Cross-Sectional Ch.20 Female Pelvis Definitions, Location, Gross Anatomy, Blood Supply, and Physiology
Extends laterally from the uterus to the ovaries, within the true pelvis. The tubes course within the peritoneal folds so the broad ligaments. they are lateral to the uterus, anteromedial to the ovaries, and posterior to the urinary bladder
Uterine tubes location
Branches off the _________________ artery the supply blood to the cervical portion of the uterus anastomose (join with) branches of the __________ artery to form the anterior and posterior azygos arteries of the vagina
Uterine, vaginal
Extends from the posterior aspect of the cervix around the lateral walls of the rectum to the sacrum
Uterosacral ligaments
After the stage in which we see the oocyte float freely within the enlarged follicular antrum of the graafian follicle, the follicular cells of the cumulus oophorus completely surround the ______________________ and the _______________________ and are called the _________________-.
zona pellucida, secondary oocyte, corona radiata
Uterine size is directly related to the
# of years post menarche
Throughout meiotic division, the ovum continues to mature, forming the secondary oocyte. Now the oocyte...
...floats freely within the enlarged follicular antrum of the graafian follicle
Ovulation occurs ____________ after follicle formation
14 days
At day ____ of the ovarian cycle, ovulation occurs when the ____________ is expelled into the ____________.
14, mature ovum, genital tract
In women between ages ________________, ovarian volumem is 6.8mL
15 - 55yrs
The luteal phase of the ovarian cycle begins at days ________
15-28
The fallopian tube, round ligament, ovarian ligament, and vascular structures of the uterus and ovaries are positioned between the
2 layers of each broad ligament
How long is the menstrual cycle?
28 days average
At ovulation, how many mL of follicular fluid is released into the peritoneal cavity?
5-10
After what age does age-related growth of the ovaries usually begin?
5-6 years
The cervical portion of the uterus enters the vagina and lies ________ to it
90 degrees
In the absence of fertilization, the production of LH, estrogen, and progesterone diminished resulting in what?
A new cycle begins on day 1 with menses
What happens during the menstrual cycle?
A single ovum reaches maturity and is released into the genital tract
Each primordial follicle is composed of what?
A single primary oocyte and surrounding follicular cells that form an encasement
The region of the true pelvis posterior to the broad ligaments
Adnexa
Two important factors influencing uterine size and shape
Age and parity
After age 5-6, ___________ related growth beings, associated with an increase in _________________________.
Age, cystic functional changes
Ovarian size varies during the life span depending all what 5 things?
Age, menstrual status, pregnancy status, body habitus, and menstrual cycle phase
In what segment of the uterine tube does fertilization most often occur?
Ampulla segment
the isthmus segment of the uterine tube widens laterally, forming the __________________ and ______________ sections
Ampullary, Infundibular
When the bladder is empty and the cervix and vagina form a 90 degree angle, and the uterine body and fundus are bent at a great anterior angle UNTIL the fundus is pointing INFERIORLY and resting on the cervix
Anteflexed uterus
Area between the uterus and pubic bone, AKA the vesicouterine pouch
Anterior cul-de-sac
Hormones secreted by the _____________ and the ____________ control changes in the ovaries and the uterine endometrium throughout the menstrual cycle
Anterior pituitary gland, ovaries
The ovaries can be located anywhere within the adnexa, EXCEPT
Anterior to the uterus or broad ligaments
When the bladder is empty and the cervix and vagina form and 90 degree angle, and the uterine body and fundus are tipped or tilted ANTERIORLY
Anteverted uterus
Arteries that loop around and encircle the periphery of the uterus and branch into the radial arteries.
Arcuate arteries
The obturator internus muscles are muscles that originate along the _________ line of the __________________ and course ___________ to the lateral walls of the true pelvis. They narrow __________ to pass through the lesser sciatic notch
Arcuate, Innominate bones, parallel, inferiorly
Bicornuate uterus is best appreciated in the _____ or _______ ______ sections
Axial, short axial
Arteries formed by anastomosed uterine and vaginal arteries to supply blood to the anterior and posterior portion of the vagina
Azygos arteries
Recognized sonographically by the presence of two endometrial canals that usually communicate at the level of the cervix
Bicornuate uterus
The vagina forms the distal portion of the _________ ___________
Birth canal
Specifically speaking, the infundibulum passes through the posterior aspect of the ________ _____________ to reach the ________
Broad ligament, ovary
Double folds of peritoneum that extend from the uterine cornua to the lateral pelvic walls
Broad ligaments
Supplies blood to the common iliac lymph nodes
CIA
Ligaments that maintain the normal axis of the cervix, approximately perpendicular to the vaginal canal.
Cardinal and Uterosacral ligaments
Extend from the upper cervix and isthmus to the obturator fascia at the lateral walls of the pelvis
Cardinal ligaments
The deep or basal layer of the endometrial canal is composed of __________________________ and _______________________
Cellular stroma, mucosal glands
A highly vascular portion of the ovarian stroma, located in the center of the ovary, that communicates with the parametrium of the broad ligament at the ovarian hilum. Contains ovarian vasculature, lymphatics, and nerves supported by fibrous connective tissue.
Central medulla
Before puberty the ________ accounts for a significantly greater portion of the organ than it does in adulthood
Cervix
Lower cylindrical portion of the uterus that projects into the vagina
Cervix
At the level of the _________ the uterine artery gives rise to the vaginal artery, which courses ___________.
Cervix, inferiorly
The days of the endometrial or menstrual cycle are numbered according to what?
Changes in the endometrial lining of the uterus
What aids in the transport of the ovum
Cilia propelling a gentle current of secreted fluids
The mucosal lining of the uterine tubes consist of _____ _____________ _____ and ___________ ______
Ciliated epithelial cells, secretory cells
The most posterior muscle pair of the pelvic diaphragm extending from the ischial spine to the sacrum and coccyx
Coccygeus muscles
____________ __________ ___________ can result in anatomic variations of the uterus, cervix, and vagina resulting from the incomplete fusion or agenesis of the mullerian ducts
Congenital uterine malformations
The outer layer of the primary follicle composed of _______________ tissue, and includes the _____________ and the ___________
Connective, theca interna, theca externa
The part of the uterus that lies between the uterine fundus and cervix
Corpus
The remaining follicular structure that contains a central blood clot surrounded by the theca granulosa luteal cells, theca luteal cells, and the theca externa
Corpus luteum
Because of LH stimulation, the ______________________ eventually regresses and only a fibrous tissue mass, called the ______________________, remains in the ovary
Corpus luteum, corpus albicans
hHG allows the _____________ to continue secreting estrogen and progesterone throughout the _________________ of pregnancy
Corpus luteum, first trimester
A layer of follicular cells continuous with the zona granulosa
Cumulus oophorus
Ovarian volumes is only MARGINALLY effected by __________
Cyclic changes
Follicular phase occurs during
Days 1-14 of the ovarian cycle
The sigmoid colon is continuous with the _____________ _________ in the LLQ of the abdominopelvic cavity, and is loosely secured to the posterior pelvic wall by the __________.
Descending colon, mesocolon
During puberty the __________ of the uterus and endometrial __________ markedly increase, and the corpus and fundus portions of the uterus enlarge, changing the uterus from ____________ to ______________ shaped
Diameter, thickness, tubular, pear
When are the lowest ovarian volumes are observed?
During the luteal phase
When are the highest ovarian volumes observed?
During the preovulatory phase
Supplies blood to the external iliac lymph nodes
EIA
What supplies the pelvic lymph nodes with blood?
EIA, IIA, CIA
Cervical canal extending 2-4cm from its internal os, where it joins the endometrial canal to its external os, which projects into the vaginal vault
Endocervical canal
Proximal portion of the birth canal that is formed by the uterine endometrium. It is continuous with the endocervical canal
Endometrial canal
The thin, bright, reflective sonographic appearance of the central, linear, opposing surfaces of the endometrium that form the endometrial canal.
Endometrial stripe
The _________, __________, and __________form a continuous channel through which the fetus passes at birth.
Endometrial, endocervical, endovaginal
Innermost, mucosal layer of the uterine wall that is continuous with vaginal epithelium inferiorly and uterine tube mucosa superolaterally
Endometrium
Hormone produced by the ovaries that promoted proliferation or preparation of the uterine endometrium for possible implantation by a zygote
Estrogen
During the secretory phase of the endometrial cycle the continued production of ________ and now ___________ by the corpus luteum promotes continues _____________ and ____________ of the endometrium.
Estrogen, progesterone, thickening, swelling
To prepare a suitable environment for implantation the ____________ glands of the endometrial lining secrete a _______________ mucus.
Exocrine, glycogen-rich
Portion of the endocervical canal that projects into the vaginal vault
External Os
A gonadotropin produced by the anterior pituitary gland
FSH
What all lies between the two layers of each broad ligaments?
Fallopian tube Round ligament Ovarian ligament Vascular structures of the uterus and ovaries
TRUE OR FALSE: ~~~~~~~~~~~~~~~~~~ Although many follicles develop in the ovaries in response to FSH, only two follicles mature completely and rupture to release an ovum at ovulation.
False (why?)
Descriptive area given to the area SUPERIOR to the pelvic inlet (linea terminalis) and inferior to the iliac crests.
False pelvis
Defined as the more superior aspect of the pelvic cavity , extending from the iliac crests (superiorly) to the linea terminalis (inferiorly)
False pelvis location
Iliopsoas muscle Rectus abdominus Transverse abdominus
False pelvis muscles
TRUE OR FALSE: ~~~~~~~~~~~~~ The corpus and fundus of the uterus show considerably less variation is size than the cervix
False, complete opposite actually
TRUE OR FALSE: ~~~~~~~~~~~~~~~~~ Broad ligaments are considered true ligaments because they provide the maximum support for the uterus
False, if you don't know why review it.
TRUE PF FALSE: ~~~~~~~~~~~~~~~~ The spiral arteries supply all the uterine endometrium, except for its first layer of branches which receives its blood from small branches off the spiral arteries called the straight arteries
False, switch them
True or False ~~~~~~~~~~~~~~ During first pregnancy, it is uncommon for the ovaries to become displaced and never return to their original position.
False, this is a common occurrence
Production of LH, estrogen, and progesterone diminishes in the absence of ___________
Fertilization
At day 14 of the ovarian cycle ovulation occurs, and the __________ of the uterine tube draw the released egg into the ___________.
Fimbria, infundibulum
Fringelike extensions that overlie the ovary and direct the released ovum into the uterine tube
Fimbriae
Ovarian encasements containing an immature ovum, and the site of ova maturation
Follicles
The breakdown of ovarian follicle cells, which consist of an oocyte surrounded by granulose cells and internal and external theca cells
Follicular astresia
A fluid filled cavity that forms between the cellular layers of the zona granulosa
Follicular atrium
The developing oocyte rests along the wall of the ____________________ and is surrounded by the ____________________
Follicular atrium, cumulus oophorus
What are fimbriae of the uterine tube?
Fringelike extensions of the infundibulum which overlie the ovary and direct the released ovum into the uterine tube
What can cause subtle displacement of the uterus
Full bladder or rectum
The superficial layer is referred to at the __________ layer or zone because it increases in size during the menstrual cycle and partially sloughs off at the time of menses
Functional
Situated between the insertion of the uterine tubes at the level of the uterine cornua
Fundus
The infundibulum is the ________-_________ end portion of the uterine tubes
Funnel shaped
The vagina, ovaries, uterus, and uterine tubes are all a part of the ___________ _________ anatomy
Genital tract
Uterine tubes conduct a mature ovum from the ovaries to the uterus through ______________ of their smooth muscle walls
Gentle peristalsis
A single layer of epithelial calls lining the outer surface of the ovary
Germinal epithelium
One secondary follicle continues to mature to become a ____________ or dominant follicle before ovulation.
Graafian
While the remaining secondary follicles undergo atresia, the _______________ migrates to the surface of the ovary
Graafian follicle
Slow and steady compression of the bowel between the anterior and posterior abdominal wall
Graded compressions
The false pelvis can also be referred to as the ___________ or __________ pelvis
Greater or major
The obturator internus is secured to the medial aspect of the
Greater trochanter
The piriformis muscles are attached to the superior aspect of each
Greater trochanter
After implantation of a fertilized egg, the developing placenta secretes _________
Human chorionic gonadotropin (hCG)
The vagina sits in the __________ region of the _________ cavity
Hypogastric, Peritoneal
Supplies blood to the internal iliac lymph nodes
IIA
What all supplies the vagina with blood?
IIA, UA, VA, AA
What are two palpable external landmarks that aid in evaluating the pelvis
Iliac crests and pubic/pubic symphysis
Located lateral to the pubococcygeus muscles. This pair extends from the obturator fascia and ischial spine anteriorly to the coccyx posteriorly.
Iliococcygeus muscles
The psoas major muscles join the iliacus muscles at the level of the iliac crests to form the ____________ _____________ of the false pelvis
Iliopsoas bundles
Muscles that courses anteriorly along the linea terminalis, to travel over the pelvic brim and insert into the lesser trochanter of the femur
Iliopsoas muscles
Bones included in the "innominate bones"
Ilium, Ischum, Pubis
The 5-10 mL released into the peritoneal cavity at ovulation end up settling where?
In the posterior cul-de-sac
Two paired ligaments supporting the ovaries and maintaining their relative positions in the adnexal regions
Infundibulopelvic and ovarian ligaments
Extends from the infundibulum and the lateral aspect of the ovary to the lateral pelvic wall
Infundibulopelvic ligament
Segment of the uterine tube that terminated at the fimbriated end of the infundibulum and opens into the peritoneal cavity adjacent to the ovary
Infundibulum segment
What does FSH do?
Initiates follicular development
Bones that encircle most of the pelvic cavity, forming its lateral and anterior margins.
Innominate bones
Iliac crests are a portion of ___________ bones the define the most ____________,_____________aspect of the pelvic cavity.
Innominate, superior, bilateral
The middle layer of the myometrium
Intermediate spiral bands
Portion of the endocervical canal that joins or opens into the endometrial canal
Internal Os
The transverse abdominis muscle group lies deep to the
Internal and external obliques
Continuation of the CIA with multiple branches including the uterine artery
Internal iliac artery
What supplies the uterus with blood?
Internal iliac artery, uterine artery, arcuate arteries, radial arteries, straight arteries, and spiral arteries.
Segment of the uterine tube enclosed within the muscular wall of the uterus.
Interstitial or intramural segment
The four segments of the uterine tubes
Interstitial or intramural, isthmus, ampulla, and infundibulum
The narrowest portion of the uterine tube
Intramural or interstitial segment
The corpus is continuous with the uterine cervix at a point marked by a constriction of the uterus called the ___________
Isthmus
Constricted portion of the uterus where the body or corpus meets or is continuous with the uterine cervix
Isthmus (uterine)
Segment of the uterine tube immediately adjacent to the uterine wall, and is short, straight and narrow.
Isthmus Segment
What happens to the ruptured follicle after the mature ovum ins expelled into the genital tract?
It collapses, fills with blood, and is transformed into a temporary endocrine gland beginning the luteal phase of the ovarian cycle
What happens to the corpus luteum after the placenta takes over it's function
It regresses and forms the corpus albicans
Hormone that promotes the secretion of estrogen and progesterone by the ovary
LH
The corpus is considered the body, and __________ part of the uterus
Largest
Ligaments that extend to fuse with the tendinous arch of the obturator internus muscles
Lateral ligaments
What is the formula for calculating ovarian volume?
Length x height (AP thickness) x width x 0.523
The true pelvis is also referred to as the
Lesser or minor pelvis
A hammock across the floor of the true pelvis formed by the pubococcygeus and the iliococcygeus muscles
Levator ani muscles
What muscles provide primary support to the pelvic viscera and aid in the contraction of the vagina and rectum?
Leviator ani muscles ( pubococcygeus and the iliococcygeus muscles)
Where the rectus sheath fuses with the transverse abdominis muscles in the midline of the body
Linea alba
Imaginary arcuate line drawn along the inner surface of the pelvic bone -- from the pubic or pubis symphysis (anteriorly) then to the sacral promontory(posteriorly) -- that marks the plane separating the false from the true pelvis.
Linea terminalis
the location of the true pelvis is defined as extending from the ___________________ to the ____________________ inferiorly. It is a ________-_________ cavity aligned _______________ and _____________ within the skeletal framework.
Linea terminalis, pelvic diaphragm, bowl-shaped, posteriorly, inferiorly
Can be defined as that part of the peritoneal cavity extending from the iliac crests superiorly to the pubic diaphragm inferiorly
Location of the pelvis
What hormone is produced throughout the ovarian cycle by the anterior pituitary hormone?
Luteinizing hormone (LH)
The central medulla contains what?
Lymphatics, ovarian vasculature, and nerves supported by fibrous connective tissue
At birth, the ovaries are relative large as a result of ___________________
Maternal hormone stimulus
The pubococcygeus muscles are the most ________________ and _____________ muscle pair of the pelvic diaphragm muscles. These muscles extend from the ______________ to the ____________, encircling the ____________________
Medial, anterior, pubic bones, coccyx; urethra, vagina, and rectum
Onset of menstruation
Menarche
The timing of __________ and _____________ in the endometrial cycle corresponds to the follicular phase of the ovarian cycle. ( days ____ to ____)
Menses, proliferation, 1, 14
Days 1-5 of the menstrual cycle usually correspond to what?
Menses, when the thickened superficial layer of the endometrium is shed in the form of blood through the vagina
Monthly sloughing off of the endometrial lining of the nonpregnant uterus
Menses/Menstruation
The monthly cyclical the female reproductive system normally undergoes between the age of puberty and menopause
Menstrual cycle
Double layer of visceral peritoneum that wraps around a bowel segment and attached it to the posterior abdominal wall
Mesentery
A short, double fold of peritoneum extending from the posterior aspect of the broad ligament to the ovarian hilum
Mesovarium
Which layer of the bladder folds when the bladder is empty, and descends and becomes smooth then the bladder is full?
Mucosa
Multiple viable births
Multiparous
Muscle layer that forms the bulk of the uterus
Myometrium
The ring-like structure of the pelvis surrounds and protects the lower intestines, the reproductive organs the urinary bladder and important components of the
Nervous and circulatory systems
The ________________ ___________ is located in the hypogastric portion of the peritoneal cavity, between the urinary bladder (anteriorly) and the rectum (posteriorly)
Nonpregnant uterus
No viable births
Nulliparous
The ovaries in ______________ ___________ lie in a craniocaudal long axial direction on the iliopsoas muscle of the lateral pelvic walls between the eternal iliac vessels anteriorly and the internal iliac vessels and uterus posteriorly
Nulliparous women
The tough muscle layer that covers the internal surface of the obturator internus muscles
Obturator fascia
Muscles that originate along the acute line of the innominate bones and course parallel to the lateral walls of the true pelvis. They narrow inferiorly to pass through the lesser sciatic notch
Obturator internus
True pelvis muscles
Obturator internus Piriformis Pelvic diaphragm muscles
The production of female gametes (egg cells)
Oogenesis
Arteries that branch off the abdominal aorta at a level inferior to the renal artery branches
Ovarian arteries
Ligament that supports the medial aspect of the ovary to the uterine cornu
Ovarian ligament
Consists of the peripheral cortex and the central medulla; AKA the body of the ovary
Ovarian stroma
Paired organs lying on the posterior surface of the broad ligaments *HINT* ~~~~~~~ These organs are almond-shaped
Ovaries
Normally lie posterolateral to the uterus within the adnexa, are quite mobile, and influenced by the condition of the surrounding structures. Usually never move anterior to the uterus or broad ligaments
Ovaries location
Occurs when the ovarian follicle bursts and releases the mature ovum
Ovulation
Each ovarian artery courses anterior to the _________ and ___________ muscles within the retroperitoneum. They travel medially along the __________________________ ligament to reach the _______________________.
Psoas, iliopsoas, infundibulopelvic, ovarian hilum
Anterior fusion of the innominate bones
Pubic/ pubic symphysis
The most medial and anterior muscle pair of the pelvic diaphragm muscles. These muscles extend from the pubic bones to the coccyx, encircling the urethra, vagina, and rectum
Pubococcygeus muscle
The iliococcygeus muscles are located lateral to the ___________________ muscles. This pair extends from the ____________________ and _________________ anteriorly to the _____________ posteriorly.
Pubococcygeus, obturator fascia, ischial spine, coccyx
Ligaments that extend anteriorly from the bladder neck and attach to the pubic bones
Pubovesical ligament
Arteries the penetrate the uterine myometrium and give rise to the straight arteries
Radial arteries
The posterior cul-de-sac can also be referred to as the __________ pouch or pouch of ___________
Rectouterine, Douglas
Situated posterior to the vagina, is fixed in position, and is largely retroperitoneal
Rectum
Paired muscles that extend from the sixth ribs and the xiphoid process down to the pubic symphysis.
Rectus abdominis
Much of the anterior wall of the abdominopelvic cavity is formed by the _____________
Rectus abdominis muscles
The rectus abdominis muscles are intersected by the transverse tendinous bands and are wrapped in a muscular sheath called the
Rectus sheath
In the _________ state the vaginal walls collapse together, and the epithelial lining folds into ______________
Relaxed, transverse ridges
When the bladder is empty and the cervix and vagina are linearly oriented, and the uterine body and fundus are bent at a great posterior angle until the fundus is pointing inferiorly, adjacent to the cervix
Retroflexed uterus
When the bladder is empty and the uterine body and fundus are tipped posteriorly and the angle of the cervix and vagina increases, making them more linearly orientated
Retroverted uterus
Both estrogen and LH peak when?
Right before ovulation
Which ligaments maintain the forward bend of the uterine fundus
Round
Ligaments that originate at the uterine cornu and courses with in the broad ligaments to the anterolateral pelvic wall; pass over the pelvic brim, through the inguinal canal, and is secured at the labia majora
Round ligaments
Ligaments that provide structural support to the uterus
Round, cardinal, and uterosacral ligaments
The descriptive REGIONS of the pelvis
Rt Iliac, Hypogastric, Lft Iliac
The most superior surface on the body of the first sacral vertebrae
Sacral promontory
An arbitrary division defined by the ______________ _______________ and _____________ _____________ designates the true and false pelves.
Sacral promontory, Linea terminalis
Bones that constitute the distal segment of the vertebral spine and form the posterior border of the pelvic cavity
Sacrum and coccyx
Bones of the pelvic skeleton
Sacrum, coccyx, innominate bones
Ovulation, at/near the 14th day of the menstrual cycle, marks the beginning of what phase of the endometrial cycle?
Secretory phase
The _____________ phase of the endometrial cycle corresponds to the luteal phase of the ____________ cycle. (days _____ to _____)
Secretory, ovarian, 15, 28
Thin membrane the covers the myometrium and forms the outer layer of the uterus
Serosa
Descends toward the rectum in the inferoposteior aspect of the pelvis at the level of the third sacral vertebra, and is somewhat variable in length and position.
Sigmoid colon
________________________ give rise to the arcuate arteries
Small uterine artery branches
The cervix is composed of _________________ fibers interlaced with _______________ fibers, creating a more rigid framework
Smooth muscle, collagen
Space that separated the anterior bladder wall from the pelvic symphysis and is typically filled with extraperitoneal fat
Space of Retzius
Arteries that perfuse the proliferating uterine endometrium, with blood flow that is responsive to hormonal changes of the menstrual cycle
Spiral arteries
Blood is supplied to the urinary bladder by the ___________ and _______________ ___________ arteries, tributaries of the internal iliac arteries
Superior, inferior vesicular
The uterine artery continues ___________ toward its termination at the ________________________
Superiorly, fundus of the uterus
The ovarian helium is located along the _______________ aspect of the ovary.
Superoanterior
TRUE OR FALSE: ~~~~~~~~~~~~~~~~~ The uterine artery is one of two separate vascular pathways that maintain the blood supply to each ovary
TRUE
The piriformis muscles are muscles that originate in the _________________________ of the true pelvis, along the lower portion of the ___________, posterior to the __________. They travel _________________, narrowing to pass through the greater sciatic notch
Posterior aspect, Sacrum, uterus, anterolaterally
Any fluid collection within the peritoneal cavity often drains into this space
Posterior cul-de-sac
Space between posterior to uterus and anterior to rectum
Posterior cul-de-sac
The mesovarium is a.....
Posterior extension of the broad ligament that serves to suspend, but does not surround, the ovaries
The coccygeus muscles are the most ____________ muscle pair of the __________________ extending from the ____________ to the ___________ and _________
Posterior, pelvic diaphragm, ischial spine, sacrum, coccyx
The innominate bones join __________ at the sacrum and coccyx and fuse _______________ at the pubis or pubic symphysis
Posteriorly, anteriorly
What causes, marked displacement of the uterus
Pregnancy
After menopause, uterine size reduces significantly and the uterus assumes a _________________ shape
Prepubertal
What are all the stages of follicle maturation during the normal menstrual cycle?
Primordial follicle Primary follicle Secondary follicle Graafian follicle Ovulation Corpus luteum Corpus albicans
At menarche the ovaries contain thousands of _________________
Primordial follicles
A hormone that promotes glandular secretion of the endometrium
Progesterone
What hormone negatively inhibits the production of LH?
Progestrone
What is the second phase of the endometrial cycle?
Proliferation
Prominent paired muscles that originate at the lateral aspect of the lower thoracic vertebrae and course anterolaterally in their descent to the iliac crest. somewhat triangular in shape; situated vertically in the body
Psoas major muscle
What muscles compose the Iliopsoas muscles
Psoas majors, Iliacus muscles
The true pelvic contains
The urinary bladder, various loops of small bowel, the genital tract, and the ovaries
Which cells differentiate into estrogen-secreting cells to fulfil an endocrine function?
Theca interna cells
Forms the anterolateral borders of the abdominopelvic cavity
Transverse abdominis muscles
TRUE OF FALSE: ~~~~~~~~~~~~~~~~~ Most of the follicular cells undergo follicular atresia beyond the stage of the secondary follicle
True
TRUE OR FALSE: ~~~~~~~~~~~~~~~~~ A bicornuate uterus is the most common of the congenital malformations of the female genital tract
True
TRUE OR FALSE: ~~~~~~~~~~~~~~~~~ During late pregnancy the isthmus is taken up into the corpus to form the lower uterine segment,
True
TRUE OR FALSE: ~~~~~~~~~~~~~~~~~ The name germinal epithelium arose from the mistaken belief that the germ cells originated from the tissue layer (germinal epithelium of the ovary)
True
TRUE OR FALSE: ~~~~~~~~~~~~~~~~~ The ovaries are the only organs within the abdominopelvic cavity NOT lined with visceral peritoneum
True
Two COMPARTMENTS that make up the pelvic cavity area
True and false pelvis
Descriptive term given to the region DEEP to the pelvic inlet (linea terminalis)
True pelvis
Defined as extending from the linea terminalis to the pelvic diaphragm inferiorly. It is a bowl-shaped cavity aligned posteriorly and inferiorly within the skeletal framework.
True pelvis location
TRUE OR FALSE: ~~~~~~~~~~~~~~~~~ The uterine tube and the ovary are not intimately connected.
True; thus the genital tract creates a channel between the outside and the peritoneal cavity
A fibrous connective tissue capsule found beneath the epithelial layer of the ovary
Tunica albuginea
Fixed inferiorly at its base in the true pelvis, posterior to the pubic symphysis and anterior to the uterus and vagina. Location of superior portion is variable.
Urinary bladder location
The vagina is between the __________ and __________ (anteriorly) and the _____________ (posteriorly)
Urinary bladder, urethra, rectum
What arteries supply the ovaries with blood?
Uterine and ovarian arteries
Branch of the internal iliac artery that supplies blood to the reproductive organs of the pelvis.
Uterine artery
Round ligaments originate at the ______________ and course with in the __________________ to the ___________________ pelvic wall; pass over the pelvic brim, through the _________________, and is secured at the ________________
Uterine cornu, broad ligaments, anterolateral, inguinal canal, labia majora
The ovarian artery branched off the uterine artery at the level of the ______________ to travel laterally within the broad ligament to reach the ______________
Uterine cornu, ovarian hilum
The straight arteries supply all the ______________________, except for its first layer of branches which receives its blood from small branches off the straight arteries called the ______________
Uterine myometrium, spiral arteries
Coiled, muscular, bilateral tubes emerging from the cone-shaped cornua of the uterus, which are located at the junction of the superior and lateral uterine margins
Uterine tubes
The fundus is the __________ and most __________ portion of the uterus
Widest, superior
Proliferating follicular cells are collectively called ____________________ encircle the zona pellucida
Zona granulosa
A primary follicle contains a primary oocyte surrounded by a membranous protein layer, called the ______________
Zona pellucida
What are the four layers of the urinary bladder?
inner mucosa, submucosa, muscularis, outer serosa
The space within the vaginal canal encircling the cervix forms the ________________________________ of the vagina
anterior, posterior, and lateral fornices
The innermost layer of the myometrium is composed of
circular and longitudinal fibers
The theca interna cells of multiple secondary follicles fulfil an endocrine function as they differentiate into ______________-_____________ cells
estrogen-secreting
"egg cell"
gametes
This hormone has an analogous function to LH, maintaining the corpus luteum allowing it to continue to secrete estrogen and progesterone throughout the first trimester of pregnancy
hCG
Volume = length x ________(_________________) x width x __________
height (AP thickness), 0.523
The endometrial canal is also know as the
proximal portion of the birth canal
Fat and cellular connective tissue surrounding the two layers of each broad ligament and the structures they contain
Parametrium
Number of viable offspring
Parity
The fundus, corpus, isthmus, and cervix are all
Parts of the uterus
Act of giving birth
Parturition
A group of skeletal muscles lining the floor of the true pelvis and supporting the pelvic organs
Pelvic diaphragm muscles
Pubococcygeus Iliococcygeus Coccygeus
Pelvic diaphragm muscles
The linea terminalis is an imaginary line drawn from the symphysis pubis around to the sacral promontory, marking the dividing plane between the true and false pelvis. The circumference of this plane is termed the
Pelvic inlet
Broad, Round, Cardinal, Uterosacral, Infundibulopelvic, Ovarian, Pubovesical, and Lateral are all
Pelvic ligaments
Part of the axial skeleton which links the lower extremities to the rest of the body through the lumbosacral spine
Pelvis
The ovarian stroma consists of the ____________ ___________ and the ___________ _____________.
Peripheral cortex, central medulla
The ____________ constitutes the bulk of ovarian tissue and is the site of _______________ ( the production of female gametes)
Peripheral cortex, oogenesis
The pelvis is part of which body CAVITY?
Peritoneal
Uterine tubes course within the _________ along the superior free margin of the ____________________, until they reach the __________
Peritoneum, broad ligament, ovaries
Muscles that originate in the most posterior aspect of the true pelvis, along the lower portion of the sacrum, posterior to the uterus. They travel anterolaterally, narrowing to pass through the greater sciatic notch
Piriformis muscles
Responsible for the dramatic enlargement of the uterus during pregnancy and the radial muscle contractions necessary to expel the fetus at parturition
The combination of myometrial fibers
Which layer of the endometrial canal is not significantly influenced by the menstrual cycle?
The deep or basal
During this phase of the ovarian cycle 10-20 primordial follicles begin to mature. This initial maturation process results in the development of several primary follicles
The follicular phase
Each innominate bone is formed by _________________ between the Ilium, Ischium, and pubis.
The fusion of three ossification centers
What cells enlarge and secrete progesterone during the ovarian cycle
The granulosa luteal cells of the corpus luteum
Describe the mucosal lining of the ampulla segment of the uterine tube
The mucosal lining folds into complex matrices, filling much of the tubular lumen
What can influence ovarian volume parameters
The presence of large follicle(s) or pathology
During this phase of the endometrial cycle, between mense and ovulation, the endometrium thickens under the influence of estrogen, preparing the uterine cavity to receive the fertilized egg
The proliferation phase
The __________ extends superior to inferior, from the external os of the uterine cervix to the external genitalia. The external orifice is located posterior to the urethral orifice between the labia minora
Vagina
Artery that branch inferiorly from uterine artery to supply blood to the vagina and the fundus of the bladder
Vaginal artery
Composed of a mucosal lining of epithelial cells, a thin smooth muscle wall, and an outer adventitia.
Vaginal walls
Formed by anastomosed uterine and ovarian arteries to pass through the mesosalpinx of the broad ligament, to meet the uterine tubes
Vascular arch
What arteries supply the urinary bladder with blood?
Vesicular and vaginal arteries
What triggers the shedding of the endometrial lining of the uterus?
When estrogen and progesterone diminish
At which state is the developing oocyte and its surrounding structures called secondary follicules
When the developing oocyte rests along the wall of the follicular atrium and is surrounded by the cumulus oophorus cells and internal and external theca cells
The ampulla is the __________ and most ___________ segment of the uterine tube.
longest, coiled
The outer layer of the myometrium is composed of
longitudinal fibers
