Anatomy Flashcards

1
Q

In both genders, what are the roots of the external genitalia anchored to?

A

The bony margin of the anterior half of the pelvic outlet
The thick, fibrous perineal membrane within this area

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2
Q

Posterior border of the pelvic inlet?

A

The sacro-illiac body, projecting in as the sacral promontory

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3
Q

What ligaments help make up the true pelvis?

A

Sacrospinous and sacrotuberous ligaments

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4
Q

Where do the ligaments that help make up the true pelvis attach?

A

Sacrotuberous ligament - ischial tuberosity to sacrum
Sacrospinous ligament - ischeal spine to sacrum

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5
Q

What muscles help make up the true pelvis?

A

Obturator internus and piriformis

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6
Q

Where does the piriformis arise from

A

Anterior sacrum and sacro-illiac joint

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7
Q

Where does the piriformis insert?

A

Greater trochanter

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8
Q

Where does the piriformis pass through

A

Transversely through the greater sciatic foramen via the sciatic notch

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9
Q

Where does the obturator internus arise from?

A

The inferior margin of the superior pubic ramus and the pelvic surface of the obturator membrane

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10
Q

Where does the obturator internus insert?

A

Greater trochanter of the femur

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11
Q

Where does the obturator internus pass through

A

The inferior sciatic foramen

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12
Q

What structures create the pelvic outlet

A

Anterior - Pubic symphysis to ischeal tuberosity
Posterior - sacrotuberous ligament and coccyx

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13
Q

What are the pelvic floor muscles

A

Anterior - levitator ani
Posterior - coccygeas

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14
Q

What is the innervation for the pelvic floor

A

S2 - S4

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15
Q

Name the muscles that make up the levitator ani

A

Pubococcygeus, illiococcygeas, puborectalis

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16
Q

Illiococcygeas is attached to…

A

Ischeal spine and tendonous arch of levitator ani

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17
Q

What makes up the borders of the pelvic outlet

A

Coccyx, pubis symphysis, ischeal tuberosity

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18
Q

What does piriformis do

A

Lateral rotation of the femur

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19
Q

What nerve roots innervate piriformis

A

S1 & S2

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20
Q

What innervates obturator internus

A

Obturator nerve

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21
Q

What does obturator internus do

A

Lateral rotation of the femur

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22
Q

Where does the obturator nerve arise from

A

Anteriorly from L2,3,4

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23
Q

What passes through the urogenital hiatus

A

Urethra and vagina

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24
Q

What are the segments of the perineum

A

Anterior - the urogenital triangle
Posterior - the anal triangle

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25
Q

What does the bulb of the penis become

A

Corpus spongeosum

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26
Q

What do the crura extend to become on males

A

The corpus cavernosum

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27
Q

What are the erectile muscles

A

Females - ischeocarvenosus and bulbospongiosus
Males - same but the bulbospongiosus is fused in the midline

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28
Q

What are the margins of the anal triangle

A

Anterior - posterior margin of the perineal membrane
lateral - Ischeoanal fossa
Posterior - coccyx
Posterio-lateral - sacrotuberous ligament

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29
Q

What is the blood supply to the true pelvis

A

Internal iliac artery (from the common iliac artery)

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30
Q

What is the artery to the perineum?

A

The internal pudendal artery (arising from the internal iliac artery)

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31
Q

Where does the pudendal nerve arise from

A

S2, S3 and S4

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32
Q

Where does the pudendal nerve arise from

A

S2, S3 and S4

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33
Q

What does the pudendal nerve innervate

A

Sensory - external genetalia, skin around anus, anal canal and perenium
Motor - pelvic muscles, external urethral sphincter and external anal sphincter

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34
Q

How does the pudendal nerve and internal pudendal artery enter the perineum?

A

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

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35
Q

Where does the pudendal nerve pass in relation to the sciatic nerve?

A

Posterior

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36
Q

Where does the pudendal nerve pass in relation to the sciatic nerve?

A

Posterior

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37
Q

What is the pudendal canal?

A

The fascia covering obturator internus and the Ischeoanal fossa.
It contains the pudendal nerve, and internal pudendal artery and veins

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38
Q

Where does the internal rectal artery arise from

A

The internal pudendal artery within the pudendal canal

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39
Q

What does the pudendal nerve split to form

A

Dorsal nerve of the clitoris/penis and the perineal nerve

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40
Q

Where does the dorsal nerve of the clitoris/penis pass?

A

Deep perineal pouch

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41
Q

Where does the perineal nerve pass after it exits the pudendal canal

A

The superficial perineal pouch

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42
Q

Where does the internal pudendal artery pass

A

Continues within the deep perineal pouch

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43
Q

Where does the perineal artery pass

A

Superficial perineal pouch

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44
Q

What does the internal pudendal artery supply

A

Erectile tissue, urethra and clitoris/penis

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45
Q

What does the posterior labial/scrotal nerve supply?

A

Sensory - Skin of Labia Majora/scrotum

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46
Q

What does the perineal artery supply?

A

Labia/scrotum, transverse perineal muscles and perineal body

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47
Q

Where is colles fascia?

A

Membranous layer of the superficial perineal fascia binding down the muscles at the root of the penis

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48
Q

What arteries branch from the posterior illiac artery

A

Iliolumbar, lateral sacral and gluteal (superior and inferior)

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49
Q

What arteries branch from the anterior illiac artery

A

Internal pudendal artery, inferior vesicle/vaginal artery, middle rectal artery, obturator artery, umbilical and uterine artery

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50
Q

To what lymph nodes do the ovaries and testes drain

A

Para-aortic lymph nodes

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51
Q

What is the arterial supply to the levitator ani muscle

A

Inferior gluteal artery

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52
Q

Where is the cremasteric fascia derived from?

A

Internal oblique

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53
Q

What is derived from the transversalis fascia

A

Internal spermatic fascia

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54
Q

Where is the external spermatic fascia derived from

A

External oblique

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55
Q

Where do the uterine arteries run

A

Cardinal ligaments at the base of the broad ligaments

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56
Q

Where does the ovarian artery arise from

A

Abdominal aorta
(At L2 just below the renal artery)

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57
Q

What is dartos fascia

A

Specialised connective tissue layer over shaft, scrotum and foreskin. The muscles of dartos proper within the scrotum are responsible for thermoregulation

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58
Q

What is the name for the deep fascia of the penis?

A

Bucks fascia

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59
Q

What runs through the suspensory ligament of the ovary

A

Ovarian artery, ovarian vein, ovarian nerve plexus

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60
Q

Describe the fallopian tube anatomy from most distal to the uterus

A

Fimbrae > infundibulum> ampulla > isthmus > uterus

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61
Q

What connects the uterine fundus to the labia majora

A

Round ligament

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62
Q

What does the uterosacral ligament connect

A

Cervix/posterior vaginal vault to the posterior pelvic wall

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63
Q

What ligament contains the uterine vessels

A

Cardinal ligaments

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64
Q

What are the two layers of the uterine endometrium

A

Deep stratum basalis
Superficial stratum functionalis

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65
Q

What are the three sections of the broad ligament

A

Mesosalpinx
Mesovarian
Mesometrium

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66
Q

Lymphatic drainage of the fallopian tube

A

Mixed - iliac, sacral, aortic

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67
Q

Cell types within the fallopian tubes

A

Ciliated columnar epithelium cells
Peg cells (non ciliated secretory cells)

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68
Q

Where do the ovarian arteries arise from

A

Aorta below the renal arteries (L2)

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69
Q

Where do ovarian veins drain into

A

Left -> left renal vein
Right -> inferior vena cava

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70
Q

Nerves of the ovary?

A

Ovarian and uterine plexus

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71
Q

Cells of the ectocervix

A

Stratified squamous non-keratinized epithelium

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72
Q

Cells of the endocervix

A

Mucus secreting simple columnar epithelium

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73
Q

Cervix blood supply

A

Uterine artery (from internal illiac artery)

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74
Q

Cervix blood drainage

A

Plexus in the broad ligament -> uterine veins -> internal iliac veins

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75
Q

Cervix lymphatic drainage

A

Internal Iliac!
external illiac, sacral, aortic, inguinal lymph nodes

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76
Q

What is the sit bone

A

Ischial tuberosity

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77
Q

What is the arterial supply to Levatator ani

A

Inferior gluteal artery

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78
Q

What innervates the internal anal sphincter

A

Pelvic splanchnic nerves (S2-S4, parasympathetic)

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79
Q

What drains to the internal iliac lymph nodes

A

Prostate, cervix, proximal vagina, corpus cavernosa, lower rectum

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80
Q

What drains into the para-aortic lymph nodes

A

Ovaries, testes, kidneys, uterus

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81
Q

What drains into the superficial inguinal lymph nodes

A

Distal vagina, distal anus, testes, vulva (skin areas!)

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82
Q

What drains to the external iliac lymph nodes

A

Body of uterus, cervix and superior bladder

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83
Q

What does ischiocavernosus do

A

Maintain penile erection.
Innervated by the deep perineal nerve

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84
Q

Layers of the penis superficial to deep

A

Skin, colles fascia, bucks fascia, tunica albuginea

85
Q

Explain somatic sensory innervation of the vagina

A

Inferior 1/5 has somatic sensory innervation. Arises from deep perineal nerve from the pudendal nerve.

86
Q

Where is the external urethral sphincter located in males?

A

Membranous urethra in the deep perineal pouch

87
Q

Round ligament placement?

A

Horns of the uterus to labia majora

88
Q

Ovarian ligament placement

A

Lateral surface of the uterus to ovaries

89
Q

Broad ligament origin and insertion

A

Sides of uterus to walls and floor of pelvis

90
Q

Where do suspensory ligaments originate and insert

A

Ovaries to walls of pelvis

91
Q

Urethral lining cell type

A

Stratified squamous epithelium (transitional near the bladder)

92
Q

What supplies somatic innervation to the external urethral sphincter

A

Pudendal nerve

93
Q

What does the inferior hypogastric plexus supply

A

Uterine/vaginal plexus
Vesical plexus
Prostatic plexus

94
Q

What nerve roots supply the anal reflex

A

S3 & S4

95
Q

What supplies the external anal sphincter

A

Inferior rectal nerve (S2-S4)

96
Q

What supplies the internal anal sphincter

A

Inferior hypogastric plexus

97
Q

What innervates Levatator ani

A

Ramus of S4 and pudendal nerve (S2-S4)

98
Q

What is the perineal flextire

A

Angle maintained by puborectalis, important for continence

99
Q

What makes up the linea terminalis

A

Arcuate line, pectin pubis, pubic crest

100
Q

Where is the sacral plexus in comparison to piriformis

A

Anterior

101
Q

Motor function of pudendal nerve

A

Perineal skeleton muscles, external urethral and anal sphincters, levitator ani

102
Q

Sensory function of pudendal nerve

A

Perineal skin, penis, clitoris

103
Q

Energy source for spermatogenesis

A

ATP dephosphorylation (conversion of ATP to ADP and inorganic phosphate)

104
Q

What hormone controls spermatogenesis

A

FSH (mainly)

105
Q

Pain sensation in the cervix

A

Pelvic splanchnic nerves

106
Q

At what spinal level does the aorta pass through the diaphragm

A

T12

107
Q

Nerve roots for lower abdominal reflex

A

T7-T12

108
Q

Nerve roots for cremasteric reflex

A

L1

109
Q

What lies posterior to suspensory ligament

A

Ureter

110
Q

What runs through the suspensory ligament

A

Ovarian artery and veins

111
Q

Cardinal ligament contents

A

Uterine artery and vein

112
Q

Cardinal ligament contents

A

Uterine artery and vein

113
Q

What structures are at risk of the cervix is perforated

A

Uterine artery and vein

114
Q

What is the mesovarium

A

Where the broad ligament attaches to the ovaries

115
Q

Where does the round ligament pass

A

Through the deep inguinal ring to enter the inguinal canal

116
Q

What ligament can cause pain in pregnancy

A

Round ligament

117
Q

Where does the uterosacral ligament run

A

Uterus to sacrum

118
Q

Where is the pubucervical fascia run

A

Cervix to pubic bone

119
Q

What spinal level does the ovarian artery emerge

A

L1

120
Q

Blood supply to cervix

A

Uterine artery from anterior division of internal illiac artery

121
Q

Blood supply to upper third of vagina

A

Uterine artery

122
Q

What arterial injury most likely to cause rectal sheath hematoma

A

Inferior epigastric artery

123
Q

Lap trochar can injure which artery?

A

Aorta

124
Q

What autonomic nerves control the bladder

A

the superior hypogastric plexus

125
Q

What innervation does the ovary get?

A

Sympathetic and parasympathetic from the uterine and ovarian plexuses

126
Q

How do nerves reach the ovary?

A

Via the suspensory ligament of the ovary

127
Q

Innervation of upper vagina?

A

Parasympathetic and sympathetic innervation from hypogastric plexus.
NO somatic (pain) innervation

128
Q

What artery is contained within the round ligament

A

Sampson’s artery (branch of inferior epigastric)

129
Q

What ligaments on females are gubernaculum remnants?

A

Round and ovarian suspnsory

130
Q

Anterior vulval nerve supply

A

Ilioinguinal nerve, genital branch of genitofemoral nerve

131
Q

Posterior vulval nerve supply

A

Pudendal nerve (perineal nerve and labial nerve) and posterior cutaneous nerve of the thigh

132
Q

Clitoral nerve supply

A

Cavernous nerves (parasympathetic), clitoral branch of the pudendal nerve

133
Q

What nerve roots can a pfannenstiel incision damage

A

T12-L1

134
Q

What nerve can be damaged in lithotomy

A

Lateral cutaneous nerve of the thigh (L2-L3)

135
Q

Nerve roots of diaphragmatic shoulder tip pain from ectopic

A

C3- C5

136
Q

Peritoneal pain transmitted by sympathetic nervous system what nerve roots

A

T10- L2 (umbilicus, suprapubic anterior thigh)

137
Q

Irritation of cervix/vagina/bladder felt?

A

Parasympathetic nervous system S2-S4 buttocks and posterior thigh

138
Q

Describe the penile nerve system

A

Point and Shoot
Erection is Parasympathetic S1-S3
Ejaculation is Sympathetic T12-L1

139
Q

Function of bartolins gland

A

Mucoid secretions, lubricate vagina and vulva

140
Q

What is the male equivalent of bartholins

A

Bulbourethral gland

141
Q

Embryological origin of bartholins

A

Urogenital sinus

142
Q

Histology of bartholins

A

Columnar epithelium ->transitional epithelium -> squamous epithelium

143
Q

Nerve to bartholins

A

Pudendal

144
Q

What is the female equivalent of the prostate gland

A

Skenes gland

145
Q

Female equivalent of corpus spongiosum

A

Vestibular bulbs

146
Q

Labia minor male equivalent

A

Urethral surface of penis

147
Q

Labia Majora male equivalent

A

Scrotum

148
Q

What do paramesonephric/mullerian ducts form when exposed to XX

A

Fallopian tubes, uterus, cervix, upper 1/3 vagina

149
Q

In XX what happens if paramesonephric ducts fail to fuse

A

Didactic uterus/uterine septum

150
Q

What do mesonephric/wolffian ducts do in presence of XY

A

Proliferate to form epididymis, vas deferens, seminal vesicles

151
Q

What do mesonephric/wolffian ducts do in presence of XX

A

Regress
(Leave garters duct behind)

152
Q

What do paramesonephric/mullerian ducts do in presence of XY

A

Regress

153
Q

What does urogenital sinus form in males

A

Bladder, urethra, prostate, bulbourethral glands

154
Q

What does urogenital sinus form in females

A

Bladder, urethra, skenes gland, bartolins

155
Q

Describe the blood supply to the bladder

A

Superior vesical artery, vaginal artery supplementation, inferior vesicle artery

156
Q

Venous drainage of the bladder

A

Vesical venous plexus

157
Q

What nerves help fill the bladder

A

Sympathetic - hypogastric nerve T12-L2
Relaxes detrusor

158
Q

What contracts detrusor muscle

A

Involuntary - parasympathetic, S2-S4 pelvic nerve

159
Q

What controls voluntary micturation

A

Somatic, pudendal nerve, S2-S4

160
Q

Where are skenes glands

A

Distal end of urethra in women
(2 mucous glands)

161
Q

Main cell type of urethra

A

Stratified columnar epithelium (with transitional epithelium towards the top)

162
Q

Innervation of urethra

A

Pudendal nerve and vesical plexus

163
Q

Median nerve roots

A

C6-T1

164
Q

Median nerve motor function

A

Flexor and pronator in anterior forearm compartment

165
Q

Median nerve sensory function

A

Lateral aspect of palm, thumb, 2.5 fingers

166
Q

Origins of median nerve

A

Axilla from brachial plexus

167
Q

Location of median nerve relevant to brachial artety

A

Lateral in upper arm, cross at halfway, medial in lower arm

168
Q

What happens if median nerve damaged

A

Can’t 👌
Can’t flex wrist

169
Q

Spinal roots of ulnar nerve

A

C8-T1

170
Q

Motor function of ulnar nerve

A

Small finger, half of ring finger, associated palm and dorsal hand

171
Q

Sensory function of ulnar nerve

A

Medial one and a half fingers and associated palm area

172
Q

Where does the ulnar nerve arise from

A

Brachial nerve within axilla region

173
Q

Ulnar nerve journey through arm

A

Descends between axillary artery and vein, travels posterior to the elbow via ulnar tunnel, enters posterior compartment of arm

174
Q

What deformity does damage to the ulnar nerve cause

A

Claw like hand deformity

175
Q

What does ulnar nerve damage do to thumb

A

Weakens adduction

176
Q

Radial nerve roots

A

C5-T1

177
Q

Radial sensory innervation

A

Posterior forearm, lateral dorsuk.of hand, lateral surface of bottom half of three and half lateral digits

178
Q

Radial motor innervation

A

Triceps and forearm extensors

179
Q

How does the radial nerve travel in the upper arm

A

In the humerus radial groove

180
Q

How does the radial nerve travel in the upper arm

A

In the humerus radial groove

181
Q

What vessel accompanies the radial nerve

A

Deep brachial artery

182
Q

How does the radial nerve enter the forarm

A

Anterior to the lateral epicondyle

183
Q

Radial nerve divisions?

A

Deep - motor posterior forearm
Superficial - sensory dorsal hand

184
Q

Radial nerve divisions?

A

Deep - motor posterior forearm
Superficial - sensory dorsal hand

185
Q

What happens with damage to the radial nerve

A

Drop wrist

186
Q

Musculotaneous nerve roots

A

C5-C7

187
Q

Musculotaneous nerve motor innervation

A

Muscles.of anterior upper arm

188
Q

Musculotaneous nerve sensory innervation

A

Lateral cutaneous nerve of the forarm

189
Q

Musculotaneous nerve damage?

A

Weakened elbow and shoulder flexion
Weak forearm supination

190
Q

What happens to ulnar nerve when arm flexed

A

Moves anteriorly
(Further from insertion site of posterior to sulcus)

191
Q

Dermatomal level for innervation of anus

A

S5
If any voluntary contraction of anal sphincter then a spinal cord injury is motor Incomplete

192
Q

What are the three main contributors to the inferior hypogastric plexus

A

Superior hypogastric plexus
Sacral splanchnic nerves
Pelvic splanchnic nervee

193
Q

What is the widest part of the male urethra

A

Prostatic urethra

194
Q

What is the flow of sperm from testes to ejaculation

A

Seminiferous tubules > rete testes > efferent tubules > epididymis > vas deferens > ejaculatory duct > urethra

195
Q

What is the embryological origin of the anterior Pituitary

A

Rathkes pouch (ectoderm)

196
Q

What is the embryological origin of the posterior pituitary

A

Infundibulum

197
Q

What is the cremasteric fascia derived from

A

Internal oblique

198
Q

What is the internal spermatic fascia derived from

A

Transversalis fascia

199
Q

What type of joint is the pubic symphysis

A

Secondary cartilaginous

200
Q

When a sten cell creates more stem cells, this process is called

A

Mitosis

201
Q

In men what does LH act on

A

Leydig cells

202
Q

What do.leydig cells do in summary

A

Convert cholesterol to testosterone

203
Q

What cell in males does fsh act on

A

Sertoli cells

204
Q

What does fsh do in Sertoli cells in summary

A

Create androgen bonding protein

205
Q

What does androgen bonding protein do.

A

Makes testosterone less lipophilic so it stays within the Seminole tube lumen

206
Q

What does testosterone do in the testes

A

Stimulate primary spermatocytes to become secondary spermatocytes (meiosis I)
Stimulate secondary spermatocytes to become spermatids (meiosis II)
Stimulate spermatids to become spermatozoa (spermatogenesis)

207
Q

What cells make inhibin in men

A

Sertoli cells

208
Q

What does inhibin do in men

A

Inhibits production of fsh by acting on hypothalamus and anterior Pituitary

209
Q

What is another name for the suspensory ligament of the ovary?

A

Infundibulopelvic ligament