anatomy Flashcards
what separates the greater and lesser sciatic foramen
sacrospinous ligament
what is the role of the greater sciatic foramen
passageway for structures to pass from the pelvis into the gluteal region
what is the role of the lesser sciatic foramen
communication between the perineum of the pelvis and the gluteal region
nervous supply to the perineal muscles
pudendal nerve
what is the importance of the perineal body
important to pelvic floor strength
what is the relationship between parietal peritoneum and the pelvic organs
inferior part of parietal peritoneum covers the superior aspect of the pelvic organs
what is another name for the recto-uterine pouch
pouch of douglas
where can the fusion of the 3 bones of the hip be seen
in the acetabulum
where does the ovarian artery arise from
the abdominal aorta
what is used to remember the relationship between the ureter and the uterine artery
water under the bridge
what are the 3 bones that form the hip
ilium, pubis and ishium
what does the bony pelvis consist of
2 hip bones, sacrum and coccyx
what does the pelvic floor separate
the pelvic cavity from the perineum
what are the 3 layers of the pelvic floor
pelvic diaphragm
muscles of perineal pouches
perineal membrane
what is the pelvic diaphragm made of
levator ani and coccygeus muscles
what is the structure of the levator ani
3 paired skeletal muscles: pubococcygeus, puborectalis and iliococcygeus
what are the 2 gaps in the pelvic floor and what are their roles
urogenital hiatus - allows the passage of the urethra (and vagina in females)
rectal hiatus - allows passage of the anal canal
what is a vaginal prolapse
herniation of urethra, bladder, rectum or rectouterine pouch through the supporting fascia
how does a vaginal prolapse usually present
lump in the vaginal wall
what embryonic layer do the urogenital and reproductive systems arise from
intermediate mesoderm
what causes the development of male reproductive organs
sex determining region on Y chromosome causes primitive sex cords to form testis/medullary cords
how long does spermatogenesis usually take
64-74 days
when does spermatogenesis occur
starts at puberty and continues throughout life
what regulates the descent of the testes
gubernaculum
which genital ducts remain in men and women
mesonephric in males
paramesonephric in females
when does sexual differentiation occur in an embryo
from week 7
what causes degeneration of the paramesonephric duct in males
sertoli cells secrete AMH
what causes the development of mesonephric ducts in males
sertoli cells stimulate gonadal ridge cells to form leydig cells which secrete testosterone
what causes the development of paramesonephric ducts in females
presence of oestrogen and the absence of testosterone and AMH
what are the derivatives of vaginal development
superior vagina - paramesonephric ducts
rest - urogenital sinus
what causes the masculinisation of the external genetalia
dihydrotestosterone
what are the 3 layers of the uterus from outside in and what are they made of
perimetrium - loose connective tissue
myometrium - smooth muscle (+collagen and elastic tissue)
endometrium - secretory mucosa
what is the most common position of the uterus
anteverted and anteflexed
what does it mean if a uterus is anteverted
cervix tipped anteriorly relative to the axis of the vagina
what does it mean if a uterus is anteflexed
uterus tipped anteriorly relative to the axis of the cervix
what are the 2 main ligaments of the uterus
broad and round
what is the role of the broad ligament of the uterus
helps maintain the uterus in it’s midline position
what is the role of the round ligament of the uterus
just an embryological remnant
what is another name for the uterine tubes
fallopian tubes
where does fertilisation occur
ampulla
what is the primary female reproductive organ
ovaries
what are the 2 main functions of the ovaries
oogenesis
produce steroids - mainly oestrogens and progestrogens
what causes the ovary to secrete oestrogen and progesterone
response to LH and FSH from the anterior pituitary
what are graafian follicles
mature follicles in the ovary prior to ovulation
what is required to maintain the corpus luteum
LH (or HCG in pregnancy)
where does lymph from the ovaries drain
para-aortic nodes
venous drainage of the ovaries
L ovarian vein - left renal vein
R ovarian vein - inferior vena cava
what type of cells line the vagina
non-keratinised stratified squamous epithelium
what examination can be used to palpate the position of the uterus
bimanual palpation
where is the most common site for cervical cancer to occur
transition zone
where stratified squamous epithelium turns into simple columnar epithelium
how does the cervix facilitate the passage of sperm into the uterine cavity
dilation of the external and internal os
what are bartholins glands and what is their role
glands on the side of the vaginal opening
secrete fluid to help lubricate the vagina
what kind of innervation controls pain from the perineum
somatic sensory
describe innervation to the perineum
body wall so somatic sensation
via pudendal nerve S2,3,4
describe innervation of the superior aspect of the pelvic organs
TOUCHING THE PERITONEUM
visceral afferents - run along sympathetic fibres
enter spinal cord between T11-L2
how is pain from the superior aspect of pelvic organs perceived
suprapubic pain
describe innervation of the inferior aspects of pelvic organs
NOT TOUCHING THE PERITONEUM
visceral afferents, run with parasympathetics
enter spinal cord at S2,3,4
how is pain from the inferior aspect of pelvic organs percieved
in the S2-4 dermatome = perineum
at which vertebral level does the subarachnoid space end
S2
where do we inject epidural anaesthetic
L3/4
how can we estimate the level of the L4 spinous process
horizontal line for the most superior point of the iliac crests
where does spinal anaesthetic get injected into
the subarachnoid space
what can be a complication of a spinal anaesthetic and why
hypotension as causes vasodilation due to blockade of sympathetic tone
what bony landmark can be used to identify the pudendal nerve
ischial spine
what might be performed to help prevent perineal trauma during child birth
episiotomy
what direction do the external obliques run in
anteroinferior direction - hands in pockets
how does the linea alba form
interweaving of the muscle aponeurosis
name the 2 main arterial supplies to the anterior abdominal wall
superior and inferior epigastric arteries
arterial supply to the lateral abdominal wall
intercostal and subcostal arteries
which layers are stitched closed following a caesarean
uterine wall + peritoneum
rectus sheath
skin
incision for a laparotomy
vertical midline incision
what incisions are usually made for a laparoscopy
subumbilical and lateral ports
what do we need to make sure we avoid when inserting a lateral port for laparoscopy
inferior epigastric artery
