GYNECOLOGY-5-

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GYNECOLGY AND OBSTETRICS Mind Map on GYNECOLOGY-5-, created by Ali Almudarsy on 30/06/2017.
Ali Almudarsy
Mind Map by Ali Almudarsy, updated more than 1 year ago More Less
Ali Almudarsy
Created by Ali Almudarsy about 7 years ago
Ali Almudarsy
Copied by Ali Almudarsy about 7 years ago
Ali Almudarsy
Copied by Ali Almudarsy about 7 years ago
Ali Almudarsy
Copied by Ali Almudarsy about 7 years ago
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Resource summary

GYNECOLOGY-5-
  1. Anatomy and the female pelvic organ
    1. External genitalia
      1. MLLCVP
      2. internal genitalia
        1. VUFO
          1. Vagina
            1. fibromusculomembranous sheath
              1. between uterine cavity & exterior at the vulva= excretory channel
                1. birth canal of parturition
                  1. walls
                    1. Anterior wall=7 cm
                      1. 2 lateral walls
                        1. posterior wall=9 com
                        2. fornices
                          1. 4 fornices
                            1. anterioral
                              1. posterior
                                1. 2 lateral
                                2. high amount of glycogen in fornix =2.5-3 mg
                                3. Relations
                                  1. anterior
                                    1. bladder & urethra
                                    2. posterior
                                      1. pouch of douglas , anterial rectal wall & anal canal
                                      2. lateral
                                        1. pelvic celluar tissue
                                          1. levator ani & bulbocavernosus muscles
                                            1. Vestibular bulbs & bartholin's glands
                                            2. Structures
                                              1. Epithelium
                                                1. under action of sex hormones =stratified sq. epithelium at birth up to 10-14 days
                                                  1. prepuberty and in postmenopause = epithelium become thin,few layers only
                                                    1. puberty till menopause= stratified sq. epithelium +3 cells ( basal , intermediate and superficial cornified cells)
                                                2. secretion
                                                  1. vagina secretion is very small in ammount
                                                    1. little excess in mid menstrual ,menstruation & during pregnancy &sexual excitement
                                                      1. vaginal secretion derived from=
                                                        1. glands of cervix
                                                          1. uterus
                                                            1. transudation of vaginal epithelium
                                                              1. Bartholin's glands(during sexual excitment)
                                                              2. PH of vaginal secretions
                                                                1. acidic and varies during life and menstrual cycle
                                                                  1. convertion of glycogen into lactic acid by the Doderlein's bacilli is depending on oestrogen
                                                                    1. the highest glycogen in vaginal fornix=2.5-3mg /the lowest in lower third =0.6-0.9mg
                                                                      1. Doderlein's bacillus= propably comes from the intestine

                                                                        Annotations:

                                                                        • وجود هذه البكتريا مرتبط بوجود هرمون الاستروجين فمن دونه لاحموضه ولا لاكتك اسد
                                                                        1. ph acidic prevent growth of the other pathogenic organism
                                                                      2. appear after birth =3-4days
                                                                        1. disappears after 10-14 days
                                                                          1. puberty
                                                                          2. menopause
                                                                          3. PH=higher in upper vagina because of contaminated cervica secretion (alkaline).
                                                                          4. Tissue fluid ,epithelial debris, some leucocytes , electrolytes,protiens and lactic acid (0.75 percent concentration)
                                                                          5. Nerves & Blood supply of vagina
                                                                            1. arteries
                                                                              1. 1- cervicovaginal branch of the uterine artery
                                                                                1. 2- vaginal artery
                                                                                  1. 3- middle rectal artery
                                                                                    1. 4- internal pudendal artery
                                                                                      1. anastomose with another and form =2 azygos arteries (anterior & posterior)
                                                                                      2. veins
                                                                                        1. 1- internal iliac vein
                                                                                          1. 2- internal pudendal veins
                                                                                          2. Nerves
                                                                                            1. sympathetic & parasympathetic from pelvic plexis
                                                                                              1. lower part = pudendal nerve
                                                                                          3. THE UTERUS (8 cm)
                                                                                            1. hollow pyriform muscular organ
                                                                                              1. between bladder (front) and rectum(behind)
                                                                                                  1. position
                                                                                                    1. anteversion & anteflexion
                                                                                                      1. uterus inclines to the right = (dextrorotation)
                                                                                                        1. cervix is direct to the left = (levorotation) and comes in close relation with the left ureter.
                                                                                                      2. measurements & parts
                                                                                                        1. long =8 cm ,wide =5 cm ,walls=1.25 cm thick ,weight =50-80 gm
                                                                                                        2. Body or corpus
                                                                                                          1. Fondus= between opening of uterin tubes
                                                                                                            1. Body= between the opening of the tubes and isthmus
                                                                                                              1. cornua of the uterus = round ligament,ovary ligament &uterine tube attached each cornu
                                                                                                                1. Isthmus (0.5 cm)
                                                                                                                  1. ismthus =between body & cervix
                                                                                                                    1. isthmus =limited by above anatomical internal os / below histological internal os (aschoff)
                                                                                                                      1. some consider isthmus as apart of the lower portion of the body of the uterus
                                                                                                                        1. Cervix (2.5 cm)
                                                                                                                          1. lowermost part of the uterus
                                                                                                                            1. from histological internal os and ends at external os =opens into the vagina
                                                                                                                              1. cavity (3.5 cm)
                                                                                                                                1. cavity of uterus is triangular on coronal section ( base above & apex below)
                                                                                                                                  1. no cavity in founds
                                                                                                                                    1. cervical canal is fusiform and measures =2.5 cm
                                                                                                                                      1. normal length of the uterine cavity with cervical canal =6-7 cm
                                                                                                                                      2. cylindrical in shape =2.5 in length and diameter
                                                                                                                                        1. In nulliparous
                                                                                                                                          1. Vaginal part of cervix is conical with the external os looking circular
                                                                                                                                          2. In parous
                                                                                                                                            1. Vaginal part of cervix is cylindrical with external os having bilateral slits
                                                                                                                                          3. cervix parts= supravaginal part (1.25) & vaginal part(1.25 cm)
                                                                                                                                      3. Relations
                                                                                                                                        1. anteriorly
                                                                                                                                          1. above internal os =body form the posterior wall of the uterovesical pouch / below internal os base of bladder by loose areolar tissue
                                                                                                                                          2. laterally
                                                                                                                                            1. double folds of peritonium of the broad ligament attached laterally between which the uterine artery ascends up
                                                                                                                                              1. attachment of mackenrodt's ligament extends from the internal os down to the supravaginal cervix and lateral vaginal wall
                                                                                                                                                1. about 1.5 cm away at the level of internal os ,at left side is crosssing of the uterine artery and the ureter
                                                                                                                                                  1. uterine artery crosses from above and in front of the uretersoon before the ureter enters the ureteric tunnel
                                                                                                                                                  2. posteriorly
                                                                                                                                                    1. covered with peritoneum and form the anteriorr wall of the pouch of douglas containing coils of intestine.
                                                                                                                                                  3. structures
                                                                                                                                                    1. body (3 layers )
                                                                                                                                                      1. perimetrium
                                                                                                                                                        1. myometrium
                                                                                                                                                          1. 3 distinct layers can be identified during pregnancy =outer longitudinal ,middle interlacing and the inner circular
                                                                                                                                                          2. endometrium
                                                                                                                                                            1. all components are changed during menstral cycles
                                                                                                                                                              1. endometrium changed to decidua during pregnancy
                                                                                                                                                            2. cervix
                                                                                                                                                              1. epithelial lining of the cervix
                                                                                                                                                                1. portio vaginalis
                                                                                                                                                                  1. changes with level of oestrogen
                                                                                                                                                                    1. irritated not only by hormone but also by infection and trauma
                                                                                                                                                                      1. more chance to get = sever dysplasioa , carcinoma in situ , invasive carcinoma
                                                                                                                                                                    2. secretion
                                                                                                                                                                      1. endometrium secretion
                                                                                                                                                                        1. changed with menstrual cycle and pregnancy
                                                                                                                                                                        2. cervical glands (ph=7.8)
                                                                                                                                                                          1. fructose has got nutritive function to the spermatozoa
                                                                                                                                                                            1. under oestrogenic stimulation=glycoprotein network is arranged parallel to each other thus facilitating sperm ascent.
                                                                                                                                                                              1. progesterone produces interlacing bridges thereby preventing sperm penetration
                                                                                                                                                                              2. pelvic peritonium in relation to the uterus
                                                                                                                                                                                1. neves and blood supply of the uterus
                                                                                                                                                                                  1. arteries
                                                                                                                                                                                    1. uterian rtery
                                                                                                                                                                                      1. another source=ovarian artery & vaginal arteies to which the =uterine arteries anastomose
                                                                                                                                                                                      2. veins
                                                                                                                                                                                        1. uterine vein
                                                                                                                                                                                          1. drain into internal iliac veins
                                                                                                                                                                                        2. nerves
                                                                                                                                                                                          1. principally from =sympathetic system
                                                                                                                                                                                            1. T5 , T6 (motor) // T10 , L1 spinal segments (sensory)
                                                                                                                                                                                              1. area of abdomen
                                                                                                                                                                                            2. partly from= parasympathetic system
                                                                                                                                                                                              1. pelvic nerve which consists of both motor and sensory fibers from S2,S3,S4
                                                                                                                                                                                                1. End of ganglia of frankenhauser which lie on either sides of the cervix
                                                                                                                                                                                              2. changes of uterus with age
                                                                                                                                                                                                1. at birth
                                                                                                                                                                                                  1. child birth
                                                                                                                                                                                                    1. puberty
                                                                                                                                                                                                      1. menopause
                                                                                                                                                                                                        1. position of uterus
                                                                                                                                                                                                          1. antevertion 90
                                                                                                                                                                                                            1. anteflexion 120
                                                                                                                                                                                                2. fallopian tubes (uterin tube) 10cmL/1mmD
                                                                                                                                                                                                  1. Fallopian tube parts
                                                                                                                                                                                                    1. interstatitial (intamural)
                                                                                                                                                                                                      1. isthmus 2.5LD
                                                                                                                                                                                                        1. ampulla-tortuous part 5cm
                                                                                                                                                                                                          1. infundibulum 1.25 cm L/6mmD
                                                                                                                                                                                                          2. structures of fallopian tube
                                                                                                                                                                                                            1. serous
                                                                                                                                                                                                              1. muscular (outer= longitudinal /inner= circular)
                                                                                                                                                                                                                1. mucous membrane(longitudinal folds)
                                                                                                                                                                                                                  1. لاتوجد اي غدد في هذه الطبقه
                                                                                                                                                                                                                2. function of fallopian tube
                                                                                                                                                                                                                  1. transport of gametes
                                                                                                                                                                                                                    1. to facilititae fertilization
                                                                                                                                                                                                                      1. survival of zygote throughit secretion
                                                                                                                                                                                                                      2. nerves and blood supply of fallopian tube
                                                                                                                                                                                                                        1. arteries
                                                                                                                                                                                                                          1. uterian a. & ovarian a.
                                                                                                                                                                                                                          2. veins
                                                                                                                                                                                                                            1. pampiniform plexus into the ovarian veins
                                                                                                                                                                                                                            2. nerves
                                                                                                                                                                                                                              1. uterian & ovarian nerves
                                                                                                                                                                                                                          3. ovaries 3 cm l, 2 cm in breath , 1 cm in thicked
                                                                                                                                                                                                                            1. Germ cell maturation ,storage and it's release
                                                                                                                                                                                                                              1. Steroidogenesis
                                                                                                                                                                                                                                1. Relations of ovary
                                                                                                                                                                                                                                  1. Structures
                                                                                                                                                                                                                                    1. During puperty to menopause
                                                                                                                                                                                                                                      1. primordial follicles
                                                                                                                                                                                                                                        1. maturing follicles
                                                                                                                                                                                                                                          1. Graafian follicles
                                                                                                                                                                                                                                            1. Corpus luteum
                                                                                                                                                                                                                                              1. CORPUS ALBICANS
                                                                                                                                                                                                                                            2. special instrument for inspection
                                                                                                                                                                                                                                          2. female urethra 4 cm L /6 mmD
                                                                                                                                                                                                                                            1. Relations
                                                                                                                                                                                                                                              1. Glands
                                                                                                                                                                                                                                                1. sphincters
                                                                                                                                                                                                                                                  1. Involuntary internal sphincter
                                                                                                                                                                                                                                                    1. voluntary muscles and the fibers
                                                                                                                                                                                                                                                      1. Sphincter urethra in the urogenital diaphram
                                                                                                                                                                                                                                                      2. blood supply
                                                                                                                                                                                                                                                        1. applied anatomy
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