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Endo Repro Exam > Female Reproductive Anatomy > Flashcards

Female Reproductive Anatomy Flashcards

(52 cards)

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1
Q

development of female reproductive anatomy

A

*Mullerian ducts fuse to form uterus & top of vagina

note - urinary, reproductive, and GI tracts develop in close proximity; often pathophysiology in one organ produces symptoms in neighboring organs

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2
Q

female external genitalia: perineum

A

*the area between the anus and vulva, rich in sensory nerve endings & vascularity that are important in providing sexual arousal
*no valves in vulvar veins
*clinical implications:
-rapid healing
-common hematomas related to birth trauma
-infection is rare

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3
Q

female external genitalia: vulva

A

*collective term for the female external reproductive sex organs
*includes: mons pubis, labia majora, labia minora, clitoris, urethra, vaginal introitus, and surrounding glands
*boundaries extend from:
-mons pubis anteriorly to rectum posteriorly
-one lateral genitocrural fold to the other

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4
Q

female external genitalia: mons pubis

A

*a layer of fatty tissue over the pubic symphysis of the pubic bone

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5
Q

female external genitalia: clitoris

A

*a homologue of the dorsal part of the penis
*consists of 2 erectile corpora cavernosa that end in the glans
*surrounded by a hood/prepuce (extension of labia minora) and covered by stratified squamous epithelium
*highly sensitive and a source of sexual pleasure, enlarging in response to nerve stimulation

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6
Q

female external genitalia: vestibule

A

*contains the vaginal and urethral openings
*covered by stratified squamous epithelium
*includes 2 types of glands:
1. Bartholin’s glands
2. vestibular glands

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7
Q

female external genitalia: labia majora

A

*2 cutaneous folds that extend from the mons pubis to the perineum
*covered with squamous epithelial cells (like the rest of the body’s skin)
*made of adipose and fibrous tissue
*lined with hair follicles & sebaceous glands
*have to treat as deep as 3mm for VIN in this area, due to deep hair follicles

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8
Q

female external genitalia: labia minora

A

*2 flaps located on each side of the vaginal opening
*lined by squamous epithelium, but lack hair and sebaceous glands
*made of dense connective tissue, erectile tissue, and elastic fibers (no adipose tissue)

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9
Q

female external genitalia: hymen

A

*thin and typically perforated layer at entrance to vagina
*fibrous tissue with few small blood vessels
*small tags are remnants of hymen in adult/sexually active females

note - imperforate hymen = defect in vaginal canalization

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10
Q

female external genitalia: urethra

A

*extends from bladder to vestibule
*composed of stratified transitional epithelium proximally and stratified squamous epithelium distally

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11
Q

female external genitalia: lesser vestibular glands

A

*aka Skene glands
*open into distal urethra
*homologous to prostate in males
*smaller and more numerous mucous glands

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12
Q

female external genitalia: Bartholin Glands

A

*aka greater vestibular glands
*two tubuloalveolar mucous glands at 4 o’clock and 8 o’clock at vaginal orifice
*about the size of a pea
*homologous to Cowper glands in male
*most common large cyst of the vulva arises from this structure

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13
Q

female external genitalia: vestibular bulbs

A

*erectile tissue on either side of vaginal orifice
*homologous to bulb of the penis

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14
Q

female external genitalia: pelvic floor

A

*the levator ani is a collection of 3 muscles:
1. puborectalis
2. pubococcygeus
3. iliococcygeus

*physiologically, normal levator ani muscles are in a constant state of contraction
*with increases in intra-abdominal pressure, the levator ani contract more to support the pelvic viscera
*if they are not strong enough, the anatomic position of the urethra, vagina, and rectum are not maintained

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15
Q

female internal genitalia: vagina

A

*a muscular tube that connects the external female genitalia to the uterus
*line with non-keratinizing squamous epithelium
*goes posteriorly with the uterus laying almost horizontally and at least 90 degrees between uterus and vagina

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16
Q

female internal genitalia: vaginal arteries

A

*mostly symmetrical, coming in laterally and anastomosing in the center
*anterior divisions of the interior iliac arteries supply most of the blood to the uterus, cervix, and vagina
*vaginal artery is usually a branch of the uterine artery

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17
Q

female internal genitalia: lymphatic drainage of vagina

A

*drains to the internal iliac and superficial inguinal nodes

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18
Q

vagina - pH and lubrication

A

*vagina has low pH due to bacterial metabolism of glycogen in sloughed cells from walls, resulting in lactic acid accumulation
*lubrication: transudate from increased vascular flow of Bartholin’s glands, cervical glands during intercourse

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19
Q

vaginal support

A

*vagina does not have any intrinsic support; reliant on ligaments, organs, and muscles to hold it in place
*level 1: uterosacral ligaments to pelvic walls
*level 2: fascial support
*level 3: urethra, levator ani muscles, and perineal body

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20
Q

female internal genitalia: cervix

A

*the lowest, narrow portion of the uterus which attaches to the vagina
*portio vaginalis: the portion that sticks into the vagina; covered by squamous epithelium
*cervical canal:
1. external os: narrowing off the vagina, at the lower portion of the cervical canal
2. internal os: narrowing at the top of the cervical canal
*columnar epithelium covers glandular tissue (secretes mucus, facilitating sperm transport)

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21
Q

histology of the cervix

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A

*transition from squamous (ectocervix) to columnar (endocervix) epithelium at the SCJ (squamo-columnar junction or transformation zone)
*squamocolumnar junction (transformation zone) is most common site for cervical cancer
*columnar epithelium is in the cervical canal; useful for secreting mucous and facilitating sperm transport

22
Q

vascular supply of the cervix

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A

*cervix has its major vessels at 3 and 9 o’clock
*uterine arteries → cervical arteries
*numerous anastomoses with vaginal and middle hemorrhoidal arteries

23
Q

lymphatic drainage of the cervix

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A

*lymph drainage nodes:
-internal iliac
-common iliac
-external iliac
-obturator
-visceral nodes of parametria

24
Q

innervation of the cervix

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A

*parasympathetic fibers of S2-S4
*exocervix has less pain sensors than endocervix

25
female internal genitalia: uterus
*shaped like an inverted pear *the non-gravid uterus consists of body and cervix, demarcated by a relatively narrow isthmus *fundus = portion above the uterine tubes *uterus has a trilaminar wall consisting of: 1. inner vascular and secretory **endometrium** 2. a hormonally-stimulated intermediate smooth muscle **myometrium** 3. outer visceral peritoneum (**perimetrium**)
26
layers of the uterus: endometrium
*the inner layer of the uterus *composed of simple columnar epithelium, endometrial glands, and stroma (connective tissue) *vascular & secretory ***undergoes cyclical changes to prepare for implantation to occur; sheds with menstruation if implantation does not occur**
27
layers of the uterus: myometrium
*a hormonally-stimulated intermediate **smooth muscle layer** *dilates the cervical canal and expels the fetus during childbirth
28
layers of the uterus: perimetrium
*visceral peritoneum that covers the surface of most of the fundus and body of the uterus and continues bilaterally as the broad ligament (mesometrium)
29
uterus support
*uterus is normally anteverted and anteflexed, so that its weight is borne largely by the urinary bladder *receives significant passive support from cardinal ligaments and uterosacral ligament *receives active support from the muscles of the pelvic floor
30
vascular supply & drainage of the uterus
*blood supply: uterine arteries & ovarian arteries *venous drainage: uterine & ovarian veins
31
lymphatic drainage of the uterus
*lymphatic drainage nodes: -aortic -lumbar -pelvic -internal iliac
32
innervation of the uterus
*afferent nerves: T11, T12 *sympathetic: ovarian and hypogastric plexus *parasympathetic: pelvic nerve, S2-S4
33
relationships between rectum, uterus/vagina, and bladder
*vesicouterine pouch - anterior *rectouterine pouch (of Douglas) - posterior; deepest point of peritoneal cavity
34
uterine (fallopian) tubes
*the conduits & sites of fertilization for oocytes discharged into the peritoneal cavity *connect the ovaries to the uterus *3 portions: 1. isthmus - closest to the uterus 2. ampulla 3. infundibulum (fimbriated, funnel-like) - closest to the ovary
35
vascular supply of uterine (fallopian) tubes
*ovarian and uterine arteries
36
uterine (fallopian) tubes - histology
*ciliated columnar to help transport oocyte
37
ovaries - overview
*sit at the end of each uterine (fallopian) tube *within ovarian follicles, differentiation of an embryonic ovum into a mature ovum ready for fertilization takes place (oogenesis)
38
support of the ovaries
*suspended by peritoneal folds: the mesovarium from the posterosuperior aspect of the broad ligament, the ovarian ligament which connects it to the uterus, and the suspensory ligament
39
vascular supply of the ovaries
*ovarian arteries & uterine arteries
40
venous drainage of the ovaries
1. right ovarian vein drains directly into IVC 2. left ovarian vein drains into left renal vein before draining into IVC
41
lymphatic drainage of ovaries
*para-aortic lymph nodes
42
female pelvic ligaments: broad ligament
*connects: **uterus to lateral pelvic wall** *structures contained: **ovary, fallopian tube, round ligament** *notes: **fold of peritoneum comprising the mesometrium, mesovarium, and mesosalpinx**
43
female pelvic ligaments: round ligament
*connects: **uterine horn to labia majora** *notes: travels through inguinal canal; derivative of gubernaculum
44
female pelvic ligaments: cardinal ligament
*connects: **cervix to lateral pelvic wall** *structures contained: **UTERINE VESSELS (uterine artery/vein)** *notes: condensation at the base of the broad ligament; **uterine vessel ligation during hysterectomy risks damaging the URETER (water under the bridge)**
45
female pelvic ligaments: uterosacral ligament
*connects: **cervix to sacrum** around each side of rectum
46
female pelvic ligaments: suspensory / infundibulopelvic ligament
*connects: **ovary to lateral pelvic wall** *structures contains: **ovarian vessels (ovarian artery)** *notes: ovarian vessel ligation during oophorectomy risks damaging the ureter
47
ureters - anatomically narrow sites
*sites that are anatomically narrowed (easier for stones to get caught): 1. ureteropelvic junction 2. crossing of the external iliac artery 3. passing through the bladder wall
48
ureters - at-risk surgical sites
1. where the ovarian vessels lie just lateral to the ureter 2. where the ureter passes inferior to the uterine vessels (water under the bridge) 3. where the ureter lies 1 cm lateral to the cervix
49
female reproductive system - anatomic abnormalities
1. absence of ovary 2. ectopic ovarian tissue 3. absence of uterus - due to degeneration of Mullerian ducts 4. failure of Mullerian duct fusion 5. absence of vagina - due to failure of vaginal plate development 6. vaginal atresia - due to failure to canalize (source of imperforate hymen)
50
arterial supply of the female reproductive organs (general)
*anterior branch of the **internal iliac artery** supplies most of the female reproductive organs *uterine artery (branch of anterior internal iliac) supplies most of the uterus *ovarian arteries (descended from the abdominal aorta) supply the ovaries
51
which ligament in the female pelvis contains the UTERINE vessels (artery & vein)?
**CARDINAL ligament** *connects cervix to lateral pelvic wall note - uterine vessel ligation during hysterectomy risks damaging the URETER (water under the bridge)
52
which ligament in the female pelvis contains the OVARIAN vessels (artery & vein)?
**SUSPENSORY ligament (aka infundibulopelvic ligament) of the ovary** *connects ovary to lateral pelvic wall

Endo Repro Exam (56 decks)

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