Uterus (353-360)

Question 1

What are the ligaments and supports of the uterus and ovaries?;

Answer 1

• Broad ligament (attaches sides of uterus to the pelvis [acts as mesentery]).
• Round ligament (remnant of the gubernaculum extending from the uterine horns to the labia majora via the inguinal canal).
• Ovarian ligament (joins ovaries to uterus).
• Suspensory ligament of ovary (ovary to lateral wall).
• Cardinal ligament (Located at the base of the broad ligament, extends from the cervix to the lateral pelvic walls).
• Uterosacral Ligament (Extends from the cervix to the sacrum). Inferior aspect of uterus is supported by structures in pelvis floor- the levator ani, perineal membrane and perineal body.

Question 2

What structures are contained within the ligaments of the uterus & ovary & what is function of each ligament?;

Answer 2

Broad ligament (acts as mestenary). Round ligament (maintains anteverted position of uterus). Ovarian ligament (support only). Suspensory ligament of ovary (contains ovarian artery, ovarian vein, ovarian nerve plexus and lymphatic vessels). Cardinal ligament (contains the uterine artery and vein). Uterosacral ligament (support only).

Question 3

What is the blood supply to the uterus and the cervix?;

Answer 3

Uterine artery (branch of anterior division of internal iliac artery). Uterine veins via plexus in broad ligament.

Question 4

What is the lymphatic drainage of the uterus, cervix and vagina?;

Answer 4

Follows arteries.
Utereus, cervix and vagina - iliac lymph nodes

Question 5

What is meant by the obstetric conjugate?;

Answer 5

Distance between sacral promotory to pubic symphysis - it’s the narrowest point that the head needs to descend.

Question 6

What is the blood supply to the urinary bladder?;

Answer 6

Superior vesicular artery and inferior vesicular artery (both branch of anterior division of internal iliac artery)

Question 7

What are the common types of bladder cancers?:

Answer 7

Transitional cell carcinoma (80% cases *remember inner lining of bladder is transitional epithelium [urothelium]). Squamous cell carcinoma. Adenocarcimoa (rare).

Question 8

What drugs are used in the treatment of bladder cancer?;

Answer 8

Mytomycin C or Bacille Calmette-Guerin (BCG)