Lecture 6 - Female pelvis and perineum Flashcards
(40 cards)
What organs can be found in the female pelvic cavity?
- Ovaries and fallopian tubes
- Uterus and cervix
- Vagina
- Ureters, bladder and urethra
- Rectum
- Caecum, appendix, parts of the sigmoid colon and ileum (false pelvis)
- Vessels, nerves and lymphatics
What is different about the male and female pelvic cavity?
No sharing of the reproductive and urinary passages in females as in the male.
How is the uterus joined to the posterior pelvic wall?
Via the broad ligaments - they are transverse mesenteries.
What are the landmarks of the true pelvis?
- Bound in front and below by pubic symphysis and superior rami of the pubis
- Above and behind by sacrum and coccyx
- Laterally by broad, smooth quadrangular area of bone
Where do the fallopian tubes join the uterus?
At the joining of the funds and the body of the uterus.
Where does fertilisation of the egg normally take place?
In the ampulla region of the fallopian tubes, which is then pushed through into the uterus via vibrations of the infundibulum.
What muscle is the uterus made up of?
Smooth involuntary muscle.
How are the cervix and vaginal wall stabilised?
Via cervical ligaments, which anchor the cervix in position within the pelvis and prevent the uterus from prolapsing through the vagina by providing pass support.
What are the cervical ligaments?
- Pubo-cervical ligament
- Transverse cervical/cardinal ligament
- Uterosacral ligament
Which is the most important cervical ligament?
Transverse cervical ligament - strongest and most important ligament that holds the cervix and vaginal wall in place despite the abdominal pressure pushing them downwards.
What is the cervix?
A fibro-muscular cylinder that is roughly 2.5cm long from the internal and external os. It opens between the body of the uterus and the outside via the vagina.
How can premature birth be linked to the cervix?
If the cervix is shorter than 2.5cm, premature birth is common.
What cells make up the cervical canal?
The cervical canal is lined with mucus-secreting simple columnar epithelium.
What is the vaginal surface of the cervix made up of?
Stratified squamous non-keratinised epithelium. There are no glands in the vagina.
Describe the relationship between the cervix and the vagina?
- Projects into the anterior vaginal wall at a right angle to the vaginal axis
- Cervix and vagina form an angle of roughly 90 degrees, known as the angle of anteversion
- The cervix is anteverted onto the vagina
- The body of the uterus is ante flexed on the cervix
What do the cervical ligaments form part of?
The pelvic fascia.
What is the vagina?
A fibromuscular canal that is typically between 7 and 9 cm long.
Where is the urethra (female) found?
Fused to the anterior vaginal wall - herniation through to the vagina can occur if the wall is weak.
Why is the posterior fornix clinically relevant?
- Can be used as a route to the ovaries such as in IVF treatment allowing collection of eggs from the ovary
- Can also drain a pelvic abscess through the posterior fornix as fluid commonly collects here in the rectal-uterine pouch, preventing damage of other organs
What are the different regions of the uterus?
- Fundus
- Body
- Lower segment
- Cervix
What are the different regions of the fallopian tubes?
- Infundibulum
- Ampulla
- Isthmus
- Fimbriae
- Uterine parts
What is the role of the fimbriae and the infundibulum?
They are involved in the collection of the ovum from the ovary after ovulation. The egg will enter the fallopian tube here at the abdominal ostium.
How is there potential communication between the abdominal cavity and the reproductive organs in the female?
Via the abdominal ostium at the end of the fallopian tube - there is no such passage in males.
What happens after the 9th month of pregnancy?
The head of the foetus descends into the true pelvis and engages, causing the uterus to move inferiorly slightly. In late pregnancy it can be difficult to breathe due to diaphragmatic movements against the growing foetus.
