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female reproductive organ

PELVIS B

CASE
50 YEAR OLD FEMALE WHO HAS BORNE 5 CHILDREN COMPLAIN - VAGINAL SPOTTING AFTER SEXUAL INTERCOURSE FOR THE PAST 6 MOS RECENTLY HAVE A FOUL SMELLING VAGINAL DISCHARGE LEFT LEG SEEMS LARGER THAN THE OTHER SIDE SHE HAD PREVIOUS SYPHILIS, 1 PACK OF CIGARETTES PER DAY X 20 YEARS P.E. - LEFT FLANK TENDERNESS; LEFT THIGH AND CALF CIRCUMFERENCE LARGER THAN THE RIGHT PELVIC EXAM- NORMAL EXTERNAL GENITALIA; 3CM GROWTH ON THE LIP OF THE LEFT CERVIX

DX

CERVICAL ADENOMA WITH METASTATIC EXTENSION , ILIAC LYMPH NODE AND LEFT URETER OBSTRUCTION

CERVICAL CANCER

CERVICAL CANCER
AGE[40-60] EARLY SEXUAL CONTACT MULTIPLE PARTNERS HX OF STD INFECTION SMOKER DIETARY FACTORS VIT A DEF

HPV INFXN TYPE 16/18

MGT

TX
PX- FDA APPROVED HPV VACCINE CERVARIX/ GARDASIL
DEPENDS ON STAGINGCRYOSURGERY[COOLANT GAS]; LEEP- LOOP ELECTROSURGICAL EXCISION PROCEDURE

FEMALE REPRODUCTIVE ORGAN

FEMALE REPRODUCTIVE ORGAN

OVARY

ALMOND SHAPED LOC. POSTERIOR TO THE BROAD LIGAMENT


SITE WHERE OOCYTES DEVELOPS, BOTH REPRODUCTIVE AND ENDOCRINE ATTACHED TO THE LATERAL PELVIC WALL BY THE SUSPENSORY LIGAMENT- PART OF THE BROAD LIGAMENT CONTAINS NERVES AND VESSELS, MESOVARIUM- SMALL MESENTERY OF THE OVARY SURFACE IS COVERED BY GERMINAL EPITHELIUM,

OVARY

ARTERIAL SUPPLY

ARTERIES

OVARIAN ARTERIES>>> ABDOMINAL AORTA ASCENDING BRANCHES OF THE UTERINE ARTERIES>>>> INTERNAL ILIAC

VENOUS

VEINS

R OVARIAN>>>IVC

L OVARIAN>>>L RENAL VEIN

LYMPH DRAINAGE

LYMPH

NERVE SUPPLY

OVARIAN CA

OVARIAN CA

ASR

UTERINE TUBES

CONVEY THE FERTILIZED OR UNFERTILIZED OOCYTES TO THE UTERINE CAVITY BY CILIARY ACTION AND MUSCULAR CONTRACTION AND TO TRANSPORT SPERM

SUPPORTED BY A MESOSALPINX>> A PART IN THE BROAD LIGAMENT

UTERINE TUBES

PARTS
INFUNDIBULUM= FUNNEL SHAPED, FIMBRIATED, AND OPENS INTO
THE PERITONEAL CAVITY

AMPULLA= WIDEST LONGEST PART, SITE OF THE FERTILIZATION

ISTHMUS
INTRAMURAL DIVISION-OPENS INTO THE UTERINE CAVITY

ARTERIAL SUPPLY

OVARIAN ARTERY ASCENDING BRANCH OF THE UTERINE ARTERY

SALPINGITIS

SALPINGITIS
PAIN OVULATION/SEXUAL INTERCOURSE

ABNORMAL SMELL AND COLOR OF VAGINAL DISCHARGES


LBP, ABD. PAIN BLOATING N.GONNORHEA AND CHLAMYDIA SCARRING PREDISPOSES - ECTOPIC PREGNANCY

ECTOPIC TUBAL PREGNANCY

UTERUS

UTERUS
FUNDUS-SUPERIOR PART, UPPER SEGMENT, TERM
REACH XIPHOID, T9

CORNU-NEAR ENTRY OF THE TUBES BODY-BET CORNU AND THE


CERVIX, ISTHMUS- DIVIDING LINE BETWEEN CERVIX AND THE BODY; PREFERRED SITE FOR SURGICAL INCISION IN CS.

CERVIX-INFERIOR PART PROTRUDES INTO


VAGINA,EXTERNAL OS, CERVICAL OS, INTERNAL OS. EXTRNAL OS- ROUND IN NULLIPAROUS, TRANSVERSE IN MULTIPAROUS

VESSELS

UTERINE ARTERIES>>>IIA

DRAINS TO IIV; >>IVC

NERVES

UTERINE SUPPORT
PELVIC DIAPHRAGM[ LEVATOR ANI MUSCLES] UROGENITAL DIAPHRAGM

URINARY BLADDER
ROUND LIGAMENT OF THE UTERUS- RMNANT OF THE GUBERNACULUM, EXITS ABDOMEN VIA DEEP INGUINAL RING, MAINTAINS POSITION OF THE UTERUS=ANTERVERSION TRANSVERSE CERVICAL LIGAMENT/ CARDINAL LIGAMENT OF MCKENRODTLATERALLY FROM CERVIX TO THE SIDE OF PELVIS, PART OF BROAD LIGAMENT, CONTAINS UTERINE ARTERY UTEROSACRAL LIGAMENT-POSTERIORLY FROM CERVIX TO THE SACRUM, MAINTAINS THE ANTERVERSION PUBOCERVICAL-ANTERIORLY FROM THE PUBIS SYMPHYSIS TO THE CERVIX, PREVENTS CYSTOCELE [BLADDER HERNIATION] INTO THE ANTERIOR VAGINAL WALL

UTERINE SUPPORT

UTERINE SUPPORT
BROAD LIGAMENT-DOUBLE FOLD OF PARIETAL
PERITONEUM, EXTENDS LATERALLY FROM THE UTERUS TO THE SIDES OF THE PELVIS MESOSALPINX-TUBES

MESOVARIUM-OVARY
MESOMETRIUM-UTERUS SUSPENSORY LIGAMENT OVARY

CONTENTS BROAD LIGAMENT


OVARIAN ARTERY, VEINS, NERVES UTERINE TUBES

OVARIAN LIGAMENT OF THE UTERUS


ROUND LIGAMENT OF THE UTERUS EPOOPHORON-REMNANT MESONEPHRIC TUBULES

PAROOPHORON- RUDIMENTARY TUBULES BET EPOOPHORON AND UTERUS


GARTNER DUCT- REMNANT OF MESONEPHRIC DUCT URETERS-LIES AT THE BASE OF THE BROAD LIGAMENT , INFERIOR AND POSTERIOR TO THE UTERINE ARTERY, PROXIMITY
TO ARTERY SOMETIMES LIGATED DURING HYSTERECTOMY

POSITION

POSITION

ANTEFLEXED- ANTERIOR BEND OF THE UTERUS AT


THE ANGLE BET. CERVIX AND BODY OF THE UTERUS

ANTEVERTED- ANTERIOR BEND OF THE UTERUS AT


THE ANGLE BET. CERVIX AND VAGINA

CLINICAL CONDITIONS

endometrial CA
most common CA involving Rep organs prolonged estrogen stimulation menopause DM obesity nulliparity early menarche late menopause

abnormal uterine bleeding

HYSTERECTOMY

HYSTERECTOMY
TOTAL- FUNDUS, BODY,CERVIX

SUPRACERVICAL- BODY ONLY


ABDOMINAL= PFANNENSTIEL[ABOVE THE PUBIC BONE]-LAPAROTOMY VAGINAL
LAPAROSCOPIC ASSISTED VAGINAL H

LAVH

conditions
endometriosis- presence of glandular tissues outside the uterus leiomyoma- proliferation of smooth muscles in the uterus which becomes calcified

BLOCKS

BLOCKS

CERVIX

CERVIX

2.5-3CM L ;LOWER PART OF THE UTERUS DIVIDED INTO SUPRAVAGINAL- ABOVE THE VAGINAL VAULT,PORTIO VAGINALIS-PROTUDES INTO THE VAGINA INTERNAL OS- JUNCTION BETWEEN THE UTERUS AND THE CERVIX

CERVIX
PROLIFERATIVE PHASE-WATERY MUCUS
SECRETORY PHASE- VISCOUS SOFTENING AND DILATATION DURING-PREG-RELAXIN

ECTOCERVIX

OUTER EPITHELIAL SURFACE OF THE POTIO VAGINALIS ENDOCERVIX- LINING OF THE ENDOCERVICAL CANAL TRANSFORMATION ZONE- CHANGES OF THE TYPES OF EPTHELIUM[ COLUMNAR>SQUAMOUS] FROM THE ENDOCERICAL CANAL TO THE ECTOCERVIX

TRANSFORMATION

CYSTS

TRANSFORMATION
NABOTHIAN CYST- MUCUS FILLED CYST, OCCURS WHEN THE STRATIFIED SQUAMOUS EPITH.(ECTOCERVIX) COVERS THE SIMPLE COLUMNAR EPITH OF THE ENDOCERVIX SITE FOR SQUAMOUS CA IN CERVIX [CERVICAL INTRAEPITHELIAL NEOPLASIA] CERVICAL SPREAD-SIDES-URETERS OBSTRUCTED SENTNEL NODE-OBTURATOR LYMPH NODE PAPANICOLAU SMEAR-MTD OF DIAGNOSIS- CELL STUDY FROM THE ENDOCERVIX DETECT PRECANCEROUS AND CANCEROUS CELLS

PAP SMEAR

VAGINA

VAGINA
LONGEST PART OF THE BIRTH CANAL DISTENSION LIMITED BY ISCHIAL SPINE AND SACROSPINOUS LIGAMENTS; CERVIX TO THE VESTIBULE FORNIX- VAGINAL RECESS AROUND THE CERVIX

FORNIX

FORNIX
ANTERIOR FORNIX-LOCATED ANTERIOR TO THE CERVIX, RELATED TO THE VESICOUTERINE POUCH, BLADDER PALPABLE THROUGH THE ANT. FORNIX DURING DIGITAL EXAM LATERAL FORNIX- LATER TO THE CERVIX POSTERIOR TO THE CERVIX- RELATED TO THE POUCH OF DOUGLAS[RECTO UTERINE POUCH],SACRAL PROMONTORY, RECTUM, COCCYX PALPABLE SITE FOR CULDOCENTESIS CULDOCENTESIS- EXTRACTION OF FLUID FROM POSTERIOR FORNIX/ RECTOUTERINE POUCH

VASCULAR
VAGINAL BRANCHES- UTERINE AIIA-SUPERIOR PORTION
INTERNAL PUDENDAL- IIA-MIDDLE AND INFERIOR PORTION VAGINAL VEINS-UTERINE PLEXUSIIV-IVC

CONDITIONS
CYSTOCELE- BLADDER TO VAGINA RECTOCELE-RECTUM TO VAGINA

VAGINITIS- INFXN DUE TO T. VAGINALIS, CANDIDA ALBICANS, GARDNERELLA VAGINALIS


T.VAGINALIS- FLAGELLATED PROTOZOAN, PRODUCES PURULENT, MALODOROUS DISCHARGE,WHITISH, FROTHYSTRAWBERRY RED, METRONIDAZOLE C. ALBICANS-COTTAGE CHEESE, DISCHARGE, AZOLE ANTIFUNGALS G.VAGINALIS-NO MUCUSAL CHANGES, FISHY ODOR, THIN HOMOGENOUS FISHY DISCHARGE, BACTERIAL VAGINOSIS METRO AND CLINDA