Female Pelvic Viscera Flashcards
(55 cards)
1
Q
Label all:
A
2
Q
Adnexa of uterus =
A
- ovary + uterine tube
3
Q
Label all:
A
4
Q
Label:
A
bladder
5
Q
Location of uterus in relation to the bladder in females:
A
- uterus lays on top of urinary bladder.
- urge to urinate is entirely pressure driven.
- increased urge to urinate during pregnancy due to inreased uterine weight on the bladder.
6
Q
Vestibule of vagina:
A
- area between labia minora.
- urethra and vaginal canal open into vestibule.
7
Q
Path of vagina to abdominal cavity:
A
cause of pelvic inflammatory disease
- opening of vagina
- up vagina
- into cervix
- into uterus
- through and out fallopian tubes
8
Q
Vagina blood supply:
A
- pelvic portion: vaginal artery; branch of uterine artery/internal iliac.
- perineal portion: internal pudendal artery.
9
Q
Nervous innervation to pelvic vagina:
A
- Autonomics: uterovaginal plexus
- Pain: pelvic splanchnic nerves (parasympathetic; S2-S4 lower limb pain)
10
Q
Uterovaginal plexus is a sub-plexus of:
A
inferior hypogastric plexus
11
Q
Nervous innervation to perineal vagina:
A
Pudendal nerve (motor and sensory)
12
Q
Vaginal fornices:
A
- recesses created by cervix entering vagina.
- exploited for examination and surgical access.
13
Q
The anterior fornix can be used to palpate:
A
bladder
14
Q
The lateral fornices can be used to palpate:
A
ovaries, oviduct, ureters
15
Q
The posterior fornix can be used to palpate:
A
uterus, rectum, rectouterine pouch (pouch of Douglas)
16
Q
Through what vaginal pouch can you enter the rectouterine pouch (pouch of Douglas), and therefore the abdominal/pelvic cavity?
A
posterior fornix
17
Q
Label all:
A
18
Q
Label all:
A
19
Q
The two openings of the cervix:
A
- internal os = between cervix and uterus.
- external os = between cervix and vagina.
20
Q
What is the normal anatomical position of the uterus:
A
anteverted and anteflexed.
- anteverted = angle cervix enters vagina.
- anteflexed = angle between cervix and uterus body.
21
Q
Anteflexion of uterus:
A
- angle between cervix and uterus body.
- uterus tipped forward as it rests on the urinary bladder.
22
Q
Anteversion of uterus:
A
- angle cervix enters vagina.
- protects/covers external os of cervix.
23
Q
As the urinary bladder fills in females, what will occur to the uterus?
A
- retroflexion: uterus body and fundus tips posteriorly.
- retroflex uterus = retrovert cervix angle into vagina.
24
Q
Label all:
A
25
The three layers of the uterus:
**PME**
* **_outer_** = perimetrium; has peritoneum covering it.
* **_middle_** = myometrium; thickest layer, a muscular layer.
* **_inner_** = endometrium
26
The uterus is supported by what ligaments?
1. round ligaments.
2. transverse cervical (cardinal) ligaments.
3. uterosacral ligaments.
27
Blood supply to the uterus:
* uterine artery; branch of internal iliac.
* Runs in transverse cervical (cardinal) ligament.
* Passes OVER ureter.
28
What occurs to the uterine artery as it enter and traverese the uterine wall?
* uterine artery coils back on itself
* when uterus expands during pregnancy, uterine artery can expand with it.
29
Nervous innervation to uterus:
* **_Sympathetic pain pathway:_** fundus, body, and uterine tubes
* **_Parasympathetic pain pathway:_** cervix
30
Dilation of the cervix pain is transmitted to the CNS how?
* visceral afferents running along parasympathetics via pelvic splanchnic nerves.
* S2-S4; lower leg pain.
31
Function of uterine tubes:
* passageway for ovulated eggs to reach uterus
32
Infundibulum:
* distal-most portion of uterine tube
* the opening into peritoneal cavity
33
The little fingers on the end of the uterine tube surrounding the infundibulum:
fimbriae
34
Fertilization typically takes place in what part of the uterine tube?
ampulla
35
The proper ovarian ligament and round ligament of the uterus arise from what embryonic structure?
* caudal genital ligament
* proximal end = proper ovarian ligament.
* distal end = round ligament of the uterus.
36
The two ligaments assoicated with the ovaries:
1. **proper ovarian ligament**
* **** attaches ovary to uterus
2. **suspensory ligament of ovary**
* a fold of peritoneum elevated by the ovarian artery and vein
37
Path of ovarian artery and vein to ovaries:
* direct branch off aorta around L2
* runs through suspensory ligament of ovary to ovary
38
Nervous innervation to ovaries:
* above pelvic pain line.
* pain afferents run along sympathetic nerves.
* pain referred to T10 and T11 dermatomes. Low back pain.
39
Ovarian pain is referred to what dermatomes?
* T10 and T11 dermatomes.
* Low back pain.
40
Vesicouterine pouch location:
* between bladder and uterus.
* formed by peritoneum/broad ligament covering uterus.
41
Rectouterine pouch location:
* between uterus and rectum.
* formed by peritoneum/broad ligament covering uterus.
42
Label all:
43
Significance of rectouterine pouch (pouch of Douglas):
* Deepest/most inferior extent of female peritoneal cavity.
* Any fluid in a female's abdomen will settle in the rectouterine pouch.
* Can be assayed via posterior fornix.
44
Label all:
45
What ligaments form the white lines in the image?
* transverse cervical (cardinal) ligaments.
* carry uterine arteries.
* primary support of cervix at pericervical ring.
46
Label all:
47
Cause of uterine prolapse (2):
1. pericervical ring dilated or stretched.
2. connective tissue structures attaching to pericervical ring damaged.
## Footnote
**external os of the cervix protrudes first.**
48
Hysterectomy:
* surgical removal of the uterus
49
Reasons for hysterectomy (5):
1. uterine prolapse
2. endometriosis
3. abnormal uterina bleeding
4. fibroids
5. cancer
50
Three types of hysterectomies:
1. radical hysterectomy
2. total hysterectomy
3. partial/sub-total hysterectomy
51
Radical hysterectomy:
* removal of entire uterus, adnexa, and upper part of vagina.
52
Total hysterectomy:
* removal of uterus fundus, body, and cervix.
* adnexa and upper part of the vagina remain.
53
Partial/sub-total hysterectomy:
* removal of uterine body and fundus.
* pericervial ring and adnexa stay.
54
Two types of fibroids:
1. **_myoma_** = muscle fibroid.
2. **_leiomyoma_** = muscle and connective tissue fibroid.
55
Endometriosis:
* endometrial tissue somewhere other than the uterus.
* ectopic endometrial tissue.
* tissue grows in response to hormonal changes and can be painful.
