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Mound of adipose tissue, skin, and hair that cushions the pubic symphysis?

Mons Pubis (mons veneris)

Amt of fat in mons pubis does what during puberty and menopause?

Increases in puberty

Decreases in menopause

This is a terminus of the round ligament of the uterus and extends interiorly and posteriorly?

Labia majora

This is a scrotom homolog?

Labia majora

Which contains sudoriferous and sebaceous glands, labia majora or labia minora?

Labia majora

This contains only sebaceous glands, is hairless and folds medial to the labia major?

Labia minora

This is a penile shaft skin homolog?

Labia minora

Where does the labia minora merge anteriorly?

Clitoris

Covering of the clitoris?

Prepuce (clitoral hood)

This is a small, cylindrical mass of erectile tissue and nerves?

Clitoris

Exposed portion of the clitoris?

Glans

This is a glans penis homolog?

Clitoris

Where is the vestibule located?

Between the labia minora

What does the vestibule contain?

External urethral orifice
Vaginal orifice
Ducts of several glands

Where is the external urethral orifice located?

Located anterior to the vaginal orifice and posterior to the clitoris

Membranous urethra homolog?

Vestibule

What consists of 2 elongated masses of erectile tissue and is deep to the labia on both sides of the vaginal orifice?

Bulb of the vestibule

Corpus Spongiosum homolog

Bulb of the vestibule

Which glands produce a small amount of mucus during sexual arousal and provide lubrication?

Greater vestibular (Bartholin) glands
(4 and 7 o'clock)

Bulbourethral gland homolog?

Greater vestibular (Bartholin) glands

Which glands are located on both sides of the vaginal orifice?

Greater vestibular (Bartholin) glands

Which glands secrete mucus into ducts that open into the urethral orifice?

Paraurethral (Skene's) glands

Which glands are located on either side of the urethral orifice?

Paraurethral (Skene's) glands

Prostate homolog?

Paraurethral (Skene's) glands

A diamond-shaped area medial to the thighs and buttocks in males and females?

Perineum

What area contains the external genitalia and anus?

Perineum

What is the perineum bound by anteriorly?

Pubic symphysis

What is the perineum bound by laterally?

Ischial tuberosities

What is the perineum bound by posterolaterally?

Sacrotuberous ligaments

What is the perineum bound by posteriorly?

Coccyx

Name the 2 triangular areas contained in the perineum

Urogenital (external genitalia and urethral orifice) and anal (anus)

This supports the abdominal and pelvic organs, composed of levator ani and coccyges, and is important in fecal continence?

Pelvic diaphragm

What muscles compose the Levator Ani muscle group?

Puborectalis
Pubococcygeus
Iliococcygeus

T/F. The Levator Ani muscle is tonically contracted most of the time to provide fecal/urinary continence.

True

What is the urogenital diaphragm?

Fibromuscular sheet that stretches across the pubic arch

Purpose of urogenital diaphragm

Provides framework for attachment of erectile body of clitoris

Major source of vesicourethral control

This is the shape and size of an inverted pear?

Uterus

What does the uterus consist of?

Fundus
Body
Isthmus

What layer of muscle forms the Pouch of douglas and vesicouterine pouch?

Perimetrium

What is the lowest point in the abdominal cavity for fluid accumulation?

Rectouterine pouch (Pouch of Douglas)

What commonly causes excess fluid in the pouch of douglas?

Ruptured ovarian cyst
local or distant malignancy

What connects the two superficial transverse perineal muscles and is a common area for dissection to loosen up the muscles in that area?

Perineal body

Where is the perineal body located?

Center of the bases of the urogenital and anal triangles

T/F. There is no perimetrium or peritoneal separating the bladder and the cervix.

True

What area contains the thinnest part of the myometrium?

Cervix

What muscle contracts as a result of oxytocin release during labor and delivery?

Myometrium of the uterus

The myometrium contracts when what hormone is secreted during labor and delivery?

Oxytocin

How many layers compose the myometrium?

3

Which layer of the myometrium is circular?

2

Which layer of the myometrium is thickest?

Circular (middle)

What layer of the uterus is composed of simple columnar epithelium?

Endometrium

Is the endometrium ciliated and secretory?

Yes

Which layer of the uterus is most vascularized?

Endometrium

Where does the cervical canal open into the uterine cavity?

Internal os

Where does the cervical canal open into the vagina?

External os

What structure elongates during pregnancy (after the 28th week) and becomes the lower uterine segment?

Uterine isthmus

What are the main cell types of the cervix?

Squamous epi cells and columnar epi cells

Where are squamous epi cells located in the cervix?

Ectocervix (exocervix)

Where are the columnar epi cells located in the cervix?

Endocervix (cervical canal)

Portio

portion of the cervix extending into the vagina. Includes parts of the endocervix and exocervix

Fornix

Recessed vagina that borders the lateral cervix

Where does 95% of the cervical neoplasia occur?

Transformation zone

Ectropion

Columnar cells are visible on the ectocervix

When does ectropion most commonly occur?

near menarche, during pregnancy, or when using oral contraceptives

What symptoms will the patient experience when ectropion occurs?

More vaginal secretions or postcoital spotting

Which ligaments help maintain anteversion?

Round ligaments

When do gonads begin to form during gestation?

4 weeks

When do primordial germ cells in the ovary complete first meiotic division during gestation?

20 weeks

When does the undiff embryo begin to respond to gene effects of Y chromosomes?

8-9 weeks

What is the earliest that you can determine if the embryo is going to be a female or male?

8-9 weeks (appearance or non-appearance of Sertoli cells coming from the Y chromosomes)

Which of genital ducts is female, (Paramesonephric duct or Mesonephric Ducts)

Paramesonephric (Muellerian) Ducts

Which of the genital ducts is male, (Paramesonephric duct or Mesonephric Ducts)?

Mesonephric (Wolffian) ducts

What causes the phenotypic appearance in males?

Hormones produced by the fetal testes

What causes regression of the Muellerian ducts?

Mullerian Duct Inhibitory Substance (MIS) secreted by the Sertoli cells whose proliferation are generated by the Y chromosome

What is produced by the Leydig cells?

Testosterone

What is normal pH for the vagina?

3.8 to 4.5 (acidic)

How much cervical mucus does the average woman produce per day?

20 - 60 ml

How does the cervical mucus become more sperm friendly?

Becomes less viscous and more alkaline

How long are the fallopian tubes usually?

4 inches or 10 cm long

Function of the fallopian tubes

Transport the 2ndary oocytes, ovum, zygote, and sperm

Where are the fallopian tubes located?

Between the folds of the broad ligaments

What part of the fallopian tube opens to the pelvic cavity and has fimbriae on the lateral portion?

Infundibulum

What produces local currents that draw the ovulated 2ndary oocyte into the fallopian tube?

Infundibulum

T/F. The Infundibulum is attached to the contralateral ovary.

False (ipsilateral)

What is the longest part of the fallopian tube?

Ampulla

What part of the fallopian tube is connected to the anteriolateral wall of the uterus?

Isthmus

What are the 3 parts of the fallopian tube?

Infundibulum
Ampulla
Isthmus

Which layer of the fallopian tube is composed of ciliated epithelium containing secretory (peg) cells with microvilli?

Mucosa

What is the function of the secretory (peg) cells in the mucosa of the fallopian tube?

Secrete fluid containing nutrients for the oocyte (fertilized ovum and sperm)

What kind of motion does the muscularis layer of the fallopian tube perform to move the oocyte to the uterine cavity?

Peristalsis

What are the 4 major pelvic ligaments?

Cardinal
Round
Broad
Uterosacral

Which pelvic ligaments anchor the cervix and vagina to the pelvic wall and provides most of the passive support of the uterus (with the bladder)?

Cardinal

Which pelvic ligaments divide pelvis into anterior and posterior compartments?

Broad

Which pelvic ligament anchors the uterus to the pelvic wall?

Broad

Which pelvic ligament actually envelopes the round ligaments?

Broad

What is the portion of the broad ligament that contains the fallopian tube called?

Mesosalpinx

Which pelvic ligaments anchor the uterus to the sacrum?

Uterosacral

Bregma

Anterior fontanelle with 3 suture lines attached (anterior, posterior, and transverse)

What is the favorable presenting diameter of the average full term infant?

Suboccipitobregmatic (vertex, OA, flexed)
9.5cm

Name the 4 basic bony pelvic shapes

Anthropoid
Android
Gynecoid
Platypelloid

Which of the basic bony pelvic shapes are most favorable for vaginal delivery?

Anthropoid -20%
Gynecoid - 50%

What are the pelvic planes?

Pelvic Inlet

Plane of Greatest Diameter

Plane of Least Diameter

Pelvic Outlet

Pelvic inlet?

Opening into the true pelvis that contains the bladder, uterus; Path of the birth canal from sacral promontory to pubic symphisis.

How does the fetal head enter the pelvic inlet?

Enters in transverse position

What are the pelvic inlet boundaries?

Superior border of pubis
Linea terminalis (iliopectineal line)
Sacral promontory

What are the boundaries for the plane of greater diameter?

Posterior pubis at maximum convexity
Superior border of obturator formina
2nd/3rd sacral vertebral junction

What is important about the plane of least diameter?

Clinically most important

Frequent site of arrests

What is the boundaries for the plane of least diameter?

Lower posterior pubic edge anteriorly

Ischial spines and sacrospinous ligaments laterally

Sacrum posteriorly

What are the boundaries of the pelvic outlet?

Sacrotuberous ligaments and sacrococcygeal joint posteriorly

Inferior margins of pubic rami anteriorly

Ischial tuberosities laterally

what are the 3 key diameters to assess for fetal descent during labor?

Inlet
Midplane
Outlet

What are the 3 types of measurements for the pelvic inlet?

True conjugate
Obstetric conjugate
Diagnonal conjugate

What measurement of the pelvic inlet is made by measuring the length of the finger that can go into the vaginal cavity? (From sacral promontory to just outside of the vagina.)

Diagnonal conjugate

How do you get the obstetric conjugate?

Subtract 1.5 cm to 2 cm from Diagonal conjugate. (Estimating 1.5 to 2 cm of bone and soft tissue)

Fetal head engagement

Fetal biparietal diameter passes through pelvic inlet and seen in obstetric conjugate

Pelvic outlet

Distance between the maternal ischial tuberosities (Width/diameter of birth canal)

Station

Description of where the bony presenting part is in relationship to the ischial spines

What station is the bony presenting part when the head is engaged?

0 station

Asynclitic

Head engages crooked or cock-eyed instead of parallel to pelvic plane

Synclitic

Head engages parallel to the pelvic plane

What station is the bony presenting part when it is 2 cm before reaching the ischial spine?

-2 station

How can an asynclitic type of fetal head engagement help in the birthing process in some cases?

When it enters the pelvis, the asynclitic diameter is actually shorter than the biparietal diameter.

What are the estimates of the midplane?

Pelvic Side Walls
- Convergent
- Parallel (Usual and desired)

Bispinous diameter
(distance between ischial spines)
- Prominent
- Average

Sacrospinous ligament
- Usually 3 fingers between ischial spine & midline sacrum

What are the estimates of the pelvic outlet?

Posterior sagittal - >8cm

Infrapubic angle - >90 degrees

Bituberous diameter - >8.5cm

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