Lecture 2

Question 1

Which parts of the female reproductive system are found in the pelvis?

Answer 1

Ovaries, uterine tubes, uterus, superior part of vagina

Question 2

Which parts of the female reproductive system are found in the perineum?

Answer 2

Inferior part of vagina, perineal muscles, Bartholin glands, clitoris, labia

Question 3

Pouch of Douglas

Answer 3

Recto-uterine pouch

Question 4

Clinical relevance of posterior fornix of vagina

Answer 4

A needle can be passed through there to drain pouch of Douglas

Question 5

The broad ligament is formed of

Answer 5

A double layer of peritoneum

Question 6

The broad ligament is located

Answer 6

Between the uterus and the lateral floors and walls of the pelvis

Question 7

Which ligament is an embryological remnant?

Answer 7

The round ligament

Question 8

Location of round ligament

Answer 8

Attaches to lateral aspect of uterus and passes through deep inguinal ring to attach to superficial perineal tissue.

Question 9

What is contained proximally by the broad ligament?

Answer 9

The round ligament

Question 10

What keeps the uterus in position and prevent prolapse?

Answer 10

Strong uterine ligaments, endopelvic fascia, pelvic floor muscles

Question 11

Zygote implantation occurs…

Answer 11

In body of uterus

Question 12

Ectopic pregnancy

Answer 12

Occurs with implantation of zygote outwith uterine body

Question 13

Normal uterine position

Answer 13

Anteverted (relative to vaginal axis) and anteflexed (relative to cervical axis)

Question 14

Normal variation of uterine position

Answer 14

Retroverted and retroflexed

Question 15

What area of the cervix is sampled in a cervical smear?

Answer 15

The squamo-columnar junction

Question 16

Where does fertilisation occur?

Answer 16

Ampulla

Question 17

What is the communication between the genital tract and peritoneal cavity?

Answer 17

The fimbriated ends of the fallopian tubes open out into peritoneal cavity

Question 18

Ovary shape and size

Answer 18

Almond

Question 19

Embryologically where do ovaries develop?

Answer 19

Posterior abdominal wall

Question 20

What holds vaginal walls apart superiorly?

Answer 20

The cervix - forming a fornix

Question 21

Parts of the fornix

Answer 21

2 lateral, anterior, posterior

Question 22

Where can the ischial spines be palpated on digital examination?

Answer 22

Laterally at 4 and 8 oclock

Question 23

How can you assess uterine position?

Answer 23

Bimanual palpation

Question 24

Palpation of adnexae for large masses or tenderness

Answer 24

Place examining fingers into lateral fornix and press with other hand on ipsilateral iliac fossa

Question 25

What forms the floor of the pelvis and the roof of the perineum?

Answer 25

Pelvic diaphragm

Question 26

What forms most of the pelvic diaphragm

Answer 26

The levator ani muscle

Question 27

What kind of muscle is levator ani?

Answer 27

Skeletal, under voluntary control, tonic contraction

Question 28

Nerve supply to levator ani?

Answer 28

S3,4,5

Question 29

Nerve supply to perineal muscles?

Answer 29

Pudendal nerve

Question 30

What do the perineal muscles attach to?

Answer 30

Perineal body

just deep to skin

Question 31

Borders of breast bed

Answer 31

Ribs 2 to 6, lateral sternal border, mid axillary line

Question 32

What does the breast lie on?

Answer 32

Deep fascia

Question 33

What muscles does the breast lie on?

Answer 33

Pectoralis major and serratus anterior

Question 34

How does breast tissue attach to the skin?

Answer 34

Via suspensory ligaments

Question 35

Where does the majority of breast lymph drain to?

Answer 35

Ipsilateral axillary lymph nodes

Question 36

Lymph from inner breast quadrants can drain where?

Answer 36

To parasternal lymph nodes (and then supraclavicular)

Question 37

Lymph from lower inner quadrant can drain where?

Answer 37

To abdominal lymph nodes

Question 38

Level 1 axillary nodes

Answer 38

Inferior and lateral to pectoralis minor

Question 39

Level 2 axillary nodes

Answer 39

Deep to pectoralis minor

Question 40

Level 3 axillary nodes

Answer 40

Superior and medial to pectoralis minor