6. Midline structures of the pelvis Flashcards
what wall does the ureter run down to reach the pelvis?
posterior abdominal wall
F: what does the ureter run posterior to, to enter the bladder?
uterus
F: Name of pouch between uterus and rectum
rectouterine pouch
F: Name of pouch between uterus and bladder
vesicouterine pouch
F: another name for rectouterine pouch
pouch of douglas
bone posterior to rectum
coccyx
bone anterior to bladder
pubic symphysis
what do the peritoneal pouches collect?
free fluid and pus
which pouch is most likely to collect more pus and fluid
rectouterine pouch
where is the detrusor muscle?
apex of bladder
where is the fundus of the bladder?
superior surface
where is the base of the bladder?
posterior surface
function of detrusor muscle?
contracts to expel urine
where do the ureters enter the bladder?
at the supralateral corners of the bladder
name of smooth muscle area in the bladder
trigone
does the trigone contract or relax? and why
relax to allow urine to escaepe the bladder
through what hole does urine leave the bladder?
urethral opening
name of ridges/elevations on the inside of the bladder wall
rugae
function of rugae
increase SA of bladder when it fills with urine
3 areas of the uterus
fundus, body, cervix
what does the cervix extend into
vagina
name of opening of the vagina into the cervix
external os
name the 4 fornices in the vagina
- right lateral
- left lateral
- posterior
- anterior
name 3 sections of uterine tube from medial to lateral
isthmus, ampulla, infundibulum
name of projections at the end of the uterine tubes
fimbrae
which reproductive organ does the fimbrae sit next to
ovary
name of structure which is an extension of the peritoneum which drapes over the uterus
broad ligaments
name the 3 ligaments which lie within the broad ligament
- suspensory ligament
- ovarian ligament
- round ligament
where does the ovarian ligament run to and from
uterus to ovary
where does the suspensory ligament run to and from
ovary to pelvic wall
what 2 vessels does the suspensory ligament contain
ovarian artery and ovarian vein
where is the round ligament?
inferior section of the broad ligament
which 2 abdominal muscles protude into the pelvis
psoas major
iliacus
where does the rectum start from?
S3
M: gland inferior to the bladder
prostate gland
what structure runs through the prostate gland?
urethra
what vessel transports sperm from the testes to the base of the penis>
vas deferens
name of gland posterior to the vas deferens
seminal vesicle
what does the seminal vesicle produce
semen
name of duct inbetween vas deferens and seminal vesicle
ejaculatory duct
where does the ejaculatory duct run into (2)
prostate and prostatic urethra
M: name of peritoneal pouch inbetween rectum and bladder?
rectovesical pouch
name of folds in the rectum
rectal folds
how many rectal folds on the LHS?
2
how many rectal folds on the RHS?
1
function of rectal folds
prevent faeces from passing out of the rectum
what does the rectum lead into?
anus
name of junction between the anus and rectum
anurectal junction
where is the urethral crest located?
in the prostate gland
which part of the vas deferens joins with the seminal vesciles to form the ejaculatory duct?
ampulla
name of covering on the ovary
mesoovarium
What is the rectum a direct continuation of>?
sigmoid colon
what type of membrane is the peritoneum?
serous
which part of the urethra runs through the prostate gland?
prostatic urethra
which glands lie near the ejaculatory ducts?
bulbourethral gland
which part of the urethra lies within the penis?
membranous urethra
name the 2 membranes around the prostate gland
- fibrous capsule
2. sheath derived from pelvic fascia
what lies between the 2 surrounding membranes of the prostate gland?
prostatic venous plexus
In a normal prostate, what is palpable posteriorly?
midline sulcus
what procedure can be done to approach the prostate without surgically opening the peritoneal cavity?
transurethral resection of the prostate
how can prostate cancer be spread to the vertebral column?
vertebral venous system
glands which lie between the posterior wall of the bladder and the rectum in males?
seminal vesicles
where do the vas deferens originate?
epididymis
how do the vas deferens gain access to the abdomen?
inguinal canal
Name of the final part of the vas deferens?
ampulla
what do the seminal vesicles secrete - component of semen?
alkaline fructose
4 components of sperm
- sperm cells
- alkaline fructose
- pre-ejaculate
- PSA
what occurs in a vasectomy?
peice of vas deferens is removed in order to steralise
which part of the vas deferens is cut during a vasectomy?
the initial part - at the epididymis
where is the internal os?
in the body of the uterus
3 layers of the uterine wall (deep to superficial)
- endometrium
- myometrium
- epimetrium
where is the epimetrium derived from?
peritoneum
what type of tissue is the myometrium?
smooth muscle
which layer of the uteral wall thickens and is shed?
endometrium
Name the normal position of the uterus (2)
anteverted and anteflexed
which 2 ligaments support the uterus within the pelvis?
- broad ligament
2. round ligament
what can repeated childbirth cause?
weakening of ligaments - uterine drops
what are fibroids?
benign tumours in the myometrium
where in relation to the broad ligament is the uterine tube?
superior
what does ‘water under the bridge’ mean?
ureter is under the uterine artery
what is the round ligament an embryological structure of?
gubernaculum
role of gubernaculum in male foetus?
draws testes through the inguinal canal
where does the round ligament start from and where does it travel?
- uterine horns
- labia majora
- inguinal canal
where in the uterine tube does fertilisation occur?
ampulla
what is an ectopic pregnancy?
when the egg implants in the uterine tubes instead of the uterus
Sterilisation process in women
hysterectomy
what happens during ovulation?
egg is released from ovary
where do ovarian arteries orginate?
abdominal aorta L2
where do the ovarian veins drain into?
R; IVC
L; Left renal vein
what do ovarian arteries anastomose with?
uterine arteries
why is a uterine artery embolisation carried out?
to block the blood supply to fibroids
issues during uterine artery embolisation
the ovarian arteries supply the fibroids
which nerve lies adjacent to the ovary on the lateral wall of the pelvis?
obturator nerve
what muscles does the obturator nerve supply?
thigh muscles
what can thigh pain be an indication of?
ovarian tumour
which part of the peritoneal cavity is the posterior fornix closely related to? and why is this clinically significant?
rectouterine pouch - can drain pus/fluid transvaginally
issue when implanting IUD/coil in to the uterus via the vagina
the device may enter the peritoneal cavity through the posterior fornix
what is the lymphatic drainage of the vagina and uterus?
superficial inguinal lymph nodes
what does the internal iliac artery divide into?
inferior gluteal artery
what region of the GI tract is supplied by the inferior rectal artery?
lower half of the anal canal and anus
