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S & F 4 Test 2 > Aldridge - Pelvic Viscera > Flashcards

Aldridge - Pelvic Viscera Flashcards

1
Q

What is the apex of the urinary bladder attached to ?

A

The median umbilical ligamentt

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2
Q

What does the urinary bladder rest on in males?

A

Prostate gland

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3
Q

Suprapubic catheterization to draw urine from bladder if urethral catheritization not possible due to urethral obstruction

A

Suprapubic cystostomy

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4
Q

What are represented by the corners of the trigone of the bladder?

A

Upper trigone corners are the ureter openings

Bottom is the urethra

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5
Q

A three-layered smooth muscle coat of the bladder

Stimulated by parasympathetic fibers of pelvic splanchnic nerves

A

Detrusor muscles

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6
Q

What is required for the process of micturition to occur?

A

Parasympathetic nerve stimulation which tells the detrusor muscle to contract and the internal sphincter of the bladder (sphincter vesicae) to relax)

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7
Q

_________ nerves send parasympathetic stimulation the detrusor and internal sphincter of bladder

A

Pelvic splanchnic

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8
Q

________ fibers innervate trigonal muscle and internal sphincter of bladder resulting in their contractions

A

Sympathetic

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9
Q

What is neurogenic bladder?

A

Spinal cord injury at S2-S4 resulting in dilated, flaccid bladder

(Loss of parasympathetic supply)

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10
Q

What levels are afferents of the urinary bladder arising from ?

A

S2-S4 thru pelvic splanchnic nerves

L1 L2 thru lumbar nerves

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11
Q

Referred pain of the bladder goes where?

A

To the tip of the penis, also thru S2-S4 nerves

The hypogastric region of the anterior abdominal wall (L1)

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12
Q

What vertebral level does the rectum arise at?

A

S3

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13
Q

The anorectal junction is located at _______

A

The pelvic diaphragm

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14
Q

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

A

Rectovesical pouch

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15
Q

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

A

Rectouterine pouch (of douglas)

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16
Q

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

A

Rectal prolapse

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17
Q

Outgrowth of ductus deferens

Secretes nutrient rich fluid for semen

Joins ductus deferens to form ejaculatory duct

A

Seminal vesicle

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18
Q

What is the widest and most dilatable part of the urethra?

A

The prostatic part

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19
Q

How does the ductus deferens enter the pelvis?

A

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.

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20
Q

What is significant of the prostatic secretions?

A

They are alkaline to help neutralize the acidic vagina

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21
Q

The prostatic venous plexus is valveless and drains into the internal iliac vein and communicates with ______

A

The internal and external vertebral venous plexus. Highway for metastases of prostatic carcinoma. `

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22
Q

What is the path of metastases from the prostate to the spinal cord?

A

Prostatic venous plexus

Vesical venous plexus

Internal iliac vein

Lateral sacral vein

Internal vertebral venous plexus (to vertebral column)

Radicular veins (to spinal cord)

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23
Q

The involuntary discharge of semen

Dependent on sympathetic innervation (from spinal level L1) of ductus deferens, seminal vesicle and prostate gland

A

Emission

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24
Q

What does sympathetic innervation (from spinal level L1) do to cause emission? (3 steps)

A

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

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25
Q

Abnormal position of the uterus

Long axis of cervix is approximately in line vertically w/ the long axis of vagina

A

Retroverted uterus

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26
Q

Abnormal position of the uterus

Body of uterus is bent posteriorly

Lies in the rectouterine pouch

A

Retroflexed uterus

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27
Q

Angle between cervix and vagina

A

Anteversion

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28
Q

Angle between body and cervix of uterus

A

Anteflexion

29
Q

Two layered lateral reflection of the peritoneum from the uterus to the lateral pelvic wall

A

Broad ligament of the uterus

30
Q

Contents of the broad ligament of the uterus (x4)

A

Uterine tube

Round ligament of uterus

Round ligament of ovary

Uterine artery and vein

31
Q

The majority of the blood in erection goes to the ____

A

Corpus cavernosum

32
Q

Primary erectile tissue. Located dorsally. 2 of them.

A

Corpus cavernosum

33
Q

The deep penile artery runs into the _-______

A

Corpus cavernosum

34
Q

What is the course of the dorsal artery of the penis?

A

Internal iliac -> anterior division -> internal pudendal artery —> dorsal artery of penis -> skin of penis, fascial sheath surrounding erectile tissues

Anastamoses w/ artery of bulb of penis at glans penis

35
Q

Where does the deep dorsal vein of penis drain to?

A

The prostatic venous plexus and or the vesical venous plexus

36
Q

Skin of penis lymph drains to ____

A

Superficial inguinal nodes

37
Q

The deep structures of penis lymph drains to

A

Internal iliac nodes

38
Q

Primary erectile tissue

A

Corpus cavernosum

39
Q

The root of the penis is in the _______

A

Superficial pouch

40
Q

The ductus deferens _________ the ureter

A

Crosses over

41
Q

The bladder is attached to the anterior abdominal wall by the _____

A

Median umbilical ligament

42
Q

The internal urethral sphincter is a continuation of -___

A

The detrusor muscle

43
Q

Above the pelvic pain line, visceral pain afferents follow ______ back to CNS

A

Sympathetics

44
Q

Below the pelvic pain line, visceral afferents follow ________ back to CNS

A

Parasympathetics

45
Q

Lowest level of the peritoneum in females

A

Rectouterine pouch

46
Q

Wall that separates the vaginal and the rectum

A

Retrovaginal septum

47
Q

The seminal vesicle is formed embryologically as a lateral outgrowth of ______

A

Ductus deferens

48
Q

BPH at the median lobe of the prostates causes :

A

Nocturia

49
Q

BPH in the right and left lobe of the prostate can cause?

A

Compression of the urethra

50
Q

A groove on each side of the urethral crest in the prostatic urethra that receives 20-30 prostatic ducts

A

Prostatic sinus

51
Q

What are the 4 parts of the broad ligament of the uuterus?

A

Mesometrium

Mesovarium

Mesosalpinx

Suspensory ligament of ovary

52
Q

Uterine artery is _______ to ureter

A

Superior

53
Q

What are the CONTENTS of the broad ligament. (Different questions from ‘parts’)

X4

A

Uterine tube

Round ligament of uterus

Round ligament of ovary

Uterine artery and vein

54
Q

This is a remnant of the distal gubernaculum found in the broad ligament of uterus. Attaches to the lateral side of the uterus inferior to the uterine tube and then goes thru the inguinal canal to the labia majora.

A

Round ligament of uterus

55
Q

The round ligament of the ovary is a remnant of the ________ gubernaculum

A

Proximal

56
Q

Lymphatics from the fundus of the uterus go where?

A

They follow the ovarian vessels to the lumbar lymph nodes

57
Q

Lymphatics from body and cervix of uterus go where?

A

Iliac lymph nodes

58
Q

Fertilization usually takes place in the _____ of the uterine tube

A

Ampulla

59
Q

What are the superior and posterior borders of the ovarian fossa?

A

Ovarian fossa is on lateral wall of pelvis
\

Superior: external iliac vessels

Posterior: internal iliac vessels and ureter

60
Q

Ovarian arteries arise from aorta at vertebral level ____

A

L2

61
Q

Describe the course of the ovarian artery

A

Arises from the aorta at L2. Descends on posterior abdominal wall to the pelvic brim, crosses over the external iliac vessels and enters the suspensory ligament of the ovary.. enters mesovarium to supply ovary and sends branches medially to supply uterine tube.. anastamoses with the uterine tube

62
Q

Ovarian veins drain to _____ on right and _____ on left

A

Inferior vena cava

Left renal vein

63
Q

Lymphatics from the ovary join from those from the fundus of the uterus and uterine tubes to ascend to:

A

Lumbar lymph nodes

64
Q

The inerior end of the vagina is orginally covered by a fold of mucous membrane called ____

A

The hymen

65
Q

Part of vaginal lumen which surrounds cervix

Divided into four regions

A

Fornix of vagina

66
Q

What is culdocentesis?

A

The aspiration of fluid from the rectouterine pouch by puncture of the posterior vaginal wall

67
Q

Bladder bulges again anterior wall of vagina

A

Cystocele

68
Q

Rectum bulges agains posterior wall of vagina

A

Rectocele

69
Q

Cystitis is more common in females because?

A

Female urethra is shorter

S & F 4 Test 2 (15 decks)

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