4-Female Pelvic Organs

Front 1

Where are the uterus and adnexa located?

Back 1

in the lesser pelvis

Front 2

What are the two main parts of the uterus? What separates them?

Back 2

body and cervis
separated by isthmus

Front 3

What is the superior, rounded portion of the body of the uterus called?

Back 3

fundus

Front 4

Name the superiolateral portion of the uterus where uterine tubes enter.

Back 4

Cornu/horn

Front 5

Name the elongated inferior portion of the uterus. What does it project into?

Back 5

cervix/neck
projects into the upper vagina and presents an opening, the external os

Front 6

What is the difference between the external and internal os?

Back 6

internal-opening through which sperm can access the isthmus of the uterus
external-opening through which sperm can enter the cervix

Front 7

What is the constricted portion of the uterus called? What does it separate?

Back 7

isthmus
body from cervix

Front 8

What is the internal layer of the uterus? What is its main characteristic?

Back 8

endometrium
highly vascular, sloughing during menstral cycle

Front 9

Define endometriosis.

Back 9

overgrowth of the uterine endometrium out of the uterus and into the uterine tube and pelvic cavity where it becomes established on the pelvic peritoneum, causing pain

Front 10

Name the middle and outer layer of the uterus.

Back 10

middle-myometrium
outer-perimetrium

Front 11

What is the term used for when the uterus is turned or shifted backwards? position further back than normal

Back 11

retroversion
retrocession

Front 12

What is the term used when the uterus is bent backwards? forwards?

Back 12

retroflexion
anteflexion

Front 13

What is the normal position of the uterus?

Back 13

anteverted (tilted forward) and anteflexed (bent forward)

Front 14

What does the angle of anteversion related to?

Back 14

the axis of the cervix with respect to the axis of the vagina

Front 15

What does the angle of anteflexion pertain to?

Back 15

the axis of theuterine body with respect to the axis of the cervix

Front 16

When palpating the uterus, what is an early sign of pregnancy?

Back 16

softening of the uterine isthmus

Front 17

What type of fascia is located between the peritoneum and superior fascia of the pelvic diaphragm? Is it inferior or superior to the pelvic fascia?

Back 17

endopelvic fascia
superior

Front 18

In addition to suspensory functions, what else are the pelvic ligaments associated with?

Back 18

blood vessels, nerves and lymphatics

Front 19

Describe the peritoneum of the mesentery? What is another name for the mesentery?

Back 19

double layer
broad ligament

Front 20

Name the 3 structures that the broad ligament encloses.

Back 20

uterine tube, round ligament of uterus, ligament of ovary

Front 21

What is the main portion of the broad ligament? What is it the mesentery of?

Back 21

mesometrium
uterus

Front 22

What is the name of the fold of peritoneum from which the uterine tubes are suspended? What does it contain?

Back 22

Mesosalpinx
Epoophoron-remnants of mesonephric tubules

Front 23

What is the fold of peritoneum from which the ovaries are suspended? What is it perpendicular to?

Back 23

mesovarium
perpendicular to mesosalpinx

Front 24

What is the purpose of the cardinal ligament?

Back 24

-suspends cervical region of the uterus from the lateral pelvic walls

Front 25

What are two other names for the cardinal ligament?

Back 25

Transverse cervical, mackenrodt's ligament

Front 26

What artery runs with the cardinal ligament?

Back 26

uterine A

Front 27

What can be the result of a weakened levator ani?

Back 27

uterine prolapse

Front 28

What is the round ligament of the uterus a remnant of?

Back 28

gubernaculum

Front 29

What does the round ligament of the uterus attach to after it has passed through the broad ligament an dinguinal canal? Where does it attach on the uterus?

Back 29

skin of the labium majora
just inferior to the uterine tubes

Front 30

What is the clinical significance of the round ligament during pregnancy?

Back 30

it can be pulled on and cause pain in the vulvar region

Front 31

What does the uterosacral ligament attach? What fold is this ligament contained in?

Back 31

posterior cervix of uterus to the sacrum
uterosacral fold

Front 32

What does the uterine artery branch from? What does it anastomose with superiorly and inferiorly?

Back 32

internal iliac
ovarian A superiorly and vaginal A inferiorly

Front 33

What are the nerves in the true pelvis derived from?

Back 33

Lumbosacral trunk (L4,5), 5 sacral nerves, and one coccygeal N

Front 34

What are the somatic nerves that innervate the uterus? Name the specific nerve and its nerve levels?

Back 34

sacral & coccygeal N plexuses
pudendal N from S2-4

Front 35

Does the pudendal N come from ventral or dorsal rami?

Back 35

ventral

Front 36

Name the two main mixed ANS of the pelvis. Which is sympathetic and parasympathetic?

Back 36

sacral sympathetic trunk pelvic splanchnic nerves-parasympathetic

Front 37

What does the sacral sympathetic trunk communicate with?

Back 37

ventral rami of sacral & cocygeal N plexuses and inferior hypogastric plexus

Front 38

What spinal levels are the pelvic splanchnic nerves from? What do they merge with?

Back 38

S2,3,4
hypogastric nerves

Front 39

What forms the inferior hypogastric n plexus? What type of nerves are they?

Back 39

hyupogastric nerves and pelvic splanchnic nerves
mixed

Front 40

Which lymph nodes drain the fundus of the uterus? What do these nodes run with?

Back 40

superficial inguinal lymph nodes run with the round ligament of the uterus

Front 41

Which nodes drain the lower body of the uterus?

Back 41

external iliac

Front 42

Which nodes drain the cervix?

Back 42

internal iliac

Front 43

What type of organ is the vagina? What does it extend from?

Back 43

fibromuscular
from uterus to vulva

Front 44

What artery supplies the proximal part of the vagina?

Back 44

vaginal artery

Front 45

What is the vaginal artery a branch of?

Back 45

uterine artery

Front 46

Which artery supplies the distal vagina?

Back 46

internal pudendal A

Front 47

What is the lower 1/5 of the vagina innervated by? What is it sensitive to?

Back 47

somatic nerves
touch and temperature

Front 48

What do the somatic nerves branch from?

Back 48

deep perineal branch of pudendal nerve

Front 49

What is the upper 4/5 of the vagina innervated by? What is it sensitive to?

Back 49

viscerally innervated by the ANS
stretch

Front 50

Sympathetic fibers derived from the upper lumbar spinal cord levels travel to what plexus?

Back 50

inferior hypogastric plexus

Front 51

The inferior hyposgastric plexus is joined by what other nerves?

Back 51

pelvic splanchnic nerves

Front 52

Mixed automomic nerves travel toward the uterus and vagina along w/ the uterine artery to form the _______ plexus.

Back 52

uterovaginal

Front 53

What areas are numbed by a caudal epidural?

Back 53

subperitoneal and somatic areas

Front 54

How can the pudendal nerve be accessed for a nerve block?

Back 54

accessed where n crosses the lateral aspect of the sacrospinous ligament near its attachment to the ischial spine

Front 55

What nodes does the superior part of the vagina drain to?

Back 55

internal and external iliac lymph nodes

Front 56

What nodes does the middle part of the vagina drain?

Back 56

internal iliac

Front 57

What nodes does the inferior vagina drain?

Back 57

sacral and common iliac and superficial inguinal lymph nodes

Front 58

What can be palpated during a vaginal exam?

Back 58

cervix, ischial spines, sacral promontory, ovarian cysts

Front 59

What is the part of the uterine tube that passes through the upper body of the uterus?

Back 59

uterine/intramural portion

Front 60

Where is the uterine tube the narrowest?

Back 60

at the uterine/intramural portion of uterine tube

Front 61

Name the 3 extramural portions of the uterine tube.

Back 61

isthmus, ampulla, infundibulum

Front 62

Name the longest portion of the tube? Where does this tube end?

Back 62

ampulla, ends in dilation near fimbriae

Front 63

Name the distal end of the uterine tube? What is it open to?

Back 63

infundibulum
peritoneal cavity

Front 64

In what part of the uterine tube does fertilization occur?

Back 64

ampulla

Front 65

What is the opening of the infundibulum called that is in close proximity to the ovary?

Back 65

ovarian fimbria

Front 66

Infections of the vagina, uterus, and uterine tubes may result in _____.

Back 66

peritonitis

Front 67

What is a major cause of infertility in women?

Back 67

blockage of the uterine tubes (often the result of pelvic infection and inflammation)

Front 68

Where are the ovaries located w/ respect to the broad ligament?

Back 68

above and behind it

Front 69

What does the suspensory ligament of the ovary contain?

Back 69

ovarian A&V, nerves and lymphatics

Front 70

Where does the suspensory ligament of the ovary run?

Back 70

just inferior to the uterine tube

Front 71

What do the ovarian arteries branch from?

Back 71

abdominal aorta

Front 72

What do the ovarian arteries anastomose with?

Back 72

uterine arteries

Front 73

What does the R ovarian vein drain to? L?

Back 73

R-vena cava
L-L renal vein

Front 74

What supplies the PSNS innervation to the ovaries?

Back 74

pelvic splanchnic nerves

Front 75

Sympathetic and afferent fibers reach the _____ plexus by descending along the ovarian vessels and via communications from the _____ plexus

Back 75

ovarian
pelvic (uterovaginal)

Front 76

Which nodes do the ovaries drain to?

Back 76

lumbar

Front 77

Describe the pathway of sperm starting at the vagina.

Back 77

vagina-external os of uterus-cervical canal-internal os-isthmus-body-horn-intramural uterine tube-extramural (isthmus to ampulla) portions of uterine tube

Front 78

What can occur if the ovum is released from the ovary but not captured by the fimbriae of the uterine tube?

Back 78

ectopic pregnancy

Front 79

What can occur if the ovum is fertilized in the peritoneal cavity?

Back 79

ectopic pregnancy

Front 80

The urethra runs from bladder to _____.

Back 80

urethral orifice

Front 81

Name the 3 ligaments of the bladder.

Back 81

inferior (arcuate) pubic, lateral & medial pubovesicle

Front 82

What supplies blood to the inferior aspect of the bladder in females?

Back 82

vaginal/inferior vesicle artery

Front 83

What is the main artery supplying the bladder? What is this artery a branch of?

Back 83

superior vesicle artery
(proximal) part umbilical artery

Front 84

In females, what is the space between the pubis symphysis and bladder?

Back 84

retropubic (prevesical) space

Front 85

What are the concave recesses lateral to the bladder?

Back 85

paravesical fossa

Front 86

What are the concave recesses lateral to the rectum? What do these spaces allow for?

Back 86

pararectal fossa
permit expansion of rectum

Front 87

What is herniation of bladder into the vaginal wall?

Back 87

cystocele

Front 88

What is the space between the portions of the uterus and bladder that are covered w/ peritoneum?

Back 88

vesicouterine pouch

Front 89

What is the space between the portions of the uterus and rectum which are covered w/ peritoneum?

Back 89

rectouterine pouch/cul-de-sac of Douglas

Front 90

What is the most inferior part of the peritoneal cavity in women?

Back 90

rectouterine pouch/cul-de-sac of Douglas

Front 91

Infections of the rectouterine pouch can be drained through the _____ of the vagina.

Back 91

posterior fornix

Front 92

Indoscopic instruments can be introduced into the lower peritoneal cavity through the posterior fornix. What is this procedure called? What is its purpose?

Back 92

culdoscopy
diagnostic purposes of rectouterine pouch

Front 93

What is the vaginal fornix?

Back 93

recess around the superior end of the vagina resulting from projection of cervix into proximal vagina

Front 94

What completely encircles the cervix?

Back 94

fornix

Front 95

Which umbilical fold contains the occluded umibilical artery?

Back 95

medial

Front 96

What did the umbilical artery extend from?

Back 96

superior vesicle arteries to the umbilicus

Front 97

What does the median umbilical fold ascend to? What does it contain?

Back 97

ascends to umbilicus
contains urachus

Front 98

What is the urachus?

Back 98

canal between bladder and allantois in the fetus

Front 99

The uterosacral/sacrouterine/rectouterine fold passes superiorly and posterior from the _____ to the middle of the sacrum.

Back 99

cervix

Front 100

What is the name of the raised peritoneum over the ureter as it enters the pelvis?

Back 100

ureteric fold

Front 101

What is located between the peritoneum and the superior fascia of the pelvic diaphragm?

Back 101

endopelvic fascia

Front 102

What is the name of the fascia that is a continuation of the fascia covering the muscles surrounding the abdominal cavity?

Back 102

superior fascia of pelvic diaphragm/parietal pelvic fascia

Front 103

In the pelvis, the fascia covering the upper surface of the pelvic diaphragm can be separate into 3 fascia types. Name them.

Back 103

pubococcygeus, iliococcygeus and coccygeus fascia

Front 104

What is the thickening on either side of the midline of the superior fasica of pelvic diaphragm referred to as?

Back 104

tendinous arch of pelvic fascia

Front 105

Anteriorly, the thickened fascia attaches the base of the bladder to the pubis in the female to form what ligament?

Back 105

pubovesicle

Front 106

Fascia attaches to the sacrum by what ligament?

Back 106

uterosacral

Front 107

What is the hypogastric sheath formed by?

Back 107

pelvic fascia that resolves itself into three layers

Front 108

The anterior most portion of the hypgastric sheath carries what artery? What is this ligament called?

Back 108

superior vesicle
lateral vesicle ligament

Front 109

What does the posterior most portion of the hypgastric sheath carry? What is this ligament called?

Back 109

middle rectal A
lateral rectal ligament

Front 110

What is the middle subdivision of the hypogastric sheath called?

Back 110

transverse cervical ligament of Mackenrodt