Anatomy Flashcards
What separates the pelvic cavity from the perineum?
The pelvic floor
What components of the female reproductive system are found in the pelvic cavity?
Ovaries
Uterine tubes
Uterus
Superior aspect of the vagina
What components of the female reproductive system are found in the perineum?
Inferior aspect of the vagina Perineal muscles Bartholin's glands Clitoris Labia
What are the only primary organs of the female reproductive system?
The ovaries
What forms the floor of the peritoneal cavity, and also the roof of the pelvic cavity?
Parietal peritoneum
In females, where does fluid collect in the peritoneal cavity?
Pouch of Douglas (when in the anatomical position).
How many peritoneal pouches exist in females?
2
Rectouterine pouch
Uterovesical pouch
What is the only peritoneal pouch found in males?
Rectovesical pouch
What is the name of the procedure through which fluid in the pouch of Douglas is collected?
Culdocentesis
The double layer of parietal peritoneum found anterior and posterior to the uterine tubes is called what?
Broad ligament
What is the role of the broad ligament?
To maintain the uterus in a midline position.
What is the round ligament?
An embryological remnant that attaches to the uterine horns (found laterally).
What are the 3 layers of the uterus?
Perimetrium
Myometrium
Endometrium
Implantation of a zygote outwith the uterus is referred to as what?
Ectopic pregnancy
What is the most common position observed for the uterus?
Anteverted and anteflexed.
What 3 components support the uterus position?
Strong ligaments
Endopelvic fascia
Muscles of the pelvic fascia
Weakness of the uterine support may lead to what?
Uterine prolapse
What change occurs at the transformation zone of the cervix?
Squamous epithelium changes to columnar epithelium.
This is a squamo-columnar junction.
What is the opening of the uterine tube at the ovary called?
The osteum
This is where the egg enters the tube.
What is the role of the fimbriae?
As the osteum is also open to the peritoneal cavity, the fimbriae are present in order to ensure the egg enters the uterine tube.
Where does fertilisation occur?
Ampulla (this is the middle of the uterine tube).
Radio-opaque dye can be passed through the uterine tubes, if it is observed to reach the peritoneal cavity, what can be assumed?
Uterine tubes are patent.
What is the function of the ovary?
To secrete oestrogen and progesterone in response to the anterior pituitary hormones.
Releases ova.
How many fornices exist?
4
Drainage of the pouch of Douglas can be achieved through which fornix?
Posterior fornix
Which nerves supply the levator ani muscles?
Nerve to levator ani (S3, S4 and S5) Pudendal nerve (S2, S3 and S4)
What forms the floor of the pelvic cavity and the roof of the perineum?
Levator ani
Which nerve supplies the most of the perineum?
Pudendal nerve
What is the perineal body?
A bundle collagen and elastic tissue where all perineal muscle fibres attach.
What is the female erectile tissue?
Bartholin’s glands
These secrete a lubricating fluid.
What is found between the breast tissue and deep fascia?
Retromammary space
What is the role of the retromammary space?
To allow the breast tissue to move relative to the underlying muscle.
What is the functional unit of the breast?
Terminal ductal lobular units (TDLU)
Where does the lymph from the inner breast quadrants drain to?
Parasternal lymph nodes with some drainage to the abdominal lymph nodes.
Where is most lymph from the breast drained to?
Ipsilateral axillary lymph nodes
Axillary lymph nodes, in addition to the breast, supply which part of the body?
The upper limb.
If lymph node clearance needed, this can cause lymphoedema of the upper limb.
What arteries supply the breast?
Internal thoracic artery (also called the internal mammary artery)
Thoracic/Thoracoacromial arteries
What is the main route of venous drainage from the breast?
Axillary vein
What is the 3 layers of the pelvic floor?
Pelvic diaphragm
Muscles of perineal pouches
Perineal membrane
What is the deepest layer of the pelvic floor?
Pelvic diaphragm
What 2 muscles are involved in the pelvic diaphragm?
Levator ani
Coccygeus
At the anterior aspect of the levator ani muscles, a gap exists - what is this called?
Urogenital hiatus
What passes through the urogenital hiatus?
Urinary tract
Genital tract
What is the most important pelvic floor structure?
Perineal body
This links all of the pelvic floor structures.
During what would the pelvic floor actively contract?
Coughing/sneezing/vomiting
This is to ensure urinary and fecal continence.
What is the role of the puborectalis muscle?
It is a muscle that is always tonically contracted to maintain continence following rectal filling.
Becomes active contraction as filling continues.
What is a urethrocele?
Herniation of the urethra
What is a cystocele?
Herniation of the bladder
What is a rectocele?
Herniation of the rectum
What is an enterocele?
Herniation of the recto-uterine pouch (intestines found here).
How is herniation usually observed?
Through the vagina.
What is a 1st degree uterine prolapse?
Descent of the uterus into the vagina only.
What is a 2nd degree uterine prolapse?
Descent of the cervix, further down the vagina.
What is a 3rd degree uterine prolapse?
Cervix observed outside the vagina.
What is a 4th degree uterine prolapse?
The entire uterus is outside the vagina.
How is prolapse often described?
A dragging sensation or the feeling of a lump.
What artery is the main supply of the pelvis and perineum?
Internal iliac artery
Which joint is responsible for weight transfer from the vertebral body to the ilium and then the femurs?
Sacroiliac joint
What ligaments form the greater/lesser sciatic foraminae?
Sacrospinous ligament
Sacrotuberous ligament
In normal anatomical position, the anterior border of the pubis and what other part of the pelvis lie in the same vertical plane?
ASIS
What does the uterine artery supply?
Uterus
What does the ovarian artery supply?
Ovaries
Uterine tubes
Which artery does the vaginal artery branch off?
Uterine artery
Does the ureter pass above the uterine artery?
No, the ureter passes below the uterine artery.
It is referred to as ‘water under the bridge’.
What is THE artery of the perineum?
Internal pudendal artery
What are the 3 main nerves of the pelvis?
Sciatic nerve
Pudendal nerve
Nerve to the levator ani
What is the pelvic girdle?
The pelvic ring which connects the lower limbs to the axial skeleton.
What are the bones of the hips?
Ilium
Ischium
Pubis
What are the ischial tuberosities?
The bony bumps sat on.
What is the pelvic inlet?
Entrance to the pelvic cavity from the abdomen.
What is the pelvic outlet?
The inferior aspect of the pelvic cavity.
What is the pelvic cavity?
The space within the bony pelvis. It is continuous with the abdominal cavity above.
What is palpable in the lateral fornices of the vagina?
Ischial spines
Where does the sacrospinous ligament run between?
Sacrum
Ischial spine
Where does the sacrotuberous ligament run between?
Sacrum
Ischial tuberosity
What hormone causes the relaxation of ligaments during pregnancy?
Relaxin
Where is the obturator foramen found?
The anterior aspect of the pelvis.
What covers the obturator foramen?
Obturator membrane
A small space remains (called the obturator canal) where a neurovascular bundle passes through.
Which arch is wider in females, and why?
Pubic arch
To allow more room for childbearing.
Where does a negative station indicate?
Foetal head is above the ischial spines.
What does a positive station indicate?
Foetal head is below the ischial spines.
Nerves within the pelvis are of which modality?
Sympathetic
Parasympathetic
Visceral afferent
Nerves within the perineum are of which modality?
Somatic sensory
Somatic motor
Pelvic organs at the superior aspect of the cavity produce pain in which region?
Suprapubic region
Enters the spinal cord at levels T11-L2.
At which vertebral level does the spinal cord become the cauda equina?
L2
Where should lumbar puncture/epidural be carried out?
Between L3-L4.
What are the most superficial muscles of the lateral body wall?
External oblique
The blending of the external oblique at the midline produces which structure?
Linea alba
What are the external oblique fibres on each side continuous with?
The contralateral internal oblique.
What muscle is found deep to the internal oblique?
Transversus abdominis
Where is the neurovascular plane of the abdomen found?
Between the internal oblique and transversus abdominis - within the anterolateral abdominal wall.
Which muscles are divided by tendinous interceptions which act to improve mechanical efficiency (forms the ‘6 pack’)?
Rectus abdominis
What structure separates the two rectus abdominus muscles at the midline?
Linea alba
What is the umbilical ring?
A defect in the linea alba that allowed foetal vessels to pass.
Forms the umbilicus.
What is the rectus sheath?
The combined aponeuroses of the anterolateral abdominal wall muscles.
What structure is effectively a midline thickening of the rectus sheath?
Linea alba
Above the umbilicus, how many rectus sheaths are found?
2
An anterior and posterior sheath.
Below the umbilicus, how many rectus sheaths are found?
1
Anterior only.
What arteries supply the anterior abdominal wall?
Superior epigastric arteries
Inferior epigastric artery
What arteries supply the lateral abdominal wall?
Intercostal arteries
Subcostal arteries
If the patient is not pregnant, can the uterus be palpated?
No,it only becomes palpable after 12 weeks gestation.
After 12 weeks pregnancy, where can the uterus be palpated?
The pubic symphysis
What is the most common form of C-section carried out?
LSCS
What muscles are not cut during LSCS?
Rectus abdominis
These are separated laterally.
Is the bladder drained prior to LSCS?
Yes
What should be sutured following LSCS?
Uterine wall
Visceral peritoneum
Rectus sheath
Skin
Where is the inferior epigastric artery found?
Medial to the deep inguinal ring, just superior to the femoral artery.
After how many weeks gestation can gender be determined?
7 weeks
At which vertebral level does the testes originate?
T10
