Studiesal Uge 1 Flashcards
Explain the main features of os coxae, and relate them to the articulated skeleton
Describe the correct orientation of the pelvis with the anterior superior iliac spine and the upper margin of the pubic symphysis in the same vertical plane
Identify/locate crista pubica
Identify/locate pecten ossis pubis
Identify/locate linea arcuata ossis illi
Identify/locate linea arcuata ossis illi
Identify/locate ala ossis illi
Identify/locate promontorium ossis sacri
Identify/locate foramen obturatum
Identify/locate insicura ischiadica major and insicura ischiadica minor
Identify/locate ligamentum sacrotuberale and ligamentum sacrospinale
What is the pelvic inlet/apertura pelvis superior?
The pelvic inlet or superior aperture of the pelvis is a planar surface which defines the boundary between the pelvic cavity and the abdominal cavity (or, according to some authors, between two parts of the pelvic cavity, called lesser pelvis and greater pelvis).
What is the pelvic outlet/apertura pelvis inferior?
Why is foramen obturatum not completely closed?
Foramen obturatum er som regel næsten fuldstændigt dækket af membrana obturatoria, en stærk bindevævsmembran, som kun har hul helt øverst i foramen obturatum. Dette hul benævnes canalis obturatorius og herigennem løber nervus-, vena- og arteria abturatoria, som alle sammen løber ned af låret.
What structures are transmittet through the greater sciatic notch?
The notch holds the piriformis, the superior gluteal vein and artery, and the superior gluteal nerve; the inferior gluteal vein and artery and the inferior gluteal nerve; the sciatic and posterior femoral cutaneous nerves; the internal pudendal artery and veins, and the nerves to the internal obturator and quadratus femoris muscles.
What type of joint is the sacroiliac joint?
The sacroiliac joint is a synovial plane joint (glideled)
Are there variations in female pelvis morphology?
The shape of the pelvis often differs between males and females. A female’s pelvis is generally wider and more open than a male’s pelvis. This helps with vaginal childbirth.
Even among females, though, pelvis shape varies. Generally speaking, there are four main pelvis types. The type you have may affect the ease in which you can give birth vaginally.
- Genetics and environmental factors determine the ovarall shape of your pelvis
Name the types of pelvis shapes
The four different pelvis shapes are:
- Gynecoid: The most common type of pelvis in females and is thought to be the most favorable pelvis type for a vaginal birth
- Android: It’s narrower than the gynecoid pelvis and it can make labor difficult
- Anthropoid: The elongated shape of the anthropoid pelvis makes it roomier from front to back than the android pelvis. But it’s still narrower than the gynecoid pelvis. Some women with this pelvis type may be able to have a vaginal birth, but their labor might last longer
- Platypelloid: The shape of the platypelloid pelvis can make a vaginal birth diffucult because the baby may have trouble passing through the pelvic inlet. Many pregnant women with a platypelloid pelvis need to have a C-section
What are the major differences in the morphology of the bony pelvis in male and female?
What is the reason for differences in the morphology of the bony pelvis in male and female?
A male pelvis is designed to support a heavy body build and a stronger muscle structure while a female pelvis mainly serves for the purpose of childbearing.
Identify musculus obturatorius internus
Identify musculus piriformis
What are the actions of musculus obturatorius internus?
Abducts & laterally rotates the extended hip and abducts the flexed thigh at the hip, and stabilizes the hip during walking.
What are the actions of musculus piriformis?
he piriformis laterally rotates the femur with hip extension and abducts the femur with hip flexion.
Describe the placement and attachments of musculus obturatorius internus
Describe the placement and attachments of musculus piriformis
Where does nervus obturatorius arise?
Nervus obturatorius arises from L2-L4 spinal nerves and supplies the medial compartment of the thigh.
What foramen does nervus obturatorius pass through to reach the medial compartment of the thigh?
Nervus obturatorius pass though foramen obturatum through canalis obturatorius.
What is the pelvic diaphragm?
The pelvic diaphragm forms the muscular floor of the pelvic cavity.
What are the muscle forming the pelvic diapgrahm collectively called?
Musculus levator ani
How does musculus levator ani act during defecation?
While in quiescent state, the urethra and the rectum are mechanically closed at the levator hiatus. The muscle relaxes at the beginning of urination and defecation. By this means the levator ani muscle plays a crucial role in the preservation of urinary and bowel continence.
What is the anatomical region inferior to the pelvic diaphragm?
The perineum
Identify and locate membrana perinei
Identify and locate crus clitoridis
Identify and locate musculus ischiocavernosus
Identify and locate musculus bulbospongiosus
Identify and locate bulbus vestibuli
Identify and locate glandula vestibularis major/Bartholin’s gland
Identify the structures
Identify the structures
Identify and locate spatium profundum perinei
Identify and locate spatium superficiale perinei
Which regions are the perineum divided into?
Regio urogenitalis & Regio analis
What are the Bartholin’s glands (landulae vestibulares majores) function?
Their primary function is the production of a mucoid secretion that aids in vaginal and vulvar lubrication
What are the Skene’s glands (glandulae vestibulares minores) function?
The Skene’s glands primary function is to lubricate the urethra and vagina during sexual arousal
Hvad er fossa ischioanalis?
Fossa ischioanalis er den kileformede region, som ligger på hver side under diaphragma pelvis mellem canalis analis og bækkenvæggen.
Which motor and sensory nerves supplies the perineum?
The motor and sensory nerve supply to the perineum is derived from the
pudendal nerve (S2, S3 and S4), a branch of the sacral plexus.
What is the blood supply of the perineum?
Perineum fornynes hovedsageligt fra aa. pudendae internae, som på hver side lige bag ved diaphragma urogenitale afgiver a. perinealis til musklerne, og som desuden afgiver overfladiske grene til huden som rr. scrotales posteriores et rr. perineales. Desuden afgiver a. pudenda interna også a. rectalis inferior, som forsyner regio analis, især sphincter ani externus.
What is the venous drainage of the perineum?
Venerne følger arterierne
Hvad er episiotomi?
Episiotomi er et mindre kirurgisk indgreb, der anvendes for at lette fødslen.
For at undgå eller begrænse læsioner i diaphragma pelvis ved barnets passage under fødslen, kan pladsforholdende bedre ved et indklip i vaginas bagvæk og tilstødende del af perineum, når vævet her står udspændt. Ingrebet kaldes en episiotomi. Klippet skal udgå bøjagtig fra midten svarende til commisura posterior, så man undgår bulbus vestibuli og musculus bulbocavernosus, og gå dorsolateralt i en vinkel på 45 grader, så man undgår at lædere sphinctermuskulaturen omkring anus.
Identify ostium urethra externum
Identify the vagina
Identify cervix uteri
Identify fornix vaginae
Identify all the structures
Identify fundus uteri
Identify cavitas uteri
Identify cavitas uteri
Identify canalis cervicalis uteri
Identify tuba utera including it’s compartments
Identify ovarium
Identify the myometrium and endometrium
Identify ligamentum ovarii proprium
Identify ligamentum latum uteri (broad ligament)
Identify ligamentum teres uteri (round ligament)
What is the function of the round ligemants (ligamentum teres uteri)?
The round ligament of uterus acts to hold the uterus anterior-ward to in anteflexion and anteversion, especially by counteracting any posterior-ward forces that may be being exerted upon the uterus (e.g. distended bladder, or gravity while in a recumbent postition).
What is the function of the broad ligament (ligamentum latum uteri)?
The broad ligament serves as a mesentery for the uterus, ovaries, and the uterine tubes. It helps in maintaining the uterus in its position, but it is not a major contributing factor.
Ligamentum latum uteri (broad ligament) can be divided into which subdivisions?
- Mesometrium: Mesentery for the uterus
- Mesosalpinx: Mesentery for tuba uterina
- Mesovarium: Mesentary for ovarium
What are the spaces in front and behind the uterus called?
The space in front of the uterus is called excavatio vesicouterina (utero-vesical pouch) and the space behind the uterus is called excavatio rectouterina (recto-uterine pouch of Douglas).
What is the normal position of the uterus?
The normal position is an anteverted uterus
Why is the position of the uterus important?
It is important that the uterus is somehow normal, but about 20-25% of women have a retroverted uterus. The position of the uterus does not affect the sperm’s ability to reach the egg. However, an extremely severe tilted uterus may interfere with the sperm’s ability to fertilize the egg.
Which arteries supply the uterus and ovaries?
Uterus forsynes fra de to aa. uterinae, som når uterus ved overgangen mellem corpus og cervix. Arterien fortsætter, efter at have afgivet grene til cervix uteri, op langs lateralkanten af uterus, hvor den ender som ramus tubarus og ramus ovaricus.
A. ovarica forsyner overierne og ender som rami tubarii arteriae ovaricae, som forsyner ovarierne samt tubae uterinae
What structures are closely related to the uterine arteries?
Aa. uterinae ligger i parametriet, hvor de 1,5-2 cm fra lateralfladen af uterus krydser foran ureter. Denne tætte erlation er vigtig at erindre sig ved underbinding af a. uterina ved f.eks. hysterektomi - fjernelse af uterus
Where do the ovarian arteries come from?
Arteria ovarica arise from aorta abdominalis
What is the lymphatic drainage of the uterus and ovary?
Lymfekarrene er talrige og danner plexer i endometriet, myometriet og under mesotelet i perimetriet. Fra perimetriet spreder lymfekarrene sig til mange forskellige lymfeknuder.
Fra fundus uteri løber langt de fleste lymfekar lateralt i den øverste del af ligamentum latum uteri og fortsætter til lymphonodi lumbales sammen med lymfekarrene fra tuba og ovariet.
Fra cervix uteri tager et ret varierende forløb, men følger dog normalt tre veje, idet de forløber fremad, lateralt og bagud
- Fremad dræneres de til lymphonodi iliaci externi
- Lateral dræneres de til lymphonodi iliaci interni
- Bagud dræneres de til lymphonodi sacrales
What is oogenesis?
Oogenesis is a series of steps in which a oocyte differentiates into a mature ovum.
What is the first step of oogenesis?
The first step of oogenesis is the development of primordial germ cells to oogonium or primordial ovum.
During early embryonic development, primordial germ cells from the dorsal endoderm of the yolk sac migrate along the mesentery of the hindgut to the outer surface of the ovary, which is covered by a germinal epithelium, derived embryologically from the epithelium of the germinal ridges. During this migration, the germ cells divide repeatedly. Once these primordial germ cells reach the germinal epithelium, they migrate into the substance of the ovarian cortex and become oogonia (oogonium) or primordial ova (primordial ovum).
What is the second step of oogenesis?
Each primordial ovum collects a layer of spindle cells from the ovarian strom (the supporting tissue of the ovary) and causes them to take on epitheloid charachteristics; these epitheloid-like cells are called granulosa cells. The ovum surrounded by a single layer of granulosa cells is called a primordial follicle.
At this stage, the ovum is still immature and is called a primary oocyte, requiring two more cell divisions before it can be fertilized by a sperm.
How does the primordial germ cell replicate?
The primordial germ cell complete mitotic replication
How do the primordial germ cell differentiate to oogonium or primordial ovum?
Primordial germ cells migrate to the outer surface of the ovary, which is covered by a germinal epithelium. During this migration, the germ cells divide repeatedly. Once these primordial germ cells reach the germinal epithelium, they migrate into the substanse of the ovarian cortex and become oogonia or primodial ova.
What is the third step of the oogenesis?
The first stage of meiosis starts during fetal development but is arrested in the late stage of prophase I until puberty, which usually occurs between ages 10 and 14 in females. The first meiotic division of the oocyte is completed after puberty.
Each oocyte divides into two cells, a large secondary oocyte and a small first polar body. Each of these cells contains 23 duplicated chromosomes.
- The first polar body may or may not undergo a second meiotic division and then degenerates
- The secondaty oocyte undergoes a second meiotic division, and after the sisterchromatids separate, there is a pause in meiosis
What is needed to resume the meiotic division after the sister chromatids seperate?
The secondary oocyte needs to be fertilized in order for the final step in meiosis to occur, and the sister chromatids in the ovum go to separate cells.
From which cells are oogonia derived?
Primodial germ cells
In which structure does one find a primary oocyte?
A primary oocyte is found in the primary follicle
In which structure is a secondary oocyte formed?
A secondary oocyte is formed in the preovulatory (mature) follicle
What is the mechanism of action for the combined oral contraceptive (COC)?
The mechanism of action for the combined oral contraceptive is that appriopriate administration of estrogen and progesterone can prevent the preovulatory surge of LH secretion by the pituitary gland, which is essential in causing ovulation.
What effect does estrogen and progesterone have on FSH and LH concentrations?
Estrogen and progesterone exhibits negative feedback effects on LH and FSH secretion
