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Reproductive System > Anatomy > Flashcards

Anatomy Flashcards

1
Q

What are the bones that form the acetabulum?

A

1) Ilium
2) Pubis
3) Ischium

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2
Q

Where is the obturator foramen?

A

Between the pubis and ischium

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3
Q

What is the joint between the spine and the hip?

A

Sacroiliac joint

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4
Q

What separates the abdominal and pelvic cavity?

A

Technically no but have pelvic diaphragm

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5
Q

What are the 4 bones that form the pelvic girdle?

A

2 hip bones (formed by pubis, ilium, ischium)
Sacrum
Coccyx

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6
Q

The sacrum is an inverted triangle in shape. The base of the sacrum is (superior/inferior) while its apex is (superior/inferior).

A

Base: superior
Apex: inferior

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7
Q

What type of joint is the pubic symphysis?

A

Cartilaginous

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8
Q

The sacrum is formed by the ______ of the ____ sacral vertebrae.

A

Fusion of the 5 sacral vertebrae

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9
Q

What are the 4 anatomical landmarks of the pubic bone?

A

1) Superior rami
2) inferior/ischiopubic rami
3) Pubic symphysis
4) Pubic crest (adjacent to symphysis)
5) Pubic tubercle

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10
Q

What are the 2 landmark of the ischium?

A

1) Ischial tuberosity (most inferior)
2) Ischial spine (when viewed posteriorly)

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11
Q

What is the only bony landmark that is in contact with the floor when seated?

A

Ischial tuberosity

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12
Q

What are the 3 landmarks of the ilium?

A

Superior to inferior:
1) Iliac crest
2) Anterior superior iliac spine
3) Anterior inferior iliac spine

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13
Q

What is the ligament connecting the anterior superior iliac spine to the pubic tubercle?

A

Inguinal ligament

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14
Q

What is the anterior tip of S1 called?

A

Sacral promotory

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15
Q

The sacral canal continues the vertebral canal from the cauda equina and terminates as the _____________.

A

Sacral hiatus

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16
Q

Where do the sacral nerves exit the sacral vertebrae from?

A

Anterior and posterior sacral foramina

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17
Q

What is the name for coccyx pain?

A

Coccydynia

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18
Q

What are 3 primary roles of the pelvic girdle?

A

1) Transmit weight from axial skeleton to lower limbs and help with body movements
2) Protects abdominal and pelvic organs
3) Childbearing

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19
Q

What is the difference between the greater/false and lesser/true pelvis?

A

Organs within the greater/false pelvis are abdominal intestines
whereas organs within the lesser/true pelvis are pelvic organs (uterus, rectum)

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20
Q

What are the borders of the pelvic inlet?

A

Anterior: Pubic symphysis

Posterior: Sacral promontory, Ala of sacrum

Lateral: Iliopectineal/arcuate lines

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21
Q

What are the borders of the pelvic outlet?

A

Anterior: Pubic symphysis

Posterior: Coccyx

Anterolateral: Ischiopubic/Inferior ramus

Posterolateral: Sacrotuberous ligament

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22
Q

When the body is in the upright position, which 2 anatomical landmarks are located in the same vertical plane?

A

1) Anterior superior iliac spine
2) Pubic symphysis

Pelvis has anterior tilt

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23
Q

What are 5 differences between the female and male pelvis?

A

F:
1) Bones: lighter, thinner
2) Pelvic cavity: wide and shallow
3) Pelvic inlet: round/oval
4) Sacrum: wide, short, curved
5) Subpubic angle large
6) Coccyx: flexible, straighter
7) Ischial spine: more everted

M:
1) Bones: heavier thicker
2) Pelvic cavity: narrow, deep
3) Pelvic inlet: smaller, heart-shaped
4) Sacrum: narrow, long, straight
5) Subpubic angle more acute
6) Coccyx: less flexible, more curved
7) Ischial spine: faces medial

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24
Q

The greater sciatic notch is located ______ to the lesser sciatic notch.

A

Superior

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25
Q

The greater sciatic notch is a large concave area located on the ________ border of the ilium.

A

Posterior

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26
Q

What are the joints that hold the pelvis together?

A

1) Pubic symphysis
2) Sacrospinous ligament
3) Sacrotuberous ligament

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27
Q

What is an example of a structure that passes through the greater and/or lesser sciatic foramen?

A

Neurovascular bundle
(to gluteal, thigh, perineal regions)

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28
Q

Where is the piriformis muscle found?

A

Between sacrum → greater sciatic foramen → femur

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29
Q

Where is the obturator internus found?

A

Within obturator foramen

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30
Q

How is the obturator canal formed?

A

Obturator membrane covering obturator internus leaves a gap

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31
Q

What are the 2 main structures that form the pelvic diaphragm?

A

1) Levator ani (puborectalis, pubococcygeus, iliococcygeus)
2) Small coccygeus

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32
Q

What are the 2 openings in the pelvic floor?

A

1) Urogenital hiatus
2) Rectal hiatus

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33
Q

What are the 4 functions of the pelvic floor/diaphragm?

A

1) Support visceral pelvic contents
2) Divides pelvic cavity rom perineum below
3) Resistant rises in intraabdominal pressure (eg. coughing, heavy lifting, chronic constipation)
4) Sphincteric actions (puborectalis controls part of anorectal junction → voluntary control of defecation)

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34
Q

What are the 3 muscles that constitute the levator ani?

A

1) Puborectalis
2) Pubococcygeus
3) Iliococcygeus

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35
Q

The coccygeus muscle originates from the _____________ and attaches to the ________________.

A

Coccygeus:
Origin: Ischial spine
Attachment: Coccyx

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36
Q

Describe the innervation of the levator ani muscle.

A

Perineal branch of S4
Pudendal nerve (S2-4)

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37
Q

Levator ani
Origin:
Anterior:____________
Posterior:__________
Lateral:______________

Insertion: (i)_____________________
(ii) ____________________
(iii) ____________________

A

Levator ani
Origin:
Anterior: pubic body
Posterior: ischial spine
Lateral: thickened fascia of obturator internus (tendinous arch)

Insertion:
(i) puborectalis: U-shaped sling around anal canal, attaches to pubis contralaterally
(ii) Pubococcygeus
(iii) iliococygeus
- both to coccyx, perineal body, anococcygeal ligament

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38
Q

What is pelvimetery?

A

Diagnostic technique used to evaluate dimensions of women’s pelvis → predict potential for vaginal delivery

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39
Q

What are the 3 diameters of the pelvic inlet and how are they measured?

A

1) AP: midpoint of sacral promontory to midpoint of upper margin of pubic symphysis (11cm)

2) Oblique: sacroiliac joint to contralateral iliopectineal eminence (12cm)

3) Transverse: max transverse (13cm)

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40
Q

What are the 3 diameters of the pelvic outlet and how are they measured?

A

1) AP: tip of sacrum to lower margin of pubic symphysis (11cm)

2) Oblique: middle of sacrotuberous ligament to contralateral junction of ischiopubic ramus (12cm)

3) Transverse: inner aspects of both ischial tuberosities (11cm)

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41
Q

Comparing the diameters of the pelvic inlet and outlet, at the inlet the ______ is the largest, whereas at the outlet the _________ is the largest.

A

Inlet: transverse (13cm)
Outlet: AP (13cm)

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42
Q

What is cephalopelvic disproportion?

A

Any clinically significant mismatch between the size/shape of the presenting part of the fetus and the size/shape of the maternal pelvis and soft tissue.

  • when accurate CPD diagnosis made, safest choice is cesarean
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43
Q

How does one determine whether a female is able to deliver an average-sized baby anatomically?

A

Per-vaginal digital examination of diagonal conjugate:
- 2 fingers into vagina until sacral promontory → place other hand on external border then measure
- take 1.5 off/if length is 12.5cm is ok

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44
Q

What is the primary arterial supply of the pelvis?

A

Internal iliac artery

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45
Q

At which spinal segment level do the common iliac arteries bifurcate?

A

L4

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46
Q

The internal iliac artery divides into the (short/long) anterior and (short/long posterior) branch.

A

Long anterior
Short posterior

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47
Q

What are the 3 accessory glands of the male reproductive system?

A

1) Seminal vesicles
2) Prostate gland
3) Bulbourethral glands

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48
Q

What are the relations of the prostate?

A

Anterior: Pubic bone
Superior: Bladder
Posterior: Rectum
Inferior: Pelvic diaphragm

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49
Q

What is the primary function of the prostate?

A

Produce part of seminal fluid that nourishes and transports sperm in the semen

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50
Q

Each ejaculatory duct is formed by the union of ________ and ___________.

A

Vas deferens and duct of seminal vesicle

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51
Q

What are the lobes of the prostate?

A

1) Anterior
2) Median
3) Lateral
4) Posterior

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52
Q

What are the histological divisions of the prostate gland?

A

1) Fibromuscular stroma
2) Central zone
3) Transitional zone (BPH)
4) Peripheral zone (Prostatic cancer)

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53
Q

Where do the ejaculatory ducts open into?

A

Urethral crest/midline ridge of the prostatic urethra

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54
Q

In females, the paramesonephric duct forms the uterus, cervix, and vagina. What is the homologue in males?

A

Prostatic utricle

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55
Q

What is the homologue of the prostate in females?

A

Paraurethral glands

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56
Q

What is a uvula vesicae?

A

Elevation of the middle lobe of the prostate
- may obstruct passage of urine from the bladder

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57
Q

Describe the arterial supply of the prostate.

A

1) Inferior vesical artery
2) Middle rectal artery
3) Internal pudendal artery

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58
Q

Describe the venous drainage of the prostate.

A

Veins form prostatic plexus → drain into internal iliac vein

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59
Q

How do the prostatic glands release their secretions into the urethra?

A

Through prostatic sinuses into prostatic urethra

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60
Q

Why do prostatic cancers tend to metastasise to bones?

A

Venous drainage by prostatic plexuses which form valveless venous communications with vertebral venous plexus

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61
Q

What are the parts of the uterus?

A

1) Fundus
2) Body
3) Cervix

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62
Q

What is a hysterectomy?

A

Removal of the uterus

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63
Q

What is the name of the upper 1/5 of the cervix?

A

Isthmus uteri

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64
Q

Where is a LSCS (lower segment caesarean section) done anatomically?

A

Isthmus of cervix

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65
Q

In most women, the uterus is ante_______ and ante______. Which means: ___________________.

A

Anteverted:
- long axis of uterus is bent forward in relation to long axis of vagina

Anteflexed:
- long axis of uterus is bent forward in relation to long axis of cervix

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66
Q

What are some possible complication of a retroverted, retroflexed uterus?

A

1) Dysmenorrhea
2) Dyspareunia
3) Sterility
4) Backache
5) Uterine prolapse

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67
Q

What are the structures that support the uterus?

A

1) Fibromuscular ligaments:
a) Cardinal ligament
b) Uterosacral ligament
c) Pubocervical ligament

2) Peritoneum (not rly)
a) Broad ligament

3) Pelvic diaphragm
4) Perineal body
5) Uterine axis (anteverted & anteflexed position)
6) Urogenital diaphragm

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68
Q

The broad ligament extends from the _________________ to the ______________.

A

Sides of uterus to lateral walls of pelvis

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69
Q

The lateral peritoneum of broad ligament is prolonged superiorly and is known as the ______________________.

A

Suspensory ligament of the ovary/infundibulo-pelvic ligament

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70
Q

What are the structures located within the 2 layers of the broad ligament?

A

1) Uterine vessels
2) Lymphatics
3) Ovarian ligament
4) Vestigial remnants of mesonephric tubules (epoophoron and paraoophoron)

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71
Q

What is the ligament located around the uterus?

A

Mesometrium (part of broad ligament)

72
Q

What is the ligament located around the fallopian tube?

A

Mesosalpinx (part of broad ligament)

73
Q

What is the ligament located around the ovary?

A

Mesovarium (part of broad ligament)

74
Q

Which ligament does the uterine artery pass through?

A

Cardinal ligament (fibromuscular)

75
Q

Is the uterine artery superior to the ureter?

A

Yes
“Water (ureter) under the bridge (uterine artery)”

76
Q

What is the round ligament?

A

Cranial end of Gubernaculum attached between the lower pole of ovary and side of uterus

77
Q

What is the ovarian ligament?

A

Portion of Gubernaculum crossing sides of uterus till caudal end attached on labia majora

78
Q

Where are fertilised eggs usually implanted?

A

Upper and posterior wall of uterus in midsagittal plane

79
Q

What are the parts of the fallopian tube?

A

Medial to distal
1) Uterine/interstitium (short)
2) Isthmus (narrow)
3) Ampulla (widest, where fertilisation usually occurs)
4) Infundibulum
5) Fimbriae

80
Q

The infundibulum/fimbriae of the fallopian tube has a free lateral end that expands and opens into the ____________ where it can pick up ova from the ovary.

A

Peritoneal cavity

81
Q

How are females permanently sterilised?

A

Tubectomy:
- ligation of uterine tubes

82
Q

Are ova still released from the ovary after a tubectomy?

A

Yes

83
Q

Describe the arterial supply of the uterus.

A

Internal iliac →uterine artery → branch →
i) Superior (anastomose with ovarian artery)
ii) Inferior (anastomose with vaginal artery)
iii) Lateral (anastomose with the other uterine artery)

84
Q

Describe the arterial supply o the fallopian tube.

A

Branches of ovarian artery (below tube, between layers of broad ligament)
- anastomoses with uterine artery

85
Q

Describe the venous drainage of the uterus.

A

Veins run along artery at lower edge of broad ligament
→ internal iliac vein

86
Q

Describe the innervation of the uterus.

A

Inferior hypogastric plexus
- sympathetic from T12 and L1 → uterine contraction and vasoconstriction
- parasympathetic from S2-4 → uterine inhibition and vasodilation

87
Q

Describe the lymphatic drainage of the uterus.

A

Lymphatics follow artery and drain into internal iliac group

88
Q

What is the pelvic pain line?

A

Inferior border of peritoneum (threshold determining course of visceral pain)
- above/in contact → sympathetic splanchnic nerves
- below → parasympathetic pelvic splanchnic nerves

89
Q

What is cystocele?

A

Anterior vaginal wall prolapse
- caused by weakening of the pelvic floor muscles and connective tissue that support the bladder and anterior wall of vagina

90
Q

What is rectocele?

A

Posterior vaginal wall prolapse
- caused by weakening of pelvic floor muscles and connective tissue between posterior wall of vagina and rectum

91
Q

How are the pelvis are the perineum separated?

A

By the pelvic diaphragm

92
Q

What is the lithotomy position?

A

Best view for examination/ of the perineum
- lower limbs are abducted
- hip and knee joints are flexed

93
Q

What are the structures within the scrotum?

A

1) Testes
2) Epididymis
3) Spermatic cord

94
Q

Describe the descent of the testes.

A

Start 4-6weeks:
1) Gubernaculum anchors the inferior pole of the testis to scrotal skin and pulls towards the scrotum through inguinal canal

2) during 12th week, peritoneum evaginates forming processus vaginalis

3) during 9th month, testes travel through deep inguinal ring, inguinal canal and reach scrotal sac

4) Processus vaginalis obliterates few weeks before birth leaving visceral peritoneum (tunica vaginalis) and parietal (close to scrotal wall)

95
Q

What are the functions of the fluid found between the laters of the tunica vaginalis in males?

A

1) Lubrication
2) Temperature regulation
3) Protection

96
Q

What is hydrocele?

A

Abnormal collection of fluid between the 2 layers of the tunica vaginalis

97
Q

What are the 2 types of hydrocele and how are they differentiated?

A

1) Communicating
- patent processus vaginalis

2) Non-communicating
- etiology: trauma, infection, tumours, HF/LF

Differentiated by Hx taking
- hydrocele appears in the morning/after lying down for long periods and dissipates at night (accumulation of fluid from abdomen/pelvis)

98
Q

How is simple hydrocele differentiated from a solid mass?

A

Hydrocele transillumination

99
Q

What are the layer covering the testis?

A

Superficial to deep:
1) Skin
2) Dartos muscle (cont. of Camper’s fascia)
3) Colle’s fascia (cont. of Scarpa fascia)
4) External spermatic fascia (cont. of EOM)
5) Cremaster master and fascia (cont. of IOM)
6) Internal spermatic fascia (cont. of transversalis fascia)
7) Tunica vaginalis (parietal then visceral)

100
Q

The cremaster muscle is under (somatic/autonomic) control and is suppled by ________ nerve.

A

Autonomic
Genital branch of genito-femoral nerve

101
Q

What is the main artery supplying the perineum?

A

Internal pudendal artery

102
Q

What are the 3 main branches of the internal pudendal artery?

A

1) Inferior rectal
2) Perineal artery
3) Dorsal artery of penis/clitoris

103
Q

Describe the path of the internal pudendal artery from the pelvis to the perineum.

A

1) Exits pelvis inferiorly via greater sciatic foramen
2) Cross close to ischial spine
3) Enters perineum through the lesser sciatic foramen

104
Q

Which artery gives rise to the internal pudendal artery?

A

Internal iliac artery

105
Q

What is the main nerve supplying the perineum?

A

Pudendal nerve

106
Q

Where does the pudendal nerve arise from?

A

Ventral rami of S2-4

107
Q

Which type of nerve fibers does the pudendal nerve not carry?

A

Parasympathetic
- have both sympathetic and autonomic

108
Q

Describe the path the pudendal nerve takes from the pelvis to the perineum.

A

1) Exits pelvis inferiorly via greater sciatic foramen
2) Curves around sacrospinous ligament (close to insertion of ischial spine)
3) Enters perineum through the lesser sciatic foramen

109
Q

What are the branches of the pudendal nerve?

A

1) Inferior rectal nerve
2) Superficial perineal nerve
3) Dorsal nerve of penis/clitoris
4) Posterior nerve of penis

110
Q

What is the nerve(s) that provides parasympathetic innervation to the perineum?

A

Pelvic splanchnic nerves

111
Q

Where do the pelvic splanchnic nerves arise from?

A

S2-4

112
Q

Describe the general lymphatic drainage of the perineum and the relevant exceptions.

A

Most drain into superficial inguinal nodes

except:
(i) Glans penis (ii) clitoris drain into deep inguinal nodes

(iii) testes drain to para-aortic lymph nodes

113
Q

What is the Alcock’s canal?

A

Canal in perineum formed by fascia of obturator internus muscle and deep pelvic fascia

114
Q

What are the vessels that run through the Alcock’s canal?

A

1) Pudendal nerve
2) Internal pudendal artery
3) Internal pudendal vein

115
Q

What are 2 nerve block procedures used to anaesthesise the perineum?

A

1) Pudendal nerve block
- bony landmark ischial spine
- uses: (2nd stage of labour, repair of episiotomy, outlet instrument delivery, minor surgeries of perineum)

2) Ilioinguinal nerve block
- for superior/anterior parts of perineum eg. mons pubis

116
Q

What is the anatomical landmark for the differentiation of the urogenital and anal triangle?

A

Ischial tuberosities on both sides

117
Q

The anal triangle contains the anal canal and two ______________________ that lie on either side of the anal canal.

A

Ischiorectal fossae

118
Q

What are the ischiorectal fossae?

A

Wedge-shaped space filled with fat and poorly vascularised
- lying on either side of the rectum
- communication through deep anal space posteriorly (no communication of anterior side)

119
Q

What are the boundaries of the ischiorectal fossa?

A

Base: Skin
Medial: Sloping levator ani muscle and anal canal
Lateral: Obturator internus, pudenda canal, ischial tuberosity
Edge: Junction btwn medial and lateral wall

120
Q

What are 2 functions of the ischiorectal fossae?

A

1) Passageway for neurovascular structures (pudendal nerve and internal pudendal vein/artery)

2) Facilitate defecation
- allows expansion of anal canal

121
Q

What nerve is at risk of being severed during the incision and drainage of a perianal abscess?

A

Inferior rectal nerve
- can lead to incontinence

122
Q

The urogenital diaphragm is a ___________-layered tough fibrous tissue sheets that fills the urogenital triangle. It gives attachment to the ____________.

A

UG diaphragm:
- double layered
- attachment for external genitalia

123
Q

The inferior layer of the UG diaphragm is (thinner/thicker) and often called the ______________.

A

Inferior:
- thicker
- perineal membrane (inferior fascia)

124
Q

True or false: The bulbourethral glands drain into the adjacent membranous urethra.

A

False.
Drains to penile urethra inferior

125
Q

The deep perineal pouch is formed by _____________________.

A

Deep perineal pouch:
- space between 2 layers of UG diaphragm

126
Q

Deep transverse perineal muscle

Origin:
Insertion:
Action:
Innervation:

A

Deep transverse perineal muscle

Origin: Internal surface of ramus of ischium
Insertion: Perineal body
Action: stabilises perineal body + provides support to adjacent pelvic and perineal structure
Innervation: pudendal

127
Q

What is the function of the bulbourethral glands?

A

Accessory sex gland:
- produces pre-ejaculatory fluids to neutralise acidic urine residue

128
Q

What is the female equivalent of the bulbourethral glands in females?

A

Bartholin’s glands

129
Q

What are the contents of the deep perineal pouch in males?

A

i) parts of membranous urethra
ii) external urethral sphincter muscle
iii) bulbourethral glands
iv) deep transverse perineal muscles

130
Q

What are the contents of the deep perineal pouch in females?

A

1) Part of female urethra
2) Part of vagina
3) Sphincter urethrae
4) Deep transverse perineal muscles

131
Q

What forms the superficial perineal space?

A

Space between Colle’s fascia and inferior fascia of UG diaphragm

132
Q

What organs are located within the superficial perineal space?

A

External genital organs

133
Q

What are the 3 parts of the penis?

A

1) Root
2) Body
3) Glans Penis

134
Q

True or false: The root of the penis is located in the superficial perineal pouch and visible externally, containing the proximal part of the erectile tissues.

A

False.
Root of penis:
- located in superficial perineal pouch
- NOT visible externally
- contains proximal part of erectile tissues

135
Q

What are the 2 erectile structures that form the penis?

A

1) Corpus cavernosum
2) Corpus spongiosum

136
Q

What are the names of the roots of the 2 erectile structure of the penis?

A

1) Crus (Corpus cavernosum)
2) Bulb (Corpus spongiosum)

137
Q

Which erectile structure forms the glands penis?

A

Corpus spongiosum

138
Q

Which erectile tissue does the penile urethra pass through?

A

Corpus spongiosum

139
Q

The skin covering the shaft of the penis is thin, loose and elastic and lacks___________.

A

lack hair follicles and sebaceous glands

140
Q

What is the prepuce?

A

Foreskin
- fold of skin covering glans penis
- double layered (i) outer skin (ii) inner mucous membrane

141
Q

What is the function of the prepuce?

A

1) Provide protection to glans penis
2) Maintain glans penis sensitivity by keeping it moist

142
Q

What is phimosis?

A

Inability to retract prepuce

143
Q

What are 3 complications of phimosis?

A

1) Prepuce inflammation
2) UTI
3) Poor hygiene
4) Penile cancer (long-standing phimosis)

144
Q

True or false: Circumcision is recommended in all px with phimosis.

A

False.
Physiological phimosis does not require treatment (returns to normal by puberty)

145
Q

What is the mons pubis?

A

Mound of hairy skin and subcutaneous fat in front of pubic symphysis

146
Q

What are 3 differences between the labia majora and minor?

A

Majora:
1) hair bearing
2) external (more lateral also)
3) filled with subcutaneous tissue and terminal part of round ligament

147
Q

Where is the vestibule?

A

Area enclosed by labia minora, containing openings of vagina and urethra

148
Q

Superiorly, the labia minora divides into 2 layers:
i)_________________
ii)__________________

A

1) Prepuce (above clitoris)
2) Frenulum (below)

149
Q

What is the fourchette?

A

Small fold of tissue where labia minora meet posteriorly
- may be torn during vaginal delivery due to sudden stretching of vulval orifice

150
Q

What 2 structures are the clitoris formed by?

A

1) Corpus carvernosa
2) Glans clitoris

151
Q

Each crus of the clitoris is attached to ______________________.

A

Perineal membrane and ischiopubic ramus

152
Q

In contrast to males, the corpus spongiosum is split in two, forming ______________________.

A

Bulbs of vestibule
- unite ventral to urethral orifice to form thin strand of spongiosum erectile tissue that ends into the clitoris as the glans

153
Q

Describe the musculature of the penis.

A

Both skeletal and innervated by pudendal nerve:
1) Ischiocavernosus muscle
- spirals over corpora cavernosa
- support and mvt of erect penis

2) Bulbospongiosus muscle
- spirals over corposa spongiosum
- expulsion of urine and semen

154
Q

Describe the structure of erectile tissues.

A

Numerous sinusoids/cavernous spaces (lined by single layer of endothelial cells) among interwoven trabeculae of smooth muscles and supporting connective tissue

155
Q

Describe the mechanism of erection and ejaculation.

A

1) Erotic stimulation → parasympathetic stimulation

2) Smooth muscle relaxation in fibrous trabeculae + artery dilation → Cavernous spaces fill w blood

3) Blood-filled spaces compress veins against tunica albuginea → block backflow of blood/venous return → erection

4) Ejaculation → sympathetic stimulation → closure of internal urethral sphincter to prevent backflow of semen into bladder

156
Q

Describe the musculature of the clitoris.

A

1) Ischiocavernosus
- spirals on crura of clitoris
- compresses clitoral crura → maintain erection and enhancing clitoral engorgement and sensitivity

2) Bulbospongiosus
- covers vestibular bulb
- contributes to clitoris erection

157
Q

What and where is the perineal body?

A

Central tendon of the perineum
- fibromuscular structure
- located midline of perineum, at junction of anus and urogenital triangle

158
Q

What are 3 muscles that attach to the perineal body?

A

1) Bulbospongiosus
2) Deep/Superficial transverse perineal muscle
3) External anal sphincter
4) Levator ani (puborectalis)

159
Q

What is a episiotomy?

A

Incision of vaginal opening to enlarge birth outlet and facilitate delivery of fetus
- prevents multiple tears
- 2 types: mediolateral (safer), midline (worse)

160
Q

What are the structures that are incised during an episiotomy?

A

1) Skin
2) Subcutaneous tissues
3) Superficial and deep transverse perineal muscles
4) Bulbospongiosum
5) Puborectalis (of levator ani)
5) Posterior vaginal wall

161
Q

What is the main concern of weakness/damage to the perineal body?

A

Pelvic organ prolapse

162
Q

Describe the path and structure of the male urethra.

A

1) Pre-prostatic (1cm)
- directly inferior to bladder

2) Prostatic (3-4cm)
- widest

3) Membranous (1-2cm)
- surrounded by external urethral sphincter (voluntary by pudendal nerve)

4) Penile/spongy (14-15cm)
- has a distal widening (navicular fossa)
- surrounded by corpus spongiosum

163
Q

What are the widest and narrowest parts of the male urethra?

A

Narrowest: external urethral orifice

Widest: Prostatic urethra

164
Q

In a male px with a spongy urethral rupture, where can urine leak to?

A

1) Anterior abdominal wall
2) Around penis
3) Superficial perineal pouch
4) Scrotum

Will NOT leak into the (i) anal triangle or (ii) lower limbs/thigh
- (i) Colle’s fascia attaches to perineal membrane
- (ii) Scarpa’s fascia attached to fascia lata

165
Q

Why are UTIs more common in females?

A

Shorter urethra (3-4cm vs 18-20cm)

166
Q

In a male px with a membranous urethral rupture, where can urine leak into?

A

1) Deep perineal pouch
2) Retroperitoneal space (extravasated from deep perineal pouch)

167
Q

The vagina is a fibromuscular tubular structure of 9-10cm in length. It is situated anterior to ___________ and posterior to ______________.

A

Anterior to: rectum, anal canal perineal body

Posterior to: Urinary bladder, urethra

168
Q

What is a vaginal fornix?

A

Circular groove formed by margin of cervix and vagina
- anterior, posterior, 2 lateral (total 4)

169
Q

The posterior fornix is covered by the peritoneum, specifically the ___________.

A

Rectouterine pouch/Pouch of Douglas

170
Q

What are 3 arteries that supply the vagina?

A

1) Uterine artery
2) Vaginal artery
3) Internal pudendal artery

171
Q

Describe the lymphatic drainage of the vagina.

A

Upper 4/5: Iliac nodes
Lower 1/5: Superficial inguinal nodes

172
Q

Describe the nerve supply of the vagina.

A

Upper 4/5th: Inferior hypogastric plexus (only sensitive to stretch)

Lower 1/5th: Somatic innervation by pudendal nerve (sensitive to touch and temperature)

173
Q

What is cervical effacement?

A

When the cervix softens, thins and shortens occurring late in pregnancy

174
Q

What is a Bartholin’s cyst?

A

Cyst formed by fluid accumulation/inflammation of Bartholin’s gland

175
Q

What are 3 muscles deep to the breast?

A

1) Pectoralis major
2) Serratus anterior
3) External oblique

176
Q
A

Reproductive System (7 decks)

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