive Anatomy Flashcards

1
Q

The pelvic is divided into 2 regions by?

A

Linea Terminalis
Which is an imaginary line

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2
Q

When pelvis is divided into 2 regions what are the regions called

A

False pelvis / greater pelvis
— Above the Linea
True pelvis / lesser pelvis
— below the Linea

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3
Q

This uterine ligament is situated anterior & inferior to the broad ligament & tubes & attached to the the Uterine Cornu to anterior pelvic wall

A

Round Ligament

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4
Q

This uterine ligament extends from later uterus & attaches to the lateral pelvic side wall

A

Broad ligament
- Mesosalpinx
- Mesovarium
- Mesometrium

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5
Q

This uterine ligament connects to the uterus at the level of the cervix to provide support for uterus and cervix

A

Cardinal ligament (Lateral Cervical)

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6
Q

This uterine ligament provides posterior support

A

Uteroscaral ligament

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7
Q

This ovarian ligament attaches to the inferior ovary to unterine cornu

A

Ovarian ligament

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8
Q

This ovarian ligament attaches the ovary to the portion layer of the broad ligament on each side

A

Mesovarium

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9
Q

This ovarian ligament attaches to lateral ovary to posterolateral pelvic wall & transmits the ovary vessels & nerves

A

Suspensory ligament
— infundibuopelvic

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10
Q

This pelvic muscle is forms most of the anterior body wall, extends from xiphoid to pubic symphysis, it is also responsible for refraction/ghosting artifact

A

Rectus abdominus muscle (6 pack)

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11
Q

This pelvic muscle originates from the lower thoracic & lumbar vertebrae, courses laterally & anteriorly through the abdomen, below the level of the iliac crest fibers of this muscle begin to merge (interdigiate) with fibers from medial aspect of iliacus m forming iliopsoas m which inserts on the lesser trochanter of the femur.

A

Psoas Major

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12
Q

This muscle will most likely be mistaken for an ovary sonographically

A

Iliopsoas

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13
Q

This muscle arises at the iliac crest & extends inferiority until it merges with the psoas major m and forms part of the lateral margins of the pelvic basin

A

Iliacus

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14
Q

This muscle is a triangular sheet of muscle anchored along the brim of the true pelvis, it extends posterior;y & medically along the side wall of the true pelvis, passing beneath the lavator ani to exit through the lesser sciatic foramen & inserts on the greater trochanter

A

Obturator internus

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15
Q

This muscle is located deeply posterior in the true pelvis, ;essentially routinely imaged due to its deep location

A

Piriformis

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16
Q

What is composed of the coccygenus m & levator ani m and its functions are to resist increased intra-abdominal pressure and resist gravity

A

Pelvic diaphragm

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17
Q

What are the orifices that pass through levator ani m (from anterior to posterior)

A

Urethra
Vagina
Rectum

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18
Q

This muscle forms the posterior floor

A

Coccygeus

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19
Q

This muscle is located between the pubis & coccyx and forms the anterior / middle pelvic floor

A

Levator ani m group
- iliococcygeus m
- pubococcygeus m
- puorectalis

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20
Q

Which muscles is located in the abdominopelvic region

A

Rectus Abdominus m (anterior wall)
Psoas major m (posterior wall)

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21
Q

Which muscles are located in the false pelvis

A

Iliacus m (iliac fossa)

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22
Q

Which muscles are located in the true pelvis

A

Obturator internus m (lateral wall)
Levator ani m (middle & anterior flor)
Coccygeus m (posterior floor)
Piriformis m (posterior wall)

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23
Q

This pelvis organ is a hallow musculomembranous organ & located between symphysis pubis & vagina, the ureters inserts at the inferior posterior portion of this organ (trigone)

A

Urinary Bladder

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24
Q

This organ is approximately 7-10cm canal of smooth muscle, the upper portion of this organ surrounds the cervix creating gutters known as the vaginal fornices

A

Vagina

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25
Q

Which vaginal fornix surrounds the anterior aspect of the extrernal cervix & is smaller than the posterior

A

Anterior fornix

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26
Q

Which vaginal fornix surrounds the posterior aspect of the external cervix & is a frequent site for vaginal fluid collection due to the gravity dependence

A

Posterior fornix

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27
Q

Which vaginal fornix has 2 and surrounds the lateral aspect of the external cervix on either side

A

Lateral fornices

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28
Q

This organ is pear shaped, hallow located between the urinary bladder & rectum

A

Uterus

29
Q

This portion of the uterus is the upper expanded portion between the fallopian tubes

A

Fungus / dome

30
Q

This portion of the uterus is the main portion

A

Body / corpus

31
Q

This portion of the uterus is the area between body & cervix, it is the most flexible portion of the uterus & grows at the most rapid rate during pregnancy

A

Isthmus / lower uterine segment

32
Q

This portion of the uterus is a cylindrical projection into the vagina which provides an alkaline secretion favorable for sperm penetration & acts as a sphincter during pregnancy

A

Cervix

33
Q

This portion of the uterus is the continuation of the endometrial cavity into the cervix

A

Endometrial canal

34
Q

This cervical is is the opening from the cervix into the uterus

A

Internal os

35
Q

This cervical os is the opening from the cervix into the vagina

A

External os

36
Q

Uterine size
Age: 2-8, 9-menarche, nulliparous, muliparous
Length (mm): 33, 43, 80, 90
AP (mm): 7.5, 13, 30, 40

Postomenopausal - varied, based on parity & years since menopause

A
37
Q

A newborn uterus has a relatively larger cervical length & width
— 2/3 cervix & 1/3 body & uterus

A pediatric uterus is 1/2 cervix & 1/2 body & fundus

A postmenopausal uterus has normal adult proportions
— 1/3 cervix & 2/3 body & uterus

A
38
Q

Which layer of the uterus is the outer serosal layer which is part of the visceral peritoneum, laterally it becomes the broad ligament & anteriorly it forms vesicouterine pouch (anteriorly curl-de-sac) & posteriorly forms rectouterine pouch (pouch of Douglas / posterior cul-de-sac) & is the most dependent recess in the body

A

Perimetrium

39
Q

Which layer of the uterus is the middle muscular layer, which is composed of 3 layers of smooth muscle which contract during parturition, this layer is thick and has a relatively homogeneous appearance sonographically, & the inner portion sometimes appears hypoechoic &nis referred to as the junctional zone

A

Myometrium

40
Q

Which layer of the uterus is the inner mucous layer & consists of the superficial functional layer (stratum functionalis) & deeper permanent basel layer (stratum basalis)

A

Enometrium

41
Q

Uterine layers (outer-inner)
- perimetrum > myometrium > basal layer of endo > functional layer of endo

A
42
Q

Which uterine positional variation is forward placement of the uterus at the cervix (forming a 90 degree angel with the vagina)

A

Anteversion

43
Q

Which uterine positional variation is tiliting backward of the uterus at the cervix (oriented more literarily in relationship to the vagina)

A

Retroflextion

44
Q

Which uterine positional variation is bending forward of the uterus at the body

A

Anteflextion

45
Q

Which uterine positional variation is a bending backward of the uterus at the body (may become incarcerated during pregnancy - symptom is urinary retention)

A

Retroflexion

46
Q

Transvaginal (endovaginal)
- higher transducer frequencies than transabdominal greater than 7.5 MHz
- convex or phased array
- high level disinfection following scan * NO AUTOCLAVING *

A
47
Q

Ovarian Size
Premenopausal (varies), postmenopausal (varies)
Size: 3.5 x 2.0 x 1.5 cm, 2.0 x 1.0 x 0.5 cm
Mean volume: < 9.8 cm3, < 5.8cm3

A
48
Q

This is a pair organ, ovoid in shape & suspended within the pelvic peritoneal sac, posterior to the broad ligament

A

Ovaries

49
Q

This part of the ovarian parenchyma is the outer functional layer, it constitutes the bulk of the ovarian substance & contains a large number of primordial & developing follicles

A

Cortex

50
Q

This part of the ovarian parenchyma is the inner ovary which contains blood vessels & connective tissue

A

Medulla

51
Q

What is the area called that the ovarian vessels & nerves enter & exit the ovary

A

Ovarian hilum

52
Q

Which pelvic organ is paired musculomembranous tubes extending laterally from the uterine cornu, is 7-4cm in length, & function to transport the fertilized ovum to the uterus by means of peristaltic contractions

A

Fallopian tubes (oviducts)

53
Q

This region of the fallopian tube is narrow & relatively straight; located within uterine wall (Cornu)

A

Interstitial / intramural

54
Q

This region of the fallopian tube is the medial portion closest to uterus (medial 1/3)

A

Isthmus

55
Q

This region of the fallopian tube is the longest portion & curved around the ovary, is thin walled & distendable, normally site of fertilization (middle 1/3)

A

Ampulla

56
Q

This region of the fallopian tube is the outer, trumpet-shaped end (distal 1/3)

A

Infundibulum

57
Q

This region of the fallopian tube has numerous finger-like projections which maintain a close relationship between the tube & ovary

A

Fimbriae

58
Q

Which peritoneal recesse is located between the pubic bone & the anterior urinary bladder wall, rarely fluid is seen in this space but masses in this space will displace the urinary bladder posteriorly

A

Space of retzius (retropubic / prevesical space)

59
Q

Which peritoneal recesse is located anterior to the uterus & posterior to the urinary bladder, space is usually empty but may contain loops of bowel

A

Vesicouterine space (anterior curl-de-sac)

60
Q

Which peritoneal recesse is located posterior to the uterine cervix & anterior to the rectum, uterosacral ligaments form the lateral boundaries of the body, therefore the most common site for free peritoneal fluid to collect

A

Rectouterine space (posterior curl-de-sac)

61
Q

Blood supply to the pelvic viscera is provided by the major branches of the

A

Distal abdominal aorta

62
Q

Abd AO bifurcates at the level of the L4 into right & left common iliac arteries, the common iliac arteries bifurcates into the external & internal iliac arteries
Right & left external arteries supply the lower extremities with blood
Right & left internal iliac (hypogastric) arteries supply the pelvic visceral with blood via several branching arteries, including the uterine arteries

A
63
Q

Uterine artery crosses the ureternon each side, &at the cervix ascends along the lateral portion of the uterus within the broad ligament
At the uterine Cornu the uterine arteyncourses laterally to reach the ovary & ends by joining the ovarian artery

A
64
Q

Uterine artery gives rise to actuate arteries (circumferential within outer myometeium)
Arcuate give rise to radial arteries (supply deeper layers of myometerium
Radial give rise to spiral arteries which supply the endometrium with blood

A
65
Q

Branches of Uterine A. (Outer > Inner & Superficial > Deep)

A

Uterine A > Arcuate A > Radial A > Spiral A

66
Q

This is the lateral branches of the abdominal AO & rise just below level of the renal arteries, course to the pelvis & reach ovarian glum via the infundinopelvic ligament

A

Ovarian A (generally called Gonadal A)

67
Q

Venous System
Parallels with the arteries
Right gonadal (ovary) vein empties into inferior vena cava (IVC) just below the level of the right renal vein, while left gonadal vein empties into the left renal vein

A
68
Q

Uterine A (non-gravida pt)
Moderate-high velocity/ high resistance
Higher resistance in proliferation phase
Higher resistance in postomenopausal

A
69
Q

Ovarian Arteries
Follicular phase low velocity, high resistance
Periovulatory period & Luteal phase resistance drops on dominant follicle side (lower PI & RI) low resistance
Postmenopausal RI approach 1.0 (high resistance)

A

ESP 2023 OBGYN (5 decks)

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