The female reproductive system Flashcards
(47 cards)
1
Q
Why do women get sharp pain at ovulation?
A
- Ovum ruptures capsule of ovary
- This is a traumatic process
2
Q
What protects us from ovarian cancer?
A
- Anything that stops us from ovulating e.g. pregnancy, breastfeeding, contraception
- Release of ovum causes damage to ovary, making cancer more likely
3
Q
What is an ovarian cyst?
A
- Fluid filled swelling of ovary
- Can be benign or malignant
- Vary massively in size
- Cystic ovary ca twist, resulting in torsion
- Don’t want cyst to burst - if it’s cancerous it can seed woman with cancer cells
4
Q
What are the labia majora?
A
- Prominent folds of tissue extending from mons pubis to perineum
- Has same origins as male scrotum
5
Q
What are the labia minora?
A
- Lesser folds extending from clitoral hood to posterior aspect of vagina
- Formed by urethral folds
6
Q
What is the clitoris?
A
- Collection of nerve endings in anterior portion of external genitalia of women
- Develops from genital tubercle
- Site of sexual pleasure
7
Q
What is the perineum?
A
- Portion of skin and muscle that stretches between vagina and anus
8
Q
Describe the anatomical location of the vagina
A
- Extends from external genitalia to cervix in an superior-posterior direction
- Urethra and bladder sit anterior
- Rectum sits posterior
9
Q
What are the functions of the vagina?
A
- Facilitates childbirth
- Intercourse
- Can expand drastically due to muscular walls and rugae
10
Q
Describe the lining of the vagina
A
- Stratified squamous epithelium
- Glycogen-rich - provides nutrients for lactobacilli
- Lactobacilli metabolise glycogen to lactic acid to keep pH of vagina low
11
Q
What is a fornix?
A
- Where cervix protrudes into vagina
- Leaves a circular gutter between walls of vagina and cervix
- Split into anterior, posterior, left and right fornix
12
Q
What is the cervix?
A
- Narrow channel connecting vagina to uterus
- External os is opening to vagina
- Internal os is opening to uterus
13
Q
What happens to the cervix during childbirth?
A
- Cervix stretches to 10 cm wide
- External os does not return to ‘pinpoint’ appearance following childbirth
- Appears more linear in shape
14
Q
What is cervical ectropian?
A
- Columnar epithelium of the inside of the cervix is shown externally
- Can occur due to taking combined oral contraceptive pill or due to normal hormonal changes
15
Q
What could be seen on the cervix that indicates cervical cancer?
A
- Pale tissue
- New blood vessel formation
- Some ulceration
16
Q
Describe the anatomical location of the uterus
A
- Lies in the pelvis
- Superior to vagina
- Posterosuperior to bladder
- Anterior to rectum
- Ovaries sit superolateral to uterus
17
Q
What is the name of the potential space between the uterus and the rectum?
A
- Rectouterine pouch or pouch of Douglas
- Important anatomical landmark because any free fluid in the peritoneum will sit here
18
Q
What are the two components of the wall of the uterus?
A
- Myometrium
- Endometrium
19
Q
What is the function of the myometrium?
A
- Muscular component of uterine wall
- Contracts during childbirth and shedding of the uterine lining during periods
20
Q
What is the function of the endometrium?
A
- Proliferates, forming lining of womb for an embryo to embed in
21
Q
What are the 3 axes of the female reproductive tract?
A
- Axis of vagina
- Axis of cervix
- Axis of uterine body
- 2 angles exist between the axes, maintained by the round ligament
22
Q
Where does the angle of -version exist?
A
- Between axis of vagina and axis of cervix
- If angle is <180o, the cervix is antiverted
- If angle is >180o, the cervix is retroverted
23
Q
Where does the angle of -flexion exist?
A
- Between axis of cervix and axis of uterus
- If angle <180o, uterus is antiflexed
- If angle >180o, uterus is retroflexed
24
Q
What is the function of the fallopian tubes?
A
- Transport ovum from ovary to uterus
- Transport sperm from uterus to meet ovum ready for fertilisation
- Tubes contract by peristalsis to move ovum towards uterus
- Cilia help waft ovum and sperm
25
Why is it important to remember that the fallopian tubes are not attached to the ovary?
- Ovum could be released from ovary but not reach fallopian tube
- Can embed elsewhere in the abdomen
- Creates a gap in the peritoneum
26
What are the 4 parts of the fallopian tube?
1. Fimbriae - finger like projections that act as a funnel to make sure the ovum ends up in the fallopian tube
2. Infundibulum - first part of fallopian tube that ovum enters
3. Ampulla - middle part of tube
4. Isthmus - point of attachment to uterus
27
Where does ectopic pregnancy most commonly occur?
- Ampulla of fallopian tube
28
Why is ectopic pregnancy so dangerous?
- Embryo ruptures fallopian tube and cause severe internal bleeding
- Can lead to fertility issues, miscarriage and death of the mother (if bleeding isn't treated)
29
What are the symptoms of ectopic pregnancy?
- Abdominal pain
- Vaginal bleeding
- Bleeding can lead to shock, tachycardia, hypotension
- Shoulder tip pain
30
Why does ectopic pregnancy cause shoulder tip pain?
- Blood irritates diaphragm
- Causes referred pain in dermatome of phrenic nerve roots
- C2, C3, C4
31
How do we rule out ectopic pregnancy?
- In any woman of child-bearing age
- Pregnancy test
- Ultrasound scan
32
What is the function of the ovaries?
- Storage and maturation site for oocyte
- Produce oestrogen and progesterone
33
What helps the ovaries descend?
- Gubernaculum
- Ovaries stop descending in pelvis because developing uterus gets in the way
34
What are the 3 main parts of the ovaries?
1. Medulla (inner part)
2. Cortex (outer part)
3. Epithelium
35
What is the role of the medulla of the ovaries?
- Site of neurovascular structures
- Supplies nutrients through blood to cortex
36
What is the role of the cortex of the ovaries?
- Composed of connective tissue called stroma
- Contains thousands of follicles
37
What is the function of the epithelia of the ovaries?
- Simple cuboidal epithelium
- Called germinal epithelium because it protects the germ cells
38
Why is it significant that the ovaries are not covered by visceral peritoneum?
- Means that an ovum could miss the fallopian tubes and be released into the peritoneal cavity
- Peritoneum is a potential site for ectopic pregnancy
39
What is the broad ligament?
- Flat sheet of peritoneum that covers uterus, fallopian tubes and ovaries
- Runs from pelvic wall, across internal genitalia, and attaches to pelvic wall on opposite side
40
What are the 3 divisions of the broad ligament?
1. Mesometrium - portion surrounding uterus and external iliac vessels
2. Mesovarium - projects from broad ligament and attaches to hilum of ovary. It encloses neurovascular bundle supplying ovary but does not enclose ovary itself.
3. Mesosalpinx - encloses fallopian tube only
41
Which structures are found within the broad ligament?
1. Ovarian and uterine arteries
2. Ovarian ligament
3. Round ligament of uterus
4. Suspensory ligament of ovary
42
What are the 2 main ligaments that attach to the ovary?
1. Ovarian ligament
2. Suspensory ligament of the ovary
43
What is the function of the ovarian ligament?
- Attaches ovary to uterus
- Fibrous band
- Lies within broad ligament
- Remnant of gubernaculum
44
What is the function of the suspensory ligament of the ovary?
- Extends outwards from ovary to lateral abdominal wall
- A fold of peritoneum
- Contains ovarian artery, vein, nerve plexus, lymphatics
45
What is the function of the round ligament?
- Remnant of gubernaculum
- Attaches to labia majora
- Passes through inguinal canal
- Attaches to uterus at point at which fallopian tubes also join
46
What are the main arteries supplying the female reproductive system?
- Ovarian artery - arise directly from abdominal aorta
- Uterine artery - branch of internal iliac artery
- These anastomose across the uterus creating Helicine branches
- Also branch to form tubal vessels which supply fallopian tubes
- Vaginal arteries - branches of internal iliac arteries
47
What are the main veins draining the reproductive system?
- Ovarian veins
- Left ovarian vein drains directly into left renal vein, right ovarian vein drains directly into vena cava
- Uterus drains into uterine veins via a plexus in the broad ligament
- Vagina drains via a plexus into vaginal vein
- Both then drain to internal iliac vein
