Flashcards in Cobine: Female Pelvis Deck (54):
Structures covered by peritoneum in the female pelvis
uterus/round lig of uterus
The peritoneum continues from the anterior abdominal wall, curves at the level of the (blank), covers the (blank) surface of the bladder to the (blank) of the uterus, forming the (blank) pouch; then covers the fundus/body of the uterus, extends over the (blank) of the vagina, extends from the uterus to the rectum forming the (blank) pouch, then covers the anterior/lateral parts of the superior rectum and the lateral sides of the middle rectum before becoming sigmoid (blank) at S3
pubic bone; superior; isthmus; vesicouterine; fornix; rectouterine; mesocolon
(blank) fossa on each side of the bladder; (blank) fossa on each side of the rectum; separated by the (blank) of the uterus
paravesical; pararectal; broad ligament
What is contained in the broad ligament of the uterus?
1. uterine tubes
2. ovaries and their ligaments
3. round ligament of the uterus
Deep recesses where fluid can accumulate in event of an infection; this pouch can collect blood or puss, is posterior to the fornix of the vagina
vesicouterine and rectouterine (Pouch of Douglas) pouches; Pouch of Douglas
an inflammation of the peritoneum, may result from infection (e.g. from rupture of a hollow organ) or from a non-infectious process. If left untreated, sepsis.
extraction of fluid from the Pouch of Douglas via the posterior fornix of the vagina
small incision, endoscope inserted for viewing.
T/F: pelvic peritonitis is usually fatal
What passes over the ureter in the female on its course to the posterior bladder? This is something to keep in mind when performing a hyst.
The apex of the bladder is in direct relation to the (blank). The bladder fundus is in direct relation to the (blank).
fundus of the uterus; anterior wall of the vagina
When empty, the bladder is in the (blank) pelvis. When full, the bladder is in the (blank) pelvis.
lesser pelvis; greater pelvis
What is significant about the retropubic space?
allows distensibility of the bladder
What is significant about the lateral ligaments (pubovesical) of the bladder and the tendinous arch of pelvic fascia?
keep the bladder in place
What composes bladder walls?
Utereric orifices and the internal urethral orifice are at the angles of the (blank) bladder
Ureteric orifices are encircled by loops of (blank) that tighten as the bladder contracts to prevent the reflux of urine into the ureter
detrusor muscle; trigone; detrusor muscle
Blood supply to:
1. anterosuperior bladder
2. fundus and neck
1. superior vesical arteries
2. vaginal arteries (inferior vesical in males)
3. obturator and inf. gluteal arteries
Venous drainage in female bladder corresponds to arteries. (blank) plexus receives blood from the dorsal vein of the clitoris, and this plexus communicates with the (blank) plexus.
vesical venous plexus; vaginal
double layer of peritoneum extending from the sides of the uterus to the lateral walls and floor of the pelvis keeping the uterus in place
broad ligament of the uterus
3 parts of the broad ligament
1. contains the uterine tube
2. contains the ovary
3. acts as the mesentery for the uterus
Where the broad ligament is prolonged superiorly over the ovarian vessles; superolateral to the ovary
suspensory ligament of the ovary
lies anteroinferior to the uterotubal junction, courses to deep inguinal canal, passes through the inguinal canal and terminates at the labium majus
round ligament of the uterus
What are the ovarian ligament and round ligament of the uterus vestiges of?
extend from the supravaginal part of the cervix and lateral vaginal fornices to the lateral walls of the pelvis (contains uterine artery and vein)
transverse cervical ligaments (cardinal ligament)
condensations of the pelvic fascia that extend from the cervix to the posterolateral pelvic walls
The ovary is suspended by peritoneal folds: from the posterosuperior aspect of the broad ligament by the (blank) and from the lateral pelvic walls by the (blank)
mesovarium; suspensory ligaments of the ovary
(blank) contains ovarian vessels, lymphatics, and nerves which run within the suspensory ligament of the ovary contained within it
When an oocyte is expelled, it passes into the (blank). It is trapped by the fimbriae (finger-like projections) of the (blank) of the uterine tube and swept up into the ampulla for possible fertilization
peritoneal cavity; infundibulum
Two parts of the uterus - what demarcates the two parts?
Two surfaces of the uterus
body (superior 2/3) and cervix (narror inferior 1/3); isthmus; vesical and intestinal
The body of the uterus lies on the (blank); the cervix lies between these two things
bladder; bladder and rectum
What separates the supravaginal part of the cervix from the rectum?
Pouch of Douglas
Two parts of the cervix
supravaginal (between isthmus and vagina) and vaginal
Narrow space surrounding the external os of the uterus (cervix); has anterior, posterior, and lateral parts
Three parts of uterine wall
1. serosal layer
2. middle coat of smooth muscle, main branches of blood vessels, dilates the cervical os during childbirth, producing cramping
3. inner mucous coat that is shed during menstruation, location of blastocyst implantation
The cervix is mostly fibrous vs. the muscular uterine body.
External os is H shaped in parous women.
Blood supply to uterus
uterine arteries, ovarian arteries (uterine arteries also supply placenta)
The uterus is normally (blank) with respect to the vagina, and (blank) with respect to the cervix
anteverted (90 degrees); anteflexed (170 degrees)
T/F: normally some weight of the uterus is borne by the urinary bladder
Causes of uterine prolapse
weakened pelvic floor muscles/ligaments
lack of estrogen after menopause
pressure on pelvic muscles
1st degree prolapse vs. 2nd degree vs. 3rd degree
1st: cervix still inside vagina
2nd: cervix outside of vulva
3rd: complete prolapse
Conduct the ovum, usual site of fertilization
Extend laterally from the uterine horns and open into the peritoneal cavity near the ovaries
Lie in the mesosalpinx in the free edges of the broad ligaments
Ideally, the uterine tubes arch (blank) and (blank) to the ovaries. However, lots of variation can occur.
Four parts of uterine tube
4. uterine part
The vagina extends from the (blank) to the vestibule. Superior end surrounds the (blank). Its walls are usually (blank). It passes through the medial margins of the (blank) muscles.
cervix; cervix; collapsed; levator ani
Blood supply to vagina
1. uterine arteries
2. vaginal and internal pudendal arteries
Venous drainage from vagina
vaginal veins --> vaginal venous plexus --> continuous with uterine venous plexus --> uterine vein --> internal iliac veins (also communication with vesical and rectal venous plexuses)
T/F: The vagina has rugae
Pregnancy can be detected as softening of the uterine (blank) - cervix feels separated from the body
What ligament contains the uterine artery and vein?
Where does the round ligament of the uterus terminate?
at the labium majus
Two vestiges of the gubernaculum?
Round ligament of the ovary
Round ligament of the uterus
The ovary is suspended in the peritoneal cavity and its peritoneal surface is characterized by scarring from (blank)
What separates the supravaginal part of the cervix from the bladder? What separates it from the rectum?
loose CT; pouch of Douglas
Which part of the cervix is between the isthmus and the vagina? Which part protrudes into the vagina?