DR3 Female Reproductive System Answers PDF

DR3: Female Reproductive System ANSWERS Station 1 Arrange the follow structure of the female reproductive tract in the correct order. Ovary – To release hormones and develop oocytes Uterine tube – To transport oocyte to uterus and allow transport of sperm to oocyte Uterine cavity – To facilitate imp...

DR3: Female Reproductive System ANSWERS Station 1 Arrange the follow structure of the female reproductive tract in the correct order. Ovary – To release hormones and develop oocytes Uterine tube – To transport oocyte to uterus and allow transport of sperm to oocyte Uterine cavity – To facilitate implantation of a fertilised oocyte and house the developing embryo/fetus Cervix – allow passage of fluids (semen/menstral blood) out of the uterus and to seal the uterus during pregnancy. Vaginal cavity – to allow passage of menstral blood and allow entry of the penis during sexual intercourse. Station 2 How would you describe the position and location of the adult ovary? - The ovaries are typically located deep within the true pelvis, close to the lateral pelvic walls. They are typically found posterior to the ampulla of the uterine tubes. Note – that the position of the ovaries can vary from person to person. In a cross-section of the ovary, two regions can be described: the cortex and the medulla. What structures are typically found in these regions? - The cortex will house the oocytes and associated follicular cells. These follicular cells are derived from the somatic support cells in the developing gonad (follicular cells/granulosa cells). Also, the surrounding connective tissue will develop into thecal cells (internal and external layers). - The medulla acts as a conduit for blood vessel, nerves, and lymphatics, running with in the connective tissue core. Identify the elements of the ovarian cortex in the histological section. 1 – Primoridal follicle 2 – Primary follicle 3 – Cumulus oophorus 4 – Oocyte 5 – Thecal cells/layer 6 – Antrum Which cavity is the oocyte released into before being collected by the uterine tube? - Peritoneal cavity What hormone released by this structure (corpus luteum) aids in endometrial thickening? - Progesterone Station 3 The infundibulum of the uterine tube opens into which cavity? - Peritoneal cavity In which region of the uterine tube does fertilisation typically occur? - Ampulla Consider the angulation of the uterus. What is the typical position of the uterus in the pelvic cavity? - Anteverted and anteflexed Which axes form the angulations of the uterus? - Anteversion is form by the axis of the cervix and vagina - Anteflexion is formed by the axis of the uterine body and cervix What deviations of the positioning can occur, and what might this malposition predispose the patient to? - Combinations of anteversion, anteflexion, retroversion and retroflexion. - Malpositioning of the uterus can predispose the uterus to prolapse and can be cause my relaxation of the supporting structures and growths on the uterus. Station 4 What space of the vagina is closely related to the rectouterine pouch? - Posterior fornix What surface of the cervix can be viewed during a speculum examination? - Ectocervix Identify the elements of the cervix indicated by Pins 1-3. - Pin1: Internal os - Pin2: Cervical canal - Pin3: Internal os Identify the surface anatomical components of the female perineum. - A: Mons pubis - B: Labium majus - C: Clitoris - D: External urethral orifice - E: Vestibule - F: Vaginal orifice - G: Labium minus What gland opens at the region shown by the asterix? - Greater vestibular (Bartholin’s) gland Station 5 The subregions of the broad ligament are: mesosalpinx, mesovarium, mesometrium. The infundibulum ligament (Pin4) is a peritoneal region. What structures are deep to this portion of peritoneum? - Ovarian artery, ovarian vein, sympathetic fibres and associated visceral a^erents. Consider what structures run between the layers of the broad ligament/ - Uterine tubes, Ovaries, ovarian ligaments, uterine and vaginal arteries and veins, and autonomic fibres. Pin 5 (round ligament of the uterus) is derived from the gubernaculum. What other structure connecting to the uterus is derived from the gubernaculum? - Ovarian ligament Name two thick connective tissue structures that tether the uterus and cervix to the sacrum and lateral pelvic wall. - Uterosacral ligament - Cardinal (transverse cervical) ligament Station 6 Identify the vessel indicated by pins 1-3. - Pin1: Ovarian artery - Pin2: Uterine artery - Pin3: Internal pudendal artery What is the relationship between the ureter and the uterine artery? - The ureter run inferior to the uterine artery close to the uterus. What is the origin of the ovarian artery? - Aorta at the level of L2 vertebra The uterine artery is homologous to which artery present in the male? - Inferior vesical artery Which major vein receives blood from the right ovary? - Inferior vena cave receives blood from the right ovarian vein. - The left renal vein receives blood from the left ovarian vein. Station 7 Which nerves supply the area of skin shown by Pins 1-4? - Pin1: Dorsal nerve of the clitoris - Pin2: Posterior labial nerve - Pin3: Inferior rectal nerve - Pin4: Anterior labial nerve A 39-year-old woman is brought to A+E with severe abdominal pain. An MRI reveals a tumour at her left ovary and a biopsy confirms ovarian carcinoma. Which of the following actions could be performed to reduce the pain from the ovarian carcinoma? A. Cut the broad ligament (does not carry any nerve fibres of the ovary) B. Cut the hypogastric nerve (carries autonomics and visceral a7erents of the uterus, cervix and upper vagina). C. Cut the Infundibulopelvic ligament (visceral a7erents following the sympathetic supply to the ovary via the ovarian artery. The IP ligament is a peritoneal covering that overlies the ovarian vessel. Cutting this structure can interrupt nerve fibres running in the peritoneum and reduce ovarian pain). D. Cut the pelvic splanchnic nerves E. Cut the pudendal nerve Station 8 Which muscles overlie these erectile bodies (corpora cavernosa/corpora spongiosa)? - Bulbospongiosus and ischiocavernosus What is the motor innervation of these muscles? - Perineal nerves from the pudendal nerve What structure acts as an attachment site for the bulbs of the vestibule? - Perineal membrane Identify the components of the clitoris. Station 9 N/A – This is an active review activity using plasticine. Station 10 Mid-sagittal female pelvic MRI A. Pubic symphysis B. Bladder C. Uterus D. Rectum E. Rectouterine pouch What is the position of structure C? - Retroflexed uterus Mid-sagittal female pelvic MRI T1 A. Vagina B. Posterior fornix C. Clitoris D. Cervix E. Vesicouterine pouch Hysterosalpingogram (HSG) A. Uterus B. Uterine tube C. Sacroiliac joint D. Cervix E. Sacral promontory