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Genitourinary > Anatomy > Flashcards

Anatomy Flashcards

1
Q

Key bony landmarks of the pubis

A 
Iliac crest
Iliac fossa
ASIS
Anterior sacro-iliac joint
Ischial spine
Pubic symphysis
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2
Q

Bony tubercle at the top of the femur

A

Lesser trochanter

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3
Q

Holes in the pubis next to the pubic symphysis

A

Obturator foramen

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4
Q

4 key muscles of the posterior abdominal wall

A

Psoas (medial)
Quadratus
Iliacus
Transversus (lateral)

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5
Q

Quadratus lumborum origin

A

Iliac crest

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6
Q

Quadratus lumborum insertion

A

12th rib

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7
Q

Quadratus lumborum action

A

Supports posterior abdominal wall and 12th rib

Involved in forced expiration and flexing trunk to one side

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8
Q

Quadratus lumborum innervation

A

Anterior rami

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9
Q

Iliacus origin

A

Iliac fossa

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10
Q

Iliacus insertion

A

Lesser trochanter of femur (joins psoas to form common tendon)

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11
Q

Iliacus action

A

Hip flexion

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12
Q

Iliacus innervation

A

Femoral nerve from L2-4

Only one not innervated by segmental rami

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13
Q

Psoas origin

A

T12, L1-L5 vertebral bodies and interverterbral discs

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14
Q

Psoas insertion

A

Lesser trochanter of femur (joins iliacus to form common tendon)

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15
Q

Psoas action

A

Raises body from supine position

Bends trunk laterally and hip flexion

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16
Q

Psoas innervation

A

Anterior rami

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17
Q

How many pairs of arteries and veins supply and drain the posterior abdominal wall?

A

5 pairs of arteries and 5 pairs of veins

Arteries come from posterior aspect of aorta

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18
Q

Kidney position

A

Retroperitoneal
Both on top of psoas and quadratus lumborum
Right kidney behind and below rib 12
Left kidney behind and below ribs 11 and 12

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19
Q

What spinal level does the ureter exit the kidney?

A

L1 - transpyloric plane

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20
Q

Fascia and fat around the kidneys

A

Peritoneum
Renal fascia - continuous with transversalis fascia
Perinephric fat immediately surrounding kidney
Paranephric fat separating kidney and perinephric fat from muscles

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21
Q

Renal veins

A

IVC anterior to aorta and ureters/renal pelvis
Each hilum has one renal vein branching from L1/L2 level
IVC posterior to splenic vein and body of pancreas
IVC sends small branch to right kidney and 3x longer branch to left kidney

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22
Q

Nutcracker syndrome

A

Compression of the left renal vein by the overpassing superior mesenteric artery stops left kidney from draining

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23
Q

Renal arteries

A

Aorta sends small branch to left kidney and slightly longer branch to right kidney at L1/L2 level
Renal arteries posterior to IVC
Superior mesenteric artery of aorta descends down anterior to left renal vein

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24
Q

Innervation of kidneys

A

Sympathetic: T10/11/12
Parasymapthetic: Vagus
Referred pain to flank (middle outer segments)

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25
Q

Lymphatic drainage of kidneys

A

Para-aortic nodes at L1/L2

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26
Q

Morrisons pouch

A

Potential space - shouldn’t be anything there but can fill with fluid
Between liver and kidney

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27
Q

Ureters

A

Smooth muscle tubes that carry urine from kidneys to bladder using smooth muscle contractions and filtration pressure from glomeruli
About 25 cm long

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28
Q

Ureteric course

A

Exit kidneys at the transpyloric plane L1
Extend vertically down from hilum on the surface of psoas muscle
Crosses bifurcation of common iliac artery at anterior sacroiliac joint
Passes on lateral wall of pelvis towards ischial spine
Enters bladder on interior surface at trigone

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29
Q

Trigone

A

Smooth triangular region at base of bladder where the ureters enter to deposit urine and the urethra exits
In between ureteric openings is the inter-ureteric crest

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30
Q

Arterial supply of ureters

A

Superior third: renal artery
Middle third: gonadal arteries and iliac arteries
Inferior third: superior vesical artery from internal iliac artery

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31
Q

Venous drainage of ureters

A

Superior third: renal vein
Middle third: gonadal veins and iliac veins
Inferior third: superior vesical vein to internal iliac vein

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32
Q

Nervous supply of ureters

A

Superior third: renal plexus T11/T12

Inferior third: hypogastric plexus (superior and inferior)

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33
Q

Lymphatic drainage of ureters

A

Para-aortic nodes at L1/L2 to iliac nodes

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34
Q

Ureteric pain

A

Loin to groin

Referred to different areas depending on area affected

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35
Q

3 constrictions of ureters

A

Pelvi-ureteric junction (where the renal pelvis becomes the ureter)
Where ureters cross the pelvic brim (anterior crossing of common iliac artery bifurcation)
Ureto-vesicular junction (where they enter the wall of the bladder)
- most common sites of renal calculus obstruction

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36
Q

Bladder epithelium

A

Transitional epithelium
Rugae to help expand as it fills
Smooth muscle coat and smooth muscle sphincters at the neck

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37
Q

Bladder muscle

A

Detrusor muscle, innervated by parasympathetic nerves

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38
Q

Arterial supply of bladder

A

Superior and inferior vesical arteries off internal iliac arteries

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39
Q

Inferior vesical artery in females

A

Normally corresponds to uterine artery

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40
Q

Venous drainage of bladder

A

Vesical plexus which drains to internal iliac veins

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41
Q

Nervous supply of bladder

A

ANS inferior hypogastric plexus at L1/L2
Sympathetic: sacral splanchnic nerves (L1/L2)
Parasympathetic: pelvic splanchnic nerves
Pain referred to suprapubic region at L1/L2 dermatomes

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42
Q

Male urethra

A

4 distinct regions:

1) pre-prostatic (IUS)
2) prostatic (widest part)
3) membranous (thinnest part, through deep perineal pouch)
4) spongy (through corpus spongiosum)

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43
Q

Female urethra

A

No distinct regions, no internal urethral sphincter

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44
Q

Male urethral sphincters

A

EUS: consciously controlled, in the deep perineal pouch (membranous section of urethra)
IUS: sympathetically controlled, present to prevent retrograde ejaculation during sex

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45
Q

Drainage of urethra

A

Main drainage to internal iliac nodes

Drainage changes as the urethra becomes more distal, more information not important

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46
Q

Nerves of the lumbar plexus

A 
Subcostal (T12)
Iliohypogastric (L1)
Ilioinguinal (L1) 
Genitofemoral (L1 and L2)
Lateral femoral cutaneous (L2 and L3)
Femoral (L2, L3 and L4)
Obturator (L2, L3 and L4)
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47
Q

Iliohypohastric nerve

A

L1
Motor: transversus abdominis and internal oblique
Sensory: lateral gluteal and pibuc skin
Emerges at lateral border of psoas and runs obliquely over quadratus lumborum superior to ilioinguinal
Pierces transversus abdominis

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48
Q

Ilioinguinal nerve

A

L1
Motor: transversus abdominis and internal oblique
Sensory: Skin of medial thigh, root of penis and scrotum, mons pubis and labia majora
Emerges at lateral border of psoas and runs obliquely over quadratus lumborum inferior to iliohypogastric
Pierces internal oblique to enter inguinal canal and accompany spermatic cord through superficial inguinal ring

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49
Q

Genitofemoral nerve

A

L1 and L2
Motor: cremaster muscle
Sensory: scrotum, mons pubis, skin of upper anterior thigh
Two branches - genital and femoral
Emerges through and runs on top of psoas
Genital branch enters spermatic cord
Femoral branch passes under inguinal ligament

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50
Q

Lateral femoral cutaneous nerve

A

L2 and L3
Sensory only: skin on anterior and lateral thigh
Emerges from lateral border of psoas and descends obliquely across surface of iliacus
Passes under inguinal ligament at lateral side

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51
Q

Bernhardt-Roth syndrome

A

Numbness of outer thigh due to compression of lateral femoral cutaneous nerve as it passes under the inguinal ligament
Can be caused by exercise, seat belts, tight clothing etc.

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52
Q

Femoral nerve

A

L2, L3 and L4
Motor: pectineus, iliacus and anterior compartment of thigh
Sensory: skin on anterior thigh and medial leg
Emerges from lower lateral border of psoas, runs between iliacus and psoas and passes under inguinal ligament to thigh

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53
Q

Obturator nerve

A

L2, L3 and L4
Motor: obturator externus and medial compartment of thigh
Sensory: skin on medial thigh
Emerges from lower medial border of psoas, passses behind common iliac arteries and lateral to internal iliac and ureters
Exits via obturator foramen

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54
Q

3 key pelvic ligaments

A

Inguinal ligament
Lacunar ligament
Pectineal ligament

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55
Q

Inguinal ligament

A

ASIS to pubic tubercle

Formed from rolled edge of external oblique aponeurosis

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56
Q

Lacunar ligament

A

Connects inguinal and pectineal ligaments

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57
Q

Pectineal ligament

A

Pectineal line of pubic bone

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58
Q

Inguinal canal

A

Oblique passage through lower abdominal wall
Prevents herniation of abdominal contents
4 cm long
Deep inguinal ring to superficial inguinal ring
Carries ilioinguinal nerve

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59
Q

Inguinal canal in males

A

Carries structures to and from testis and abdomen via spermatic cord

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60
Q

Inguinal canal in females

A

Carries round ligament of uterus from pelvis to labia majora

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61
Q

Superficial inguinal ring

A

Triangular shaped defect in aponeurosis of external oblique
Superior and lateral to pubic tubercle
Margins give rise to external spermatic fascia of spermatic cord

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62
Q

Deep inguinal ring

A

Oval opening in transversalis fascia

Gives rise to internal spermatic fascia of spermatic cord in men and round ligament fascia in women

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63
Q

Mid-inguinal point

A

Halfway between ASIS and pubic symphysis

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64
Q

Conjoint tendon

A

Common tendon of pubic crest/pectineal line made from transversus abdominis and internal oblique

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65
Q

Cremaster muscle

A

Muscular layer from the internal oblique

Draws testes up into the body

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66
Q

3 layers of spermatic cord

A

External spermatic fascia
Internal spermatic fascia
Cremasteric muscle

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67
Q

Anterior wall of inguinal canal

A

Aponeurosis of external oblique

A bit of internal oblique

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68
Q

Floor of inguinal canal

A

Inguinal ligament and lacunar ligament

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69
Q

Roof of inguinal canal

A

Fibres of internal oblique and transversus abdominis

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70
Q

Posterior wall of inguinal canal

A

Transversalis fascia and conjoint tendon

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71
Q

Inguinal triangle

A

Site of direct hernia, where abdominal structures push through weakened abdominal wall
Made up by the rectus abdominis, inferior epigastric artery and inguinal ligament

72
Q

Spermatic cord

A

Begins at deep inguinal ring and ends at testis
Arises from peritoneal diverticulum (processus vaginalis) and pushes through abdominal wall, pulling a tubular sheath from each layer to make 3 concentric layers to guide structures through the inguinal canal

73
Q

Tunica vaginalis

A

Remnant of peritoneal outpouching pinching off in the scrotum

74
Q

Scrotum

A

Outpouching of skin from abdominal wall

Contains testes, epididymis and lower end of spermatic cords

75
Q

Scrotum blood supply

A

Internal and external pudendal arteries

76
Q

Fascia of scrotum

A

Superficial continuous with Scarpas
Fat replaced by Dartos
Dartos continuous posteriorly with Colles

77
Q

Contents of spermatic cord

A 
3 arteries:
- testicular
- artery of vas deferens
- cremasteric
3 nerves: 
- genital branch of genitofemoral
- sympathetic nerves from testicular plexus
- ilioinguinal (pierces cord halfway down)
3 others:
- vas deferens
- lymphatics
- tunica vaginalis
3 venous plexuses
78
Q

Testicular torsion

A

Spermatic cord twists around, cutting off blood supply causing ischaemia
Absent or decreases cremasteric reflex
Epididymis still has normal blood flow

79
Q

Cremasteric reflex

A

Stroke superior medial thigh to stimulate sensory fibres of femoral branch of genitofemoral nerve and ilioinguinal nerve
Stimulates motor fibres of genital branch of genitofemoral nerve which draws testes up into body

80
Q

Indirect hernia

A

Can be congenital - processus vaginalis or inguinal canal not forming properly, creating weak spot
Herniation occurs through deep inguinal ring and through entire inguinal canal into scrotum within spermatic cord
Lateral to inferior epigastric artery
Any age

81
Q

Direct hernia

A

Abdominal contents herniate through weak spot in fascia of posterior wall of inguinal canal, through inguinal triangle
Medial to inferior epigastric artery
Males and elderly most at risk

82
Q

Femoral hernia

A

Herniation occurs through femoral canal below inguinal ligament
Uncommon, most likely to occur in females due to more space in the femoral canal
Have to cut lacunar ligament to treat

83
Q

Ala

A

‘Wings’ of the sacrum

For articulation with ilium

84
Q

Sacral openings

A

Sacral foramen - 4 pairs of anterior and 4 pairs of posterior
Sacral canal at the top
Sacral hiatus at the bottom (where you can do an epidural)

85
Q

Pelvic tilt

A

60 degrees anteriorly so ASIS is in line with pubic tubercle

Sacrum tilted 40 degrees

86
Q

Pelvic boundaries

A

Anterior, posterior and lateral walls are all bone
Muscular floor made from pelvic diaphragm
Perineum below pelvic diaphragm

87
Q

3 key ligaments of the pelvis

A

Sacrotuberous
Sacrospinous
- together these convert the greater and lesser sciatic notches into greater and lesser sciatic foramen
Posterior sacroiliac ligament

88
Q

2 key joints of the pelvis

A 
Anterior sacroiliac joint (synovial)
Pubic symphysis (secondary cartilagenous)
89
Q

2 key muscles of the pelvic wall

A

Piriformis

Obturator internus

90
Q

Piriformis origin and insertion

A

Origin: sacrum
Insertion: greater trochanter

91
Q

Obturator internus origin and insertion

A

Origin: ischiopubic ramus
Insertion: medial aspect of greater trochanter

92
Q

Vessels that pass through the greater sciatic foramen above piriformis

A

Superior gluteal vessels

Superior gluteal nerve

93
Q

Vessels that pass through the greater sciatic foramen below piriformis

A 
Inferior gluteal vessels
Inferior gluteal nerve
Internal pudendal vessels
Pudendal nerve
Nerve to obturator internus
Sciatic nerve
94
Q

Vessels that pass through the lesser sciatic foramen

A

Internal pudendal vessels
Pudendal nerve
Nerve to obturator internus
Obturator internus muscle

95
Q

Vessels that pass through both the sciatic formamina

A

Internal pudendal vessels
Pudendal nerve
Nerve to obturator internus

96
Q

Vessels that pass through obturator canal

A

Obturator nerve

Obturator vessels

97
Q

Pudendal nerve spinal level

A

S2, S3 and S4

98
Q

Which nerve is at risk during an intramuscular injection?

A

Sciatic nerve

99
Q

Which nerve is at risk during a lateral approach to the hip?

A

Superior gluteal nerve

100
Q

Internal iliac artery branches (Group A Type I)

A

Superior gluteal 1st
Umbilical 2nd from the other side
Inferior gluteal 3rd
Ends with internal pudendal

101
Q

Venous drainage of pelvis

A 
Venous plexuses
- vesical
- prostatic
- rectal
- uterine
- vaginal
All drain to internal iliac veins
102
Q

Deep dorsal vein of the penis/clitoris

A

Passes through anterior deficiency in perineal membrane and then into vesical/prostatic plexuses

103
Q

Sacral plexus

A 
L4, L5, S1-4 and anterior rami
Innervates structures external to pelvis
Superior gluteal
Inferior gluteal
Sciatic
Posterior femoral cutaneous
Pudendal
Nerve to levator ani/coccygeous
104
Q

Superior gluteal nerve

A

L4, L5, S1
To gluteus medius and maximus
Passes superior to piriformis

105
Q

Inferior gluteal nerve

A

L5, S1 and S2
To gluteus maximus
Passes inferior to piriformis

106
Q

Sciatic nerve

A

L4-S3
Motor and sensory of hamstrings and leg
Tibial usually leaves below piriformis
Common peroneal may leave below, above or through piriformis

107
Q

Nerves to levator ani and coccygeous

A

S3 and S4

Motor only for levator ani and coccygeous

108
Q

Pudendal nerve

A 
S2-S4, motor and sensory
Supplies perineal muscles including:
- levator ani
- external sphincter
- sphincter urethrae
- bulbospongiosus
- ischiocavernosus
- transverse perineals
109
Q

2 nerve plexuses of pelvic viscera

A

Superior hypogastric at anterior body of L5 and sacral promontory
Inferior hypogastric at pelvic floor

110
Q

Sympathetic supply of pelvic viscera

A

L1/2 fibres
Descend to pelvis via superior hypogastric plexus and directly from sacral splanchnic nerves
Plexus splits to form two hypogastric nerves

111
Q

Parasympathetic supply of pelvic viscera

A

S2-4 fibres
Ascend via hypogastric nerves to superior hypogastric plexus into abdomen
Direct into inferior hypogastric plexus
Pelvic splanchnic nerves

112
Q

Sympathetic pelvic viscera function

A

Contract internal urethral and anal sphincters
Ejaculation
Move secretions along epididymis

113
Q

Parasympathetic pelvic viscera function

A

Vasodilation of erectile tissues

Stimulates bladder contraction

114
Q

Pelvic outlet boundaries

A 
Pubic symphysis at the top
Ischiopubic ramus (top 2 sides)
Ischial tuberosity at the sides
Sacrotuberous ligament (bottom 2 sides)
Coccyx at the bottom
Forms a diamond shape
115
Q

Perineal body

A

Palpable anchoring point

Strong fibrous connective tissue mass that muscles can connect to

116
Q

Positions of the urogenital and anal triangles

A

Urogenital triangle faces inferiorly

Anal triangle faces posteriorly

117
Q

3 divisions of the levator ani

A

Ischiococcygeous
Iliococcygeous
Pubococcygeous

118
Q

Levator ani innervation

A 
Pudendal nerve (S2-4) and nerve to levator ani (S3/4)
Pudendal nerve sits on top of levator ani inferior to nerve to levator ani
119
Q

Puborectalis

A

Muscular sling that pulls rectum forwards into an angle, allowing faecal control

120
Q

Iliococcygeous

A

Attaches to fascia of obturator internus

Prevents prolapse of pelvic viscera

121
Q

Anal canal

A

Continuation of rectum once it passes beneath pelvic floor

122
Q

Anal columns

A

Contain anal glands and superior rectal vessels

123
Q

Pecten

A

Transition between true gut and skin underneath anal columns but before Hilton’s white line

124
Q

Hilton’s white line

A

Shows fascial plane between muscles in the anus

125
Q

Internal anal sphincter

A

Smooth muscle under involuntary control

Deep to external anal sphincter, separated by connective tissue

126
Q

External anal sphincter

A

Skeletal muscle under voluntary control
Perineal body to anococcygeal ligament
Closes anus with the help of puborectalis
Innervated by pudendal nerve

127
Q

Arterial supply of rectum

A

Superior rectal artery from inferior mesenteric
Middle rectal artery from internal iliac
Inferior rectal from internal pudendal

128
Q

Lymphatic drainage of rectum

A

Pre-aortic nodes at L3

Internal iliac nodes

129
Q

Lymphatic drainage of anal canal

A

Superficial inguinal nodes

130
Q

Anorectal venous drainage

A

Superior rectal vein drains back to portal system
Middle rectal vein drains back to systemic system
- portal-systemic anastomosis results in likelihood of anorectal varices in portal hypertension

131
Q

Haemorrhoids

A

Can be internal from the internal venous plexus - often painless but can prolapse
Or external from the external venous plexus - painful
Both are likely to bleed
Can clot and thrombose

132
Q

Ischioanal fossa

A

Fatty wedge shaped space

Lateral to anal canal, inferior to levator ani, medial to pudendal canal

133
Q

Ischioanal ulcers

A

Hitting pudendal nerves and vessels can lead to impotence and incontinence

134
Q

3 palpable landmarks of the ischioanal fossa

A

Ischial tuberosity laterally
Coccyx posteriorly
Perineal body in midline between anus and vagina or scrotum
Used to avoid lateral apex

135
Q

Urogenital diaphragm

A

Inferior layer of fascia called the perineal membrane

Sphincter urethrae and deep transverse perineal muscles superior and deep to perineal membrane

136
Q

Deep perineal pouch

A

Everything superior to perineal membrane

In women, more muscles for urinary continence due to absence of internal urethral sphincter

137
Q

Bulbourethral glands

A

Only in men

Lubricating glands for urethra in the perineal pouch

138
Q

Bartholin’s glands

A

Only in women

Lubricating glands for vagina in superficial perineal pouch

139
Q

Superficial perineal pouch

A 
Structures between perineal membrane and skin
Contains:
- nerves and vessels
- erectile tissues
- perineal muscles
- Bartholin's glands
140
Q

Main branches of the internal pudendal artery

A 
Inferior rectal
Perineal
Dorsal artery of penis or clitoris
\+ others, not important
Toegther, supply everything in the perineum
141
Q

Defaecation process

A

Relaxation of puborectalis to straighten anorectal angle (innervation by pudendal S2-4 and nerve to levator ani S3-4)
Relaxation of internal (pelvic splanchnic S2-4) and external (pudendal S2-4) anal sphincters
Parasympathetic pelvic splanchnic S2-4 causes rectal contraction
Increased intra-abdominal pressure via somatic nervous system by diaphragm contraction and larynx closure

142
Q

Micturition innervation

A

Sacral stretch reflex
Parasympathetic: pelvic splanchnic S2-4 fires to Detrusor muscle which creates full bladder sensation
Sympathetic: L1-2 fibres contract internal urethral sphincter
Somatic: pudendal S2-4 consciously controls external urethral sphincter
CNS: coordinates muscles and overrides ANS need to urinate

143
Q

Sex and the nervous system

A

Parasympathetic: pelvic splanchnic S2-4 from inferior hypogastric plexus passes through deep perineal pouch to erectile tissues and vasodilates
Sympathetic: from inferior hypogastric plexus, ejaculation (contraction of smooth muscle) and contraction of internal urethral sphincter in men to prevent retrograde ejaculation
Pudendal nerve S2-4 responsible for sensory and cyclical orgasm

144
Q

Saddle anaesthesia

A

Compression of cauda equina produces similar effect to epidural

145
Q

Pudendal nerve damage/entrapment

A 
Pain
Numbness
Altered sense of ejaculation
Fecal and urinary incontinence
Common in cyclists
146
Q

Pouches in genitalia

A

Men: vesicorectal
Women: vesicouterine and rectouterine (important clinically)

147
Q

Female erectile tissue

A

Crus of clitoris contributes to body of clitoris and becomes corpus cavernosum
Bulb of vestibule contributes to head of clitoris and surrounds vaginal orifice

148
Q

Male erectile tissue

A

Crus of penis becomes corpus cavernosum of penis

Bulb of penis becomes corpus spongiosum of penis and glans penis

149
Q

2 important genital muscles

A

Ischiocavernosus - attached along ischiopubic rami
Bulbospongiosus - attached posterior to perineal body
Both innervated by pudendal nerve

150
Q

Bulbospongiosus

A

In men: attached in midline raphe
In women: split either side of vaginal orifice
For erection and orgasm

151
Q

Vasculature of the penis

A

2 dorsal arteries which accompany dorsal nerves of the penis from pudendal nerve
1 deep dorsal vein which passes through anterior deificiency in perineal membrane to prostate/bladder
2 deep arteries inside corpus cavernosum
Suerficial dorsal veins of penis under superficial fascia
Urethra in corpus spongiosum

152
Q

Tunica albuginea

A

Tough fibrous capsule that surrounds each testis

153
Q

Epididymis

A

Sperm storage area that opens into vas deferens

154
Q

Efferent ductules

A

Connect rete testis to epididymis

155
Q

Testis

A

Consists of lobules which have 1-3 seminiferous tubules each, all of which open into rete testis
3 degrees cooler than abdomen

156
Q

Testicular supply

A

Testicular artery: L2 branch of aorta
Testicular veins: pampiniform plexus (right TV to IVC and left TV to left renal vein)
Lymphatic drainage to para-aortic nodes at root of testicular artery L2
Testicular plexus innervation

157
Q

Vas deferens

A

Muscular tube
Travels in spermatic cord through inguinal canal
Empties into prostate to join urethra
Joins seminal vesicle to form ejaculatory duct

158
Q

Vas deferens pathway

A

Enters body cavity lateral to inferior epigastric artery from spermatic cord and crosses over the external iliac vessels passing medially toward the prostate. It then passes over the top of the ureter to join seminal vesicles and form ejaculatory duct.

159
Q

Seminal vesicles

A

5 cm coils that secrete liquid component of semen and fructose
Posterior to bladder and superior to prostate

160
Q

4 zones of prostate

A

Peripheral
Central
Transitional
Anterior

161
Q

Peripheral prostate

A

Majority
Surrounds distal urethra
Most cancers start here

162
Q

Central prostate

A

Surrounds ejaculatory duct

163
Q

Transitional prostate

A

Portion mostly reponsible for BPH

164
Q

Anterior prostate

A

Mostly non-glandular

165
Q

Prostatic tissue

A

Alveoli lines with columnar glandular epithelium innervated by parasympathetic nerves, embedde in a thick fibromuscular stroma innervated by sympathetic nerves

166
Q

Structures that support the prostate

A

Puboprostatic ligament

Levator prostatae

167
Q

Prostate gland

A

Inferior to bladder
Secretes proteolytic enzymes and acid phosphatase
Contains prostatic urethra and ejaculatory duct
Suplied by branches of internal iliac artery and drained by internal iliac vein

168
Q

Fallopian tubes

A

Isthmus
Ampulla
Infundibulum
Fimbrae

169
Q

Uterus angles

A

50% population anteflexion
25% middle
25% retroflexion
Commonly, uterus angles up (anterversion) and flexes over (anteflexion)

170
Q

Uterine ligaments

A 
Broad ligament (SI support)
Round ligament (anterversion)
Uterosacral (AP support)
Pubocervical (AP support)
Transverse cervical (ML support)
171
Q

Broad ligament

A

Mesosalpinx - where it loops over fallopian tubes
Mesovarium - where it loops around ovaries
Mesometrium - where it loops around uterus

172
Q

Ovarian ligament

A

Anchors ovary to uterus

Remnant of gubernaculum

173
Q

Suspensory ligament of the ovary

A

Anchors ovary to pelvis

174
Q

Ovaries

A

Ova and hormone production
Supplied by ovarian artery at L2
Drained by ovarian vein
Innervated by ovarian plexus

175
Q

Lymphatic drainage of female reproductive system

A

Ovaries: aortic nodes at root of ovarian artery, L2
Superficial inguinal nodes via round ligament
Uterus, vagina and cervix all mix of iliac nodes.

176
Q

DHT syndrome

A

Loss of 5 alpha reductase which converts testosterone to dihydrotestorone which is the more potent form. Lack of DHT causes males to express physically and mentally as females until puberty, at which time a surge of testosterone causes development of male genitalia.

Genitourinary (6 decks)

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