Female and Male Reproductive Anatomy

Question 1

The pelvic floor is formed by the bowl-shaped pelvic diaphragm which includes what?

Answer 1

The coccygeus and levator ani muscle group (LAM)

Question 2

What makes up LAM?

Answer 2

puborectalis, pubococcygeus, iliococcygeus

Question 3

The diaphragm attaches to a thickening in the obturator fascia known as what?

Answer 3

The tendinous arch of levator ani, which covers the obturator internus muscle overlying the lateral pelvic wall

Question 4

What is the anterior gap in the medial borders of the LAM that allows passage of the urethra, and the vagina in females?

Answer 4

Urogential hiatus

Question 5

What is mostly tonically contracted-resists increases in intra-abdominal pressure
Supports abdominopelvic viscera and
assists in maintaining urinary and fecal continence?

Answer 5

Urogential hiatus

Question 6

What is actively contracted during activities and is innervated by the levator ani nerve, inferior rectal n, and coccygeal plexus?

Answer 6

Urogential hiatus

Question 7

What nerve is injured during vaginal birth and pelvic reconstructive procedures?

Answer 7

The levator ani n

Arises from ventral sacral rami of S4 mostly

Question 8

Disruption of what nerve leads to pelvic floor dysfunction and urinary incontinence and prolapse of pelvic viscera?

Answer 8

Levator ani n

Question 9

What is a muscular tube located between the bladder and the rectum and inferior to the uterus?

Answer 9

Vagina

Opens through the perineal membrane into the vestibule

Question 10

The vagina is about how long?

Answer 10

8cm

Question 11

What is the vagina supported by?

Answer 11

The pubovaginalis part of the levator ani m. and the perineal membrane

Question 12

Where does the urethra in females begin?

Answer 12

At the internal urethral orifice of the bladder

Question 13

What does the urethra pass through?

Answer 13

The external urethral sphincter, perineal membrane then through the perineum and vestibule

Question 14

What does the superior part of the vagina surround?

Answer 14

The cervix of the uterus

Question 15

What is culdoscopy?

Answer 15

Tool to examine the uterine tubes or ovaries

Question 16

What is culdocentesis?

Answer 16

To aspirate fluid from the rectouterine pouch

Question 17

What is the arterial supply of the uterus, ovary, and vagina?

Answer 17

Ovarian, uterine and vaginal artery

Question 18

Where does the ureter pass in relation to the uterine artery?

Answer 18

The ureter passes the uterine artery along the lateral sides of the uterus

Question 19

The uterine arteries enter the sides of the uterus through what?

Answer 19

The broad ligament

Question 20

Branches of the uterine arteries ascend and descend to anastomose with what?

Answer 20

The vaginal arteries and the ovarian arteries

Question 21

What are the surfaces of the uterus?

Answer 21

Vesical surface and intestinal surface

Question 22

What are the parts of the uterus?

Answer 22

Fundus
Uterine horns
Body of the uterus
Cervix of the uterus (with cervical canal)
Fornices
External os
Internal os

Question 23

What are the layers of the uterus?

Answer 23

Endometrium
Myometrium
Perimetrium

Question 24

What are the parts of the uterine tubes?

Answer 24

Isthmus, ampulla, infundibulum, fibriae, ovary

Question 25

What do the uterine tubes transport?

Answer 25

The ovum to the uterus and is 10 cm long

Question 26

The distal ends of the tubes are open to what?

Answer 26

The peritoneum

Question 27

The fundus of the uterus is normally in what position?

Answer 27

Anteverted and anteflexed The axis of the uterus is angled anteriorly (relative to the vagina) and the top of the fundus "flexes" anteriorly over the bladder

Question 28

If the uterus is not anteverted and antiflexed, what does it caused?

Answer 28

Increased intra-abdominal pressure can push the uterus inferiorly Contributes to prolapse of the uterus

Question 29

What is a double layer of peritoneum that "drapes" over the uterus and associated structures?

Answer 29

The broad ligament of the uterus

Question 30

What encloses the round ligament of the uterus as it extends from the anterior-lateral part of the uterus to the deep inguinal ring?

Answer 30

The broad ligament

Question 31

What are condensations of endopelvic fascia that support the uterus and attach to the lateral sides of the uterus and vagina?

Answer 31

Transverse cervical ligaments

Question 32

What vessels and nerves run through (or along) the transverse cervical ligaments?

Answer 32

Uterine vessels

Question 33

What are condensations of endopelvic fascia that extend from the sides of the cervix to the sacrum?

Answer 33

Uterosacral ligaments

Question 34

What are the parts of the broad ligament?

Answer 34

``` Mesoalpinx mesovarium mesometrium suspensory ligament of the ovary round ligament of the uterus ligament of ovary ```

Question 35

The ligaments help to support the uterus, but what are extremely important in preventing prolapse of pelvic structures?

Answer 35

Levator ani muscle and the perineal body

Question 36

The ovaries are suspended from the lateral pelvic wall by what?

Answer 36

The suspensory ligament of the ovary which contains ovarian arteries, veins, nerves and lympatics

Question 37

The inferior part of the vagina is innervated by what?

Answer 37

Somatic branches from the internal pudendal n

Question 38

The middle and superior parts of the vagina and the uterus are innervated by what?

Answer 38

Visceral nn. - uterovaginal plexus (part of pelvic plexus) - sympathetics form lumbar splanchnics - parasympathetics from pelvic splanchnics S2, S3, S4 (motor to the uterus and vagina)

Question 39

Where are anesthetic agent injected into for spinal block?

Answer 39

The subarachnoid space between L3 and L4. | Produces complete anesthesia below the waist. uterine contractions cannot be felt

Question 40

What do peripheral nerve blocks allow?

Answer 40

Sensation of uterine contractions

Question 41

What occurs during the pudendal block?

Answer 41

Blocks S2, S3, and S4 dermatomes and the inferior part of the the vagina.

Question 42

What is the landmark for a pudendal block?

Answer 42

Sacrospinous ligament

Question 43

What abolishes sensation in the anterior vulva?

Answer 43

Ilioinguinal block

Question 44

In a peripheral nerve block, the pundendal and ilioinguinal block must be preformed. What may also need to be anesthetized?

Answer 44

The posterior femoral cutaneous nerve (perineal branches)

Question 45

What is superior to perineal membrane and embedded within sphincter urethrae (external urethral sphincter) in males?

Answer 45

The bulbourethral glands

Question 46

What do bulborethral glands open into?

Answer 46

Spongy urethra

Question 47

What lubricates the urethra?

Answer 47

Mucus-like secretions from the bulbourethral glands

Question 48

Lymphatics - the prostate drains primarily into what?

Answer 48

internal iliac nodes

Question 49

lymphatics - the bladder drains primarily to what?

Answer 49

external iliac nodes

Question 50

Lymphatics - the perineal structures drain primarily to what?

Answer 50

Superficial inguinal nodes