Chapter 39 reverse

Question 1

reverse

mons pubis

labia majora

labia minora

clitoris

urethral opening

vestibule of vagina

Answer 1

Pelvic landmarks

Question 2

reverse

2 coxal bones

sacrum

coccyx

true and flase pelvis

Answer 2

Bony pelvis

Question 3

reverse

situated inferior to caudal portion of parietal peritoneum

condisered pelvic cavity

Answer 3

true pelvis

Question 4

reverse

posterior wall formed by sacrum and coccyx

posterolateral wall formed by piriformis and coccygeus muscles

anteriolateral walls formed by hip bones and obturator internus muscles, which rim ischium and pubis

lower margin formed by levator ani and coccygeus muscles

known as pelvic diapraghm

Answer 4

pelvic cavity

Question 5

reverse

area below pelvic floor

Answer 5

perineum

Question 6

reverse

posterior: rectum, colon and ileum
anterior: bladder, ureters, ovaries, fallopian tubes, uterus, vagina

Answer 6

pelvic cavity

Question 7

reverse

psoas major: sidewall

iliacus: sidewall

Piriformis: posterolateral wall

Obturator internus: anterolateral pelvic sidewall

Levator ani: pelvic floor (diaphragm)

Coccygeus: posterior pelvic floor (diaphragm)

Answer 7

muscles of pelvis

Question 8

reverse

muscles extend superiorly from xyphoid process to symphysis pubis inferiorly

paried rectus abdominis anteriorly

external obliques

internal obliques

transvers abdominis anteriolaterally

Answer 8

Abdominal wall

Question 9

reverse

Psoas major

iliacus muscles

psoas muscles join with iliacus muscles to form iliopsoas muscles

Answer 9

muscles of false pelvis

Question 10

reverse

Piriformis muscles

obturator internus muscles

muscles of the pelvic diaphragm

Answer 10

Muscles of true pelvis

Question 11

reverse

Levator ani (pubococcygeus, iliococcygeus and puborectalis muscles)

Coccygeus muscles

Answer 11

muscles of pelvic diaphragm

Question 12

reverse

apex: located posterior to pubic bones

Base: anterior to vagina, superior surface related to uterus

Neck: rests on upper surface of urogenital diaphragm; inferiolateral surfaces relate to retropubic fat, obturator internus, levator ani muscles, pubic bone

Answer 12

Bladder

Question 13

reverse

cross pelvic inlet anterior to bifurcation of common iliac arteries

run anterior to internal iliac arteries and posterior to the ovaries

coarse anteriorly and medially under base of broad ligament where crossed by uterine artery

run anterior and lateral to upper vagina to ender posteroinferior bladder

Answer 13

Ureters

Question 14

reverse

collapsed musclular tube that extends from external genitalia to cervix of uterus

approx 9cm in length

l

Answer 14

Vagina physical description

Question 15

reverse

normally directed up and back fromning 90 with uterine cervix

extends up and back from vulva

upper half lies above pelvic floor

lower half lies within perineum

vaginal lumen surrounding cervix divided into 4 fornices

Answer 15

Vagina landmarks

Question 16

reverse

from vaginal and uterine arteries

drains into internal iliac vein

Answer 16

Vaginal blood supply

Question 17

reverse

projects into vaginal canal

endocervix

exocervix

protrudes into upper portion of vaginal canal forming 4 recess (fornices)

continuous ring shaped space with posterior fornix running deeper than ints anterior counterpart

Answer 17

Cervix

Question 18

reverse

cervical canal

communicates with uterine cavity by internal os

with vagina by external os

Answer 18

Endocervix

Question 19

reverse

continuous with vagina

Answer 19

exocervix

Question 20

reverse

hollow pear shaped organ

fundus

body

cervix

usually anteflexed and anteverted

covered with peritoneum except anteriorly below os where peritoneum reflected onto bladder

supported by levator ani muscles, cardinal and uterosacral ligaments

round ligaments hold uterus in anteverted position

Answer 20

Uterus

Question 21

reverse

premenarchal: 1-3 cm long by .5-1 cm wide
menarchal: 6-8 cm long by 3-5 cm wide

w/multiparity: increases by 1-2 cm

postmenapausal: 3.5-5.5 cm long by 2-3 cm wide

Answer 21

Uterine size

Question 22

reverse

posterior to vesicouterine pouch and superior surface of bladder

anterior to rectouterine pouch (of Douglas), ilium, colon

medial to broad ligaments and uterine vessels

uterine cavity is funnel shaped in coronal plane, slitlike in sagital plane

Answer 22

uterine body

Question 23

reverse

perimetrium

myometrium

endometrium

Answer 23

layers of uterus

Question 24

reverse

serous outer layer of uterous

serosa

Answer 24

perimetrium

Question 25

# reverse muscular middle layer of uterus composed of thick smooth muschle supported by connective tissue

Answer 25

myometrium

Question 26

# reverse inner mucous membrane glandular portion of uterine body

Answer 26

endometrium

Question 27

# reverse broad mesovarium mesosalpinx round cardinal uterosacral suspensory ovarian

Answer 27

uterine ligaments

Question 28

# reverse lateral aspect of uterus to pelvic sidewall

Answer 28

broad uterine ligament

Question 29

# reverse posterior fold of broad ligament encloses ovary

Answer 29

mesovarium uterine ligament

Question 30

# reverse upper fold of broad ligament encloses fallopian tube

Answer 30

mesosalpinx uterine ligament

Question 31

# reverse fundus to anterior pelvic sidewalls holds uterus forward

Answer 31

Round uterine ligament

Question 32

# reverse extend across pelvic floor laterally firmly supporst cervix

Answer 32

cardinal uterine ligament

Question 33

# reverse extend from uterine isthmus downward along side rectum to sacrum firmly supports cervix

Answer 33

uterosacral ligament

Question 34

# reverse extends from lateral aspect of ovary to pelvic sidewall

Answer 34

suspensatory uterine ligament

Question 35

# reverse extends medially from ovary to uterine cornua

Answer 35

ovarian uterine ligament

Question 36

# reverse anteversion dextroversion retroversion retroflexion

Answer 36

Uterine postions

Question 37

# reverse most common position fundus and body bent forward toward cervix

Answer 37

Anteversion uterus

Question 38

# reverse normal variant in absence of pelvic masses

Answer 38

Dextroversion uterus levoversion

Question 39

# reverse entire uterus tilted posteriorly

Answer 39

retroversion uterus

Question 40

# reverse fundus and body bent backward towards cervix

Answer 40

retroflexion uterus

Question 41

# reverse infundibulum ampulla isthmus interstitial portion 12 cm in length blood supplied by ovarian arteries and veins

Answer 41

Fallopian tubes

Question 42

# reverse funner shaped lateral tube projects beyond broad ligament to overlie ovaries free edge of the funnel has fimbriae

Answer 42

fallopian infundibulum

Question 43

# reverse widest part of tube where fertilization occurs

Answer 43

Ampulla of fallopian tube

Question 44

# reverse hardest part lies lateral to uterus

Answer 44

isthmus of fallopian tube

Question 45

# reverse pierces uterine wall ar cornua

Answer 45

interstitial of fallopian tube

Question 46

# reverse almond shaped attached at posterior aspect of broad ligament by mesovarium lie in ovarian fossa fossa bounded by ext iliacs, ureter obturator nerve dual blood supply ovarian and uterine artery blood drained by ovarian vein into IVC on right and renal vein on left

Answer 46

Ovaries

Question 47

# reverse anterior to internal iliac artery and vein medial to external iliac artery and vein ellipsoid shape with long azis oriented vertically location highly variable as ligaments loosen, especially after pregnancy

Answer 47

Variable postinos of ovaries

Question 48

# reverse outer layer (cortex) medulla

Answer 48

Ovaries normal anatomy

Question 49

# reverse primarily follicles in varying stages of development covered by layer of dense connective tissue tunica albuginea tunica albuginea surrounded by single layer of cells germinal epithelium

Answer 49

ovary cortex

Question 50

# reverse composed of connective tissue containing blood, nerves, lymphatic vessels and some smooth muscle at region of hilum

Answer 50

medulla of ovary

Question 51

# reverse ovum two known hormones estrogen: secreted by follicles progesterone: secreted by corpus luteum

Answer 51

Ovarie reproductive cell

Question 52

# reverse responsible for producing and maintaining secondary gender characteristics preparing uterus for implantation of fertilized ovum development of mammary glands in female

Answer 52

ovarian hormone responisibility

Question 53

# reverse supported medially by ovarian ligaments originating bilaterally at cornua of uterus laterally by suspensory (infundibulopelvic) ligament extending from infundibulim of fallopian tubke and ovary to sidewall of pelvis Ovary also attached to posterior aspect of broad ligament via mesovarium

Answer 53

ovarian ligaments

Question 54

# reverse ext iliacs arteries: medial psoas border ext iliac veins: medial and posterior to arteries Int iliac arteries: posterior to ureters and ovaries Int iliac veins: posterior to arteries uterine arteries and veins: between layers of broad ligaments, lateral to uterus

Answer 54

Pelvic vasculature

Question 55

# reverse arcuate arteriers radial arteries straight and spiral arteries ovarian arteries ovarian veins

Answer 55

Pelvic vasculature branches

Question 56

# reverse arclike arteries that encircle uterus in outer third of myometrium

Answer 56

arcuate arteries

Question 57

# reverse branches of arcuate arteries that extend from myometrium to base of endometrium

Answer 57

radial arteries

Question 58

# reverse branches of radial arteries that supply zona basalis of endometrium

Answer 58

Straight and spiral arteries

Question 59

# reverse branch laterally off aorta run within suspensatory ligaments and anstomose with uterine arteries

Answer 59

ovarian arteries

Question 60

# reverse right vein drains into IVC left drains into left renal vein

Answer 60

ovarian veins

Question 61

# reverse reproductive years begin around 11-13 at onset of menses end around age 50 whn menses ceases cycle approx 28 days in length begins with first day of menstrual bleeding

Answer 61

Mestrual cycle

Question 62

# reverse mestrual cycle occurs less than 21 days

Answer 62

polymenorrheic

Question 63

# reverse menstrual sycel occurs longer than 35 days

Answer 63

oligomenorrheic

Question 64

# reverse premenarche: prepuberty menarche: menstruating approx every 28 days menopause: cessastion of menses

Answer 64

menstrual status

Question 65

# reverse explosive release of ovum from ruptured graafian follicle rupture associated with small amounts of fliud in posterior cul-de-sac midcycle midcycle dull ache on either side of lower ab lasting a few hrs "mittelschmerz" middle pain

Answer 65

Ovulation

Question 66

# reverse begins with ovulatoin and about 14 days in length menstruation almost always occurs 14 days aftern ovulation cells in lining of ruptured ovarian follicle begin to multiply and create corpus luteum (yellow body) luteinization and is stimulated by LH surge corpus luteum begins secreting progesterone

Answer 66

luteal phase

Question 67

# reverse corpus luteum degenerates causing progesterone levels to decline this decline causes menstration to occur and the cycle begins again

Answer 67

9-11 days after ovulation

Question 68

# reverse human chorionic gonadotropin (HCG) produced by the zygote causes corpus luteum to persist it will continue to secrete progesterone for 3 more months until placenta takes over

Answer 68

conception and implantation

Question 69

# reverse varying levels of estrogen/progesterone levels induce changes changes correlate with ovulatory cycles of ovary 3 phases menstrual phase proliferative phase secratory phase

Answer 69

endometrial changes

Question 70

# reverse lasta approx 1-5 dyas and begins with declining progesterone levels causes spiral arterioles to constrict decreased blood flow to endometrium resulting in ischemia and shedding of zona functionalis first 5 days coincide with follicular phase of ovarian cycle as follicles produce estrogen they stimulate the superficial layer of endometrium to regenerate and grow

Answer 70

Endometrial menstrual phase

Question 71

# reverse lasts until luteiniation of graafian follicle around ovulation with ovulation and luteinization of graafian follicle progesterone secreted by ovary causes spiral arteries and endometrial glands to enlarge prepares endometrium for implanation should conception occur

Answer 71

Endometrial proliferative phase

Question 72

# reverse extends from approx day 15 to onset of menses (day 28) secretory phase corresponds to luteal phase of ovarian cycle

Answer 72

Endometrial secretory phase

Question 73

# reverse days 1-14 corresponds to follicular phase of ovarina cycle mestruation occurs on days 1-4 thin endometrium estrogen level increases as ovarian follicles develope 'increasing estrogen causes uterine lining to regenerate and thicken ovulation occurs on day 14

Answer 73

Proliferative phase summary

Question 74

# reverse days 15-28 corresponds to uteal phase of ovarian cycle ruptured follicle becomes corpus luteum corpus luteum secretes progesterone endometrium thickens no pregnancy, estrogne/progesterone decrease menses day 28

Answer 74

Secretory phase summary

Question 75

# reverse during menses not uncommon to see varying levels of fluid and debris with uterine cavity with menstruation endometrium becomes thin echogenic line during early proliferative phase as regeneration occurs endometrium will thicken to 4-8mm in proliferative phase

Answer 75

Endometrial changes

Question 76

# reverse hypoechoic 3 line sign Zona basalis anteriorly and posteriorly central line representing the cavity

Answer 76

endometrium sonogram appearance

Question 77

# reverse measures 6-10 mm and becomes isoechoic with myometrium just before ovulation after ovulation thickest dimension avg 7-14 mm becomes echogenic blurring 3 line appearance

Answer 77

Endometrium at ovulation

Question 78

# reverse patients NOT on HRT thickness of patients on HRT or taking tamoxifen may be up to 8 mm

Answer 78

postmenopausal endometrium

Question 79

# reverse abnormally heavy or long periods

Answer 79

menorrhagia

Question 80

# reverse painful periods

Answer 80

dysmenorrhea

Question 81

# reverse absence of menstruation

Answer 81

amenorrhea

Question 82

# reverse vesicouterine pouch rectouterine pouch \retropubic space

Answer 82

pelvic recess

Question 83

# reverse anterior cul-de-sac anterior to fundus between uterus and bladder

Answer 83

vesicouterine pouch

Question 84

# reverse posterior cul-de-sac posterior to uterine body and cervix between uterus and rectum

Answer 84

rectouterine pouch

Question 85

# reverse space of retzius between bladder and symphysis pubis

Answer 85

retropubic space