Anatomy Flashcards
1
Q
What are the bones that form the acetabulum?
A
1) Ilium
2) Pubis
3) Ischium
2
Q
Where is the obturator foramen?
A
Between the pubis and ischium
3
Q
What is the joint between the spine and the hip?
A
Sacroiliac joint
4
Q
What separates the abdominal and pelvic cavity?
A
Technically no but have pelvic diaphragm
5
Q
What are the 4 bones that form the pelvic girdle?
A
2 hip bones (formed by pubis, ilium, ischium)
Sacrum
Coccyx
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
7
Q
What type of joint is the pubic symphysis?
A
Cartilaginous
8
Q
The sacrum is formed by the ______ of the ____ sacral vertebrae.
A
Fusion of the 5 sacral vertebrae
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
10
Q
What are the 2 landmark of the ischium?
A
1) Ischial tuberosity (most inferior)
2) Ischial spine (when viewed posteriorly)
11
Q
What is the only bony landmark that is in contact with the floor when seated?
A
Ischial tuberosity
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
13
Q
What is the ligament connecting the anterior superior iliac spine to the pubic tubercle?
A
Inguinal ligament
14
Q
What is the anterior tip of S1 called?
A
Sacral promotory
15
Q
The sacral canal continues the vertebral canal from the cauda equina and terminates as the _____________.
A
Sacral hiatus
16
Q
Where do the sacral nerves exit the sacral vertebrae from?
A
Anterior and posterior sacral foramina
17
Q
What is the name for coccyx pain?
A
Coccydynia
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
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)
20
Q
What are the borders of the pelvic inlet?
A
Anterior: Pubic symphysis
Posterior: Sacral promontory, Ala of sacrum
Lateral: Iliopectineal/arcuate lines
21
Q
What are the borders of the pelvic outlet?
A
Anterior: Pubic symphysis
Posterior: Coccyx
Anterolateral: Ischiopubic/Inferior ramus
Posterolateral: Sacrotuberous ligament
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
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
24
Q
The greater sciatic notch is located ______ to the lesser sciatic notch.
A
Superior
25
The greater sciatic notch is a large concave area located on the ________ border of the ilium.
Posterior
26
What are the joints that hold the pelvis together?
1) Pubic symphysis
2) Sacrospinous ligament
3) Sacrotuberous ligament
27
What is an example of a structure that passes through the greater and/or lesser sciatic foramen?
Neurovascular bundle
(to gluteal, thigh, perineal regions)
28
Where is the piriformis muscle found?
Between sacrum → greater sciatic foramen → femur
29
Where is the obturator internus found?
Within obturator foramen
30
How is the obturator canal formed?
Obturator membrane covering obturator internus leaves a gap
31
What are the 2 main structures that form the pelvic diaphragm?
1) Levator ani (puborectalis, pubococcygeus, iliococcygeus)
2) Small coccygeus
32
What are the 2 openings in the pelvic floor?
1) Urogenital hiatus
2) Rectal hiatus
33
What are the 4 functions of the pelvic floor/diaphragm?
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)
34
What are the 3 muscles that constitute the levator ani?
1) Puborectalis
2) Pubococcygeus
3) Iliococcygeus
35
The coccygeus muscle originates from the _____________ and attaches to the ________________.
Coccygeus:
Origin: Ischial spine
Attachment: Coccyx
36
Describe the innervation of the levator ani muscle.
Perineal branch of S4
Pudendal nerve (S2-4)
37
Levator ani
Origin:
Anterior:____________
Posterior:__________
Lateral:______________
Insertion: (i)_____________________
(ii) ____________________
(iii) ____________________
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
38
What is pelvimetery?
Diagnostic technique used to evaluate dimensions of women's pelvis → predict potential for vaginal delivery
39
What are the 3 diameters of the pelvic inlet and how are they measured?
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)
40
What are the 3 diameters of the pelvic outlet and how are they measured?
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)
41
Comparing the diameters of the pelvic inlet and outlet, at the inlet the ______ is the largest, whereas at the outlet the _________ is the largest.
Inlet: transverse (13cm)
Outlet: AP (13cm)
42
What is cephalopelvic disproportion?
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
43
How does one determine whether a female is able to deliver an average-sized baby anatomically?
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
44
What is the primary arterial supply of the pelvis?
Internal iliac artery
45
At which spinal segment level do the common iliac arteries bifurcate?
L4
46
The internal iliac artery divides into the (short/long) anterior and (short/long posterior) branch.
Long anterior
Short posterior
47
What are the 3 accessory glands of the male reproductive system?
1) Seminal vesicles
2) Prostate gland
3) Bulbourethral glands
48
What are the relations of the prostate?
Anterior: Pubic bone
Superior: Bladder
Posterior: Rectum
Inferior: Pelvic diaphragm
49
What is the primary function of the prostate?
Produce part of seminal fluid that nourishes and transports sperm in the semen
50
Each ejaculatory duct is formed by the union of ________ and ___________.
Vas deferens and duct of seminal vesicle
51
What are the lobes of the prostate?
1) Anterior
2) Median
3) Lateral
4) Posterior
52
What are the histological divisions of the prostate gland?
1) Fibromuscular stroma
2) Central zone
3) Transitional zone (BPH)
4) Peripheral zone (Prostatic cancer)
53
Where do the ejaculatory ducts open into?
Urethral crest/midline ridge of the prostatic urethra
54
In females, the paramesonephric duct forms the uterus, cervix, and vagina. What is the homologue in males?
Prostatic utricle
55
What is the homologue of the prostate in females?
Paraurethral glands
56
What is a uvula vesicae?
Elevation of the middle lobe of the prostate
- may obstruct passage of urine from the bladder
57
Describe the arterial supply of the prostate.
1) Inferior vesical artery
2) Middle rectal artery
3) Internal pudendal artery
58
Describe the venous drainage of the prostate.
Veins form prostatic plexus → drain into internal iliac vein
59
How do the prostatic glands release their secretions into the urethra?
Through prostatic sinuses into prostatic urethra
60
Why do prostatic cancers tend to metastasise to bones?
Venous drainage by prostatic plexuses which form valveless venous communications with vertebral venous plexus
61
What are the parts of the uterus?
1) Fundus
2) Body
3) Cervix
62
What is a hysterectomy?
Removal of the uterus
63
What is the name of the upper 1/5 of the cervix?
Isthmus uteri
64
Where is a LSCS (lower segment caesarean section) done anatomically?
Isthmus of cervix
65
In most women, the uterus is ante_______ and ante______. Which means: ___________________.
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
66
What are some possible complication of a retroverted, retroflexed uterus?
1) Dysmenorrhea
2) Dyspareunia
3) Sterility
4) Backache
5) Uterine prolapse
67
What are the structures that support the uterus?
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
68
The broad ligament extends from the _________________ to the ______________.
Sides of uterus to lateral walls of pelvis
69
The lateral peritoneum of broad ligament is prolonged superiorly and is known as the ______________________.
Suspensory ligament of the ovary/infundibulo-pelvic ligament
70
What are the structures located within the 2 layers of the broad ligament?
1) Uterine vessels
2) Lymphatics
3) Ovarian ligament
4) Vestigial remnants of mesonephric tubules (epoophoron and paraoophoron)
71
What is the ligament located around the uterus?
Mesometrium (part of broad ligament)
72
What is the ligament located around the fallopian tube?
Mesosalpinx (part of broad ligament)
73
What is the ligament located around the ovary?
Mesovarium (part of broad ligament)
74
Which ligament does the uterine artery pass through?
Cardinal ligament (fibromuscular)
75
Is the uterine artery superior to the ureter?
Yes
"Water (ureter) under the bridge (uterine artery)"
76
What is the round ligament?
Cranial end of Gubernaculum attached between the lower pole of ovary and side of uterus
77
What is the ovarian ligament?
Portion of Gubernaculum crossing sides of uterus till caudal end attached on labia majora
78
Where are fertilised eggs usually implanted?
Upper and posterior wall of uterus in midsagittal plane
79
What are the parts of the fallopian tube?
Medial to distal
1) Uterine/interstitium (short)
2) Isthmus (narrow)
3) Ampulla (widest, where fertilisation usually occurs)
4) Infundibulum
5) Fimbriae
80
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.
Peritoneal cavity
81
How are females permanently sterilised?
Tubectomy:
- ligation of uterine tubes
82
Are ova still released from the ovary after a tubectomy?
Yes
83
Describe the arterial supply of the uterus.
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
Describe the arterial supply o the fallopian tube.
Branches of ovarian artery (below tube, between layers of broad ligament)
- anastomoses with uterine artery
85
Describe the venous drainage of the uterus.
Veins run along artery at lower edge of broad ligament
→ internal iliac vein
86
Describe the innervation of the uterus.
Inferior hypogastric plexus
- sympathetic from T12 and L1 → uterine contraction and vasoconstriction
- parasympathetic from S2-4 → uterine inhibition and vasodilation
87
Describe the lymphatic drainage of the uterus.
Lymphatics follow artery and drain into internal iliac group
88
What is the pelvic pain line?
Inferior border of peritoneum (threshold determining course of visceral pain)
- above/in contact → sympathetic splanchnic nerves
- below → parasympathetic pelvic splanchnic nerves
89
What is cystocele?
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
What is rectocele?
Posterior vaginal wall prolapse
- caused by weakening of pelvic floor muscles and connective tissue between posterior wall of vagina and rectum
91
How are the pelvis are the perineum separated?
By the pelvic diaphragm
92
What is the lithotomy position?
Best view for examination/ of the perineum
- lower limbs are abducted
- hip and knee joints are flexed
93
What are the structures within the scrotum?
1) Testes
2) Epididymis
3) Spermatic cord
94
Describe the descent of the testes.
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
What are the functions of the fluid found between the layer of the tunica vaginalis in males?
1) Lubrication
2) Temperature regulation
3) Protection
96
What is hydrocele?
Abnormal collection of fluid between the 2 layers of the tunica vaginalis
97
What are the 2 types of hydrocele and how are they differentiated?
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
How is simple hydrocele differentiated from a solid mass?
Hydrocele transillumination
99
What are the layer covering the testis?
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
The cremaster muscle is under (somatic/autonomic) control and is suppled by ________ nerve.
Autonomic
Genital branch of genito-femoral nerve
101
What is the main artery supplying the perineum?
Internal pudendal artery
102
What are the 3 main branches of the internal pudendal artery?
1) Inferior rectal
2) Perineal artery
3) Dorsal artery of penis/clitoris
103
Describe the path of the internal pudendal artery from the pelvis to the perineum.
1) Exits pelvis inferiorly via greater sciatic foramen
2) Cross close to ischial spine
3) Enters perineum through the lesser sciatic foramen
104
Which artery gives rise to the internal pudendal artery?
Internal iliac artery
105
What is the main nerve supplying the perineum?
Pudendal nerve
106
Where does the pudendal nerve arise from?
Ventral rami of S2-4
107
Which type of nerve fibers does the pudendal nerve not carry?
Parasympathetic
- have both sympathetic and somatic
108
Describe the path the pudendal nerve takes from the pelvis to the perineum.
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
What are the branches of the pudendal nerve?
1) Inferior rectal nerve
2) Superficial perineal nerve
3) Dorsal nerve of penis/clitoris
4) Posterior nerve of penis
110
What is the nerve(s) that provides parasympathetic innervation to the perineum?
Pelvic splanchnic nerves
111
Where do the pelvic splanchnic nerves arise from?
S2-4
112
Describe the general lymphatic drainage of the perineum and the relevant exceptions.
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
What is the Alcock's canal?
Canal in perineum formed by fascia of obturator internus muscle and deep pelvic fascia
114
What are the vessels that run through the Alcock's canal?
1) Pudendal nerve
2) Internal pudendal artery
3) Internal pudendal vein
115
What are 2 nerve block procedures used to anaesthesise the perineum?
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
What is the anatomical landmark for the differentiation of the urogenital and anal triangle?
Ischial tuberosities on both sides
117
The anal triangle contains the anal canal and two ______________________ that lie on either side of the anal canal.
Ischiorectal fossae
118
What are the ischiorectal fossae?
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
What are the boundaries of the ischiorectal fossa?
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
What are 2 functions of the ischiorectal fossae?
1) Passageway for neurovascular structures (pudendal nerve and internal pudendal vein/artery)
2) Facilitate defecation
- allows expansion of anal canal
121
What nerve is at risk of being severed during the incision and drainage of a perianal abscess?
Inferior rectal nerve
- can lead to incontinence
122
The urogenital diaphragm is a ___________-layered tough fibrous tissue sheets that fills the urogenital triangle. It gives attachment to the ____________.
UG diaphragm:
- double layered
- attachment for external genitalia
123
The inferior layer of the UG diaphragm is (thinner/thicker) and often called the ______________.
Inferior:
- thicker
- perineal membrane (inferior fascia)
124
True or false: The bulbourethral glands drain into the adjacent membranous urethra.
False.
Drains to penile urethra inferior
125
The deep perineal pouch is formed by _____________________.
Deep perineal pouch:
- space between 2 layers of UG diaphragm
126
Deep transverse perineal muscle
Origin:
Insertion:
Action:
Innervation:
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
What is the function of the bulbourethral glands?
Accessory sex gland:
- produces pre-ejaculatory fluids to neutralise acidic urine residue
128
What is the female equivalent of the bulbourethral glands in females?
Bartholin's glands
129
What are the contents of the deep perineal pouch in males?
i) parts of membranous urethra
ii) external urethral sphincter muscle
iii) bulbourethral glands
iv) deep transverse perineal muscles
130
What are the contents of the deep perineal pouch in females?
1) Part of female urethra
2) Part of vagina
3) Sphincter urethrae
4) Deep transverse perineal muscles
131
What forms the superficial perineal space?
Space between Colle's fascia and inferior fascia of UG diaphragm
132
What organs are located within the superficial perineal space?
External genital organs
133
What are the 3 parts of the penis?
1) Root
2) Body
3) Glans Penis
134
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.
False.
Root of penis:
- located in superficial perineal pouch
- NOT visible externally
- contains proximal part of erectile tissues
135
What are the 2 erectile structures that form the penis?
1) Corpus cavernosum
2) Corpus spongiosum
136
What are the names of the roots of the 2 erectile structure of the penis?
1) Crus (Corpus cavernosum)
2) Bulb (Corpus spongiosum)
137
Which erectile structure forms the glands penis?
Corpus spongiosum
138
Which erectile tissue does the penile urethra pass through?
Corpus spongiosum
139
The skin covering the shaft of the penis is thin, loose and elastic and lacks___________.
lack hair follicles and sebaceous glands
140
What is the prepuce?
Foreskin
- fold of skin covering glans penis
- double layered (i) outer skin (ii) inner mucous membrane
141
What is the function of the prepuce?
1) Provide protection to glans penis
2) Maintain glans penis sensitivity by keeping it moist
142
What is phimosis?
Inability to retract prepuce
143
What are 3 complications of phimosis?
1) Prepuce inflammation
2) UTI
3) Poor hygiene
4) Penile cancer (long-standing phimosis)
144
True or false: Circumcision is recommended in all px with phimosis.
False.
Physiological phimosis does not require treatment (returns to normal by puberty)
145
What is the mons pubis?
Mound of hairy skin and subcutaneous fat in front of pubic symphysis
146
What are 3 differences between the labia majora and minor?
Majora:
1) hair bearing
2) external (more lateral also)
3) filled with subcutaneous tissue and terminal part of round ligament
147
Where is the vestibule?
Area enclosed by labia minora, containing openings of vagina and urethra
148
Superiorly, the labia minora divides into 2 layers:
i)_________________
ii)__________________
1) Prepuce (above clitoris)
2) Frenulum (below)
149
What is the fourchette?
Small fold of tissue where labia minora meet posteriorly
- may be torn during vaginal delivery due to sudden stretching of vulval orifice
150
What 2 structures are the clitoris formed by?
1) Corpus carvernosa
2) Glans clitoris
151
Each crus of the clitoris is attached to ______________________.
Perineal membrane and ischiopubic ramus
152
In contrast to males, the female corpus spongiosum is split in two, forming ______________________.
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
Describe the musculature of the penis.
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
Describe the structure of erectile tissues.
Numerous sinusoids/cavernous spaces (lined by single layer of endothelial cells) among interwoven trabeculae of smooth muscles and supporting connective tissue
155
Describe the mechanism of erection and ejaculation.
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
Describe the musculature of the clitoris.
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
What and where is the perineal body?
Central tendon of the perineum
- fibromuscular structure
- located midline of perineum, at junction of anus and urogenital triangle
158
What are 3 muscles that attach to the perineal body?
1) Bulbospongiosus
2) Deep/Superficial transverse perineal muscle
3) External anal sphincter
4) Levator ani (puborectalis)
159
What is a episiotomy?
Incision of vaginal opening to enlarge birth outlet and facilitate delivery of fetus
- prevents multiple tears
- 2 types: mediolateral (safer), midline (worse)
160
What are the structures that are incised during an episiotomy?
1) Skin
2) Subcutaneous tissues
3) Superficial and deep transverse perineal muscles
4) Bulbospongiosum
5) Puborectalis (of levator ani)
5) Posterior vaginal wall
161
What is the main concern of weakness/damage to the perineal body?
Pelvic organ prolapse
162
Describe the path and structure of the male urethra.
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
What are the widest and narrowest parts of the male urethra?
Narrowest: external urethral orifice
Widest: Prostatic urethra
164
In a male px with a spongy urethral rupture, where can urine leak to?
1) Anterior abdominal wall
2) Around penis
3) Superficial perineal pouch
4) Scrotum
## Footnote
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
Why are UTIs more common in females?
Shorter urethra (3-4cm vs 18-20cm)
166
In a male px with a membranous urethral rupture, where can urine leak into?
1) Deep perineal pouch
2) Retroperitoneal space (extravasated from deep perineal pouch)
167
The vagina is a fibromuscular tubular structure of 9-10cm in length. It is situated anterior to ___________ and posterior to ______________.
Anterior to: rectum, anal canal perineal body
Posterior to: Urinary bladder, urethra
168
What is a vaginal fornix?
Circular groove formed by margin of cervix and vagina
- anterior, posterior, 2 lateral (total 4)
169
The posterior fornix is covered by the peritoneum, specifically the ___________.
Rectouterine pouch/Pouch of Douglas
170
What are 3 arteries that supply the vagina?
1) Uterine artery
2) Vaginal artery
3) Internal pudendal artery
171
Describe the lymphatic drainage of the vagina.
Upper 4/5: Iliac nodes
Lower 1/5: Superficial inguinal nodes
172
Describe the nerve supply of the vagina.
Upper 4/5th: Inferior hypogastric plexus (only sensitive to stretch)
Lower 1/5th: Somatic innervation by pudendal nerve (sensitive to touch and temperature)
173
What is cervical effacement?
When the cervix softens, thins and shortens occurring late in pregnancy
174
What is a Bartholin's cyst?
Cyst formed by fluid accumulation/inflammation of Bartholin's gland
175
What are 3 muscles deep to the breast?
1) Pectoralis major
2) Serratus anterior
3) External oblique
176
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