16. Pelvic Viscera

Question 1

Describe the path of the ureter

Answer 1

Retroperitoneal structure that crosses pelvic brim into pelvis minor (true pelvis) and enters postero-superior angle of bladder

Question 2

What prevents retrograde urine flow

Answer 2

One-way flap valve in intramural portion of bladder wall

Question 3

Describe the male urinary bladder

Answer 3

• 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

Question 4

What is the function of the detrusor muscle

Answer 4

push urine out of bladder

Question 5

What is the trigone

Answer 5

Opening in the floor of the bladder

• internal urethral orifice
• two ureteric orifices

Question 6

Describe the female urinary bladder

Answer 6

• location anterior to vagina and cervia
• inferior to body and fundus of uterus
• vesicouterine pouch between uterus and bladder

Question 7

What are the four parts of the male urethra

Answer 7

1. Intramural portion
2. Prostatic portion
3. Membranous
4. Spongy

Question 8

What are paraurethral glands

Answer 8

Female version of prostate

-ducts open near external urethral orifice

Question 9

What accessory sex gland produces a majority of seminal fluid

Answer 9

Seminal vesicles

Question 10

What is the largest accessory sex gland in males

Answer 10

Prostate gland

Question 11

What can be done to treat and diagnose BPH

Answer 11

Diagnose- digital rectal examine and ultrasound

Treat- drugs or surgery to increase diameter of urethra

Question 12

50% of male cancer in US originates where and how does it metastisize

Answer 12

Prostate cancer can become metastatic and enter prostatic venous plexus or lymph nodes most commonly going to bone

Question 13

What muscle maintains the 80 degree posterior-inferior flexure of the rectum

Answer 13

Puborectalis m.

Question 14

What parts of the rectum are covered by peritoneum

Answer 14

upper 1/3- covered anterio and lateral surfaces
middle 1/3- covered on anterior only
lower 1/3- no covering

Question 15

What are the spaces made by the vagina surrounding the uterine cervix and what space has the most clinical importance

Answer 15

Fornices
Two lateral, one anterior and one posterior

Posterior has most clinical applications

Question 16

What are the openings of the cervix called

Answer 16

Internal and External OS

Question 17

Describe the location of the round ligament of the uterus

Answer 17

Extends from side of uterus to pass through the inguinal canal and terminate in the labia majorum

Question 18

Describe the location of the uterosacral ligament

Answer 18

Extends from side of CERVIX towards the sacrum

Question 19

What are the three parts of the broad ligament

Answer 19

• Mesometrium attached to uterus
• Mesosalpinx attached to uterine tube
• Mesovarium attached to ovary

Question 20

What is included in the suspensory ligament of the ovary

Answer 20

Ovarian vessels, nerves and lymphatics

Connects lateral ovary to lateral wall of pelvic cavity

Question 21

What structures are below the pelvic pain line

Answer 21

• Distal Rectum
• Anal canal
• Uterine cervix
• Vagina
• Bladder

Question 22

Where is an epidural placed

Answer 22

L3-L4 epidural space

Question 23

If a mother chooses a pudendal nerve block what makes that different

Answer 23

Provides anesthesia over S2-S4 dermatomes and inferior 1/4 of vagina

Still feel pain from superior birth canal and uterine contractions

Question 24

What happens when pain is felt in the abdominopelvic organs superior to the pelvic pain line

Answer 24

• sympathetic fibers ascend to hypogastric/aortic plexuses

- to reach inferior thoracic and upper lumbar spinal ganglia