Aldridge - Pelvic Viscera Flashcards
What is the apex of the urinary bladder attached to ?
The median umbilical ligamentt
What does the urinary bladder rest on in males?
Prostate gland
Suprapubic catheterization to draw urine from bladder if urethral catheritization not possible due to urethral obstruction
Suprapubic cystostomy
What are represented by the corners of the trigone of the bladder?
Upper trigone corners are the ureter openings
Bottom is the urethra
A three-layered smooth muscle coat of the bladder
Stimulated by parasympathetic fibers of pelvic splanchnic nerves
Detrusor muscles
What is required for the process of micturition to occur?
Parasympathetic nerve stimulation which tells the detrusor muscle to contract and the internal sphincter of the bladder (sphincter vesicae) to relax)
_________ nerves send parasympathetic stimulation the detrusor and internal sphincter of bladder
Pelvic splanchnic
________ fibers innervate trigonal muscle and internal sphincter of bladder resulting in their contractions
Sympathetic
What is neurogenic bladder?
Spinal cord injury at S2-S4 resulting in dilated, flaccid bladder
(Loss of parasympathetic supply)
What levels are afferents of the urinary bladder arising from ?
S2-S4 thru pelvic splanchnic nerves
L1 L2 thru lumbar nerves
Referred pain of the bladder goes where?
To the tip of the penis, also thru S2-S4 nerves
The hypogastric region of the anterior abdominal wall (L1)
What vertebral level does the rectum arise at?
S3
The anorectal junction is located at _______
The pelvic diaphragm
Lowest part of male peritoneal cavity
Formed by reflection of peritoneum from rectum to superior-posterior surface of the bladder
Peritoneal exudates (from peritonitis) will drain to here when patient is sitting or supine. This can cause peritoneal tenderness
Rectovesical pouch
Lowest point in female peritoneal cavity
Formed by reflection of peritoneum from rectum to posterior vagina and uterus
Peritoneal exudates from peritonitis or blood from ectopic pregnancy rupture will drain here if pt is sitting or supine.. this will cause peritoneal tenderness
Rectouterine pouch (of douglas)
Abnormal descent of rectum thru anal canal
Can occur in young children since sacrum is not curved as in adult
Can occur if not enough support from puborectalis muscle of levator ani
Rectal prolapse
Outgrowth of ductus deferens
Secretes nutrient rich fluid for semen
Joins ductus deferens to form ejaculatory duct
Seminal vesicle
What is the widest and most dilatable part of the urethra?
The prostatic part
How does the ductus deferens enter the pelvis?
By crossing over the external iliac artery then crosses over the ureter at the posterolateral angle of bladder and descends to posterior surface of bladder.
What is significant of the prostatic secretions?
They are alkaline to help neutralize the acidic vagina
The prostatic venous plexus is valveless and drains into the internal iliac vein and communicates with ______
The internal and external vertebral venous plexus. Highway for metastases of prostatic carcinoma. `
What is the path of metastases from the prostate to the spinal cord?
Prostatic venous plexus
Vesical venous plexus
Internal iliac vein
Lateral sacral vein
Internal vertebral venous plexus (to vertebral column)
Radicular veins (to spinal cord)
The involuntary discharge of semen
Dependent on sympathetic innervation (from spinal level L1) of ductus deferens, seminal vesicle and prostate gland
Emission
What does sympathetic innervation (from spinal level L1) do to cause emission? (3 steps)
Smooth muscle of ductus deferens contracts to propel sperm toward prostatic urethra
Glands of prostate gland and seminal vesicles release secretions
Internal sphincter of bladder contracts to prevent reflux of semen into urinary bladder
