Anatomy of Pelvis and Perineum Flashcards
on bony pelvis be able to locate
sarcal promontory accurate line of ilium pecten pubis pubic tubercle pubic crest pubic symphysis
what are the boundaries of the pelvic inlet-looking down
ant- pubic symphysis
post- promontory of sacrum
lat- ileopectineal bones
what are the boundaries of the pelvic outlet-looking up
ant-pubic symphysis
post-coccyx
what part of the pelvis is true pelvis
inferiorly -lesser
what part of the pelvic is the false pelvis
superiorly-greater
what is the difference between Male and female pelvis
female- shallow, oval inlet, small outlet, larger subpubic angle, round obturator foramen
male- deep, heart shaped inlet, large outlet, subpubic angle smaller
what type of joint is the sacroiliac joint
synovial plane
what type of joint is the pubic symphysis
secondary cartiliginous
what muscles are on the lateral walls of the pelvis
obturator internus
piriformis
what does the pelvic floor do
divide the pelvic floor from the perineum
what are the 3 components of the pelvic floor
coccxygeus muscle
levator ani muscles-support pelvic viscera(oliococcyxgeus, pubococcygeus)
coverings of muscle
what are the perineal bodies
fibrous ligament on the floor of the pelvis which extends between the coccyx and margin of anus
merging of bulbospongiosus and external anal spchinter
what are 2 functions of the pelvic floor
passing of urine and faeces
sexual function
what is the innervation of the pelvic floor
pudendal nerve
what is a cystocele
prolapsed bladder which bulges into the vagina
what is a rectocele
rectum bulges against vagina
what is a episiotomy
mediolateral, less scarring and not cutting through the ligament
avoid excessive tearing of the perineum and perineal muscles, prevent extension of perineal tear into the anal sphcinter
what parts of the urinary system are in the pelvis
bladder
urethra
what part of reproductive system is in the pelvis
testes, prostate
fallopian tubes
vagina
what provides blood to the pelvis
right and left internal iliac artery, mostly internal pudendal
what artery supplies the testes and ovary
gonadal which comes from AA
what does the obturator artery supply
pelvic muscles
what are the 5 different veins of pelvic drainage
internal iliac veins superior rectal veins medican sartal veins gonadal veins internal vertebral venous plexus
what parts of the rectum goes into the portal circualtion
superior inferior
what part of the rectum goes into the systemic circulation
middle inferior
why might haemorrhoids be associated with cirrhosis of the liver
portal hypertension
what is the somatic component of the reproductive organs
ilioinguinal nerve enters the inguinal canal thought the superficial ring supplies skin at root of penicillin and labia in females
genitofemoral nerve enters through the deep inguinal ring
what structures are supplied by genitofemoral nerve
cremaster muscle and anterior scrotal skin
what are the nerve roots of pudendal nerev
s2-4
what bony lanmarks do you use for nerve block during childbirth
ischial spine
what is the autonomic supply
symapathic and parasympathetic fibres
what does the hypogastric plexus supply sympathetic
vas deferens
seminal vesciles
prostate
epididymis
what does the ovarian plexus supplu
female genital tract
what does hypogastric plexus parasympathetic supply
erectile tissues
what do the external iliac lymph nodes drain
inguinal lymph nodes
what do the internal iliac lymph nodes drain
gluteal region
deep perinum
what do the sacral lymph nodes drain
posterior inferior pelvic visera
what do the common iliac lymph nodes drain
external
internal
sacral lymph nodes
what groups can the reproductive organs be split into
external geenitilia
gonads-where sex cells are produced
the tube system for sperm and ovum
the accessory glands which support gametes
be able to name the male reproductive system
testi vas deferens seminal glands prostate epididymis bulbourethral glands
why are the testis outside the body
function best at a lower temperature than core body temperature
what structure is created by the testies moving outside the body during development
inguinal canal
what are the contents of the inguinal canal
vas deferens
testicular artery
artery of vas deferens
what is the outer fibrous layer of the testes
tinuca albuginea
what are the two layers of tunica vaginalis
parietal and visceral
what material is between the two layers
viscous fluid
what is a hydrocele
fluid in the sheath around the testicle
what is a haematocele
blood in the sheath around the testicle
what is the blood supply of the testicles
testicualr arteries which come from AA at l2
what is the pampiniform
small veins around the male spermatic chord
what is the function of pampiniform plexus
thermoregulation of testes
where does the right testicular vein drain to
IVC
where does the left testicualr vein drain to
left renal vein
what is a varicocele
enlargement of veins
what two lymph groups receive lymph from the testies
lumbar
paraaarotic
what is the vas deferens
a muscular tube which arises from the tail of the epididymis , enters the pelvis by crossing over the external iliac vessels.carries sperm testes to prostatic urethra
what are the seminal vesicles
located on either side of the posterior bladder
what do the seminal vesicles produce
alkaline fluid
fructose
prostaglandin
clotting factors
where is the prostate in relation to the rectum
lies in front of the rectum-ampulla of rectum lies behind it
what does the prostate secrete
protelyic enzymes which break down clotting factors allowing semen to remain fluid
what are bulbourethral glands
small structures that empty into the penile/spongey urethras
what secretions are produced by the bulbourethral glands
pre-ejaculation- neutralises acidity of urethra preparing for the passing of sperm, mucus like secretion
what is the lymphatic drainage of the prostate
internal iliac and sacral nodes
what is the lymphatic drainage of the seminal vesicles
external and internal iliac nodes
what is the lymphatic drainage of the scrotum
lumbar lymph nodes
what are the testes like histologically
convoluted tubules, leydig cells in the interstitial spaces between the tubules which produce testosterone
what is the prostate like histologically
serous alveoli with infolding epithelium
amorphous eosinophilc masses in older men
what are the seminal vesicles like histologically
honey comb appearances, well developed muscular externa
what is the ductus deferens like histologically
lumen, thick muscular tube, epithelial lining supportingg lamina propria
what is the ligament that splits the greater and less sciatic foramen
sacrospinous ligament
what goes through the greater sciatic formen
sciatic nerve, piriformi muscle
what goes through the lesser sciatic foramen
pudendal nerve and vessels
what is the thinner part of the male urethra
membranous is shortest and thinnest
what 3 things constitute to the birth canal
uterus
vagina
cervix
what are the 3 layers of the uterus
endometrium
myometrium-thick
perimetrium
what is the normal position of the uterus
ante flexed
before surgery why is it important to know the position of the uterus
to avoid perforation of the uterus with instrument
what are the fornices of the vagina
arches on the side before the cervix
through which fornix can you access the rectouterine pouch
posterior forrnix
what are the two spaces
uterovesical spa
rector uterine space
what are the 4 ligaments of the uterus and cervix
ligament of the ovary
suspensory ligament of ovary
round ligament of uterus
broad ligament
what is the broad ligament
associated with the uterus, Fallopian tubes and ovaries covering them anteriorly and posteriorly
what is the ovarian ligament
attaches to the ovary inferiorly to the uterus
what is the suspensory ovarian ligament
attaches the ovary to the lateral abdominal wall
what is the round ligament
remanent of embryonic, from uterine horns to the lava majora
what are the 4 parts of the uterine tibes
isthmus
ampulla
infundibulum
fimbrae
what is the longest and widest part if the uterine tube
ampulla
what part of the uterine tubes do fertilisation occur
ampulla
what is meant by an ectopic pregnancy
embryo attaches outside the uterus
what happens to ovaries after menopause
may become atrophied and fibrous
what is the blood supply to the gonads and genitalia
the gonadal and internal iliac arteries
where does the gonadal arteries arise from
superior to l2
where does the ovarian artery go
in the suspensory ligament to supply the brand ligament
where does the uterine artery cross
crosses over the ureter at the level of the ischial spine
what lymph nodes receive lymph from the ovaries
paraaortic
where does the upper part of the uterus drain to
pre-arotic group of lymph nodes
where does the body of the uterus drain
external iliac
where does the lower vagina drain to
superficial inguinal lymph nodes
what is the structure of the breasts
15-25 lobes with tubuloacinar gland and stroma
what are the surface markings of the breast
from 2nd rib to the 6th rib
lateral border of sternum to mid axillary line
what are the muscles of the deep surface of thebreast
pectoralis major
pectorals minor
serratus anterior
what is the blood supply of the breast
subclavian and axially arteries
where does the lateral breast drain to
pectoral lymph nodes
what does the placenta form from
trophoblast following implantation of the blastocyst into the uterine endometrium
what re the surfaces of the placenta
maternal
reverse-foetal side
what is the maternal surface like
sic shaped, stricture is rough and spongey
what is the foetal surface like
smooth and bears attachment for umbilical chord
list four functions of the placenta
gaseous exchange
nutrient uptake
wasre elimination
thermoregulation
when does the placenta separate from the wall
third trimester, 20th week of pregnancy
how many umbilical arteries are there in the umbilici chord
2
what is the function of umbilical arteries in the fatal circulation
carry deoxygenated blood from fetus to placenta
how many umbilical veins are there
1
what is the function of umbilical veins
to carry oxygenated blood from the placenta to the baby
what else is in the umbillical chord
Wharton’s jelly tissue -provides insulation and protection
what is the two triangles bound by the two ischial tuberosities
urogenital triangle
anal triangle
what triangle lies anterior inferior to the coccyx
anal triangle
what is the anal triangle
opening of anus
external anal spchinter
what is the urogenital traingle
number of layers
perineal membrane
strong deep fasciae
what are all the muscles of the perineum supplied by
branch of pudenal nerve
what are the anatomical borders of the perinuem
ant-pubic symphysis
post-tip of coccyx
lateral-inferior pubic rami
roof-pelvic floor
what are the muscles of the perineum
external anal sphincter bulbospongiosis-supports erection ischiocavernosus-maintain erection superficial transiger perineal deep transversals perineal external urethral sphincter-maintain urinary continence
what is the perineal body
meeting of the muscles-tendon
supports pelvic floor
what muscles meet at the perineal body
levator ani
bulbospongiosus
external anal sphincter
external urethral sphincter
what is the innervation of the external urethral spchinter
voluntary, pudundal nerve
what is the innervation of the internal urethral sphincter
involunatry, hypogastric nerve
what happens when the prostate enlarges
terminal dribbling
what is the widest part of the male urethrra
prostatic
what is sound lateral to the anal canal
ischio-anal fossae
what is the function of ischio-anal fossae
allows canal to expand during defection, it is made of dense fat
what structures are present in this fossa
pudendal artery, pudendal vein, pudendal nerve
what is the bulb of vestibule
elongated masses of erectile tissues
where are spermatozoa produced
seminefeous tubules in the testes
