16. Pelvic Viscera Flashcards
Describe the path of the ureter
Retroperitoneal structure that crosses pelvic brim into pelvis minor (true pelvis) and enters postero-superior angle of bladder
What prevents retrograde urine flow
One-way flap valve in intramural portion of bladder wall
Describe the male urinary bladder
- located in anterior-inferior pelvis minor
- apex is anterior and base is posterior
- Neck is where it joins the urethra, neck rests on prostate gland
What is the function of the detrusor muscle
push urine out of bladder
What is the trigone
Opening in the floor of the bladder
- internal urethral orifice
- two ureteric orifices
Describe the female urinary bladder
- location anterior to vagina and cervia
- inferior to body and fundus of uterus
- vesicouterine pouch between uterus and bladder
What are the four parts of the male urethra
- Intramural portion
- Prostatic portion
- Membranous
- Spongy
What are paraurethral glands
Female version of prostate
-ducts open near external urethral orifice
What accessory sex gland produces a majority of seminal fluid
Seminal vesicles
What is the largest accessory sex gland in males
Prostate gland
What can be done to treat and diagnose BPH
Diagnose- digital rectal examine and ultrasound
Treat- drugs or surgery to increase diameter of urethra
50% of male cancer in US originates where and how does it metastisize
Prostate cancer can become metastatic and enter prostatic venous plexus or lymph nodes most commonly going to bone
What muscle maintains the 80 degree posterior-inferior flexure of the rectum
Puborectalis m.
What parts of the rectum are covered by peritoneum
upper 1/3- covered anterio and lateral surfaces
middle 1/3- covered on anterior only
lower 1/3- no covering
What are the spaces made by the vagina surrounding the uterine cervix and what space has the most clinical importance
Fornices
Two lateral, one anterior and one posterior
Posterior has most clinical applications
What are the openings of the cervix called
Internal and External OS
Describe the location of the round ligament of the uterus
Extends from side of uterus to pass through the inguinal canal and terminate in the labia majorum
Describe the location of the uterosacral ligament
Extends from side of CERVIX towards the sacrum
What are the three parts of the broad ligament
- Mesometrium attached to uterus
- Mesosalpinx attached to uterine tube
- Mesovarium attached to ovary
What is included in the suspensory ligament of the ovary
Ovarian vessels, nerves and lymphatics
Connects lateral ovary to lateral wall of pelvic cavity
What structures are below the pelvic pain line
- Distal Rectum
- Anal canal
- Uterine cervix
- Vagina
- Bladder
Where is an epidural placed
L3-L4 epidural space
If a mother chooses a pudendal nerve block what makes that different
Provides anesthesia over S2-S4 dermatomes and inferior 1/4 of vagina
Still feel pain from superior birth canal and uterine contractions
What happens when pain is felt in the abdominopelvic organs superior to the pelvic pain line
- sympathetic fibers ascend to hypogastric/aortic plexuses
- to reach inferior thoracic and upper lumbar spinal ganglia
