Female Reproductive System and Breast Flashcards

1
Q

What is the perineum?

A

Shallow space between the pelvic diaphragm (levator ani) and the skin

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2
Q

List the parts of the female reproductive system in the pelvic cavity

A

Ovaries
Uterine tubes
Uterus
Superior part of vagina

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3
Q

List the parts of the female reproductive system in the perineum

A
Inferior part of vagina
Perineal muscles
Bartholin's glands
Clitoris
Labia
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4
Q

What is the function of the inferior part of the PARIETAL peritoneum?

A

Floor of peritoneal cavity

Roof over pelvic organs

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5
Q

State the two pouches formed by the female periotenum

A

Vesico-uterine - between bladder and uterus

Recto-uterine - between rectum and bladder (Pouch of Douglas)

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6
Q

Where does excessive abnormal fluid from the peritoneal cavity usually collect? How is this managed?

A

Pouch of Douglas (most inf. part of peritoneal cavity)

Drained via needle passed through posterior fornix of vagina

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7
Q

Name and outline the ligaments of the uterus

A
Broad ligament (double layer of peritoneum containing uterine tubes and proximal round ligament)
Round ligament (embryological remnant)
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8
Q

What is the function of the broad ligament of the uterus?

A

Helps maintain uterus in correct midline position via lateral attachments

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9
Q

List the three components of the broad ligament of the uterus, and their associations

A

Mesosalpinx (uterine tube)
Mesovarian (ovaries)
Mesometrium (uterus)

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10
Q

What are they layers of the uterus?

A

Perimetrium
Myometrium
Endometrium

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11
Q

Which layer of the uterus is shed during the menstrual cycle?

A

Endometrium

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12
Q

What is the name for the opening in the center of the ectocervix (passage between vagina and uterus)?

A

External cervical os

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13
Q

What is the name for the opening of the uterus from the cervix?

A

Internal cervical os

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14
Q

Where does implantation normally occur?

A

Body of uterus

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15
Q

Implantation outside the body of the uterus is known as…

A

Ectopic pregnancy

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16
Q

List the layers of support that help to hold the uterus in position

A

Number of strong ligaments e.g. uterosacral
Endopelvic fascia
Muscles of pelvic floor e.g. levator ani

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17
Q

Weakness of the layers of support for the uterus results in what clinical pathology of the female reproductive system?

A

Uterine prolapse

Movement of the uterus inferiorly

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18
Q

What is the most common positions of the uterus?

A

Anteverted (cervix tipped anteriorly relative to axis of vagina, sits on top of bladder)
Anteflexed (uterus tipped anteriorly relative to axis of cervix)

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19
Q

List normal variations that can occur in uterine position

A

Retroverted (uterus tipped posteriorly relative to axis of vagina)
Retroflexed (uterus tipped posteriorly relative to axis of cervix)

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20
Q

Which area of the cervix should be sampled during cervical smear, and is a common site for cervical dysplasia?

A

Squamo-columnar junction (transformation zone)

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21
Q

Outline the route taken by an ovum from ovary to implantation

A
Ovary
Infundibulum
Ampulla
Isthmus
Uterus
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22
Q

What structures present on the infundibulum open into the peritoneal cavity and pick up ovum?

A

Fimbrae

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23
Q

Where does fertilisation normally occur?

A

Ampulla of the uterine tube

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24
Q

What is the clinical term for removal of both uterine tubes and ovaries?

A

Bilateral salpingophrectomy

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25
What is the clinical term for removal of one uterine tube?
Unilateral salpingectomy
26
The uterine tubes provide communication between the genital tract and peritoneal cavity. What is the clinical consequences of this?
PID can cause peritonitis | Ectopic pregnancy can develop in peritoneal cavity
27
What is the function of the ovaries?
Secrete oestrogen and progesterone in response to FSH and LH
28
Where do the ovaries develop?
Located on posterior abdominal wall and descend to the lateral pelvic cavity
29
Ovum are released directly into the periotenal cavity. True/ False?
True | Then picked up by fimbrae
30
The walls of the vagina are normally in contact. Where is the exception to this?
Superiorly where cervix holds them apart forming a fornix
31
What is a 'fornix'?
Space around cervix
32
List the components of a fornix
Anterior Posterior 2 lateral
33
Where can the ischial spines be palpated on vaginal digital exam?
Laterally at 4 and 8 o'clock
34
What is assessed during bimanual palpation in a vaginal digital exam?
Position of uterus
35
How are the adnexae palpated on vaginal digital exam?
Fingers into lateral fornix Press on same iliac fossa Detect any large masses or tenderness
36
What are the 'adnexae' of the female reproductive tract?
The appendages to the uterus - fallopian tubes, ovaries, and ligaments
37
What is the function of the openings in the pelvic floor?
Passage of distal alimentary, renal and reproductive tracts from pelvis to perineum
38
The perineum is divided into...
Superficial and deep pouches
39
What is the urogenital triangle?
The anterior half of the perineum, bounded by the pubic symphysis and ischial spines
40
What is the anal triangle?
The posterior half of the perineum, bounded by the ischial spines and coccyx
41
The levator ani muscle is made up of...
A number of smaller muscles
42
The levator ani is a skeletal/smooth muscle for involuntary/voluntary control
Skeletal muscle | Voluntary control
43
Which muscle forms the majority of the pelvic diaphragm?
Levator ani
44
What is the function of the levator ani muscle?
Continual support for pelvic organs | Undergoes tonic contractions
45
In what situation does the levator ani muscle contract more?
Increased intrabdominal pressure
46
Weakness of the levator ani is a factor in development of what pathological condition?
Prolapse of pelvic organs
47
What is the nerve supply to the levator ani muscle?
Nerve to levator ani | Pudenal nerve
48
State the nerve roots of the pudenal nerve
S3,4,5
49
Superficial and deep perineal muscles are supplied by...
Pudenal nerve
50
What is the perineal body? What is it's function?
Bundle of collagenous and elastic tissue where perineal muscles attach, located just deep to the skin Pelvic floor strength
51
Where is Bartholin's gland or the greater vestibular gland located? What pathology can arise here?
Right and left gland around external urethral orifice | Become enlarged due to infection (forms abscess)
52
What anatomical surface feature is located anterior to pubic bones?
Mons pubis
53
List, from superior to inferior, the external surface openings for the female reproductive tract
External urethral orifice Vaginal orifice Anus
54
State the two components of the labia of the vulva
Labum majus | Labum minus
55
What is the vulval vestibule?
Part of the vulva between the labia minora containing the external urethral orifice and vaginal orifice
56
What are the surface borders of the female breast?
Ribs 2-6 Lateral border of sternum Mid-axillary line
57
What is the axillary tail of Spence?
Extension of the tissue of the breast that extends into the axilla and drains lymph nodes
58
The female breast lies on deep fascia covering which two muscles?
Pectoralis major | Serratus anterior
59
What is the clinical term for the loose areolar tissue that separates the breast from the fascia?
Retromammary space
60
The female breast attach to skin via...
Suspensory ligaments
61
What is the function of the lactiferous ducts?
Connect the nipple to the lobules of the mammary gland
62
State the two types of lobules present within the mammary gland
``` Non-lactating lobules Lactating lobules (only in pregnant women) ```
63
What female harmone is involved with the production ejaculation of breast milk respectively?
Prolactin | Oxytocin
64
What is the areola?
Area of coloured skin at base of nipple
65
State the divisions of the breast used to describe a position of a lump
``` Upper outer (9-12 o'clock) Upper inner (12-3 o'clock) Lower outer (6-9 o'clock) Lower inner (3-6 o'clock) ```
66
Outline the drainage of the majority of lymph from the breast
Ipsilateral axillary nodes --> Supraclavicular nodes
67
Which divisions of the breast can drain into both ipsilateral or contralateral axillary nodes? Why?
Inner breast quadrants | Can also drain into parasternal nodes
68
Which divisions of the breast can drain into abdominal lymph nodes?
Lower inner breast quadrant
69
Lymph from the upper limb also drains to axillary lymph nodes. What is the clinical significance of this?
Axillary clearance in treatment of breast cancers can cause LYMPHOEDEMA
70
List important structures contained within the axillary fat
Brachial plexus Axillary artery and vein Axillary lymph nodes
71
Axillary node levels are used by surgeons in clearance of lymph nodes. These are related to which muscle?
Pectoralis minor
72
State the boundaries of level 1 axillary node clearance
Inferior and lateral to pectoralis minor | BELOW PEC MINOR
73
State the boundaries of level 2 axillary node clearance
Deep to pectoralis minor | BENEATH PEC MINOR
74
State the boundaries of level 3 axillary node clearance
Superior and medial to pectoralis minor | ABOVE PEC MINOR
75
Outline the blood supply to the different aspects of the female breast
Subclavian artery --> Internal thoracic (internal mammary): PARASTERNAL --> Axillary artery: LATERAL Intercostal arteries: DEEP
76
Outline the venous drainage from the female breast
Internal thoracic (internal mammary) vein Axillary vein --> Subclavian vein Intercostal veins