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First Aid for the OB/GYN Clerkship- Reproductive anatomy
Terms in this set (83)
The major blood supply to the pelvis is from what?
internal iliac artery (hypogastric artery) and its branches
lymphatic drainage from the pelvis is what?
inguinal, pelvic, or para-aortic lymph nodes
major parasympathetic innervation to the pelvis is via what?
S2, S3, S4
pudendal nerve is formed from which spinal roots?
S2, S3, S4
the major sympathetic innervation of the pelvis is via what?
the aortic plexus, which gives rise to the internal iliac plexus
bartholin glands are located where?
4:00 and 8:00 of the vaginal orifice
bartholin glands are homologous to what?
bulbourethral glands in males
ducts of the skene's glands are located where?
on either side of the urethral orifice
blood supply of the vulva?
from branches of the external and internal pudendal arteries, which are subdivisions of the hypogastric artery (internal iliac)
lymphatic drainage of the vulva?
medial group of superficial inguinal nodes
nerve supply of the vulva?
1. anterior parts of vulva: ilioinguinal nerves and the genital branch of the genitofemoral nerves
2. posterior parts: perineal nerves and posterior cutaneous nerves of the thigh
what is the blood supply to the vagina?
hypogastric artery (anastomotic network):
1. vaginal branch of the uterine artery is the primary supply to the vagina
2. middle rectal and inferior vaginal branches of the hypogastric artery (IIA) are secondary blood supplies
3. anastomoses with cervical arteries
what is the sympathetic innervation to the vagina?
what is the parasympathetic innervation of the vagina?
what are the 5 subdivisions of the cervix?
1. Portio vaginalis
2. External os
4. endocervical canal
5. internal os
what is the portio vaginalis?
portion of the cervix projecting in to the vagina
what is the external os?
lowermost opening of the cervix into the vagina
what is the ectocervix?
portion of the cervix exterior to the external os
what is the endocervical canal?
passageway between the external os and the uterine cavity
what is the internal os?
uppermost opening of the cervix into the uterine cavity
what portion of the cervix must be completely excised to ensure proper treatment of CIN-II?
stratified nonkeratinized squamous epithelium covers what part of the cervix?
columnar epithelium lines what part of the cervix?
what is the transformation zone?
the area of metaplasia where columnar epithelium changes to squamous epithelium
what percent of lower genital tract neoplasias arise from the transformation zone?
what is the blood supply to the cervix?
cervical and vaginal branch of the uterine artery, which arises from the internal iliac artery
what is the nerve supply to the cervix?
what are the 4 components of the uterus?
what is the fundus?
uppermost region of the uterus
what is the corpus?
body of the uterus
what is the cornu?
part of the uterus that connects to the fallopian tubes bilaterally
what is the cervix?
inferior part of the uterus that protrudes into the vagina
what is the myometrium?
the smooth the muscle layer of the uterus
what are the 3 layers of the myometrium?
1. outer longitudinal
2. middle oblique
3. inner longitudinal
what is the endometrium?
mucosal layer of the uterus, made up of columnar epithelium
what is the blood supply to the uterus?
1. uterine arteries: arise from the hypogastric artery
2. ovarian arteries: arise from the aorta, and anastomose with uterine vasculature
what is the nerve supply to the uterus?
1. superior hypogastric plexus
2. inferior hypogastric plexus
3. common iliac nerves
what is the relation between the ureter and the uterine artery?
the ureter travels under the uterine artery- water under the bridge
what is the location of the fallopian tubes?
extend from the superior lateral aspects of the uterus through the superior fold of the broad ligament laterally to the ovaries
where are the fallopian tubes occluded to achieve permanent sterilization via laparoscopy?
at the isthmus
what are the anatomic sections, from lateral to medial, of the fallopian tubes?
4. intramural part
what is the infundibulum of the fallopian tube?
the most distal part of the uterine tube. helps to sweep the egg that is released from the ovary into the tube
what is the ampulla of the fallopian tube?
what is the isthmus of the fallopian tube?
what is the intramural part of fallopian tube?
pierces uterine wall and connects to the endometrial cavity
what is the most common location for ectopic pregnancy?
ampulla of the fallopian tube
what is the blood supply to the fallopian tubes?
from the uterine and ovarian arteries
what is the cause of fast dissemination of ovarian cancer in the abdomen?
no peritoneum around the ovaries
what is the nerve supply to the fallopian tubes?
pelvic plexus (autonomic) and ovarian plexus
what is the location of the ovaries?
they lie on the posterior aspect of the broad ligament
how are the ovaries attached to the broad ligament?
they are attached by the mesovarium and are not covered by peritoneum
what is the blood supply and venous drainage of the ovaries?
aorta → bilateral ovarian arteries
left ovarian vein → left renal vein
right ovarian vein → inferior vena cava
at what level do the ovarian arteries arise from the aorta?
what is the nerve supply to the ovaries?
derived from the aortic plexus
what are the important histological features of the ovaries?
the ovaries are covered by tunica albuginea, a fibrous capsule. the tunica albuginea is covered by germinal epithelium
what is the broad ligament?
peritoneal fold extends from the lateral pelvic wall to the uterus and adnexa
the broad ligament contains what structures?
uterine and ovarian blood vessels
most hysterectomies start how?
by ligation and transection of the round ligament
function of the infundibulopelvic ligament (suspensory ligament of the ovary)?
contains the ovarian artery and vein and connects the ovary to the pelvic wall
features of the round ligament?
the remains of the gubernaculum; extends from the corpus of the uterus down and laterally through the inguinal canal and terminates in the labia majora
feautres of the Cardinal ligament (mackenrodt)?
extends from the cervix (near the level of the internal cervical os) and lateral vagina to the pelvic side wall; it contains the uterine artery and vein
what is the most important support structure of the uterus?
Cardinal ligament (mackenrodt)
what are the features of the uterosacral ligaments?
each ligament extends from an attachement posterolaterally to the supravaginal portion of the cervix and inserts into the fascia over the sacrum. provides some support to the uterus
what is the most common site for ureteral injury during hysterectomy?
level of the cardinal ligament
function of the pelvic diaphragm?
forms a broad sling in the pelvis to support the internal organs
pelvic diaphragm is composed of what?
levator ani complex (iliococcygeus, puborectalis, pubococcygeus muscles) and the coccygeus muscles
position of the urogenital diaphragm?
external to the pelvic diaphragm
urogenital diaphragm is composed of what?
deep transverse perineal muscles, the constrictor of the urethra, internal and external fascial coverings
function of the urogenital diaphragm?
helps maintain urinary continence
what is the perineal body?
the central tendon of the perineum, which provides much of the support
which structures converge at the central tendon of the perineum?
median raphe of the levator ani, bulbocavernosus, superfiscial transverse perineal, external anal sphincter muscles
pelvic organ prolapse is caused by what?
defect in the pelvic diaphragm
what is cut when an episiotomy is performed?
what is the blood supply to the muscles of the pelvic floor?
internal pudendal artery and its branches
inferior rectal artery
posterior labial artery
what is the nerve supply to the pelvic floor?
pudendal nerve from S2, S3, S4
the adult pelvis is composed of which four bones?
2 innominate bones
the innominate bones of the pelvis are formed from what?
the fusion of the ilium, ischium, and pubis
what is the sacral promontory?
the first sacral vertebrae, it can be palpated during a vaginal exam
pelvimetry assesses what?
the shape and capacity of the pelvis in relation to the ability of a baby to pass through it
what are the 4 major pelvic shapes?
what is the ideal pelvic shape for vaginal delivery?
the ischial spines serve as landmarks in determining what?
station of the fetus
leading edge of the fetus head at the ischial spine +? station?