Ob Chapter 39 HH

Uterine isthmus:

Hardest part; lies lateral to uterus

Coccygeus:

Posterior pelvic floor

Vagina arterial supply:

Vaginal and uterine arteries

Rectouterine Space:

(Posterior cul-de-sac and Pouch of Douglas) the space between the uterus and the rectum.

Uterovesical Space:

(Also called the anterior cul-de-sac) the space between the bladder and the uterus.

Blood supply to the uterus:

-Arcuate arteries: Arclike arteries that encircle uterus in outer third of myometrium -Radial arteries: branches of arcuate arteries that extend from myometrium to base of endometrium

Anterior pelvic cavity:

-Bladder -ureters -ovaries -fallopian tubes -uterus -vagina

Uterine ligaments:

-Broad: lateral aspect of uterus to pelvic side wall -mesovarium: Posterior fold of broad ligament; encloses ovary -mesosalpinx: upper fold of broad ligament: encloses fallopian tube -round: fundus to anterior pelvic side walls; hold uterus forward -cardinal: extends across pelvic floor laterally; firmly supports cervix -uterosacral: extends from uterine isthmus downward, along rectum to sacrum -suspensory: Extends from lateral aspect of ovary to pelvic sidewall -ovarian: extends medially from ovary to uterine cornua

Muscles of the true pelvis:

-Piriformis -obturator internus -muscles of pelvic diaphragm -levator ani - Coccygeus

Muscles of the false pelvis:

-Psoas major -Iliacus muscles -Psoas joins with iliacus to form iliopsoas muscle

The bony pelvis:

-Two coxal bones -Sacrum -Coccyx

Uterus:

-body, fundus, cervix -usually anteflexed and anteverted -round ligaments hold uterus in anteverted position

The abdominal wall muscles:

-paired rectus abdominis anteriorly -external obliques -internal obliques -transversus abdominis anterolatterally

Posterior pelvic cavity:

-rectum -colon -ileum

Endocervix:

Cervical canal; communicates with uterine cavity by internal os; vagina by external os

Exocervix:

Continuous with vagina.

The anterolateral walls of the pelvis:

Formed by the hip bones and obturator internus muscles.

Ovarian blood supply:

Ovaries have dual blood supply from the ovarian and uterine arteries.

Levator ani:

Pelvic floor

Iliacus:

Pelvic sidewall

Psoas major:

Pelvic sidewall

Piriformis:

Posterolateral wall

Mons Pubis:

The rounded mass of fatty tissue lying over the joint of the pubic bones, in women typically more prominent.

Trigone:

The trigone is a smooth triangular region of the internal urinary bladder formed by the two ureteral orifices and the internal urethral orifice.

True Pelvis:

The true pelvis contains the pelvic colon, rectum, bladder, and some of the reproductive organs. Starts at the bulge of the sacrum.

Uterine ampulla:

Widest part of the tube where fertilization occurs

Corpus luteum:

a hormone-secreting structure that develops in an ovary after an ovum has been discharged but degenerates after a few days unless pregnancy has begun.

Perineum:

the area between the anus and the scrotum or vulva.

The pelvic floor:

(Also known as pelvic diaphragm) Formed by the levator ani and coccygeus muscles. Below the pelvic floor is the perineum.

Lower uterine segment:

(LUS) the inferior portion or isthmus of the uterus, the lower extremity of which joins with the cervical canal and, during pregnancy, expands to become the lower part of the uterine cavity.

Uterine size depends on age:

-premenarchal: 1.0-3.0cm long by 0.5-1.0 wide -menarchal: 6.0-8.0cm long by 3.0-5.0 cm wide -multiparity: increases size by 1.0-2.0 cm -postmenopausal: 3.5-5.5cm long by 2.0-3.0 wide

Vagina length:

9cm Longest along posterior wall

Obturator internus:

Anterolateral sidewall

The posterolateral wall of the pelvis:

Formed by the piriformis and coccygeus muscles.

The posterior wall of the pelvis:

Formed by the sacrum and coccyx.

Endometrium:

Inner mucous membrane, glandular portion of uterine body.

Myometrium:

Muscular middle layer of uterus composed of thick, smooth muscle supported by connective tissue.

Perimetrium:

Serous outer layer of uterus.

False Pelvis:

The false pelvis supports the intestines (specifically, the ileum and sigmoid colon) and transmits part of their weight to the anterior wall of the abdomen.

Fornix:

The fornix of the uterus (known in medical Latin as the "fornix uteri") refers to the anterior (front) and posterior (back) recesses into which the upper vagina is divided. These vault like recesses are formed by protrusion of the cervix into the vagina.

Space of Retzius:

The retropubic space (also known as the prevesical space or cave of Retzius) is an extraperitoneal space located posterior to the pubic symphysis and anterior to the urinary bladder. It is separated from the anterior abdominal wall by the transversalis fascia and extends to the level of the umbilicus.