Cobine Female Pelvis

Question 1

What structures in the female pelvis is covered by peritoneum?

Answer 1

rectum
bladder
ureter
ovarian vessels in suspensatory ligament
round ligament of the uterus
uterus
ovary

Question 2

Explain the peritoneal reflections of the female pelvis

Answer 2

continues down from anterior abdominal wall at level of pubic bone
covers superior surface of bladder
passes from bladder to the isthmus of uterus
covers fundus and body of uterus
extends over posterior fornix of vagina
passes from uterus to the rectum
passes to the rectum and covers anterior and lateral side of superior rectum and lateral sides of middle rectum
becomes sigmoid mesocolon at S3

Question 3

How is the rectouterine pouch formed?

Answer 3

from the peritoneum passing from the uterus to the rectum

Question 4

Pararectal fossa on each side of the rectum are formed by what?

Answer 4

lateral extensions of the rectouterine pouch

Question 5

What separates the pararectal fossas?

Answer 5

broad ligament of uterus (runs from uterus to lateral pelvic wall)

Question 6

What does the broad ligament contain?

Answer 6

uterine tubes, ovaries, ligaments of the ovaries, and round ligament of the uterus

Question 7

What are significant about the vesicouterine and rectouterine pouches?

Answer 7

fluid can accumulate in the event of infection

Question 8

What is significant about the rectouterine (pouch of douglas)?

Answer 8

located behind posterior fornix of vagina and can collect blood or pus and is susceptible to injury
(can result in peritonitis)

Question 9

In what circumstance will the pouch of douglas fill with blood?
pus?

Answer 9

ectopic pregnancy

ruptured appendix

Question 10

(blank) is the extraction of fluid from the pouch of douglas via the posterior fornix of the vagina.

Answer 10

culdocentesis

Question 11

What is a small incision into the vagina that allows for the insertion of an endoscope?

Answer 11

colpotomy

Question 12

In the female, the ureter passes (blank) the uterine artery.

Answer 12

under

Question 13

(blank) passes by the lateral part of the vaginal fornix and enters the posterosuperior angle of the bladder.

Answer 13

Ureter

Question 14

In the females, uterine artery passes in front of ureter, but in males (blank) passes this way.

Answer 14

vas deferens

Question 15

The apex of the bladder is in direct relation to the (blank) of the uterus

Answer 15

fundus

Question 16

THe bladder fundus is in direct relation to the (blank) of the vagina

Answer 16

anterior wall

Question 17

What helps keep the bladder in place?

Answer 17

lateral ligaments of bladder (pubovesical)

tendinou arch of pelvic fascia

Question 18

Bladder walls are composed chiefly of the (blank) muscle.

Answer 18

detrusor

Question 19

The ureteric orifices and the internal urethral orifice are at the angles of the (blank)

Answer 19

trigone bladder

Question 20

Ureteric orifices are encircled by loops of (blank) that tighten as the bladder contracts to prevent the reflux of urine into the ureter.

Answer 20

detrusor muscle

Question 21

What is the arterial supply in the female bladder?

Answer 21

anteriosuperior bladder- sup. vesicle arteries
fundus and neck- vaginal arteries
obturator and inf gluteal arteries

Question 22

What is the venous drainage in the female bladder?

Answer 22

veins correspond to arteries
vesical venous plexus
uterovaginal venous plexus
vesical venous plexus

Question 23

(blank) envelopes the pelvic urethra and neck of the bladder, receives blood from the dorsal vein of the clitoris.

Answer 23

vesical venous plexus

Question 24

(blank) communicates with the vaginal or uterovaginal venous plexus

Answer 24

vesical venous plexus

Question 25

(blank) mostly drains bladder through the inferior vesical veins into the internal illiac veins.

Answer 25

vesical venous plexus

Question 26

What are the 5 ligaments of the female pelvis

Answer 26

``` broad ligament of the uterus round ligament of the uterus suspensory ligament of the ovary ligament of the ovary cardinal ligaments ```

Question 27

(blank) is a 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.

Answer 27

Broad ligament

Question 28

The uterine tube lies within the (blank)

Answer 28

mesosalpinx

Question 29

The ovary lies within the (blank) (mesentary) on the posterior aspect of the broad ligament.

Answer 29

mesovarium

Question 30

The (blank) acts as mesentary for the uterus itself. It includes almost all of the broad ligament except for the mesovarium and mesosalpinx

Answer 30

mesometrium

Question 31

(blank) is where the broad ligament is prolonged superiorly over the ovarian vessels,lying superolateral to the ovary.

Answer 31

suspensory ligament of the ovary

Question 32

(Blank) lies anteroinferior to the uterotubal junction, courses to deep inguinal canal, passes through the inguinal canal and terminates at the labium majus (majora).

Answer 32

Round ligament of the uterus

Question 33

The round ligament of the ovary and the round ligament of the uterus comes from the (blank)

Answer 33

gubernaculum

Question 34

(blank) extend from the supravaginal part of cervix and lateral vaginal fornices to the lateral walls of the pelvis (contains uterine artery and vein)

Answer 34

Transverse cervical (cardinal) ligaments

Question 35

(blank) are condensations of the pelvic fascia that extend from the cervix to the posterolateral pelvic walls.

Answer 35

uterosacral ligaments

Question 36

Where are the ovaries located?

Answer 36

near the attachment of the broad ligament to the lateral pelvic walls

Question 37

What suspends the ovaries?

Answer 37

peritoneal folds

Question 38

What are the peritoneal folds that suspend the ovaries?

Answer 38

posteriorsuperior aspect of broad ligament by mesovarium | lateral pelvic walls by suspensory ligaments of ovaries

Question 39

(blank) contains ovarian vessels, lymphatics, and nerves

Answer 39

suspensory ligament of the ovary

Question 40

The ovary is suspended in the peritoneal cavity and its peritoneal surface is characterized by (blank) from ovulation.

Answer 40

scarrin

Question 41

The oocyte expelled passes into the (Blank)

Answer 41

peritoneal cavity

Question 42

Once the oocyte is expelled into the peritoneal cavity, what happens next?

Answer 42

the oocyte is trapped by the fimbriae of the infundibulum, of the uterine tube and swept up into the ampulla for possible fertilization

Question 43

What are the two parts of the uterus?

Answer 43

body and cervix

Question 44

What are the two surfaces of the uterus?

Answer 44

vesical and intestinal

Question 45

Th uterine body lies on the (blank)

Answer 45

bladder

Question 46

The cervix lies between what 2 things?

Answer 46

the bladder and the rectum

Question 47

The supravaginal part of the cervix is separated from the bladder by (blank) and from the rectum posteriorly by the (blank)

Answer 47

loose CT | rectouterine pouch

Question 48

What demarcates the body from the cervix in the uterus?

Answer 48

the isthmus (constricted region)

Question 49

What are the 2 parts of the cervix?

Answer 49

supravaginal (between isthmus and vagina) | vaginal (protrudes into vagina)

Question 50

The external os of the uterus is surrounded by a narrow space called the (blank)

Answer 50

vaginal fornix

Question 51

The uterine wall has three parts which are....?

Answer 51

perimetrium myometrium endometrium

Question 52

(blank) is the serosal layer of the uterus (peritoneum supported by a thin layer of CT)

Answer 52

perimetrium

Question 53

(blank) is the middle coat of smooth muscle, (thinner during pregnancy), main branches of blood vessels are contained here, hormonally stimulated at intervals to dilate the cervical os and expel baby and placenta, produces cramping during menstruation.

Answer 53

myometrium

Question 54

(blank) is the inner mucous coat, differs at varying stages of the menstrual cycle, shed during menstruation, if conception has occurred, the blastocyst implants here.

Answer 54

endometrium

Question 55

The (blank) is mostly fibrous as compared to the muscular (blank).

Answer 55

cervix | muscular uterine body

Question 56

The (blank) is rounded in nulliparous females and H shaped in parous women.

Answer 56

external os

Question 57

Blood supply is mostly via the (blank) with partial collateral supply from the (blank). (blank) also supply the placenta.

Answer 57

uterine arteries ovarian arteries uterine arteries

Question 58

(blank) accompany uterine arteries into the broad ligament and form a venous plexus which drains into the internal iliac veins.

Answer 58

uterine veins

Question 59

What is the normal position of uterus?

Answer 59

anteverted w/ respect to vagina | anteflexed w/ respect to cervix

Question 60

What are the degrees of retroversion?

Answer 60

1st, 2nd, and 3rd. | 2nd is right above the vaginal opening

Question 61

If you have a 2nd degree retroversion what can be problematic?

Answer 61

you could get uterine prolapse

Question 62

``` What are these: Retroversion Retroflexion Hyperanteflexion Anteposition, Retroposition, Lateroposition Rotation Torsion Inversion Retrocession Elevation Descensus/Prolapse ```

Answer 62

pathological changes in uterine position

Question 63

What is inversion?

Answer 63

placenta makes uterus flip inside out during labor AHHHH!!!!

Question 64

What is a first degree uterine prolapse?

Answer 64

cervix is still inside vagina

Question 65

What is a second degree uterine prolapse?

Answer 65

cervix appears outside the vulva

Question 66

What is a third degree uterine prolapse?

Answer 66

complete prolapse

Question 67

What is this: Causes and risk factors: Weakness of pelvic floor muscles and/or ligaments. More common in women who have had one or more vaginal births, risk of tearing. Also: Normal aging Lack of estrogen after menopause Anything that puts pressure on the pelvic muscles, including chronic cough and obesity Pelvic tumor (rare) Long-term constipation and the pushing associated with it can make this condition worse Retroversion

Answer 67

causes of uterine prolapse

Question 68

What is the major ligament of the pelvic floor that we want to keep an eye on for uterine prolapse?

Answer 68

cardinal ligament

Question 69

What are other names for uterine tubes?

Answer 69

fallopian tubes, oviducts

Question 70

What do uterine tubes do?

Answer 70

conduct the ovum (fertilization usually occurs in the uterine tubes)

Question 71

Where do the uterine tubes lie?

Answer 71

in the mesosalpinx in the free edges of the broad ligament

Question 72

What is this: Ideally, extend symmetrically posterolaterally to the lateral pelvic walls and arch anterior and superior to the ovaries Commonly asymmetrically arranged with one or the other often lying superior and even posterior to the uterus

Answer 72

the uterine tubes

Question 73

What is this: (most lateral) funnel shaped distal end of the tube opening into the peritoneal cavity through the abdominal ostium; fimbriae are finger like projections that spread over the medial surface of the ovary; one large fimbria is attached to the superior pole of the ovary

Answer 73

the infundibulum

Question 74

What is this: | widest and longest part of the uterine tube, where fertilization usually occurs

Answer 74

ampulla

Question 75

What is this: | thick-walled part of the tube which enters the uterine horn

Answer 75

isthmus

Question 76

What is this: (most medial)- short segment passing through the wall of the uterus and opens via the uterine ostium into the uterine cavity at the uterine horn

Answer 76

uterine part

Question 77

What is atttached to the superior pole of the ovary to keep the ovary in contact with the infundibulum?

Answer 77

large fimbria

Question 78

(blank) is where fertilization usually takes place.

Answer 78

ampulla

Question 79

What extend from the cervix to the vestibule?

Answer 79

the vagina

Question 80

What is this: Usually collapsed, anterior and posterior walls are in communication with one another except where the cervix holds them apart Posterior to the urethra (which projects into its inferior anterior wall) and bladder Anterior to the rectum Passes through medial margins of the levator ani muscles

Answer 80

vagina

Question 81

How does the vagina pass by the levator ani muscles?

Answer 81

through the medial margins of the levator ani muscles

Question 82

(blank) is the recess around the cervix, has anterior, posterior and lateral parts

Answer 82

Vaginal fornix

Question 83

In the vagina, the (blank) is the deepest part, most closely related to the rectouterine pouch

Answer 83

posterior vaginal fornix

Question 84

The vagina is compressed by 4 muscles which act as sphincters; what are these four?

Answer 84

pubovaginalis external urethral sphincter urethrovaginal sphincter bulbospongiosus

Question 85

What is the arterial blood supply to the vagina?

Answer 85

superior aspect-> uterine arteries | middle and inferior-> vaginal and internal pudendal arteries

Question 86

What is the venous drainage of the vagina?

Answer 86

vaginal veins from vaginal venous plexuses (along side of vagina) The veins are continuous with uterine venous plexus as uterovaginal venous plexus this plexus also communicates w/ vesical and rectal venous plexuses

Question 87

Are there rugae inside the vagina?

Answer 87

yes to help with stretching

Question 88

What can you feel during a female pelvic examination?

Answer 88

``` external genitalia vagina and cervix uterus, ovaries, uterine tubes uterosacral ligament rectovaginal septum uterine position pregnancy pap smear ```

Question 89

What is the external genitalia of a femal?

Answer 89

mons, clitoris, labia majora and minora, perineum, and perianal area

Question 90

How can you detect a pregnancy?

Answer 90

you can detect softening of the uterine isthmus (hegar sign) -cervix feels separate from body