Anatomy of the Woman Quiz

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Which anatomical space is correctly described as lying between the uterus and the rectum?

A Pararectal fossa
B Vesicouterine pouch
C Broad ligament
D Rectovesical pouch
E Pouch of Douglas ✓

The answer is E: Pouch of Douglas

Explanation

Why E is correct

See Uterus. Option E is correct. The uterus lies in the pelvis behind and above the bladder and in front of the rectum. The peritoneum (the thin membrane lining the abdominal cavity) dips down into the gaps around the uterus, and the gap between the uterus and the rectum is called the rectouterine pouch, or pouch of Douglas. The gap between the bladder and the uterus is the vesicouterine pouch. The pouch of Douglas is clinically important because it is the lowest part of the peritoneal cavity in a woman standing or sitting up, so any free fluid in the peritoneum, such as pus or blood, settles there. That is why it matters in internal bleeding and in infections inside the pelvis. The exam trap is to confuse the pouch behind the uterus with the one in front of it.

Name: rectouterine pouch, also called the pouch of Douglas
Site: the peritoneal gap between the uterus and the rectum
Position: the lowest part of the peritoneal cavity in a woman standing or sitting up
Importance: free fluid such as pus or blood settles there

Why the other options are incorrect

A. Pararectal fossa: The pararectal fossae are spaces beside the rectum, on each side, and are not defined by the uterus and rectum meeting. This option would be right for a question about a space lateral to the rectum.
B. Vesicouterine pouch: The vesicouterine pouch is the potential space between the bladder and the uterus, in front of the uterus rather than behind it. This option would be right for a question about the space between the bladder and the uterus.
C. Broad ligament: The broad ligament is a sheet of peritoneum draped over the uterus, tubes and ovaries, so it is a fold of tissue and not a space between the uterus and the rectum. This option would be right for a question about the peritoneal fold that supports the uterus.
D. Rectovesical pouch: The rectovesical pouch lies between the rectum and the bladder, which happens in males. In females the uterus sits between the bladder and the rectum, so the space is divided into the vesicouterine and rectouterine pouches. This option would be right for the space between the rectum and bladder in a man.

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More questions from this set. Start the quiz to answer them and see each explanation.

1
Which group of lymph nodes most commonly receives the primary lymphatic drainage from the ovaries?
2
Which artery provides the principal blood supply to the uterus in an adult woman?

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