clinical anatomy of the female reproductive system Flashcards by Amy Hollis

what parts of the female reproductive system are in the pelvic cavity?

-ovaries
-uterine tubes
-uterus
-superior part of vagina

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what parts of the female reproductive system sit in the perineum?

-inferior part of the vagina
-perineal muscles
-Bartholin’s glands
-Clitoris
-Labia

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what is dark green, light green, red, purple and blue?

dark green= true pelvis/ lesser pelvis
light green= false pelvis/ greater pelvis
red dotted line= pelvic inlet
purple= levator ani muscle
blue= perineum

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what seperates the false pelvis from the true pelvis?

pelvic inlet

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what is the orange, red and yellow

orange= clitoris
red= labia
yellow= vagina

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what is the blue, navy, green and purple?

blue= levator ani
purple= rectum
navy= uterus
green= bladder

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what is another name for pouch of douglas and why is it clinically relevant?

recto uterine pouch
-most inferior point of an upright female patient and so any excess fluid in peritoneal cavity (pus, blood etc) will go there

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what pouches do females have in their pereitoneal cavity?

vesico uterine pouch
recto uterine pouch (pouch of douglas)

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what pouches do males have in their peritoneal cavity?

rectovesicle (pouch between their bladder and rectum)

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what is the floor of the peritoneal cavity?

inferior part of the parietal peritoneum

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what is the roof over pelvic organs?

inferior part of parietal peritoneum

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what covers the superior aspect of organs and so forms the pouches in the female peritoneal cavity?

inferior part of the parietal peritoneum

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fill in the blanks (peritoneum of a female)

light blue= right ovary
navy= right uterine tube
purple= vesico- uterine pouch
orange= bladder
yellow= uterus
green= rectum
red= recto uterine pouch (pouch of douglas)

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what is the dotted line?

left broad ligament

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what is the broad ligament of the uterus made out of

-made of a double layer of peritoneum

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what is the role of the broad ligament of the uterus?

it helps maintain the uterus in its correct midline position

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where is the broad ligament found?

-it extends between the uterus and the lateral walls + floor of the pelvis

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where is the proximal part of the round ligament found?

the broad ligament

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what is the round ligament of the uterus made out of?

it is an embryological remnant

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what is labelled blue and orange?

blue= right round ligament
orange= left broad ligament

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where does the round ligament attach to the uterus?

it attaches to the lateral aspect of the uterus

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where is the round ligament of the uterus found?

-passes through the deep inguinal ring to attach to the superficial tissue of the female perineum
-attaches to the lateral aspect of the uterus
-the proximal part of the round ligament is contained in the broad ligament

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what are the 3 layers of the uterus?

-perimetrium
-myomtrium
-endometrium

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which layer of the uterus is the perimetrium

outer

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which layer of the uterus is the myometrium and what is it made of?

middle layer and is made of muscle (contracts + cramps during menstruation)

which layer of the uterus is the endometrium?

-the inner layer (thickens for fertalised eggs, sheds during menstruation)

where does impantation of a zygote occur?

in the body of the uterus

where in this uterus would implantation of a zygote occur?

in the body

name the parts of the uterus

orange= fallopian tubes/ uterine tubes yellow= body red= external cervical os (opening of cervix into vagina) green= cervix blue= vagina

if implantation occurs outwith of the body of the uterus- what is it called?

ectopic pregnancy (usually happens in the fallopian tubes)

what supports the uterus?

-number of strong ligaments (e.g. uterosacral ligaments) -endopelvic fascia -muscles of the pelvic floor (e.g. levator ani)

what happens if there is weakness in the uterine ligaments, endopelvic fascia or muscles of the pelvic floor?

weakness of these supports can result in uterine prolapse (movement of the uterine inferiorly)

what is green and orange?

orange= uretosacral ligament green= levator ani

what are the most common positions for a uterus to be in?

-anteverted and anteflexed -anteverted (cervix tipped anteriorly relative to the axis of the vagina) -anteflexed (uterus tipper anteriorly relative to the axis of the cervix and so the mass of the uterus lies over the bladder)

what is the retroverted and retroflexed variation of positioning of the uterus?

retroverted- the cervix is tipped posteriorly relative to the axis of the vagina retroflexed- the uterus is tipped posteriorly relative to the axis of the cervix

where does fertilisation occur?

in the ampulla

what is a bilateral salpingo- oophrectomy?

removal of both uterine tubes and ovaries

what is a unilateral salpinegectomy?

removal of one of the uterine tubes

blue= isthmus (narrow part) green= ampulla yellow= infundibulum (funnel part) orange= fimbriae of the infundibulum red= left ovary

what part of the uterus opens into the peritoneal cavity?

the fimbriated end of the uterine tubes

what allows communications between the genital tract and the peritoneal cavity and why is it clinically relevant?

-the fimbriated end of the uterine tubes (because they open into the peritoneal cavity) -clinically relevant because in theory infection can pass between the two areas -radioplaque dye can even spill out of the end of uterine tube and into peritoneal cavity

what are almond sized and shapes and located laterally in the pelvic cavity?

ovaries

what do ovaries ecrete in response to FSH and LH?

oestrogen and progesterone

where do ovaries develop and move to?

-Develop on the posterior abdominal wall and move onto the lateral wall of the pelvis

where is the only place where the vaginas walls are not in contact?

superiorly where the cervix holds them apart forming a fornix (space around the cervix)

what are the 4 parts of the fornix?

-anterior -posterior -2x lateral

are the walls of the vagina usually open?

no they are usually collapsed

what part of the vagina is sampled when doing a cervical screening?

the squamo columnar junction (transformation zone)

what is the perineum?

-shallow space between the pelvic diaphragm and the skin

what forms the roof of the perineum?

pelvic diaphragm

what are the anatomical borders of the uregenital triangle and the anal triangle (anatomical borders of perineum)?

anterior- pubic symphase posterior- tip of coccyx laterally- inferior pubic rami and inferior ischial rami and the sacrotuberous ligament roof- pelvic floor base- skin and fascia

what muscle is this?

levator ani muscle

what type of muscle is the levator ani msucle?

voluntary skeletal muscle

what is the role of the levator ani muscle?

-it provides continual support for the pelvic organ with tonic contraction and it reflexively contracts during situations of increased intra abdominal pressure

what supplies the levator ani muscle?

S2-4 -'nerve to levator ani'

what nerves supply the perineal muscles??

-pudendal nerve

what is the perineal body?

-bundle of collagenous and elastic tissue into which the perineal muscle attach (the star)

what is the perineal body important for?

for pelvic floor strength

what can gland commonly develop cysts andabscess in the perineum?

Bartholins gland

darker green= mons pubis (anterior to pubic bones) light blue= labium majus yellow= labium minus light green= anus darker blue= vaginal orifice purple= vestibule red= external urethral orifice orange= clitoris

where do the bed of breast extend from?

ribs 2-6 -lateral border of sternum to mid axillary line

what muscles do breasts cover?

they lie in deep fascia covering pec major and serratus anterior

what lies between the fascia and breast?

retromammary space

how do female breasts attach to the skin?

via suspensory ligaments

what does it mean if a breast has A FIXED LUMP?

means it could have gone through the retromamillary space and stuck to the underlying tissue

where is from breasts drained into?

Most (>75%) of lymph from breast tissue drains to the ipsilateral axillary lymph nodes > supraclavicular nodes> right lymphatic duct Lymph from inner breast quadrants can drain into parastinal lymph nodes Lymph from lower inner breast quadrant can drain to abdominal lymph nodes

where does lymph from the upper lymp and most of the lymph from breast drain to?

axillary nodes (and then breast goes from axillary nodes to supraclavicular nodes and to the right lymphatic duct)

what are the different levels of axillary lymph nodes?

Level I- level III level I- inferior and lateral to pectorals minor level II- deep to pectoralis minor level III- superior and medial the pectoralis minor