Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

*GIGU I > 31/32. Pelvic Viscera > Flashcards

31/32. Pelvic Viscera Flashcards

1
Q

The parietal peritoneum does not reach the pelvic floor — what is the lowest point in males?

A

Rectovesical pouch — about 2 cm above the seminal vesicles

[abdominal fluid collects here; abscesses are likely to form here]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Pelvic peritoneum in males descends anterior abdominal wall, with a loose attachment here for insertion of the bladder as it fills. The peritoneum reflects onto the superior surface of the bladder, creating the ________ ______.

Pelvic peritoneum covers the convex superior surface of the bladder and slopes down the sides of roof to ascend lateral wall of pelvis, creating a _____ _____ on each side. It descends th eposterior surface of the bladder as much as 2 cm

A

Supravesical fossa

Paravesical fossa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

The pelvic peritoneum in males — laterally forms folds over what 3 structures?

A

Ureters (ureteric fold)
Ductus deferens
Superior ends of seminal glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

The pelvic peritoneum reflects from the bladder and seminal glands onto the rectum, forming the _____ _____, which extends laterally and posteriorly to form a _______ _____ on each side of the rectum

A

Rectovesical pouch; pararectal fossa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

The pelvic peritoneum ascends the rectum from inferior to superior, so the rectum is initially subperitoneal, and then __________

It engulfs the sigmoid colon beginning at the ________ junction

A

Retroperitoneal; rectosigmoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the named space in males between the pubis and bladder?

A

Retropubic space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the named space in males between the rectum and the sacrum?

A

Retrorectal (presacral) space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the named space in males between the bladder and rectum?

A

Rectovesical pouch/fossa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

The levator ani and associated musculature supporting the pelvic floor is weak; what is the named CT assisting in this support?

A

Endopelvic fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

The endopelvic fascia exists beneath the peritoneum and covers viscera, pelvic wall, and floor; it is continuous with _____ ______

A

Endoabdominal fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

The endopelvic fascia is thickened in certain areas, particularly the tendinous arch of the ____ ____ musculature

A

Levator ani

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

The endopelvic fascia forms the _______ ligament in males

It forms the ________ and _______ ligaments in females

A

Puboprostatic

Pubovesical; pubocervical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

The endopelvic fascia forms the lateral ligament of the ____ and _____

A

Bladder; rectum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

The endopelvic fascia forms the ______ ligament which supports the cervix in females

A

Cardinal (transverse cervical)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

The endopelvic fascia forms the _______ in females, which is the thickened fascia from lateral vagina to tendinous arch of levator ani

A

Paracolpium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

In terms of anatomic relationships, the ureter travels _____ the vas deferens

The bladder is _____ to the prostate

The seminal vesicles lie on the _____ surface of the bladder

The bulbourethral gland is located ______ the UG membrane

A

Under

Superior

Posterior

Within

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Where is the prostate located in reference to the bladder and the UG membrane?

A

The prostate is immediately below the bladder but superior to the UG membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

The ureters connect the kidneys to the urinary bladder and are retroperitoneal; they pass over the pelvic brim and enter the ______ pelvis. The ureters pass obliquely through the urinary bladder wall in a ________ direction.

A

Lesser; inferomedial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

In males, the ureters run inferior to the ______ ______; in females, they run inferior to the ______ ______

A

Vas deferens; uterine artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

The ureters receive blood supply from multiple arteries — what are the 4 main branches?

A

Renal, gonadal, aortic, and internal iliac branches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What nerves supply the ureters?

A

Preaortic plexus
Hypogastric plexus
Pelvic splanchnics (parasympathetics S2-4)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How is the bladder oriented in terms of apex, fundus, body, and neck?

A

The apex points toward the pubic symphysis, the fundus just the opposite

The body lies between the apex and fundus, and the neck lies at the bottom

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What ligament connects the apex of the bladder to the internal umbilical region? What is the obliterated embryological structure?

A

Median umbilical ligament (obliterated urachus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Besides the median umbilical ligament anteriorly, what other ligaments support the bladder?

A

Lateral ligament (endopelvic fascia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

The superior surface of the bladder is triangular and bounded by a line connecting the _______

A

Ureters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

T/F: the bladder typically rises above the pelvic brim

A

False; the bladder only rises above the pelvic brim when full — if it is empty it does not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

________ muscle lines the bladder walls and is continuous with the ____ _____ sphincter, as well as the _______ sphincters

A

Detrusor; internal urethral; ureteric

[detrusor m. is visceral smooth m.]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the purpose of the sensory receptors in the bladder wall and posterior urethra?

A

They sense stretch when the bladder fills with urine, and play a role in the micturition reflex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

The internal urethral sphincter in males is made up of ________ fibers and is continuous with smooth muscle called the ______ m.

A

Circular; detrusor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

The external urethral sphincter in males is made up of skeletal fibers that are deficient in the _____ region of the urethra. It is located primarily at the level of the _______ urethra in males, but extends superiorly around the _____ urethra

A

Posterior; membranous; prostatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What innervates the internal urethral sphincter?

A

Inferior hypogastric plexus (mixed autonomic supply)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What innervates the external urethral sphincter?

A

Deep perineal branch of pudendal n. (Somatic innervation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the 4 named parts of the male urethra (from bladder to external)

A

Intramural
Prostatic
Membranous
Spongy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

The _____ ______ is simply a posterior ridge on the urethra as it passes through the prostate.

The ____ ______ is an enlarged area on the above structure onto which the 2 ejaculatory ducts open, bringing sperm from the ____ _____ and fluid from the ____ ____

A

Urethral crest

Seminal colliculus; vas deferens; seminal vesicle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

The ____ ____ is a remnant of the paramesonephric system associated with the prostate gland

The ____ ____ are depressions on either side of the ridge into which prostatic glands open and secrete an alkaline prostatic fluid

A

Prostatic utricle

Prostatic sinuses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

The prostatic urethra is surrounded by the walnut-size prostate, which is made up of 2/3 ______, 1/3 _______ tissue. The base is closely related to the neck of the _______.

A

Gland; fibromuscular; bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

The apex of the prostate is in contact with fascia on the superior aspect of the ______ sphincter and deep _____ muscles. Prostatic ducts open chiefly into the ____ ____

A

Urethral; perineal; prostatic sinuses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is the largest male reproductive accessory organ?

A

Prostate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What benign condition is common in males after middle age, in which urination may be impeded by distortion of the prostatic urethra?

A

Hypertrophy of prostate

40
Q

BPH is a common cause of what conditions?

A 
Urethral obstruction
Nocturia
Dysruia
Urinary urgency
Cystitis
Kidney damage
41
Q

How are prostatic enlargements or tumors commonly diagnosed?

A

Digital rectal exam — abnormal finding is hard and irregular shape, indicating malignancy

42
Q

The vas deferens enters the abdomen via the ______ inguinal ring. It passes superior to all structures, including the ureters and iliac vessels. It passes superiorly and medially to the ureter, expanding into an _______ before narrowing again and joining the duct of the ___ ____

A

Deep; ampulla; seminal vesicle

43
Q

_______ ______ are bilateral, lobulated sacs lying lateral to the ampulla of the vas deferens. Their ducts and the vas deferens join on each side to form an _____ ______

A

Seminal vesicles; ejaculatory duct

44
Q

What is the vascular supply to the seminal vesicles?

A

Umbilical aa.

Inferior vesicular aa.

45
Q

Which region of the prostate do the ducts of the seminal vesicle join the vas deferens to form the ejaculatory ducts?

A

Posterior/inferomedial region

46
Q

What supplies sympathetic innervation to the male reproductive organs in general?

A

Inferior hypogastric plexus T10-L2 via similar routes as bladder

47
Q

What supplies parasympathetic innervation to the male reproductive organs in general?

A

Pelvic splanchnic nn.

48
Q

Most visceral afferent fibers supplying the male reproductive organs travel with __________ fibers ___-___

A

Parasympathetic; S2-S4

49
Q

Most visceral afferent fibers supplying the male reproductive organs travel with parasympathetic fibers S2-S4. Which organs are the exception to this?

A

Testis — for which the visceral afferents travel with sympathetics to T10 (d/t their embryological development higher in abdominal cavity)

50
Q

Most lymphatic drainage from the vas deferens and inferior portion of the seminal vesicles is to the ____ ____ nodes; with the scrotal portion of the vas deferens draining into the ____ ____nodes

A

Internal iliac; external iliac

51
Q

The prostate drains lymph chiefly in the ___ ____ nodes with some to the _______ nodes

A

Internal iliac; sacral

52
Q

The superiolateral portion of the bladder drains lymph to the ____ nodes

The fundus and neck of the bladder drain to the _____ nodes

A

External iliac

Internal iliac

53
Q

What pelvic viscera is associated with the pelvic cavity in females?

A

Bladder
Uterus and ovaries
Uterine tubes
Vagina

54
Q

What 3 folds in the female pelvic cavity are comprised of 2 layers of peritoneum?

A

Rectouterine fold
Suspensory ligament of ovary
Broad ligament

55
Q

What 2 pouches exist in the female pelvic cavity and are continuous with the abdominopelvic cavity?

A 
Vesicouterine pouch
Rectouterine pouch (culdesac of douglas)
56
Q

What 3 spaces are associated with the female pelvic cavity?

A

Retropubic (prevesical) space
Retrovesical space
Retrorectal (presacral) space

57
Q

The rectouterine and vesicouterine pouches in females are separated by the _______ ligament and the uterus.

A

Round

58
Q

The _______ pouch can be surgically approached through the posterior fornix of the vagina

Note that the lateral extensions, which make up the _____ ____, can be the deepest.

Recesses lateral to the bladder are referred to as ________ ______, which get deeper as the bladder fills

A

Rectouterine

Pararectal fossa

Paravesical fossa

59
Q

What structures are contained within the broad ligament in females?

A 
Ovarian vessels (within the suspensory ligament itself)
Uterine tube
Ovary
Uterus
Proper ovarian ligament
60
Q

What structures lie in the base of the broad ligament in females?

A

Uterine artery and vein

Ureter

61
Q

What are the 3 named parts of the broad ligament in females?

A

Mesovarium - between ovary and round ligament of uterus

Mesosalpinx - between the uterine tube and round ligament of uterus

Mesometrium - going to the uterus

62
Q

Underneath the broad ligament is the ______ ______, which thickens in a certain area becoming the ______ ligament — which runs right below the uterine artery

A

Endopelvic fascia; cardinal

63
Q

The female endopelvic fascia is sometimes collectively referred to as the _____ ______. It supports the viscera and conducts neurovasculature to organs.

A

Hypogastric sheath

64
Q

What provides the main support for the uterus?

A

The cardinal ligament (aka the transverse cervical ligament)

65
Q

What ligament is found within the rectouterine fold?

A

Uterosacral ligament

66
Q

Although the cardinal ligament provides the MAIN support for the uterus, what other 3 ligaments are involved in supporting this organ?

A

Round ligament
Pubocervical ligament
Uterosacral ligament

67
Q

What blood vessels are found in the pubocervical ligament?

A

Superior vesicular artery and vein

68
Q

What vessels are found in the uterosacral ligament?

A

Middle rectal artery and vein

69
Q

The uterus is commonly divided into what 3 parts?

A

Fundus
Body
Cervix

70
Q

The ____ of the uterus protrudes into the vagina, forming the vaginal ________, as well as the internal and external os

A

Cervix; fornices

71
Q

The major changes that occur in the uterus during the menstrual cycle are primarily in the ______

A

Endometrium

72
Q

What are the 3 layers of the uterine wall?

A

Perimetrium
Myometrium
Endometrium

73
Q

When referring to uterine position, _______ refers to the angle between the cervix and vagina, and ______ refers to the angle between the uterine body and cervix.

The 2 normal positions of the uterus using the terms above are _____ and ______

A

Verted; flex

Anteverted; anteflexed

74
Q

A retroverted uterus is usually genetic — but can be caused by what other conditions?

A

Fibroids
Endometriosis
PID
Labor

75
Q

A retroverted uterus does not have an effect on fertility, but can be associated with what symptoms?

A

LBP
Dysuria
Dysparunia

76
Q

Although uncommon, pregnant retroflexed uterus can be trapped by the curve of the ____

A

Sacrum

77
Q

What condition concerning the uterus can occur when pelvic ligaments (especially the cardinal ligament) OR pelvic diaphragm weakens/tears?

A

Uterine prolapse — can be first, second, or third degree

78
Q

What is the main cause of pelvic organ prolapse in females? What are some other causes?

A

Pregnancy

Other causes include aging, menopause, and obesity

79
Q

What are the 3 histological layers of the uterine tubes?

A

Mucosa
Muscularis
Serosa

80
Q

The uterine tubes lie in the free edge of the _____ ligament and function to carry ova to the uterine cavity; assisted by motile _____ within the tube

The _____ layer folds change during menstruation, though not as dramatically

A

Broad; cilia

Mucosal

81
Q

What are the named regions of the uterine tubes? Where in the tube does fertilization typically occur?

A

Fimbria
Infundibulum
Ampulla (fertilization site)
Isthmus

82
Q

The ovaries lie on the lateral walls of the female pelvis. They are covered laterally by what structures?

A

Fimbrae of the uterine tubes

83
Q

What are the anterior, lateral, and medial attachments of the ovaries?

A

Anteriorly to broad ligament via mesovarium

Laterally to suspensory ligament

Medially to proper ovarian ligament

84
Q

The _______ is the recess between the cervix and vaginal wall

A

Fornix

85
Q

The opening to the vaginal vestibule can be partially closed by a membranous ______, which may be imperforate in 1:1000

A

Hymen

86
Q

The female urethra is adjacent to the _______ wall of the vagina. It penetrates the _____ membrane and opens anterior to the vaginal vestibule

A

Anterior; urogenital

87
Q

The female urethral sphincters differ from males in what ways?

A

The sphincter proximity and length differs — in females they are arranged superficial -> deep instead of proximal/distal

88
Q

Which urethral sphincter aids in reflex closure of the urethra during acute instances of increased intra-abdominal pressure d/t coughing, sneezing, laughing, etc.?

A

EUS

89
Q

In which part of the EUS is striated muscle length and thickness lost with age?

A

Proximal EUS

90
Q

Pelvic floor exercises can increase the size of what urethral sphincter?

A

External

91
Q

In the female pelvic viscera, most lymph drains to the __________ nodes

However there are exceptions:
The round ligament, fundus (+ external genitalia) drain to _____ nodes. The ovary, uterine tube, and fundus drain to _____ nodes

A

Iliac

Superficial inguinal; lumbar

92
Q

What provides primary efferent innervation to female internal viscera?

A

Inferior hypogastric plexus

93
Q

The ovarian plexus is composed of parasympathetics from _____ n. and sympathetics from _____

A

vagus; T10/11

94
Q

What imaginary line is considered the inferior limit of the peritoneum?

A

Pelvic pain line

95
Q

What provides general visceral afferents above the pelvic pain line?

A

Sympathetic to T12-L2

Includes structures within the broad ligament (body and fundus of uterus)

96
Q

What provides general visceral afferents below the pelvic pain line?

A

Parasympathetics to pelvic (S2-4)

97
Q

Anesthesia specifically targets pelvic pain line differences. What are the 3 types of nerve blocks utilized?

A

Spinal block or lumbar puncture — blocks from waist down (intra and sub-peritoneal plus somatic areas)

Caudal block — blocks sub-peritoneal and somatic areas innervated by pudendal n.

Pudendal nerve block — blocks areas innervated by the pudendal nerve

*GIGU I (67 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions