Anatomy Clinical Notes Flashcards
Pelvic Girdle Sexual Differences: Females
- The female pelvis in the presence of female hormones and signal timing tends to be shorter and broader overall
- Female sacrum is flatter than males
Pelvic Girdle Sexual Differences: Males
- The male pelvis in the presence of male hormones and signal timing tends to be narrower and longer
- Male sacrum is more curved than females
Pelvic Organ Prolapse
- If the Levator Ani muscles, pelvic fascia, or perineal body are stretched or damaged, the pelvic diaphragm loses support
- Injury can be from childbirth, trauma, infection or inflammatory disease
- In the weakened state, the organs from inside the pelvic cavity can prolapse or travel into the perineal region
- Treatment: pessaries, surgery, exercise
Pelvic Prolapse: Urethrocele
Prolapse of the anterior vaginal wall involving only the urethra
Pelvic Prolapse: Cystocele
Prolapse of the anterior vaginal wall including the bladder
Pelvic Prolapse: Uterovaginal
Prolapse of the posterior vaginal wall involving the rectum
Pelvic Prolapse: Enterocele
Prolapse of the posterior vaginal wall involving the rectovaginal pouch
___ is the leading cause of cervical cancer
HPV
Pap Smears collect cells from:
- External Os
- Transformation Zone
Uterine Changes: At Birth
- Uterus is under influence of maternal hormones
- Uterus takes on the dimensions of an adult (post-pubescent) uterus
Uterine Changes: During Childhood
Uterine body and cervix sizes are relatively the same
Uterine Changes: At Puberty
With hormones circulating again, the body of the uterus doubles in size
Uterine Changes: After Menopause
Reverts to a 1-to-1 ratio of the uterine body to the cervix
Hysterectomy
- Surgical removal of the uterus
- Performed for uterine cancer or endometriosis
Female Sterilization
- Uterine tubes are ligated in different methods to prevent the oocyte from traveling from the ovary to the uterus and the sperm from entering into the uterine tube, preventing fertilization
- Procedures can include removing parts of uterine tube, clamping, and placing a piece of metal into the uterine ostium
- Oocyte is reabsorbed by the body
Hemorrhoids
- Caused by swollen veins within the venous plexus that supply the rectum and anal canal areas
- Often associated with straining during defecation, constipation, pregnancy and venous return issues
- Two types can occur
Internal Hemorrhoids (Piles)
- Created from the prolapse of the rectal mucosa that contains the normally dilated veins from the internal venous plexus of the anal canal (superior rectal vein and the portal system)
- Once they ulcerate bright red blood can be seen because of arteriovenous anastomoses here
- Since they are located above the Pectinate Line (innervated by visceral fibers), they are not painful
External Hemorrhoids
- Created from blood clots in the external venous plexus (inferior rectal vein and the IVC)
- Covered by skin and can be very painful as they have somatic innervation from the inferior rectal nerves (located below the Pectinate Line)
Epidural Block
- Anesthetic is administered into the epidural space of the spinal cord (fat-filled) around L3-L4 level
- Causes the spinal nerve roots including the pain fibers from the entire birth canal, pelvic floor, and perineum to be anesthetized
- Because the pain fibers from the uterus are above the pelvic pain line, uterine contractions can still be felt
Spinal Block
- Anesthetic is injected in the subarachnoid space at the L3-L4 level
- This anesthetizes the area of the body below the waist including all pelvic and perineal structures, and the lower legs
- Typically this is done for short-duration needs since the mother needs to be inclined to keep the anesthetic in place
Pudendal Nerve Block
- Anesthetic is injected along the pudendal nerve path using the sacrospinous ligament as a landmark
- Anesthetizes the perineum so uterine and superior birth canal pain can be felt
- May be done for an episiotomy
Deferentectomy (Vasectomy)
- Process of male sterilization
- Ductus deferens are ligated or excised via a superior scrotal approach
- Prevents sperm from being present in the ejaculate by stopping it from traveling through the ductus deferens within the spermatic cord and into the body
- Sperm now degrade in the epididymis
- Can be reversible
Prostate Gland Exam
- Prostatic growth, benign hypertrophy of the prostate, is a common condition in older males
- Prostatic expansion (usually involving the middle lobes) blocks the prostatic urethra, leading to issues with urination as the urethra becomes encroached upon by the glands tissue; also may experience increased feelings of needing to urinate and increased urgency
- All or part of the prostate may be removed to help with urethral blockage
- Can check prostate by inserting fingertips via the anal canal into the rectum
Prostate malignancy typically occurs in the ___ ____ of the prostate
Peripheral Zone
