Anatomy Flashcards
In both genders, what are the roots of the external genitalia anchored to?
The bony margin of the anterior half of the pelvic outlet
The thick, fibrous perineal membrane within this area
Posterior border of the pelvic inlet?
The sacro-illiac body, projecting in as the sacral promontory
What ligaments help make up the true pelvis?
Sacrospinous and sacrotuberous ligaments
Where do the ligaments that help make up the true pelvis attach?
Sacrotuberous ligament - ischial tuberosity to sacrum
Sacrospinous ligament - ischeal spine to sacrum
What muscles help make up the true pelvis?
Obturator internus and piriformis
Where does the piriformis arise from
Anterior sacrum and sacro-illiac joint
Where does the piriformis insert?
Greater trochanter
Where does the piriformis pass through
Transversely through the greater sciatic foramen via the sciatic notch
Where does the obturator internus arise from?
The inferior margin of the superior pubic ramus and the pelvic surface of the obturator membrane
Where does the obturator internus insert?
Greater trochanter of the femur
Where does the obturator internus pass through
The inferior sciatic foramen
What structures create the pelvic outlet
Anterior - Pubic symphysis to ischeal tuberosity
Posterior - sacrotuberous ligament and coccyx
What are the pelvic floor muscles
Anterior - levitator ani
Posterior - coccygeas
What is the innervation for the pelvic floor
S2 - S4
Name the muscles that make up the levitator ani
Pubococcygeus, illiococcygeas, puborectalis
Illiococcygeas is attached to…
Ischeal spine and tendonous arch of levitator ani
What makes up the borders of the pelvic outlet
Coccyx, pubis symphysis, ischeal tuberosity
What does piriformis do
Lateral rotation of the femur
What nerve roots innervate piriformis
S1 & S2
What innervates obturator internus
Obturator nerve
What does obturator internus do
Lateral rotation of the femur
Where does the obturator nerve arise from
Anteriorly from L2,3,4
What passes through the urogenital hiatus
Urethra and vagina
What are the segments of the perineum
Anterior - the urogenital triangle
Posterior - the anal triangle
What does the bulb of the penis become
Corpus spongeosum
What do the crura extend to become on males
The corpus cavernosum
What are the erectile muscles
Females - ischeocarvenosus and bulbospongiosus
Males - same but the bulbospongiosus is fused in the midline
What are the margins of the anal triangle
Anterior - posterior margin of the perineal membrane
lateral - Ischeoanal fossa
Posterior - coccyx
Posterio-lateral - sacrotuberous ligament
What is the blood supply to the true pelvis
Internal iliac artery (from the common iliac artery)
What is the artery to the perineum?
The internal pudendal artery (arising from the internal iliac artery)
Where does the pudendal nerve arise from
S2, S3 and S4
Where does the pudendal nerve arise from
S2, S3 and S4
What does the pudendal nerve innervate
Sensory - external genetalia, skin around anus, anal canal and perenium
Motor - pelvic muscles, external urethral sphincter and external anal sphincter
How does the pudendal nerve and internal pudendal artery enter the perineum?
Exit the pelvis via the greater sciatic notch, inferior to the piriformis, pass over the sacrospinous ligament and below the sacrotuberous ligament and through the Ischeoanal fossae
Where does the pudendal nerve pass in relation to the sciatic nerve?
Posterior
Where does the pudendal nerve pass in relation to the sciatic nerve?
Posterior
What is the pudendal canal?
The fascia covering obturator internus and the Ischeoanal fossa.
It contains the pudendal nerve, and internal pudendal artery and veins
Where does the internal rectal artery arise from
The internal pudendal artery within the pudendal canal
What does the pudendal nerve split to form
Dorsal nerve of the clitoris/penis and the perineal nerve
Where does the dorsal nerve of the clitoris/penis pass?
Deep perineal pouch
Where does the perineal nerve pass after it exits the pudendal canal
The superficial perineal pouch
Where does the internal pudendal artery pass
Continues within the deep perineal pouch
Where does the perineal artery pass
Superficial perineal pouch
What does the internal pudendal artery supply
Erectile tissue, urethra and clitoris/penis
What does the posterior labial/scrotal nerve supply?
Sensory - Skin of Labia Majora/scrotum
What does the perineal artery supply?
Labia/scrotum, transverse perineal muscles and perineal body
Where is colles fascia?
Membranous layer of the superficial perineal fascia binding down the muscles at the root of the penis
What arteries branch from the posterior illiac artery
Iliolumbar, lateral sacral and gluteal (superior and inferior)
What arteries branch from the anterior illiac artery
Internal pudendal artery, inferior vesicle/vaginal artery, middle rectal artery, obturator artery, umbilical and uterine artery
To what lymph nodes do the ovaries and testes drain
Para-aortic lymph nodes
What is the arterial supply to the levitator ani muscle
Inferior gluteal artery
Where is the cremasteric fascia derived from?
Internal oblique
What is derived from the transversalis fascia
Internal spermatic fascia
Where is the external spermatic fascia derived from
External oblique
Where do the uterine arteries run
Cardinal ligaments at the base of the broad ligaments
Where does the ovarian artery arise from
Abdominal aorta
(At L2 just below the renal artery)
What is dartos fascia
Specialised connective tissue layer over shaft, scrotum and foreskin. The muscles of dartos proper within the scrotum are responsible for thermoregulation
What is the name for the deep fascia of the penis?
Bucks fascia
What runs through the suspensory ligament of the ovary
Ovarian artery, ovarian vein, ovarian nerve plexus
Describe the fallopian tube anatomy from most distal to the uterus
Fimbrae > infundibulum> ampulla > isthmus > uterus
What connects the uterine fundus to the labia majora
Round ligament
What does the uterosacral ligament connect
Cervix/posterior vaginal vault to the posterior pelvic wall
What ligament contains the uterine vessels
Cardinal ligaments
What are the two layers of the uterine endometrium
Deep stratum basalis
Superficial stratum functionalis
What are the three sections of the broad ligament
Mesosalpinx
Mesovarian
Mesometrium
Lymphatic drainage of the fallopian tube
Mixed - iliac, sacral, aortic
Cell types within the fallopian tubes
Ciliated columnar epithelium cells
Peg cells (non ciliated secretory cells)
Where do the ovarian arteries arise from
Aorta below the renal arteries (L2)
Where do ovarian veins drain into
Left -> left renal vein
Right -> inferior vena cava
Nerves of the ovary?
Ovarian and uterine plexus
Cells of the ectocervix
Stratified squamous non-keratinized epithelium
Cells of the endocervix
Mucus secreting simple columnar epithelium
Cervix blood supply
Uterine artery (from internal illiac artery)
Cervix blood drainage
Plexus in the broad ligament -> uterine veins -> internal iliac veins
Cervix lymphatic drainage
Internal Iliac!
external illiac, sacral, aortic, inguinal lymph nodes
What is the sit bone
Ischial tuberosity
What is the arterial supply to Levatator ani
Inferior gluteal artery
What innervates the internal anal sphincter
Pelvic splanchnic nerves (S2-S4, parasympathetic)
What drains to the internal iliac lymph nodes
Prostate, cervix, proximal vagina, corpus cavernosa, lower rectum
What drains into the para-aortic lymph nodes
Ovaries, testes, kidneys, uterus
What drains into the superficial inguinal lymph nodes
Distal vagina, distal anus, testes, vulva (skin areas!)
What drains to the external iliac lymph nodes
Body of uterus, cervix and superior bladder
What does ischiocavernosus do
Maintain penile erection.
Innervated by the deep perineal nerve