21: pelvis and perineum Flashcards
Where would the urethra be torn in order to have fluid accumulation in lower abdomen and around penis and scrotum?
The urethra would have been torn as it passed the perineum membrane.
What fascial continuities allowed urine to accumulate in the spaces of the lower abdomen and penis and scrotum?
Scarpas fascia (anterior abdominal wall) Membranous layer of superficial penis fascia Dartos fascia (scrotum) Colle’s fascia (perineum)
Why does urine not go into thigh?
Colle’s fascia (membranous superficial fascia of perineum) attaches to ischiopubic rami and to the perineal membrane
Why does urine not go into the anal triangle?
Scarpa’s fascia attaches to fascia lata of the thigh
What neurovascualr structures could be damaged by an abscess in the iscioanal fossa?
pudendal nerve and internal pudendal vessels; inferior rectal nerves and vessels
two anatomical landmarks for local pudendal nerve block?
ischial spine ischial tuberosity
how does a perineal abscess start?
infection within anal sinus
What are the major features of the anal canal?
anal column pectinate line anal valves anal sinus
Epithelium above pectinate line
simple columnar
Epithelium below pectinate line
Stratified squamous
Innervation above pectinate line
VA
Innervation below pectinate line
SA
Why are external hemorrhoids more painful?
They occur below pectinate line, meaning they have SA innervation.
Lymphatic drainage above pectinate line
to iliac nodes
Lymphatic drainage below pectinate line
Inguinal nodes
List the structures that are normally palpable upon male rectal exam
distended bladder
prostate
sacrum
coccyx
List the structures that are normally palpable upon female rectal exam
distended bladder
cervix
sacrum
coccyx
What is the relationship between the ureter and the common iliac artery (female)?
The Ureter courses above the common iliac artery
Whats the relationship of the ureter with the common iliac artery (male)
ureter courses over common iliac artery; also courses over the internal iliac artery
Begnign prostatic hyperplasia
The begnin enlargement of the prostate
Compresses bladder causing:
- difficulty starting stream (compresses urethra)
- frequent urination (reduced bladder volume, incomplete emptying)
What is 1 labeling?
levator ani
What is 2 labeling?
Obturator internus
Hematuria
blood in urine
Symptoms of bladder cancer
- Blood in urine (hematuria)
- can obstruct ureteral bladder orifice
- urethral obstruction
- increased urination due to incomplete bladder emptying
- difficulty in starting stream
- urethral obstruction
1
Anal column
2
pectinate line
3
anal valves
4
anal sinus
what innervates the posterior aspect of labia or scrotum?
pudendal nerve
what innervates the anteiror aspect of labia or scrotum
ilioinguinal nerve
Does the ureter pass in front of or behind the ovary?
BEHIND
What is important about the path that the pudendal nerve and vessels take?
It allows them to pass around the posteiror margin of the pelvic diaphragm without penetrating (and therefore weakening) it
