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Clinical notes on anatomy of female reproductive system

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Clinical Notes on Anatomy of
Female Reproductive System
Jana NГЎtekovГЎ
What am I planning to talk about today?
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Gynecologic examination
Imaging techniques in gynecology and obstetrics
Surgical access to the female genital organs
Perineal injuries during labor
Anatomical notes on pain during labor
Lymphatic drainage of the female genital organs
I. Gynecologic (and obstetric)
examination
• The same physical examination as in other
medical specialties - inspection, palpation,
percussion, and auscultation
• Vaginal examination - only in gynecology
Inspection of the vulva
1 Mons pubis
2 Anterior commissure
3 Prepuce of clitoris
4 Clitoris
5 Frenulum of clitoris
6 Labium minus
7 Labium majus
8 External urethral orifice
9 Orificeof duct of Bartolin’s gland
10 Margin of vaginal orifice
12 Skin of the perineum
13 Anus
14 Annococcygeal body
Speculum examination
Speculum examination
Nulliparous cervix
Multiparous cervix
Digital examination
Position of the uterus
Position of the uterus - AVF
Position of the uterus - AF, RV
Position of the uterus - RVF
Examination of the adnexa
Examination of the neighboring
structures
II. Imaging techniques
• Ultrasound examination
• Radiological investigations
– hysterosalpingography
– computed tomography (CT)
– magnetic resonance imaging (MRI)
• Endoscopic methods
– hysteroscopy
– laparoscopy
Ultrasound
Ultrasound
Ultrasound
Ultrasound
Ultrasound
Ultrasound
Hysterosalpingography - HSG
HSG - Uterus bicornis unicollis
HSG - Uterus septus
HSG - Uterus didelphis
HSG - Sactosapinx
Hysteroscopy
Hysteroscopy
Laparoscopy - Uterus
Laparoscopy - Ovary
III. Surgical access to female genital
organs
Abdominal
Vaginal
Abdominal hysterectomy
Abdominal hysterectomy
Vaginal hysterectomy
IV. Perineal injuries during labor
• Damage during the childbirth can cause:
– weakness of the pelvic floor
– incontinence of flatus
– loose stool
First degree tear
Second degree tear
Third degree tear
V. Pain during labor
• Uterine contractions  hypogastric and
pre-aortic plexus
• Dilatation of the cervix  sacral roots
• Stretched vulva and perineum  pudendal
(also ilioinguinal, genitofemoral, posterior
femoral cutaneous) nerves п‚® lumbosacral
plexus
Pudendal block
Caudal block
VI. Lymphatic drainage of the
female genital organs
1
1 Para-aortic nodes
2 Common iliac nodes
3 Obturator nodes
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5 Node of Cloquet
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10
6 Deep femoral nodes
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11
4 Internaliliac nodes
7 Fossa ovalis
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8 Long saphenous vein
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9 External iliac nodes
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10 Inguinal ligament
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11 Superficial inguinal nodes
12 Superficial femoral nodes
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13 Femoral artery
14 Femoral vein
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