7.06 Female Reproductive Anatomy

Front 1

What female reproductive parts lie in the peroneum?

Back 1

mons pubis, clitoris, labium minus, majus and erectile tissue

Front 2

What is the name of the female external genitalia?

Back 2

vulva/pudendum

Front 3

What is the uterine adnexa?

Back 3

Structures associated with the uterus - ovaries, uterine tubes

Front 4

What is the introitus?

Back 4

external vaginal opening

Front 5

What are the components of the birth canal?

Back 5

cervix, vagina, vestibule or vagina

Front 6

What guides the descent of the ovary in development, and where does the decent stop?

Back 6

gubernaculum. the descent stops in the pelvic cavity

Front 7

What two ligaments are the remains of the gubernaculum in the female?

Back 7

ligament of ovary and the round ligament

Front 8

What is the topographic relationship between uterine tube and ovary?

Back 8

The uterine tube passes over the ovary

Front 9

What are the functions of the ovaries?

Back 9

To produce ova, oestrogen and progesterone

Front 10

What connects the ovary to the uterus?

Back 10

ovarian ligament

Front 11

What attaches the uterine tube to the back of the ovary?

Back 11

The ovarian fimbria

Front 12

What attaches the ovary to the broad ligament?

Back 12

mesovarium

Front 13

Because of the _____'s close relationship to the ovary, it can be damaged when the ovary is removed.

Back 13

ureter

Front 14

Does the ovary sit infront or behind the broad ligament?

Back 14

behind

Front 15

What ovarian structure ruptures into the peritoneal cavity?

Back 15

secondary oocyte

Front 16

T/F... The ovaries are covered by peritoneum.

Back 16

False. The ovaries are covered by a single layer of simple cuboidal epithelium (hence its dull appearance as opposed to shiny peritoneum)

Front 17

What is the name for L or R lower abdominal pain occuring mid-menstrual cycle?

Back 17

Mittlelschmerz. It occurs at around the time of ovulation

Front 18

What nerve can sometimes be irritated by ovary rupture?

Back 18

Obturator nerve (passes forward on the lateral wall of ovary)

Front 19

What is the ovary's arterial and nervous supply?

Back 19

ovarian artery, which has a nerve plexus on it from spinal T10

also, small innervation from branches of hypogastric plexus

Front 20

What are other names for the uterine tubes?

Back 20

Fallopian tubes, salpinx (Greek for trumpet!)

Front 21

What are the four parts of the uterine tubes?

Back 21

Fimbriae - finger-like processes
Infundibulum - funnel
Ampulla - thin wall, relatively large lumen
Isthmus - thick wall, narrow lumen

Front 22

Where does fertilisation usually take place?

Back 22

ampulla of uterine tube

Front 23

What are the two openings of the uterine tubes?

Back 23

Uterine/intramural part - where the uterine tubes pass into uterus
Abdominal ostium - opening into peritoneal cavity

Front 24

What is the name of the superior smooth muscle layer of the uterus?

Back 24

fundus

Front 25

What is the function of the isthmus of the cervix during pregnancy?

Back 25

It is taken up by the body in pregnancy (called lower uterine segment)

Front 26

What is the name of the opening of the cervix into the vagina?

Back 26

external os

Front 27

What is the name of the opening of the uterus to the cervix?

Back 27

internal os

Front 28

What are the two appearances of the external os with speculum examination?

Back 28

Nulliparous (round with an opening) - in women who have not had pregnancy
Parous (oval and closed) - in women who have had pregnancy

Front 29

What is an ectopic pregnancy?

Back 29

When implantation is in a site other than in the normal body of the cavity of the uterus (ie, in uterine tube (most common), cervix, cervical canal or peritoneal cavity)

Front 30

What is a uterosalpingogram and how does it differ from a hysterosalpingogram?

Back 30

They are the same thing. Involves imaging of uterus with radiopaque material injected into it from external os - looking for the contrast to spill out into peritoneal cavity. looking for tubal obstruction, uterus for polyps, fibroids or developmental abnormalities

Front 31

What is the angle of anteversion?

Back 31

The angle between long axis of cervis and long axis of vagina (where uterus is tipped forward toward the bladder). 90 degrees

mneumonic: anteVersion - Vagina.

Front 32

What is the angle of anteflexion?

Back 32

The angle between the body of the uterus to the cervix (where the fundus is pointing forward relative to the cervix). ~170 degrees

Front 33

Where does the round ligament pass through after attaching to the 'armpit' of the uterus? Where is its destination?

Back 33

inguinal canal

destination: labium majus

Front 34

What is the upper-most part of the broad ligament?

Back 34

the uterine tube

Front 35

What is the broad ligament?

Back 35

double layer of peritoneum lateral to uterus

Front 36

What is the part of the broad ligament below the uterine tube?

Back 36

mesosalpinx

Front 37

What part of the broad ligament lies inferiorly to the ovarian ligament and lateral to the uterus?

Back 37

mesometrium

Front 38

What part of the broad ligament lies posteriorly to the ovary?

Back 38

mesovarium

Front 39

Does the round ligament lie anteriorly or posteriorly to the broad ligament?

Back 39

anteriorly

Front 40

What artery is contained in the transverse cervical ligament?

Back 40

uterine artery

Front 41

what structures passively support the uterus?

Back 41

pubocervical (anterior), transverse cervical (lateral) and uterosacral ligaments (posterior)

Front 42

Why is an episiotomy performed during delivery (and what is it)?

Back 42

It is a mediolateral surgical cut to peroneum/posterior vaginal wall as prophylaxis for muscle weakness or damage following delivery and uterus prolapse complications. it is sutured after delivery.

Front 43

Where does the ovarian artery originate?

Back 43

upper abdominal aorta

Front 44

What arteries branch off from the internal illiac artery?

Back 44

uterine and vaginal arteries

Front 45

What is the course of the uterine artery?

Back 45

passes tortuously up the lateral broad ligament, then divides to supply medial part of uterine tube and colateral supply to ovary.
it also branches downwards to supply upper vagina

Front 46

What artery/s supply to vagina?

Back 46

upper vagina - uterine artery
lower vagina - vaginal artery

Front 47

What is the relationship between the ureter and uterine artery? What is a complication of hysterectomy of ureter?

Back 47

ther uterine artery is like a bridge over the ureter. When uterus is removed, both sides of uterine artery are ligated, which can affect the ureter. ie. no urine flow despite constant urine production

Front 48

What innervates a female's external genitalia? What else does it innervate?

Back 48

internal pudendal artery

also innervates erectile tissue

Front 49

What do the L and R ovarian veins drain to?

Back 49

L ovarian vein drains to L renal vein
R ovarian vein drains to IVC

Front 50

What drains the clitoris?

Back 50

deep dorsal vein

Front 51

What are the menopausal changes of uterus shape?

Back 51

uterus shrinks but the cervix is proportionately larger than in earlier years

Front 52

What cervical structures pierce the upper anterior vagina?

Back 52

anterior and posterior fornices

Front 53

Where can abscesses be drained from inside the vagina?

Back 53

The posterior fornix and its adjacent rectouterine pouch (pouch of Douglas)

Front 54

What is the shape of a vaginal cross-section at the level below the fornices?

Back 54

H-shaped, due to presence of the lateral fornix

Front 55

What lies anteriorly to the vagina?

Back 55

bladder
ureter (it is fused to the anterior wall of vagina)

Front 56

What is posteriorly related to the vagina?

Back 56

Rectum and perineal body

Front 57

What fills the labia majora?

Back 57

fat longitudinally

Front 58

Where do the L and R labium majus come together?

Back 58

posterior and anterior commissure

Front 59

What is the name of the cleft between the labia majora?

Back 59

pudendal (shameful) cleft

Front 60

Where do the labia minora come together?

Back 60

posterior - frenulum of labia (fourchette)
anterior - prepuce (hood) and frenulum of clitoris (frenulum lies on the ventral surface of the clitoris)

Front 61

What is contained on the vestibule of the vagina?

Back 61

the urethra, the opening of the vagina (posteriorly), greater vestibular glands (mucus secreting), opening of paraurethral glands (Skene's glands; homologous to prostrate in males)

Front 62

Where is the location of the hymen and what is its appearance in a virgin?

Back 62

located at lower end of vagina as a fold. It has one or more small openings in a virgin, becoming larger after intercourse, and larger still after childbirth

Front 63

What are the erectile tissue structures in women?

Back 63

clitoris and bulb of vestibule

Front 64

What is the crus of the clitoris attached to?

Back 64

ischiopubic ramus

Front 65

What are the parts of the clitoris?

Back 65

2 crura, a body and the glans (analogous to penis)

Front 66

T/F... in females, the urethra is surrounded by erectile tissue

Back 66

False. true for males, but in females the erectile tissue (bulb of vestibule) forms a separate part

Front 67

What muscles lie over the crus of the clitoris and bulb of the vestibule?

Back 67

over crus - ischiocavernosus
over bulb - bulbospongiosus

Front 68

What is the consequence of an imperforate hymen?

Back 68

At menarche, female can suffer from severe abdominal pain as blood has nowhere to pass.

Front 69

What lies above the pelvic pain line, and where do the pain fibres travel?

Back 69

uterus lies above pain line. pain travels via sympathetics to T11-L2 cord level

Front 70

What is the result of a spinal block (anaesthetic to spine)?

Back 70

blocks uterine contraction pain, cervical dilation or stretch of perineal skin (as it is above pelvic pain line, T11-L2)

Front 71

What lies below the pelvic pain line and where do the pain fibres of these structures travel?

Back 71

pain from cervix and upper vagina via parasympathetics S2-4 spinal cord

Front 72

What is the result of a caudal epidural block?

Back 72

can feel uterine contraction, but not dilation of cervix or stretch of perineal skin (as it is below pelvic pain line, S2-4)

Front 73

What is the result of a pudendal nerve block?

Back 73

cannot feel stretch of perineal skin (S2-4 spinal cord level- the block is done directly on the somatic pudendal nerve (located around ischial spine))