OBSTERICS AND GYNECOLOGY EXAM
MIDTERM EXAM STUDY GUIDE LATEST
UPDATED RATED A.
, lOMoAR cPSD| 19857451
OBSTETRICS AND GYNECOLOGY MID TERM 2018
ANATOMY OF THE FEMALE REPRODUCTIVE SYSTEM
1. Female external genitalia (vulva, pudendum)
■ Mons pubis: subcutaneous adipose connective tissue
■ Labia majora: joins medially to form the posterior commissure in front of the anus. Outer skin is pigmented,
with an adipose tissue richly supplied with venous plexus that can form a hematoma if injured (homologous
to the male scrotum). The round ligament terminates at the upper border.
■ Labia minora: no fat, hair follicles or sweat glands. Divide to enclose the clitoris and unite with each other in
front and behind the clitoris to form the prepuce and frenulum respectively.
■ Hymen
■ Clitoris: homologous to the penis, attached to the surface of the pubic symphisis by a suspensory ligament
■ Vestibule: triangular space bounded by the clitoris anteriorly, posteriourly by the fourchette and on either
side by the labia minora. Consists of four openings; urethral, vaginal, bartholins gland and skene’s gland.
■ Urethra
• Skene’s glands: homologous to the prostate
• Bartholin’s glands
• Vestibular bulbs
2. The blood supply of the external genitalia
comes from the branches of the (a) internal pudendal artery (b) branches of femoral artery. The venous drainage is
to the internal pudendal vein, long saphenous vein and the vaginal/vesical venous plexus
3. Nerve supply to the external genitalia
cutaneous branch from the ilioinguinal nerve, genital branch of the genitor-femoral nerve (L1-L2)
4. Internal genital organs
■ Vagina (diameter 2.5cm): posterior wall 9cm long and anterior wall 7cm. the vaginal PH from puberty to
menopause is acidic because of the presence of Doderlain’s Bacilli which produces lactic acid from the
glycogen in exfoliated cells. Arterial supply of the vagina is from the cervicovaginal artery from uterine
artery; vaginal artery from the anterior division of the internal iliac artery; middle rectal artery and internal
pudendal artery. All form the azygos arteries by anastomosing. Venous drainage is to the internal pudendal
veins.
■ Uterus: normal position is anteversion- anteflexion, usually inclines to the right (dextrorotation) →pelvis to
the left (levorotation). 8cm long, 5cm wide, 50-80g in weight.Consists of the body (fundus,
cornuaattachment of the tubes, round ligaments and ovarian ligaments), isthmus (constricted part-limited
above and below by the anatomical and histological Os respectively, Site for CS), and cervix (insensitive to
touch, heat). The cavity is triangular shaped, no cavity in the fundal part making the length of the cavity 6.5-
7cm.
■ The perimetrium is the serous coat that invests the entire uterus except on the lateral surface
■ The myometrium consists of 3 muscle layers: outer longitudinal, middle interlacing and inner circular
■ Endometrium: mucous lining (lamina propria and surface epithelium), no submucous layer. The
endometrial secretion is alkaline.
■ Uterus nerve supply (T5-T6- motor, T10-L1-sensory)
, lOMoAR cPSD| 19857451
■ Fallopian Tube: 8-14cm in length consists of the intramural/interstitial (Shortest and narrowest 1cm),
isthmus (3-4cm), ampulla (widest, tortuous 5-8cm), and fimbrae.
■ Ovary: 3cm in length, 2cm in breadth and 1cm in thickness. Attached to the lateral pelvic wall by the
infundibulopelvic ligament
Functions: germ cell maturation, storage and egg release, steroidogegesis (hormones)
5. types of pelvis:
• gynecoid,
• platypelloid,
• android,
• mixed type
6. The pelvic floor 3 layered muscle
❖ Outer layer (4 muscles)
• Bulbo carvenosus muscle
• schiocavernosus
• uperficial transverse perineal muscle External sphincter ani
❖ Middle layer
Urogenital diaphragm
❖ inner layer
levator ani muscles: pubococcygeus, iliococcygeus, ischiococcygeus The
rectouterine pouch is the lowest part of the female pelvis
7. The Main ligaments of the uterus
● Round ligament: Originates from the corni of uterus, Runs through the inguinal canal to end at the mon
pubis. Maintains the uterus in the anteversion state
● Broad ligament: Made up of only peritoneum. vessels and uteters pass through its anterior and posterior
walls, it gives minimal support to the uterus
● Cardinal ligament: Fixes the cervix to the pelvis. It is the primary support of the uterus, helps in
anteversion
● uterosacral ligaments: draws the cervix backward and upward
8. Joints of the pelvis (false & true pelvis)
• Sacroiliac joint
• Sacrococygeal joint
• Pubis symphysis
9. Pelvic ligaments
● Sacrotuberous ligaments
● Sacrospinous ligaments (from lateral border of sacrum to ischial spine)
MIDTERM EXAM STUDY GUIDE LATEST
UPDATED RATED A.
, lOMoAR cPSD| 19857451
OBSTETRICS AND GYNECOLOGY MID TERM 2018
ANATOMY OF THE FEMALE REPRODUCTIVE SYSTEM
1. Female external genitalia (vulva, pudendum)
■ Mons pubis: subcutaneous adipose connective tissue
■ Labia majora: joins medially to form the posterior commissure in front of the anus. Outer skin is pigmented,
with an adipose tissue richly supplied with venous plexus that can form a hematoma if injured (homologous
to the male scrotum). The round ligament terminates at the upper border.
■ Labia minora: no fat, hair follicles or sweat glands. Divide to enclose the clitoris and unite with each other in
front and behind the clitoris to form the prepuce and frenulum respectively.
■ Hymen
■ Clitoris: homologous to the penis, attached to the surface of the pubic symphisis by a suspensory ligament
■ Vestibule: triangular space bounded by the clitoris anteriorly, posteriourly by the fourchette and on either
side by the labia minora. Consists of four openings; urethral, vaginal, bartholins gland and skene’s gland.
■ Urethra
• Skene’s glands: homologous to the prostate
• Bartholin’s glands
• Vestibular bulbs
2. The blood supply of the external genitalia
comes from the branches of the (a) internal pudendal artery (b) branches of femoral artery. The venous drainage is
to the internal pudendal vein, long saphenous vein and the vaginal/vesical venous plexus
3. Nerve supply to the external genitalia
cutaneous branch from the ilioinguinal nerve, genital branch of the genitor-femoral nerve (L1-L2)
4. Internal genital organs
■ Vagina (diameter 2.5cm): posterior wall 9cm long and anterior wall 7cm. the vaginal PH from puberty to
menopause is acidic because of the presence of Doderlain’s Bacilli which produces lactic acid from the
glycogen in exfoliated cells. Arterial supply of the vagina is from the cervicovaginal artery from uterine
artery; vaginal artery from the anterior division of the internal iliac artery; middle rectal artery and internal
pudendal artery. All form the azygos arteries by anastomosing. Venous drainage is to the internal pudendal
veins.
■ Uterus: normal position is anteversion- anteflexion, usually inclines to the right (dextrorotation) →pelvis to
the left (levorotation). 8cm long, 5cm wide, 50-80g in weight.Consists of the body (fundus,
cornuaattachment of the tubes, round ligaments and ovarian ligaments), isthmus (constricted part-limited
above and below by the anatomical and histological Os respectively, Site for CS), and cervix (insensitive to
touch, heat). The cavity is triangular shaped, no cavity in the fundal part making the length of the cavity 6.5-
7cm.
■ The perimetrium is the serous coat that invests the entire uterus except on the lateral surface
■ The myometrium consists of 3 muscle layers: outer longitudinal, middle interlacing and inner circular
■ Endometrium: mucous lining (lamina propria and surface epithelium), no submucous layer. The
endometrial secretion is alkaline.
■ Uterus nerve supply (T5-T6- motor, T10-L1-sensory)
, lOMoAR cPSD| 19857451
■ Fallopian Tube: 8-14cm in length consists of the intramural/interstitial (Shortest and narrowest 1cm),
isthmus (3-4cm), ampulla (widest, tortuous 5-8cm), and fimbrae.
■ Ovary: 3cm in length, 2cm in breadth and 1cm in thickness. Attached to the lateral pelvic wall by the
infundibulopelvic ligament
Functions: germ cell maturation, storage and egg release, steroidogegesis (hormones)
5. types of pelvis:
• gynecoid,
• platypelloid,
• android,
• mixed type
6. The pelvic floor 3 layered muscle
❖ Outer layer (4 muscles)
• Bulbo carvenosus muscle
• schiocavernosus
• uperficial transverse perineal muscle External sphincter ani
❖ Middle layer
Urogenital diaphragm
❖ inner layer
levator ani muscles: pubococcygeus, iliococcygeus, ischiococcygeus The
rectouterine pouch is the lowest part of the female pelvis
7. The Main ligaments of the uterus
● Round ligament: Originates from the corni of uterus, Runs through the inguinal canal to end at the mon
pubis. Maintains the uterus in the anteversion state
● Broad ligament: Made up of only peritoneum. vessels and uteters pass through its anterior and posterior
walls, it gives minimal support to the uterus
● Cardinal ligament: Fixes the cervix to the pelvis. It is the primary support of the uterus, helps in
anteversion
● uterosacral ligaments: draws the cervix backward and upward
8. Joints of the pelvis (false & true pelvis)
• Sacroiliac joint
• Sacrococygeal joint
• Pubis symphysis
9. Pelvic ligaments
● Sacrotuberous ligaments
● Sacrospinous ligaments (from lateral border of sacrum to ischial spine)
