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J Repro > ANATOMY > Flashcards

ANATOMY Flashcards

1
Q

which bones make up the pelvic inlet (4)

A

pubic symphysis
superior pubis ramus
ilium
sacral promotory (S1)

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2
Q

what shape is the pelvic inlet in males

what type of pelvis does this create

A

heart shaped

android

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3
Q

what shape is the pelvic inlet in females

A

oval shaped

better for childbirth - happened through natural selection

though now more android bc of modern medicine (c section etc)

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4
Q

which bones make up the pelvic outlet (5)

A 
pubic symphysis 
ischiopubis ramus 
ischial tuberosity 
sacrospinous ligaments (from ischial spines) 
coccyx
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5
Q

what is the space between the pelvic inlet and pelvic outlet called

A

pelvic cavity

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6
Q

which muscle is just above the pelvic outlet

A

levaotr ani

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7
Q

what is the area below the pelvic outlet called

A

perineum

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8
Q

what is the area above the pelvic inlet called

A

false pelvis (bc not pelvic cavity, actually abdo cavity)

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9
Q

what are the 3 parts of the innominate bones of the pelvis

A

ilium
ischium
pubis

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10
Q

which of ilium, ischium and pubis is most superior

A

ilium

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11
Q

where is the iliac crest between (which 2 landmarks)

A

between ASIS and PSIS

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12
Q

at which vertebral level is the iliac crest

A

L4

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13
Q

at which vertebral level is the PSIS

A

S2

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14
Q

which 2 bony prominences does the inguinal ligament attach between

A

ASIS and pubic tubercle

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15
Q

is the iliac fossa on the anterior or posterior surface of the ilium

A

anterior

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16
Q

which muscle originates in the iliac fossa

A

iliacus muscle

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17
Q

what is the posterior surface of the ilium called

which muscles attach here

A

gluteal surface

gluteal muscles

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18
Q

is the sacroiliac joint strong or weak

A

strong

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19
Q

what are the 2 attachments of the sacrospinous ligaments

A

sacrum and ischial spine

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20
Q

what are the 2 attachments of the sacrotuberous ligaments

A

sacrum and ischial tuberosity

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21
Q

which foramen is created by the sacrospinous ligament

A

greater sciatic foramen

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22
Q

which foramen is created by the sacrotuberous ligament

A

lesser sciatic foramen

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23
Q

another name for ischial tuberosity

A

sit bone

bc the bones you sit on

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24
Q

which artery and nerve wrap around the ischial spine (go through the greater sciatic foramen, round ischial spine then through lesser sciatic foramen)

A 
pudendal nerve (S2-4)
pudendal artery
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25
Q

which nerve goes through the greater sciatic foramen (2)

A

pudendal nerve

sciatic nerve??????

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26
Q

how do you find the pudendal nerve for doing pudendal nerve blocks

A

feel for ischial spines (legs in stirrups at 4 and 8 oclock)

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27
Q

how do you palpate ischial spines on vaginal examination

A

legs in stirrups

at 4 and 8 oclock positions

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28
Q

where is the ischial tuberosity

A

sticky out bit at bottom of ischium, where you sit = at bottom

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29
Q

connection between the ischium and pubis

A

ischiopubic ramus

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30
Q

how does the pubic arch differ in males and females

A

males - thicker

females - thinner, flares out

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31
Q

how does the sub pubic angle differ in males and females

A

males - narrower V (like index and middle finger)

females - wider V (like thumb and index finger V)

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32
Q

which parts (2) of the pubic bone are palpable

A

pubic symphysis

pubic tubercle

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33
Q

how many rami are there in the pubis bone

what are their names

A

2

superior pubic ramus
ischiopubic ramus

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34
Q

where is the obturator foramen

A

in between the superior pubic ramus and ischiopubic ramus

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35
Q

which foramen is between the superior pubis ramus and the ischiopubis ramus

A

obturator foramen

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36
Q

what type of joint is the pubic symphysis

why is this significant

A

secondary cartilaginous

pliable = moves lots = good for preventing breakages

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37
Q

open book/pretzel fracture in pelvis definition

A

pelvic fractures tend to break in more than one place

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38
Q

what is the danger of a pelvic fracture

A 
internal haemorrhage (bc of good vasculature) 
- hard to recognize bc internal so monitor bp etc!
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39
Q

which NORMAL joint looks like a fracture on xray (hence don’t worry)

A

sacroiliac joint

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40
Q

which part of the pelvis is the superior attachment of hamstrings (think about where hamstrings run)

A

ischial tuberosity (sit bones = bum, but don’t need as much room as glutes, hence theyre in the gluteal fossa of ilium)

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41
Q

where does the majority of the pelvic blood supply come from

A

internal iliac artery

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42
Q

which organs (1 male 1 female) are supplied by the gonadal arteries

what is the significance of this

A

male - testes (supplied by testicular artery)
females - ovaries (supplied by ovarian artery)

(ie the reproductive organs)

lymphatic supply - lymph goes to paraaortic lymph nodes (most of the rest of the pelvis goes to iliacs)

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43
Q

where do the gonadal arteries come from

A

abdo aorta (L2)

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44
Q

lymphatic drainage of testes

A

paraaortic lymph nodes

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45
Q

lymphatic drainage of ovaries

A

paraaortic lymph nodes

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46
Q

which rectal artery doesn’t come off the internal iliac (rest do)

where does it come from

A

superior rectal artery

comes off inferior mesenteric artery

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47
Q

significance of external iliac artery in supply of pelvic organs

A

little significance

just anastomoses with internal iliac branches

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48
Q

how does the internal iliac artery split

A

anterior and posterior divisions

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49
Q

3 branches of posterior division of internal iliac artery

A

PILS

Posterior division =
Iliolumbar artery
Lumbosacral artery
Superior gluteal artery

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50
Q

what does the posterior division of internal iliac artery supply

A

parietal stuff (body wall)

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51
Q

what does the anterior division of the internal iliac artery supply

A

viscera (organs)

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52
Q

branches of anterior division of internal iliac artery ()

A 
obturator artery 
superior and inferior vesical arteries 
internal pudendal artery - and branches 
middle rectal artery 
middle umbilical artery (remnant)
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53
Q

blood supply to bladder

A

superior and inferior vesical arteries (from anterior division of internal iliac)

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54
Q

blood supply to prostate

A

inferior vesical artery (bc prostate is right under bladder)

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55
Q

which vesical artery is not present in females

why

what is their alternative

A

inferior vesical artery

bc no prostate in females = don’t need it

have vaginal artery instead

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56
Q

branch of external iliac in males that supplies perineum

what does it turn into

A

external pudendal artery

turns into anterior scrotal artery

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57
Q

branches of internal pudendal (4)

A

inferior rectal
perineal artery - turns into posterior scrotal artery
dorsal artery of penis
deep artery of penis

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58
Q

which penile artery is important for erections

A

deep artery of penis

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59
Q

which artery from the anterior division of internal iliac turns into a remnant after birth

A

umbilical artery

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60
Q

which pelvic artery in females comes off the abdo aorta

A

ovarian artery (gonadal artery)

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61
Q

ovarian artery branches

A 
ovarian branch (for the ovaries) 
tubal branch (for the fallopian tubes)
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62
Q

what happens to the tubal and ovarian branches of the ovarian artery

A

they anastomose with the tubal and ovarian branches of the uterine artery

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63
Q

where does most of the venous drainage of pelvic organs go

A

internal iliac

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64
Q

where does the superior rectal vein drain

A

hepatic portal system

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65
Q

where do superior pelvic viscera (organs) drain their lymph to

A

external iliac nodes

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66
Q

where do inferior pelvic viscera (organs) drain their lymph to

A

internal iliac nodes

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67
Q

where does the superficial perineum drain lymph to

A

superficial inguinal lymph nodes `

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68
Q

lymph from which organs (male and female) drains directly to lumbar (paraaortic) nodes bc embryological origin

A

fundus of uterus and ovaries

scrotum/testes

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69
Q

roof of pelvic cavity

A

peritoneum (floor of abdo cavity)

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70
Q

3 pouches in peritoneum

which are male and which are female

A

rectouterine pouch of douglas - between uterus and rectum in females

vesico-uterine pouch - between bladder and uterus in females

vescio-rectal pouch - between bladder and rectum in males

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71
Q

what 2/3 things go through the pelvic floor

A

ureter
rectum
+/-vagina

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72
Q

which muscle lose tone to cause incontinence

A

pelvic floor muscles

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73
Q

pelvic floor injury aetiology (6)

A 
childbirth 
pregnancy 
chronic constipation 
chronic cough/sneeze 
obesity 
menopause
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74
Q

what are the muscles of the pelvic diaphragm

A

coccygeus

levator ani

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75
Q

components of pelvic floor (3)

A

pelvic diaphragm
muscles of perineal pouches
perineal membrane

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76
Q

where does the coccygeus muscle (part of pelvic diaphragm) run

A

between ischial spine and coccyx

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77
Q

which muscles make up the levator ani (3)

A

iliococcygeus
pubococcygeus
ruborectalis

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78
Q

which ligament does the coccygeus muscle run over

A

sacrospinous ligament (also from ischial spine to coccyx)

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79
Q

what is the fossa below the levator ani called

A

ischioanal fossa

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80
Q

where does the iliococcygeus (levator ani muscle) run

A

between the ilium and coccyx

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81
Q

where does the pubococcygeus (levator ani muscle) run

A

between the pubic bone and coccyx

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82
Q

where does the puborectalis (levator ani muscle) run

A

from pubic bone to pubic bone

figure of 8 sling round rectum

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83
Q

which muscle of levator ani is important for faecal continence

A

puborectalis

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84
Q

nerve supply to levator ani (2)

A

pudendal nerve S2-4

nerve to levator ani S3-5

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85
Q

is the puborectalis usually contract or relaxed

what happens when you want to defecate

A

contracted

it relaxes

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86
Q

what are the 2 types of perineal pouch

what separates them

A

deep perineal pouch
superficial perineal pouch - erectile tissues and their muscles

perineal membrane

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87
Q

in which perineal pouch (deep or superficial) is the bulbourethral gland in males

A

deep perineal pouch

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88
Q

in the male superficial perineal pouch, what does the bulbospongiosum muscle surround

how many bulbospongiosum muscles are there

A

BULB of the penis (aka corpus SPONGIOSUM)

1 bulbospongiosum muscle

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89
Q

contraction of what muscle causes ejaculation

A

bulospongiosum (is around the bulb of the penis)

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90
Q

in the male superficial perineal pouch, what does the ischial cavernosus muscle surround

how many ischial cavernosus muscles are there

A

crura (aka corpus CAVERNOSUM)

2 ischial cavernosus muscles (crura means 2 legs)

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91
Q

where does the ischial cavernosus muscle attach

in both males and females

A

to the ischial ramus

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92
Q

what is the other name for bulb of penis

A

corpus spongiosum

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93
Q

what is the other name for crura (2 legs) of penis

A

corpus cavernosum (x2)

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94
Q

what is the other name for clitoris and crura (2 legs)

A

corpus cavernosum (x2)

same as males

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95
Q

in the female superficial perineal pouch, what does the ischialcaverosus muscle surround

A

clitoris and crura (corpus CAVEROSUM)

2 ischial cavernosus muscle (bc crura means 2 legs)

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96
Q

in the female superficial perineal pouch, what does the bulbospongiosus muscle surround

A

bulbs of vestibule (corpus SPONGIOSUM)

includes the bartholins gland (produces lubrication)

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97
Q

where does the perineal membrane attach

A

pubic arch

98
Q

what layer is superficial to the pelvic floor (levator ani and coccygeus)

A

deep perineal pouch - fat, muscles, bulbourethral gland in males

99
Q

what layer is superficial to the deep perineal pouch

A

perineal membrane

100
Q

what layer is superficial to the perineal membrane

A

superficial perineal pouch - ischial cavernosus and bulbospongiosus muscles (same in female and male, just surround diff things)

101
Q

where is the inguinal region between

A

ASIs and pubic symphysis

102
Q

clinical significance of inguinal region

A

common hernia site

103
Q

where does the inguinal ligament attach between

A

ASIS and pubic tubercle

104
Q

what is the floor of the inguinal canal

A

medial half of inguinal ligament

105
Q

where is the superficial inguinal ring

A

superolateral to pubic tubercle

106
Q

where is the deep inguinal ring

A

superolateral to midpoint of inguinal ligament

107
Q

what structure are contained within the inguinal canal

A

ilioinguinal nerve
spermatic cord - in males
round ligament of uterus - in females

108
Q

what process forms the inguinal canal

A

descent of testes/round ligament of uterus

109
Q

which inguinal ring (deep or superficial) is the exit of the inguinal canal

A

superficial inguinal ring

110
Q

which inguinal ring (deep or superficial) is the entrance of the inguinal canal

A

deep inguinal ring

111
Q

which spinal nerve is ilioinguinal nerve from

A

L1

so is hypogastric

112
Q

what 4 structures go through the femoral canal

A

nerve
femoral artery
femoral vein
lymphatics

113
Q

between which abdo muscle layers does the ilioinguinal nerve (L1) travel through)

A

transversus abdominus and internal oblique (supplies them!)

114
Q

where does the ilioinguinal nerve go after it goes through the inguinal canal

A

scrotum/labium

proximal medial thigh

115
Q

visceral peritoneum definition

A

lining of peritoneal cavity (abdo cavity) that directly touch organs (eg ovary, uterus)

116
Q

parietal peritoneum definition

A

lining of peritoneal cavity (abdo cavity) that DOESNT directly touch organs (eg touches itself)

117
Q

procedure for removal of excess fluid in peritoneal cavity in the pouch of douglas

A

culdocentesis

118
Q

which ligament is formed by a double layer of parietal peritoneum

broad ligament of uterus
round ligament of uterus

A

broad ligament of uterus

119
Q

where is the urogenital triangle of the perineum between

A

ischial spines and pubic symphysis

120
Q

where is the anal triangle of the perineum between

A

ischial spines and coccyx

121
Q

which nerve supplies the perineal muscles -

A

pudendal nerve (S2-4)

122
Q

purpose of bartholins gland (aka greater vestibular gland)

A

produces lubrication

123
Q

at what position is the bartholins gland in females

in which layer of tissue (oclock)

A

4 and 8 oclock

124
Q

what is the equivalent of the bartholins gland in males

A

bulbourethral gland

125
Q

purpose of bulbourethral gland

A

produces lubrication in males

126
Q

what can Bartholin gland infection cause

A

external urethral orifice blockage

127
Q

which area is the labia major

A

the skin

128
Q

which area is the labia minor

A

the fleshy bit inside the skin

129
Q

what are the layers of the uterus (from outer to inner)

A

perimetrium
myometrium
endometrium

130
Q

which layer of the uterus sheds during menstruation

A

endometrium

131
Q

which part of the uterus is the fundus

A

the top bit

132
Q

which organ is the cervix a part of

A

uterus
the cervix is the bottom of the uterus (the neck)

THINK: cervical spin = neck, cervix = neck of uterus

133
Q

what is the normal position of the cervix

A

anteverted (tipped anteriorly from vagina)

134
Q

what is the normal position of the uterus

A

anteflexed (tipped anteriorly from cervix)

135
Q

what is a retroverted cervix

A

cervix is tipped posteriorly from vagina

136
Q

what is a retroflexed uterus

A

uterus is tipped posteriorly from cervix

137
Q

what structure does the broad ligament of the uterus change into when it touches the uterus

A

parietal peritoneum

broad ligament of uterus is just a double layer of parietal peritoneum

138
Q

where does the round ligament of the uterus come from

A

embryological remnant

descending from posterior abdo wall via inguinal canal

139
Q

where does fertilization take place

A

ampulla of fallopian tube

140
Q

what is the thinner part of fallopian tubes, next to uterus called

A

isthmus

141
Q

where do the fimbrae of the fallopian tube open up into

how do they gather eggs

clinical significance of this

A

open up into abdo cavity (peritoneal cavity)

one reaches out to catch an egg

clinical significance - infection can spread between perineum and peritoneum (eg PID, ectopic pregnancies)

142
Q

what else moves with the round ligament of uterus during embryological descent

lymphatic drainage

A

ovaries

drain to paraaortic nodes (bc that’s where they come from)

143
Q

blood supply of ovaries

A

anastomosis between ovarian branches of ovarian artery and uterine artery

(there are also tubal branches and anastomoses from both)

144
Q

where are the fornix of the vagina

how many are there

what are they called

A

top of vagina, just under cervical os

4

2 lateral, anterior, posterior

145
Q

what is the fibrous tract that guides the descent of testes/ovaries and round ligament of uterus

A

gubernaculum

146
Q

is the pelvic cavity S/PS/visceral afferent nerve supply OR somatic motor/sensory

A

S/PS/visceral afferent nerve supply

147
Q

is the perineum S/PS/visceral afferent nerve supply OR somatic motor/sensory

A

somatic motor/sensory nerve supply

148
Q

nerve modality of uterine cramping/contraction (eg menstruation/labour)

A

S/PS bc above levator ani

149
Q

nerve modality of pelvic floor contraction (eg holding in a pee, pilates)

A

somatic motor (bc levator ani or below)

150
Q

sensory supply to pelvic organs (above levator ani)

superior pelvis
inferior pelvis

A

superior pelvis T11-L2 visceral afferents

inferior pelvis S2-4visceral afferents

151
Q

which organs are classed as superior pelvis (in terms of sensory nerve supply)

examples

A

if they touch the perineum = superior pelvis

uterine tubes
uterus
ovaries

152
Q

sensory supply to perineum

A

pudendal nerve S2-4 (diff from inferior pelvis, but same nerve roots)

153
Q

which abdo wall muscles are in the ‘hand in pockets’ orientation

A

external oblique

154
Q

which abdo wall muscles are in the ‘hands on chest’ orientation

A

internal oblique

155
Q

which abdo wall muscle is external to external oblique

A

rectus abdominus

156
Q

which abdo wall muscle is internal to internal oblique

A

tranveraalis abdominus

157
Q

orientation of transversailis abdominus

A

horizontal

158
Q

orientation of abdominus rectus

A

vertical

159
Q

what is the midline blending of aponeuroses of all 4 abdo wall muscles called

A

linea alba

160
Q

where is the linea semilunaris

A

between the external oblique and its aponeurosis

161
Q

why is the rectus abdominus split into segments

A

to allow for bending

162
Q

where is there no posterior rectus sheath; above or below the arguate line (belly button)

why is this clinically significant

A

below the arguate line (belly button) - there is only an anterior one

above the arguate line (belly button) there is an anterior and posterior rectus sheath

c section/hysterectomy = below belly button = no posterior rectus sheath to cut through

163
Q

another name for c section/hysterectomy

A

pfannensteil incision

164
Q

layers you cut through in c section (5+3 things to remember)

A 
skin and fascia 
anterior rectus sheath 
MOVE (not cut) the rectus abdominus laterally
(no posterior rectus sheath)
thin fascia and peritoneum 
move bladder 
uterine wall 
amniotic sac
165
Q

which structures do you need to stitch close in c section/hysterectomy surgery

A

uterine wall
anterior rectus sheath (NOT posterior = better healing)
skin

166
Q

what is the blood supply to abdo wall muscles (3)

A

superior epigastric arteries (superiorly)
inferior epigastric arteries (inferiorly)
intercostal and subcostal arteries (laterally)

167
Q

what is the superior epigastric artery a continuation of

A

internal thoracic

168
Q

what is the inferior epigastric artery a continuation of

A

external iliac artery

169
Q

what is the intercostal and subcostal arteries a continuation of

A

posterior intercostal artery

170
Q

in a hysterectomy before you cut the uterine artery, what must you do

A

make sure its uterine artery NOT ureter

bridge over water = uterine artery goes over ureter
ureter will vermiculate (wriggle) when touched

171
Q

where is a laparotomy incision

A

vertical midline incision

172
Q

which structures are cut through in laparotomy (3)

A

skin
linea alba (poor blood supply so poor healing)
peritoneum

173
Q

what artery is at risk of damage in lateral port laparostomy insertion

A

inferior epigastric artery

174
Q

how to avoid inferior epigastric artery in lateral port incision in laparoscopy

A

inferior epigastric artery is medial to deep inguinal ring, so go lateral to deep inguinal ring

175
Q

which is the anterior surface of the penis

A

the under side - is anterior when erected

176
Q

what passes through the urethra in males

A

urine and sperm ejaculation

177
Q

which gland (prostate or seminal) in males produces seminal fluid = make semen

A

seminal gland w

178
Q

what are the 3 structures that make up the erectile body in the male penis

A

2 corpus cavernosum

1 corpus spongiosum

179
Q

which part of the erectile body of the penis contains the deep arteries of the penis

A

the 2 corpus cavernosum

180
Q

which part of the erectile body of the penis contains the spongey urethra

A

the corpus spongiosum

181
Q

erection

PS/S

A

parasympathetic

bc erection = Point = Parasympathetic
point and shoot

182
Q

ejaculation

PS/S

A

sympathetic

bc ejaculation = Shoot = Sympathetic
point and shoot

183
Q

what is the bag called that the testes sit in

A

tunica vaginalis

184
Q

excess fluid in tunica vaginalis (bag around the testes)

A

hydrocele

185
Q

blood supply to testes

A

gonadal/testicular artery - comes off abdo aorta

means testes drain lymph to paraaortic nodes!

186
Q

what is the male reproductive organ

what are the male accessory reproductive organs

A

reproductive - testes

accessory - vas deferens, seminal gland, prostate gland, penis

187
Q

contents of spermatic cord

A

3 arteries - artery to testes, cremasteric artery, artery to vas
3 nerves - autonomic nerves, genitofemoral nerve, ilioinguinal nerve (not actually in spermatic cord, but alongside it)
2 other things - vas deferens, testicular vein (pamphiform plexus)., lymphatic drainage to paraaortic nodes

188
Q

where is sperm made
where is sperm stored
what is the route of sperm after this (7)

A

made in Seminiferous tubules of testes

stored in Epididymis

goes through Vas deferens
joins duct from seminal gland with seminal fluid  = Ejaculatory duct 
prostatic Urethra
bulbourethral gland - adds lubricant 
spongey urethra 
external urethral meatus 
Penis

how to remember: SEVEN UP
N = nothing

189
Q

what does the seminal gland produce
what does bulbourethral gland add to semen
what does prostate gland add to semen

A

semen - fructose, prostaglandins and fibrinogen
bulbourethral - adds lubricant
prostate - adds alkali

190
Q

where is the central zone of the prostate gland

do cancers occur here

A

behind the prostatic urethra

no more common in peripheral zones

191
Q

blood supply to testes

A

gonadal/testicular arteries (from abdo aorta)

192
Q

venous drainage of testes

what is diff about L and R

A

gonadal/testicular veins
L goes into L renal vein then IVC
R goes straight into IVC

193
Q

lymphatic drainage of testes

A

paraaortic nodes (bc of embryological origin)

194
Q

blood supply to penis

where does this come from

A

deep and dorsal artery of penis - from internal pudendal of internal iliac

195
Q

lymphatic drainage of penis

A

superficial inguinal lymph nodes

196
Q

blood supply to scrotum (2)

where do they come from

A

posterior scrotal from internal pudendal form internal iliac
anterior scrotal from external iliac

197
Q

lymphatic drainage of scrotum

A

superficial inguinal lymph nodes

198
Q

in the pelvic inlet which is bigger, AP or transverse diameter

A

transverse

199
Q

in the pelvic outlet which is bigger, AP or transverse diameter

A

AP

200
Q

what are the 2 fontanelles on foetal skull called

A

anterior fontanelle

posterior fontanelle

201
Q

what is the suture between the anterior and posterior fontanelles on baby skull

A

sagittal suture

202
Q

what is a bulging fontanelle a sign of

A

increased ICP

203
Q

what is a compressed fontanelle a sign of

A

dehydration/malnutrition

204
Q

moulding of foetal skull definition

A

movement of one bone over another eg during child birth

fontanelles allow this

205
Q

is the occipitofrontal or the biparietal diameter longer in the foetal skull
clinical significance of this

A

occipitalfrontal

it determines the rotation of baby through the pelvic inlet and outlet

206
Q

what is the vertex of the foetal skull (which 4 things is it between)

A

between the anterior fontanelle, posterior fontanelle and parietal eminences (on each side)

207
Q

which direction is the babys head in when it descends through the pelvic inlet

A 
side ways (transverse, facing L or R) 
bc transverse diameter>AP diameter here and occipitofrontal diameter is biggest part of feotal head
208
Q

which direction is the babys head in when it descends through the pelvic outlet

A

occpitioanterior (facing downwards)

bc AP>transverse diameter diameter here and occipitofrontal diameter is biggest part of feotal head

209
Q

why is the baby delivered in ocicpitoanterior not occipitoposterior direction

A

so vertex comes out first and chin is tucked in

210
Q

what do you need to do when babies head is out of vagina

A

rotate a further 90 degrees to get shoulders out of pelvic inlet
get bottom shoulder out first, then top shoulder

211
Q

how is station measured

A

distance of foetal head (biparietal diameter) from ischial spines

212
Q

what does a positive station

A

biparietal diameter is below the ischial spines

213
Q

what does a negative station mean

A

biparietal diameter is above the ischial spines

214
Q

which muscles is the breast on top of (2)

A

pect major and serratus anterior (and deep fascia)

215
Q

which ribs is the breast between

A

ribs 2-6

216
Q

what structure creates the ‘lobules’ in the breast

A

suspensory ligaments

orientate themselves around areola

217
Q

what types of tissue are around the lobules in a breast

A 
adipose tissue (fat) 
dense connective tissue
218
Q

how many lobes are in each breast

A

15-25

219
Q

what is the gland called that is in each breast lobule (one per lobule)

A

tubuloacinar gland

220
Q

where does the tubuloacinar gland drain first

A

terminal ductules (acini)

221
Q

what is the collective term for tubuloacinar gland, terminal ductile, intralobular collecting duct, lactiferous duct

A

terminal duct lobular unit (TDLU)

222
Q

after the terminal duct lobular unit, where does the drainage of the tubuloacinar gland go

what does this look like

A

lactiferous sinus - a bulging in the lactiferous duct just before the nipple

223
Q

after the lactiferous sinus (bulging of lactiferous duct) where does drainage of the tubuloacinar gland go

A

nipple

224
Q

what happens to breast lobules after menopause

A

glands degenerate, leave the ducts

225
Q

what happens to lobules during lactation (only during pregnancy)

what hormone causes this

A

lobules expand

oestrogen and progesterone cause this

226
Q

in lactation the lobules expand, which part of the breast decreases

how does this look on histology compared to non lactating lobules

A

connective tissue and adipose tissue (fat)

histology;
lactating lobules - more dark pink = glands
non lactating lobules - more light pink = connective tissue

227
Q

which Ig is found in breast milk

what is 90% of breast milk made of

A

IgA

90% water

228
Q

blood supply to breast (2)

A

axillary artery

internal thoracic artery

229
Q

lymph node drainage of breast (3)

A

ipsilateral axillary then supraclavicular - MOST
parasternal lymph nodes then drain to contralateral breast - some
abdominal lymph nodes – rarely

230
Q

where are the 3 levels of axillary lymph nodes

A

level I - inferior and lateral to pect minor
level II - deep to pect minor
level III - superior and medial to pect minor

231
Q

what is a sentinel lymph node

A

the lymph node that die spreads to first = the one tumour has spread to = one to take out

232
Q

why don’t you remove all axillary lymph nodes if cancer

which lymph node is preferred

why

A

risk of lymphoedema in the arm

level I nodes are preferred bc still have level II and III to drain to if I is gone

233
Q

anatomy spot

which direction does uterine artery travel in
which direction does ureter travel in

A

uterine artery - horizontal

ureter - vertical

234
Q

which sciatic foramen is superior to the other

A

greater sciatic foramen is superior to lesser

THINK: greater = superior (also bigger one)

235
Q

what is in the superficial perineal pouch (generally)

A

erectile tissues and their muscles

236
Q

what is the perineal body

where is it

A

fibrous membrane in the pelvic floor

237
Q

motor supply to cervix/vagina

A

cervix/vagina = inferior pelvis, but above levator ani

S2-4 PS/S (NOT pudendal nerve, pudendal nerve is below levator ani)

238
Q

motor supply to perineum

A

S2-4 pudendal nerve

239
Q

where does pain from superior pelvic organs refer to

A

suprapubic region (same as hind gut)

superior pelvic organs = touches peritoneum

240
Q

where does pain from inferior pelvic organs refer to

A

perineum and posterior thigh

bc supplied by S2-4, and these are the dermatomes supplied by S2-4

241
Q

where does pain from perineum refer to

A

perineum

J Repro (28 decks)

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