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OB > OB Broad Perspective and Anatomy of Female Repro > Flashcards

OB Broad Perspective and Anatomy of Female Repro Flashcards

(123 cards)

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1
Q

Leading cause of women’s death worldwide as of 2013

A

Cardiovascular disease

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2
Q

Leading cause of maternal death in the Philippines

A

Pregnancy related complications

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3
Q

An average of _ among <20 y/o population has already been pregnant at least once

A

22%

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4
Q

No. of times pregnant, regardless of the duration or outcome (how many times have you been pregnant?)

A

Gravida

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5
Q

Delivered before 37 weeks

A

Preterm birth

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6
Q

Number of abortion that took place in the Philippines (2008)

A

500,000

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7
Q

Number of women who sought treatment for complications after abortion

A

90,000

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8
Q

Maternal causes of death in the Philippines

A

Complications related to pregnancy thru labor, delivery, & puerperium (38.4%)

Hypertension (35.2%)

Postpartum hemorrhage/uterine atony (17.3%)

Abortive outcome (9.1%)

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9
Q

Deals with child birth and treatment of the mother before and after childbirth

Deals with pregnancy, labor, & puerperium (6 weeks after childbirth, mother recovers to non pregnant state)

A

Obstetrics

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10
Q

Maternal mortality rate in the Philippines

A

162 deaths per 100,000 live births

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11
Q

Infant mortality rate in the Philippines

A

19.34 deaths per 1,000 live births

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12
Q

External generative tract

A 
Mons pubis
Labia majora and minora 
Clitoris
Hymen
Vestibule
Vagina
Perineum
Bartholin's
Para urethral glands
Uretha
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13
Q

Internal generative tract

A

Uterus
Cervix
Oviducts/Fallopian tubes
Ovaries

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14
Q

Also known as mons veneris
A fat filled cushion
Forming the escutcheon
Contains many nerve endings

A

Mons pubis

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15
Q

Mons pubis

A

Function: padding during coitus

Embryo: from fusion of labioscrotal swellings

Histo: stratified squamous keratinized epithelium

Blood supply: inferior epigastric artery & deep external pudendal artery

Lymphatics: superficial inguinal lymph nodes

Innervation: ilioinguinal & genitofemoral nerves

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16
Q

Innervation of mons pubis

A

Ilioinguinal and genitofemoral nerves

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17
Q

Has rich venous plexus that may develop varicosities during pregnancy due to increased venous pressure by the enlarged uterus

A

Labia majora

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18
Q

Continuos with the mons pubis superiorly

Posteriorly, merge over the perineal body to form the posterior commisure

Round ligaments terminate at its upper border

A

Labia majora

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19
Q

Highly sensitive (coitus)

Homologous with male scrotum

From labioscrotal swellings

A

Labia majora

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20
Q

Blood supply of Labia majora

A

Internal pudendal artery

Venous plexus

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21
Q

Innervation of Labia majora

A

Ilioinguinal & genitofemoral nerves

Posterior labial nerves

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22
Q

Histology of labia majora

A

Keratinized stratified squamous

Apocrine, eccrine, & sebaceous glands

Dense CT with elastic fibers and adipose

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23
Q

Length: 7-8cm
Depth: 2-3cm
Thickness: 1-1.5cm

A

Labia majora

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24
Q

Paired, thin, hairless tissue fold medial to the labia majora

Length: 2-10cm
Width: 1-5cm

A

Labia minora

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25
2 lamellae of the Labia minora
Upper: fuse to form prepuce (hood) of clitoris Lower: frenulum of the clitoris
26
Fuse in midline as low ridges of tissue called FOURCHETTE Highly sensitive (coitus)
Labia minora
27
Derived from urethral (urogenital) folds Homologous to ventral shaft of penis
Labia minora
28
Histology of labia minora
Outer: thinly keratinized stratified squamous Inner: lateral portion same as outer. Medial to Hart line: non keratinized Dermis: CT with elastic fibers, sm, and sebaceous glands Lacks hair follicles, eccrine, and apocrine glands
29
Blood supply of labia minora
Internal pudendal artery and dorsal artery of the clitoris
30
Lymphatics and Innervation of Labia minora
Lymphatics: deep inguinal nodes Innervation: dorsal nerve of clitoris and post. labial nerve (perineal nerve)
31
Beneath prepuce & above the frenulum and urethra Projects downward and inward towards vaginal opening Length: 2cm
Clitoris
32
Clitoris is composed of
Glans (stratified squamous), corpus, and 2 crura
33
Principal female erogenous organ
Clitoris
34
Derived from genital tubercle Erectile homologue of the penis
Clitoris
35
Histology of Clitoris
Keratinized stratified squamous without dermal appendages Abundant in erectile tissues
36
Blood supply of clitoris
Deep artery of clitoris (branch of internal pudendal artery) -body of clitoris Dorsal artery of clitoris - glans and prepuce
37
Lymphatics of clitoris
Deep inguinal nodes Internal iliac nodes
38
Innervation of clitoris
Inferior hypogastric plexus Dorsal nerve of the clitoris (from pudendal nerve)
39
An almond shaped area. Functionally mature female structure
Vestibule
40
Vestibule
Laterally: Hart line Medially: external hymen Anteriorly: frenulum of clitoris Posteriorly: fourchette
41
Posterior portion of vestibule is called
Fossa navicularis - posterior portion between fourchette and vaginal opening - seen only in nulliparas
42
Six opening of vestibule
Urethra Vagina 2 bartholins 2 skenes
43
Vestibule is derived from
Urogenital membrane
44
Histology of vestibule
Non keratinized stratified squamous Minor vestibular glands (acini) -mucinous columnar epi
45
Also known as greater vestibular glands Major glands measure 0.5-1cm
Bartholin glands
46
Measure 1.5-2cm and open distal to the hymenal ring (at 5 & 7 o'clock position on the vestibule)
Bartholin glands
47
May swell & obstruct to form cyst or abscess (following trauma or infection)
Bartholin glands
48
Lie inferior to vestibular bulbs & deep to inferior end of the bulbocavernousus muscle
Bartholin glands
49
Also known as skene's glands Obstruction & inflammation may lead to urethral diverticulum
Paraurethral glands
50
Lower 2/3 lie immediately above vaginal canal
Urethra Length: 2-3cm Too short that makes female more prone to UTI
51
Upper portion of vagina is separated from the rectum by
Cul-de-sac or pouch of Douglas
52
Vagina is anteriorly separated from the bladder and rectum by
Vesicovaginal septum
53
Vagina is posteriorly separated from the rectum by
Rectovaginal septum
54
Anterior wall: 6-8cm | Posterior wall: 7-10cm
Vagina
55
Transport of sperm, serves as birth canal, physiologic changes during arousal (vasocongestion & lubrication)
Vagina
56
Embryology of vagina
Upper 1/3: Müllerian duct (paramesonephric) Lower 2/3: urogenital sinus
57
Histology of vagina
Epithelial layer: non keratinized stratified squamous (Premenopausal, lining becomes thin with folds - rugae) Muscular layer: sm, collagen, & elastin Adventitial layer: collagen & elastin No glands
58
Blood supply of Vagina
Proximal: cervical branch of uterine artery & vaginal artery Posterior: middle rectal artery Distal: internal pudendal artery Venous plexus
59
Lymphatics of vagina
Upper 3rd: external, internal, and common iliac nodes Middle 3rd: internal iliac nodes Lower 3rd: inguinal lymph nodes
60
Innervation of upper vagina
Uterovaginal plexus
61
Innervation of lower vagina
Pudendal nerve
62
Surrounds vaginal orifice
Hymen
63
Diamond shaped area with boundaries that mirror those of the bony pelvic outlet
Perineum
64
Boundaries of the perineum
Anterior: pubic symphysis Anterolateral: ischiopubis rami & ischial tuberosities Posterolateral: sacrotuberous ligaments Posterior: coccyx
65
Fibromuscular mass found in the midline at the the junction between the anterior and posterior triangle of the perineum
Perineal body or central tendon of the perineum Provides perineal support
66
Homologous with male's corpora spongiosa
Vestibular bulbs
67
Contents of superficial space of anterior triangle
``` Bartholin glands Vestibular bulbs Clitoral body and crura Pudendal vessels and nerves Ischiocavernosus Bulbocavernosus Superficial transverse perineal muscles Superficial space bounded by Colles fascia and perineal membrane ```
68
Helps maintain clitoral erection by compressing the crus of clitoris by obstructing venous drainage
Ischiocavernosus muscles
69
Constrict vaginal lumen and aid release of secretion from bartholin glands Contributes to clitoral erection by compressing the deep dorsal vein of the clitoris
Bulbocavernosus muscles
70
Contents of deep space of anterior triangle
Urethra and vagina Internal pudendal artery Urethrae and urethrovaginal sphincter muscles Deep space is continuous with the pelvic cavity
71
Happens when veins in vestibular bulbs lacerate or even rupture due to child birth
Vulvar hematoma
72
Size of uterus in multiparous women
9-10 cm 6-8cm in nulliparous
73
Functions of the uterus
Implantation Pregnancy support Labor and delivery Menstruation
74
Uterus is derived from
Paramesonephric (Mullerian) ducts
75
Histological parts of the uterus
Myometrium: sm bundles with elastic fibers and blood vessels Endomentrium: basalis and functionalis
76
Blood supply of uterus
Uterine artery (from int Iliac artery) Ovarian artery (from aorta)
77
Venous drainage of Uterus
``` Arcuate veins Uterine vein Int Iliac vein Common iliac Veins in pampiniform plexus Ovarian vein Rt ovarian vein Inf vena cava Left ovarian vein Left renal vein ```
78
Lymphatics of uterus
Internal iliac nodes and para aortic nodes
79
Innervation of uteus
Autonomic - pelvic viscera Sympa - presacral nerve/ superior hypogastric plexus (T10-12) Para- anterior rami of S2-4 / pelvic splachnic nerves
80
Components of Inferior Hypogastric Plexus (Pelvic Plexus)
2 hypogastric nerves (sympa) + 2 pelvic splachnic nerves (para)
81
3 divisions of inferior hypogastric plexus
Vesical - bladder Middle rectal - rectum Uterovaginal - uterus, proximal fallopian tubes, and upper vagina
82
Upper cervical segment that lies above the vagina's attachment to the cervix
Portio supravaginalis
83
Cervical segment that protrudes into the vagina
Portia vaginalis
84
Fusiform in shape
Cervix
85
Serves as opening of the uterus (sperm transport/ barrier & chilbirth) Attaches the uterus to vagina
Cervix
86
Epithelium of endocervix
Columnar mucin-secreting epithelium
87
Epithelium of ectocervix
Non-keratinized stratified squamous
88
Where squamous and columnar epithelium of the cervix meets
Squamo-columnar junction
89
Blood supply of cervix
Cervicovaginal artery (from uterine artery)
90
Lymphatics of cervix
Internal iliac nodes
91
Innervations of cervix
Uterovaginal plexus Sensory afferent: pelvic splanchnic n. (S2-S4)
92
Oval organs located in the upper pelvic cavity Rests on ovarian fossa of Waldeyer
Ovary
93
The female gonad Supported by uteroovarian ligament
Ovary
94
Produces mature germ cells (ova) | Source of female hormones
Ovary
95
Develops from mesothelial layer of the epithelium (coelomic epithelium)
Ovary
96
Epithelium of Ovary
Epithelium: simple cuboidal (germinal layer of Waldeyer) Cortex: oocytes & developing follicles Medulla: loose CT, arteries and veins, & smooth muscle fibers
97
Blood supply of ovary
Ovarian artery (from abdominal aorta) Ovarian branch of uterine artery Ovarian vein
98
Lymphatics of ovary
Lateral aortic nodes
99
Innervation of ovary
``` Ovarian plexus (sympa) Hypogastric and aortic plexus Vagus nerve (parasympa) Sensory afferents (T10) ```
100
Also called oviducts
Fallopian tubes
101
Tubular structures arising from the uterine cornua Length: 8-14cm
Fallopian tubes
102
Where fertilization and ectopic pregnancy usually occurs
Ampulla
103
Covered by mesosalpinx at the superior margin of the broad ligament
Isthmus, ampulla, & infundibulum
104
Conduit of sperm and site of fertilization
Fallopian tubes / oviducts
105
Important in ovum transport
Tubal peristalsis created by the cilia and muscular layer contractions (endosalpinx of fallopian tubes)
106
Provides support to the uterus and other pelvic structures
Ligaments
107
4 major ligaments
Round ligament Broad ligament Cardinal ligament Uterosacral ligament RBCU
108
Corresponds embryologically to the male gubernuculum testes
Round ligament
109
Passes thru inguinal canal and terminates at upper portion of labia majora
Round ligament
110
Branch of uterine artery that runs within the round ligament
Sampson artery
111
Two winglike structures from lateral uterine margins to the pelvic sidewalls
Broad ligament
112
Divides the pelvic cavity into anterior and posterior compartments
Broad ligament
113
Also known as transverse cervical ligament or Mackenrodt ligament
Cardinal ligament
114
Originates at the supravaginal portion of the cervix and inserts into the fascia over sacrum
Uterosacral ligament
115
Aids in fallopian tube identification during puerperal sterilization
Round ligament
116
Male homologous for scrotum
Labia majora
117
Male ventral shaft
Labia minora
118
Glans penis
Clitoris
119
For protection
Mon pubis
120
For sperm transport
Vagina
121
Episiotomy: surgical repair
Midline: easy Mediolateral: more difficult
122
Episiotomy: blood loss
Midline - less Mediolateral - more
123
Leading cause of maternal death worldwide as of 2014
Pre-existing maternal conditions (cardiovascular disease, renal disease, etc)

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