Anatomy of Pelvis and Perineum Flashcards
1
Q
on bony pelvis be able to locate
A
sarcal promontory accurate line of ilium pecten pubis pubic tubercle pubic crest pubic symphysis
2
Q
what are the boundaries of the pelvic inlet-looking down
A
ant- pubic symphysis
post- promontory of sacrum
lat- ileopectineal bones
3
Q
what are the boundaries of the pelvic outlet-looking up
A
ant-pubic symphysis
post-coccyx
4
Q
what part of the pelvis is true pelvis
A
inferiorly -lesser
5
Q
what part of the pelvic is the false pelvis
A
superiorly-greater
6
Q
what is the difference between Male and female pelvis
A
female- shallow, oval inlet, small outlet, larger subpubic angle, round obturator foramen
male- deep, heart shaped inlet, large outlet, subpubic angle smaller
7
Q
what type of joint is the sacroiliac joint
A
synovial plane
8
Q
what type of joint is the pubic symphysis
A
secondary cartiliginous
9
Q
what muscles are on the lateral walls of the pelvis
A
obturator internus
piriformis
10
Q
what does the pelvic floor do
A
divide the pelvic floor from the perineum
11
Q
what are the 3 components of the pelvic floor
A
coccxygeus muscle
levator ani muscles-support pelvic viscera(oliococcyxgeus, pubococcygeus)
coverings of muscle
12
Q
what are the perineal bodies
A
fibrous ligament on the floor of the pelvis which extends between the coccyx and margin of anus
merging of bulbospongiosus and external anal spchinter
13
Q
what are 2 functions of the pelvic floor
A
passing of urine and faeces
sexual function
14
Q
what is the innervation of the pelvic floor
A
pudendal nerve
15
Q
what is a cystocele
A
prolapsed bladder which bulges into the vagina
16
Q
what is a rectocele
A
rectum bulges against vagina
17
Q
what is a episiotomy
A
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
18
Q
what parts of the urinary system are in the pelvis
A
bladder
urethra
19
Q
what part of reproductive system is in the pelvis
A
testes, prostate
fallopian tubes
vagina
20
Q
what provides blood to the pelvis
A
right and left internal iliac artery, mostly internal pudendal
21
Q
what artery supplies the testes and ovary
A
gonadal which comes from AA
22
Q
what does the obturator artery supply
A
pelvic muscles
23
Q
what are the 5 different veins of pelvic drainage
A
internal iliac veins superior rectal veins medican sartal veins gonadal veins internal vertebral venous plexus
24
Q
what parts of the rectum goes into the portal circualtion
A
superior inferior
25
what part of the rectum goes into the systemic circulation
middle inferior
26
why might haemorrhoids be associated with cirrhosis of the liver
portal hypertension
27
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
28
what structures are supplied by genitofemoral nerve
cremaster muscle and anterior scrotal skin
29
what are the nerve roots of pudendal nerev
s2-4
30
what bony lanmarks do you use for nerve block during childbirth
ischial spine
31
what is the autonomic supply
symapathic and parasympathetic fibres
32
what does the hypogastric plexus supply sympathetic
vas deferens
seminal vesciles
prostate
epididymis
33
what does the ovarian plexus supplu
female genital tract
34
what does hypogastric plexus parasympathetic supply
erectile tissues
35
what do the external iliac lymph nodes drain
inguinal lymph nodes
36
what do the internal iliac lymph nodes drain
gluteal region
| deep perinum
37
what do the sacral lymph nodes drain
posterior inferior pelvic visera
38
what do the common iliac lymph nodes drain
external
internal
sacral lymph nodes
39
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
40
be able to name the male reproductive system
```
testi
vas deferens
seminal glands
prostate
epididymis
bulbourethral glands
```
41
why are the testis outside the body
function best at a lower temperature than core body temperature
42
what structure is created by the testies moving outside the body during development
inguinal canal
43
what are the contents of the inguinal canal
vas deferens
testicular artery
artery of vas deferens
44
what is the outer fibrous layer of the testes
tinuca albuginea
45
what are the two layers of tunica vaginalis
parietal and visceral
46
what material is between the two layers
viscous fluid
47
what is a hydrocele
fluid in the sheath around the testicle
48
what is a haematocele
blood in the sheath around the testicle
49
what is the blood supply of the testicles
testicualr arteries which come from AA at l2
50
what is the pampiniform
small veins around the male spermatic chord
51
what is the function of pampiniform plexus
thermoregulation of testes
52
where does the right testicular vein drain to
IVC
53
where does the left testicualr vein drain to
left renal vein
54
what is a varicocele
enlargement of veins
55
what two lymph groups receive lymph from the testies
lumbar
| paraaarotic
56
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
57
what are the seminal vesicles
located on either side of the posterior bladder
58
what do the seminal vesicles produce
alkaline fluid
fructose
prostaglandin
clotting factors
59
where is the prostate in relation to the rectum
lies in front of the rectum-ampulla of rectum lies behind it
60
what does the prostate secrete
protelyic enzymes which break down clotting factors allowing semen to remain fluid
61
what are bulbourethral glands
small structures that empty into the penile/spongey urethras
62
what secretions are produced by the bulbourethral glands
pre-ejaculation- neutralises acidity of urethra preparing for the passing of sperm, mucus like secretion
63
what is the lymphatic drainage of the prostate
internal iliac and sacral nodes
64
what is the lymphatic drainage of the seminal vesicles
external and internal iliac nodes
65
what is the lymphatic drainage of the scrotum
lumbar lymph nodes
66
what are the testes like histologically
convoluted tubules, leydig cells in the interstitial spaces between the tubules which produce testosterone
67
what is the prostate like histologically
serous alveoli with infolding epithelium
| amorphous eosinophilc masses in older men
68
what are the seminal vesicles like histologically
honey comb appearances, well developed muscular externa
69
what is the ductus deferens like histologically
lumen, thick muscular tube, epithelial lining supportingg lamina propria
70
what is the ligament that splits the greater and less sciatic foramen
sacrospinous ligament
71
what goes through the greater sciatic formen
sciatic nerve, piriformi muscle
72
what goes through the lesser sciatic foramen
pudendal nerve and vessels
73
what is the thinner part of the male urethra
membranous is shortest and thinnest
74
what 3 things constitute to the birth canal
uterus
vagina
cervix
75
what are the 3 layers of the uterus
endometrium
myometrium-thick
perimetrium
76
what is the normal position of the uterus
ante flexed
77
before surgery why is it important to know the position of the uterus
to avoid perforation of the uterus with instrument
78
what are the fornices of the vagina
arches on the side before the cervix
79
through which fornix can you access the rectouterine pouch
posterior forrnix
80
what are the two spaces
uterovesical spa
| rector uterine space
81
what are the 4 ligaments of the uterus and cervix
ligament of the ovary
suspensory ligament of ovary
round ligament of uterus
broad ligament
82
what is the broad ligament
associated with the uterus, Fallopian tubes and ovaries covering them anteriorly and posteriorly
83
what is the ovarian ligament
attaches to the ovary inferiorly to the uterus
84
what is the suspensory ovarian ligament
attaches the ovary to the lateral abdominal wall
85
what is the round ligament
remanent of embryonic, from uterine horns to the lava majora
86
what are the 4 parts of the uterine tibes
isthmus
ampulla
infundibulum
fimbrae
87
what is the longest and widest part if the uterine tube
ampulla
88
what part of the uterine tubes do fertilisation occur
ampulla
89
what is meant by an ectopic pregnancy
embryo attaches outside the uterus
90
what happens to ovaries after menopause
may become atrophied and fibrous
91
what is the blood supply to the gonads and genitalia
the gonadal and internal iliac arteries
92
where does the gonadal arteries arise from
superior to l2
93
where does the ovarian artery go
in the suspensory ligament to supply the brand ligament
94
where does the uterine artery cross
crosses over the ureter at the level of the ischial spine
95
what lymph nodes receive lymph from the ovaries
paraaortic
96
where does the upper part of the uterus drain to
pre-arotic group of lymph nodes
97
where does the body of the uterus drain
external iliac
98
where does the lower vagina drain to
superficial inguinal lymph nodes
99
what is the structure of the breasts
15-25 lobes with tubuloacinar gland and stroma
100
what are the surface markings of the breast
from 2nd rib to the 6th rib
| lateral border of sternum to mid axillary line
101
what are the muscles of the deep surface of thebreast
pectoralis major
pectorals minor
serratus anterior
102
what is the blood supply of the breast
subclavian and axially arteries
103
where does the lateral breast drain to
pectoral lymph nodes
104
what does the placenta form from
trophoblast following implantation of the blastocyst into the uterine endometrium
105
what re the surfaces of the placenta
maternal
| reverse-foetal side
106
what is the maternal surface like
sic shaped, stricture is rough and spongey
107
what is the foetal surface like
smooth and bears attachment for umbilical chord
108
list four functions of the placenta
gaseous exchange
nutrient uptake
wasre elimination
thermoregulation
109
when does the placenta separate from the wall
third trimester, 20th week of pregnancy
110
how many umbilical arteries are there in the umbilici chord
2
111
what is the function of umbilical arteries in the fatal circulation
carry deoxygenated blood from fetus to placenta
112
how many umbilical veins are there
1
113
what is the function of umbilical veins
to carry oxygenated blood from the placenta to the baby
114
what else is in the umbillical chord
Wharton's jelly tissue -provides insulation and protection
115
what is the two triangles bound by the two ischial tuberosities
urogenital triangle
| anal triangle
116
what triangle lies anterior inferior to the coccyx
anal triangle
117
what is the anal triangle
opening of anus
| external anal spchinter
118
what is the urogenital traingle
number of layers
perineal membrane
strong deep fasciae
119
what are all the muscles of the perineum supplied by
branch of pudenal nerve
120
what are the anatomical borders of the perinuem
ant-pubic symphysis
post-tip of coccyx
lateral-inferior pubic rami
roof-pelvic floor
121
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
```
122
what is the perineal body
meeting of the muscles-tendon
| supports pelvic floor
123
what muscles meet at the perineal body
levator ani
bulbospongiosus
external anal sphincter
external urethral sphincter
124
what is the innervation of the external urethral spchinter
voluntary, pudundal nerve
125
what is the innervation of the internal urethral sphincter
involunatry, hypogastric nerve
126
what happens when the prostate enlarges
terminal dribbling
127
what is the widest part of the male urethrra
prostatic
128
what is sound lateral to the anal canal
ischio-anal fossae
129
what is the function of ischio-anal fossae
allows canal to expand during defection, it is made of dense fat
130
what structures are present in this fossa
pudendal artery, pudendal vein, pudendal nerve
131
what is the bulb of vestibule
elongated masses of erectile tissues
132
where are spermatozoa produced
seminefeous tubules in the testes
