Chapter 39: Normal Anatomy and Physiology of the Female Pelvis

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1

amenorrhea

the absence of menstruation

2

anteflexed

position of the uterus when the uterine fundus bends forward toward the cervix

3

anteverted

position of the uterus when the uterus is tipped slightly forward so that the cervix forms a 90-degree or smaller angle with the vaginal canal; most common uterine position

4

broad ligament

a broad fold of peritoneum draped over the fallopian tubes, uterus, and ovaries; extends from the sides of the uterus to the sidewalls of the pelvis, dividing the pelvis from side to side and creating the vesicouterine pouch anterior to the uterus and the rectouterine pouch posteriorly; it is divided into the mesometrium, mesosalpinx, and mesovarium

5

cardinal ligament

wide band of fibromuscular tissue arising from the lateral aspects of the cervix and inserting along the lateral pelvic floor; a continuation of the broad ligament that provides rigid support for the cervix; also called the transverse cervical ligaments

6

coccygeus muscles

one of two muscles in the pelvic diaphragm; located on the posterior pelvic floor, where it supports the coccyx

7

corpus luteum

an anatomic structure on the surface of the ovary, consisting of a spheroid of yellowish tissue that grows within the ruptured ovarian follicle after ovulation; acts as a short-lived endocrine organ that secretes progesterone to maintain the decidual layer of the endometrium should conception occur

8

dysmenorrhea

pain associated with menstruation

9

estrogen

a steroidal hormone secreted by the theca interna and granulosa cells of the ovarian follicle that stimulates the development of female reproductive structures and secondary sexual characteristics; promotes the growth of endometrial tissue during the proliferative phase of the menstrual cycle

10

false pelvis

portion of the pelvis found above the brim; that portion of the abdominal cavity cradled by the iliac fossae; also called the greater or major pelvis

11

follicle-stimulating hormone (FSH)

a hormone secreted by the anterior pituitary gland that stimulates the growth and maturation of graafian follicles in the ovary

12

gonadotropin

a hormonal substance that stimulates the function of the testes and the ovaries; in the female, FSH and LH are gonadotropins

13

gonadotropin-releasing hormone (GnRH)

a hormone secreted by the hypothalamus that stimulates the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) by the anterior pituitary gland

14

iliacus muscles

paired triangular, flat muscles that cover the inner curved surface of the iliac fossae; they arise from the iliac fossae and join the psoas major muscles to form the lateral walls of the pelvis

15

iliopectineal line

a bony ridge on the inner surface of the ilium and pubic bones that divides the true and false pelvis; also called the pelvic brim or linea terminalis

16

levator ani

one of two muscles of the pelvic diaphragm that stretch across the floor of the pelvic cavity like a hammock, supporting the pelvic organs and surrounding the urethra, vagina, and rectum; a broad, thin muscle that consists of the pubococcygeus, iliococcygeus, and puborectalis

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luteinizing hormone (LH)

a hormone secreted by the anterior pituitary gland that stimulates ovulation and then induces luteinization of the ruptured follicle to form the corpus luteum

18

menarche

the onset of menstruation and the commencement of cyclic menstrual function; usually occurs between 11 and 13 years of age

19

menopause

the cessation of menstruation

20

menorrhagia

abnormally heavy or long periods

21

menses

the periodic flow of blood and cellular debris that occurs during menstruation

22

mesosalpinx

the upper portion of the broad ligament that encloses the fallopian tubes

23

mesovarium

the posterior portion of the broad ligament that is drawn out to enclose and hold the ovary in place

24

obturator internus muscle

a triangular sheet of muscle that arises from the anterolateral pelvic wall and surrounds the obturator foramen, passes through the lesser sciatic foramen and inserts into the medial aspect of the greater trochanter of the femur, and serves to rotate and abduct the thigh

25

oligomenorrhea

abnormally light menstrual periods

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oocyte

an incompletely developed or immature ovum

27

ovarian ligament

a paired ligament that extends from the inferior/medial pole of the ovary to the uterine cornua; also called the utero-ovarian ligament

28

ovum

the female egg; a secondary oocyte released from the ovary at ovulation

29

perimetrium

a serous membrane enveloping the uterus; also called the serosa

30

piriformis muscle

a flat, pyramidal muscle arising from the anterior sacrum, passing through the greater sciatic notch to insert into the superior aspect of the greater trochanter of the femur; serves to rotate and abduct the thigh

31

polymenorrhea

an abnormally frequent recurrence of the menstrual cycle; a menstrual cycle of less than 21 days

32

premenarche

time period in young girls before the onset of menstruation

33

progesterone

a steroidal hormone produced by the corpus luteum that helps prepare and maintain the endometrium for the arrival and implantation of an embryo

34

psoas major muscle

paired muscles that originate at the transverse process of the lumbar vertebrae and extend inferiorly through the false pelvis on the pelvic sidewall, where they unite with the iliacus muscle to form the iliopsoas muscle before inserting into the lesser trochanter of the femur; serves to flex the thigh toward the pelvis

35

rectouterine recess (pouch)

area in the pelvic cavity between the rectum and the uterus that is likely to accumulate free fluid; also known as the posterior cul-de-sac and the pouch of Douglas

36

retroflexed

position of the uterus when the uterine fundus bends posteriorly upon the cervix

37

retroverted

position of the uterus when the entire uterus is tipped posteriorly so that the angle formed between the cervix and the vaginal canal is greater than 90 degrees

38

round ligaments

paired ligaments that originate at the uterine cornua, anterior to the fallopian tubes, and course anterolaterally within the broad ligament to insert into the fascia of the labia majora; hold the uterus forward in its anteverted position

39

space of Retzius

located between the anterior bladder wall and the pubic symphysis; contains extraperitoneal fat

40

striations

parallel longitudinal lines commonly seen in muscle tissue when imaged sonographically; appear as hyperechoic parallel lines running in the long axis of the hypoechoic muscle tissue

41

suspensory (infundibulopelvic) ligament

paired ligaments that extend from the infundibulum of the fallopian tube and the lateral aspect of the ovary to the lateral pelvic wall; also called the infundibulopelvic ligament

42

true pelvis

pelvic cavity found below the brim of the pelvis; also called the minor or lesser pelvis

43

uterosacral ligaments

posterior portion of the cardinal ligament that extends from the cervix to the sacrum

44

vesicouterine recess (pouch)

area in the pelvic cavity between the urinary bladder and the uterus; also known as the anterior cul-de-sac