Flashcards in Lecture 20 DA Deck (74):
What structures does the paramesonephric tube form?
Vagina, uterus and uterine tubes.
What structures does the mesonephric tube form?
Penis and scrotum.
What two embryonic structures form the gonads in males and females?
Mesonephric tube for males and paramesonephric tubes for females.
How does the mesonephric/paramesonephric tube develop?
Two tubes that merge at the midline, bringing the blood supply to the midline, making it bilateral.
What is the descent of the ovaries preceded by?
Where are the ovaries found?
In a depression on the lateral pelvic wall, between the external and internal iliac vessels, and close to the obturator nerve.
What happens in an abnormal descent of the ovaries called?
Its descent can be arrested or can descend too far, as far as the inguinal canal or labia majora. Similar can happen to the testes. Called Imperfect descent of the ovaries.
What is the clinical significance of the ovaries being close to the obturator nerve?
Disease of the ovary can irritate the obturator nerve, and one sign is when a patient has medial thigh pain (which obturator supplies), but has no knee or hip pathology (no somatic disease). This is a consequence of referred pain.
What plane do the ovaries lie on?
It lies on the plane connecting the tip of the pubic bone to the tip of the coccyx. They can be palpated.
Can the ovaries be palpated?
What is the broad ligament?
A sheet of peritomeum to which connects the ovaries to the uterus.
What is the mesovarium?
Found along the superior border of the ovaries, it connects the ovaries to the broad ligament above.
What attaches the ovaries to the side of the uterus?
The ovarian ligament, found medial to the ovaries, and passes through the broad ligament.
What is the suspensory ligament and where is it found?
It connects the ovaries to the posterior wall, and is found at the tip of the ovaries superiorly. It is formed from the broad ligament.
Where can prolapse occur in women around the pevlis?
Into the recto-uterine pouch. In severe cases, it can be into the peritoneum, a posterior fornix.
What are the 5 components of the fallopian tube?
-Intramural fallopian tube (within the wall of the uterus.
-Ithsmus, the straight part.
-Ampulla, longest, widest and most toruous part.
-Infundibulum, the terminal end.
-Fimbria, hair-like structure at the infundibulum.
Where does fertilisation take place?
At the ampulla.
What happens at the infundibulum?
Fertilised egg conveyed via peristalsis and cilliary action.
What happens when the ova is released?
The fimbria directs it into the fallopian tube.
What is peritonitis?
Infected material can pass through the vagina, through the uterus and into the abdominal peritoneal cavity, causing an infection, called peritonitis.
What is an abnormal pregnancy called, when does it occur, and where can it occur?
It occurs when the egg implants somewhere other than the ampulla. Can implant into the uterine tube. Called ectopic pregnancy.
What is so dangerous about ectopic pregnancy?
It can rupture the tube, causing serious, life threatening haemorrhage.
What shape is the uterus, and where is the cervix found?
It is pear shaped, and has two os (openings), called internal and external os. Internal is found superiorly, and external is distal. The cervix is found in between the two.
What is the ovarian fimbria?
A fimbria strand that anchors the ovary to the fimbria.
What is the cornua?
The point where the uterine tubes enter the uterus.
Where is the fundus of the uterus?
The very top.
What happens to the uterus when pregnant?
The walls thicken, and the size dramatically increases. The endometrial line thickens, and the uterus rises into the abdominal cavity.
Where is the uterus at 3 months pregnant?
Where is the uterus at 6 months pregnant?
Where is the uterus at 8 months pregnant?
What is a consequence of the uterus intruding on the abdominal cavity during pregnancy on urinating?
Puts pressure on the pelvic viscera, especially the bladder, meaning urinating on a regular basis.
What are the two components of the cervix?
Vaginal (distal), and supravaginal (proximal).
What position is the cervix relative to the vagina?
What position is the body of the uterus relative to the cervix?
How are retroversion and retroflexion caused?
Laxity of support, such as levator ani below.
What is the primary support for pelvic viscera?
What are the components of the broad ligament?
Cervical - laterally
Where is the uterus best supported?
At the cervix.
What happens to the uterus if support laxes?
Prolapse into the vagina.
Does the uterus have a perotineum?
Yes, but only the superior aspect.
What can be found between the rectum and the uterus?
What can be found between the uterus and bladder?
Where do the gonads get their blood supply?
From gonadal arteries, which come direct off the aorta.
Where do the uterus and vagina get their blood supply?
Branches off the internal iliac artery.
Where does the ovary refer pain?
To the meidal thigh above the knee.
Where are the upper and lower parts of the vagina?
Upper - above the pelvic floor.
Lower - Below the pelvic floor, into the perineum.
What is the gap between the vagina and cervix?
Is the posterior fornix covered by peritoneum?
Why is backyard abortion so dangerous?
It is difficult to navigate through the vagina into the uterus, and one may accidently go through the posterior fornix. An unbent coat hanger is usually used, the sick fucks. It will abort the baby, but the lady can die of peritonitis.
What stabilises the vagina?
Elements of the pelvic floor, the most from pubovaginalis.
What two structures pass behind the vaginal skeletal muscle?
Urethrovaginal sphincter and bulbospongiosus.
What lies outside the pelvis in males (list 4)?
Testes, epididymis, penis and scrotum.
What lies within the pelvis in males (list 6)?
Prostate, bulbourethral gland, vas deferens, seminal vesicles, and the prostatic and membranous urethras.
What is elephantitis?
Testes are grossly enlarged, and develops from an infestation of a parasitic worm, which enters the lymph system, preventing drainage. It damages the vessels, rather than the nodes.
What kind of glands are the testes?
Both endocrine and exocrine.
Where is sperm stored? Where does it go after?
Epididymis. Passes into the vas deferens by peristalsis.
What is tunica vaginalis?
Outer fibrous connective tissue encapsulating the testes.
What is tunica albuginea?
Inner fibrous connective tissue encapsulating the testes.
Where do the tunica vaginalis and tunica albuginea form, and where do they go?
They form on the posterior abdominal wall, and migrate with the gubernaculum, and reside in the scrotal sac.
What is cryptochidism?
Undescended testes, residing in the inguinal canal. Non-viable due to temperature.
What are ectopic testes? Are they viable?
Testes found at a higher position, against the abdominal wall, but still in the sac. Can be coaxed down with surgery. Otherwise it is non-viable, and more cancerous?
What drains the spermatic cord?
A plexus of veins.
Where is the widest part of the urethra in males?
What forms the ejaculatory duct, and where does it pass to?
The seminal vesicles after merging with vas deferens, form the ejaculatory duct, and passes into the prostatic urethra.
What is the pathway taken by the vas deferens?
It leads into the inguinal canal, to the back of the bladder where it meets the seminal vesicle. It dilates as it reaches it, forming an ampulla.
What is the prostatic sinus?
Found within the prostatic urethra, and secretes prostatic fluid.
Where does sperm enter the prostatic urethra?
From the seminal collicus, a small bump in the prostatic urethra.
Where is the bulbourethral gland relative to the prostate?
Inferiorly, also secretes fluid.
Is the prostate encapsulated?
What is found along the lateral margin of the prostate?
Its neurovascular supply.
What are the lobes of the prostate?
One in the middle called median lobe.
Two lateral lobes called left and right lateral lobes.
Which lobe of the prostate hypertrophies with age?
The median enlarges, and can project up into the bladder and obstruct the prostatic urethra.
Which lobe of the prostate are more susceptible to cancer?
The lateral lobes.