Anatomy Flashcards
In what spermatic vein is varicocele more common?
Left as it drains into the left renal vein at a 90deg angle
What drains into the para-aortic lymph nodes?
Ovaries/testes/ fundus of uterus
What drains into the external iliac nodes?
- Body of uterus
- Cervix
- Superior part of bladder
What drains to the internal iliac nodes?
- Prostate
- Cervix
- Corpus cavernosum
- Proximal vagina
What drains to the superficial inguinal nodes?
- Distal vagina
- Vulva
- Scrotum
- Distal anus
Where does lymph from the clitoris and glans of the penis drain to?
Deep inguinal lymph nodes
What is the venous plexus in the scrotum called?
Pampiniform plexus
What does the infundibulopelvic (suspensory) ligament attach?
Ovaries to lateral pelvic wall
What structures run with the infundibulopelvic (suspensory) ligament?
Ovarian vessels
Ligation of the ovarian and uterine vessels during oopherectomy presents a risk to what structure?
Ureter
What does the cardinal (transverse cervical) ligament connect?
Cervix to the side wall of the pelvis
What structures are contained in the cardinal ligament?
Uterine vessels
What does the round ligament connect?
Uterine horn to labia majora
What is the round ligament a derivative of?
Gubernaculum
What does the round ligament travel through?
Round inguinal canal
What does the round ligament of the uterus travel above?
Artery of Sampson
What does the Broad ligament connect?
- Uterus
- Fallopian tubes
- Ovaries
All to pelvic side wall
What ligament is contained inside the round ligament?
Round ligaments of the uterus
What is the broad ligament made of?
Fold of peritoneum that comprises the mesosalpinx, mesometrium and mesovarium
What does the ovarian ligament connect?
Medial pole of ovary to uterine horn
What is the ovarian ligament a derivative of?
Gubernaculum
What is adnexal torsion?
- Twisting of ovary and fallopian tube around infundibulopelvic ligament and ovarian ligament thus causing compression of ovarian vessels
- Associated with ovarian mass
- Presents w. acute pelvic pain, adnexal mass, N/V
What are the different types of pelvic organ prolapse?
- Ant compartment prolapse - bladder (cystocele)
- Post compartment prolapse - rectum (rectocele) or SI (enterocele)
- Apical compartment prolapse - uterus, cervix, or vaginal vault
What is pelvic organ prolapse?
Herniation of pelvic organs to or beyond the vaginal walls (ant, post) or apex
What is pelvic organ prolapse associated with?
- Multiparity
- Age
- Obesity
What are the symptoms of pelvic organ prolapse?
- Pelvic pressure
- Tissue protrusion from vagina
- Urinary frequency
- Constipation
- Sexual dysfunction
What is a pelvic organ prolapse involving all 3 compartments called?
Uterine procidentia
What are the nerves involved in expulsion of semen?
- Pelvic splanchnic nerves (S2-S4) (para)
- Hypogastric nerve (T11-L2) (symp)
- Pudendal nerve (somatic)
How does sildenafil cause erections?
Blocks the degradative action of cGMP-specific phosphodiesterase type 5 (PDE5) on cyclic GMP
- Increased cGMP
What is the histology of the transformation zone?
Squamocolomnar junction
- Ectocervix is stratified squamous
- Endocervix is simple columnar
What is the epithelium of the ovary characterised by?
Simple cuboidal epithelium (germinal epithelium covering surface of ovary)
What can renal trauma present with?
- Bruising
- Flank pain
- Hematuria
What can renal truama be due to?
Direct blows or lower rib fractures
What are the symptoms/signs of bladder rupture?
- Hematuria
- Suprapubic pain
- Difficulty voiding
- Increased BUN and creatinine (due to peritoneal absorption of urine)
Where is the most common site for bladder wall rupture?
Superior bladder wall (dome) injury
Where other than the dome is a common site of bladder injury? and what can it be caused by?
Anterior wall or neck injury
- Due to pelvic fracture -> perforation of bony spicules
Where does urine accumulate in an anterior bladder injury?
Extraperitoneal urine accumulation
- Retropubic space
What are the symptoms/signs of urethral injury?
- Blood at urethral meatus
- Hematuria
- Difficulty voiding
What kind of injury may cause an anterior urethral injury?
Perineal saddle injury
What can happen as a result of bulbar spongy urethra is disruptes as a result of ant urethral injury?
Scrotal hematoma
Where may urine collect as a result of tearing Bucks fascia?
Perineal space
What may cause posterior urethral injury?
Pelvic fracture
Where can urine collect as a result of posterior urethral injury? and what is this due to?
- May cause disruption at bulbomembranous junction (weakest part)
- > Urine leakage into retropubic space and high-riding prostate
What lines the penis and testes?
Internal to external
- Tunica albuginea (found in penis and testes)
- Deep (Buck’s) fascia (only penis)
- Superficial (dartos) fascia (only penis)
What do Sertoli cells produce?
- Inhibin B (inhibits FSH)
- Androgen-binding protein (maintains local levels of T)
- MIF
- Converts T to E via aromatase
What do tight junctions between adjacent Sertoli cells function as?
Blood-testis barrier - preventing gametes from immune attack
What can cause a temperature rise in sertoli cells and what are the effects of this?
- Decreased sperm production
- Decreased inhibin B
- Increased temperature seen in varicocele and cryptorchidism
What do the sertoli cells line?
The seminiferous tubules
Where are Leydig cells found?
Adjacent to sertoli cells in the interstitium
