Anatomy Clinical Notes

Question 1

Pelvic Girdle Sexual Differences: Females

Answer 1

• 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

Question 2

Pelvic Girdle Sexual Differences: Males

Answer 2

• 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

Question 3

Pelvic Organ Prolapse

Answer 3

• 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

Question 4

Pelvic Prolapse: Urethrocele

Answer 4

Prolapse of the anterior vaginal wall involving only the urethra

Question 5

Pelvic Prolapse: Cystocele

Answer 5

Prolapse of the anterior vaginal wall including the bladder

Question 6

Pelvic Prolapse: Uterovaginal

Answer 6

Prolapse of the posterior vaginal wall involving the rectum

Question 7

Pelvic Prolapse: Enterocele

Answer 7

Prolapse of the posterior vaginal wall involving the rectovaginal pouch

Question 8

___ is the leading cause of cervical cancer

Answer 8

HPV

Question 9

Pap Smears collect cells from:

Answer 9

• External Os
• Transformation Zone

Question 10

Uterine Changes: At Birth

Answer 10

• Uterus is under influence of maternal hormones
• Uterus takes on the dimensions of an adult (post-pubescent) uterus

Question 11

Uterine Changes: During Childhood

Answer 11

Uterine body and cervix sizes are relatively the same

Question 12

Uterine Changes: At Puberty

Answer 12

With hormones circulating again, the body of the uterus doubles in size

Question 13

Uterine Changes: After Menopause

Answer 13

Reverts to a 1-to-1 ratio of the uterine body to the cervix

Question 14

Hysterectomy

Answer 14

• Surgical removal of the uterus
• Performed for uterine cancer or endometriosis

Question 15

Female Sterilization

Answer 15

• 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

Question 16

Hemorrhoids

Answer 16

• 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

Question 17

Internal Hemorrhoids (Piles)

Answer 17

• 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

Question 18

External Hemorrhoids

Answer 18

• 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)

Question 19

Epidural Block

Answer 19

• 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

Question 20

Spinal Block

Answer 20

• 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

Question 21

Pudendal Nerve Block

Answer 21

• 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

Question 22

Deferentectomy (Vasectomy)

Answer 22

• 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

Question 23

Prostate Gland Exam

Answer 23

• 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

Question 24

Prostate malignancy typically occurs in the ___ ____ of the prostate

Answer 24

Peripheral Zone