Flashcards in Week 1 Deck (90):
What does pelvic girdle not include?
What is each hip bone a fusion between?
What muscle attaches to iliac fossa?
What is part of both ischium and pubis?
What part of ischium to yo sit on?
What attaches at pubic tubercle?
What type of joint is pubic symphysis?
What does the inguinal ligament attach between?
ASIS and pubic tubercle
On vaginal examination what can be felt at 4 and 8 o clock positions?
What ligament attaches between sacrum and iscjhial spine?
What does sacrotuberous ligament attach to?
Sacrum and ischial tuberosity
What ligaments ensure the inferior part of sacrum is not pushed superiorly when weight is suddenly transferred vertically through the vertebral column (jumping/late pregnancy)?
At what point in pregnancy do sacrospinous and sacrotuberous ligaments relax?
What do the sacrospinous ligament and sacrotuberous ligament form?
Lesser and greater sciatic foramen
What is a straddle injury?
Fracture of all four pubic rami
What is at risk of damage in trauma to bony pelvis?
Common iliac artery + common iliac vein
What diamteres of the female pelvis are larger than the males both at pelvic inlet and outlet?
Is the subpubic angle or pubic arch in female wider than male?
What can be said about the pelvic cavity in a female?
What is the vertex (fetal skul0?
Area of foetal skull: oiutlined by anterior and posterior fontanelles and the parietal eminences
What is longer - occipitofrontal diamter or biparietal diamter in foetal skull?
Occipitofrontal - foetal head longer than it is wide
At the pelvic inlet what diamter is wider- AP or transverse?
Transverse - foetus enters pelvic cavity facing either right or left
What is the distance of the foetal head from ichial spine referred to as?
Station - negative number means head is superor to spines, positive number means head is inferior
When descending through the pelvic cavity what should be said about foetal head?
At the pelvic outlet the AP diamter is wider than transverse diameter so baby should ideally leave cavity in what position?
Occipitoanterior OA position and head in extension
What is the term for any treatment in which involves gametes outside the body?
Assisted conception treatment ACT
What is the biggest cause of infertility?
What is the alcohol limit for treatment ACT?
limit up to 4 units a week
What blood borne viruses are screened for in ACT?
How do you assess ovarian reserve?
Antral follicle count or AMH
a simple procedure that uses a syringe to place semen into a woman's vagina to assist her in getting pregnant?
a fertility treatment that involves placing sperm inside a woman's uterus to facilitate fertilization. The goal of IUI is to increase the number of sperm that reach the fallopian tubes and subsequently increase the chance of fertilization?
During what, are mature eggs are collected (retrieved) from your ovaries and fertilized by sperm in a lab
An in vitro fertilization procedure in which a single sperm is injected directly into an egg?Defective sperm function remains the single most important cause of human infertility.
Intracytoplasmic sperm injection ICSI
What fertility treatment can be used for unexplained infertility, mild or moderate endometriosis and mild male factor infertility?
Intra Uterine Insemination
What fertility treatment is indicated in unexplained greater than 2 years duration, pelvic disease including tubual disease, anovulatory infertility, male factor infertility and pre-implantation genetic diagnosis?
What is given as an injection to reduce cancellation from ovulation and allows precise timing of oocyte recovery by using HCG trigger?
Down regulation using synthetic gonadotrophin releasing hormone agonist
Name three side effects of synthetic gonadotrophin releasing hormone?
Hot flushes and mood swings
What does injection of gonadotrophin hormone with (FSH or LH) cause?
Ovarain stimulation including Foolicular development
Name some side effects of ovarian stimulation?
Mild allergic reactions
Ovarian Hyperstimulation Syndrome
What four things are looked for in assessment of sperm?
What state of human embryo implants?
How many embryos are normally transferred?
1 - then luteal support (progesterone) is given.
What fertility treatment is indicated in severe male factor ifertility, previous failed IVF and preimplantation genetic diagnosis?
Intra cytoplasmic sperm injection (ICSI)
Name a complication of assisted reproduction techniques?
Ovarian hyperstimulation syndrome
If a patient gets OHSS after embryo transfer how is it treated?
1. Antithrombotic - TED stockings and fragmin
Is multiple pregnancy common in IVF?
What involves downregulation, ovarian stimulation, oocyte retrieval, embryo transfer and luteal support?
What is the highly vascular region of the ovary?
What arteries enter the hilum of the ovary from the braod ligament and supply blood to the organ?
Where is the common site for ovarian cancer?
Simple cuboidal epithelium
Underneath the ovary's simple cuboidal epithelium, what is the dense connective tissue called?
Early in embryonic development (around week 6) germ cells from the yolk sac invade the ovaries and proliferate by mitosis to form what?
What do oogonia undergo development and division via meiosis to form?
Mature oocytes or ova
What is the term for the development of oocytes, the female germ cells, from oogonia?
What is folliculogenesis?
Growth of follicle, which consists of the oocyte and any associated support cells
What is the name of the process that is loss of oogonia and oocytes?
Before birth, meiosis begins in the oocyte, but halts at what phase?
What happens if the oocyte fails to associate with pregranulosa cells (follicel cells)?
Initially the pregranulosa cells in a primoirdial follicle are squamous but what happens to them when follicle enters growth phase?
They become cuboidal
In a primary follicle, stromal cells associate with the outside of the follicle and go on to from what?
What special layer forms between the oocyte and the granulosa cells in a primary follicle?
The theca interna secretes oestrogen precurosrs which are converted to oestrogen by what?
In follicular development a space called the antrum forms and enlarges in the granulosa layer to form what?
What are the very largest antral follicles called?
One day before ovulation (release of oocyte from follicle) what happens to the largest Graafian follicle?
It completes meiosis 1 and produces one cell called a secondary oocyte
Once the secondary oocyte begins second phase of meiosis where does it stop/
After ovulation what happens to the follicle?
It turns into corpus luteum with the theca and granulosa cells secreting oestrogen and progesterone
If no implantation occurs what happens to corpus luteum?
Becomes corpus albicans
If implantation occurs what does the placenta secrete to prevent degeneration of corpus luteum?
HCG - maintains progesterone levels
Where does fertilisation usually occur in uterine tube?
What part of uterine tube has folded mucosa and lined by simple columnar epithelium with ciliated cells and secretory cells?
What part of uterine tube has epithelium lining mostly secretory with few ciliated cells?
What are the three layers of uterus?
What are the two layers of the endometrium and which one sheds?
Stratum Functionalis - sheds
What phase of the uterus involves glands becoming coiled with corkscrew appearance and secreting glycogen?
During what phase do arterioles in the functionalis undergo constriction, depriving the tissue of blood and causing ischemia, with resultant tissue breakdown, leakage of blood and tissue sloughing?
On the cervix vaginal surface it has stratified squamous epithelium - what covers the transitioning?
Simple columnar epithelium
What zone does cervical cancer most frequently occur in?
Four layers of vagina?
1. Non-keratinised stratified squamous epithelium
2. Lamina propria
3. Fibromuscular layer
What prevents growth of pathogenic bacteria in vagina?
Commensal bacteria metabolising glycogen to lactic acid
Keratinized epithelium extends into the opening of the vagina to the level of the hymen, where there is a transition to non-keratinized stratified squamous epithelium?
Contains two tubes of erectile vascular tissue (corpora cavernosa), covered by a fibrocollagenous sheath covered by skin with rich innervation and a thin epidermis.
In relation to issues specfiic to infertiltiy, what is there a right for?
In law, how long is embryo research permitted up to?
14 days (when primitive streak appears), but abortion permissible up to 24 weeks
Name a few guidelines for NHS funded fertiltiy treatment in Scotland?
1. Unexplained infertility of at least 2 years
2. Female partner under age of 40
3. Female BMI between 18.5 and 30
4. Both partners non smoking
5. Both partners abstain from illegal substances
6. Neither partner should drink before treatment
7. Not have a genetic child
Give 5 examples of code of practice from Human Fertilisation and Embryology Authority?
1. Right to people getting proper consideration of their request
2. Concerns for welfare of child
3. Pleimplantation tissue typing
4. Sex selection for medical conditions
5. Embryo with 2 genetic mother for mitochondrial disease
What are the four ethical values
1. Autonomy - right to desicion
2. Beneficence - best interset
3. Non maleficence - do no harm
4. Justice - fairness and equality