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My Anatomy Sem 2 > Anatomy Of The Pelvis > Flashcards

Anatomy Of The Pelvis Flashcards

1
Q

Renal arteries are at the level of?

A

L1-L2

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2
Q

Visceral pain afferents return to the spinal cord from the kidneys at what level? What are the referred cutaneous areas?

A

T12 to L2

Pain is referred to the cutaneous areas supplied by T12 to L2. - posterior and lateral abdominal wall below the ribs and above the iliac crest into the scrotum and labia majora and proximal anterior thigh.

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3
Q

Psoas major is innervated by?

A

L1 to L3

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4
Q

The psoas joins the iliacus at what level? What’s the innervation?

A

Joins illiacus L2-L4 - femoral nerve to become the iliopsoas

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5
Q

Quadratus lumborum is innervated by?

A

T 12 to L4

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6
Q

Supine the kidneys are approximately at what level? Is the right or left one lower?

A

Supine -Around T12 to L3 vertebrae,

Ribs 11-12 to L3-4 - When erect they are slightly lower

The right is lower than the left.

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7
Q

The right kidney is close to what structures?

A

Descending duodenum, posterior liver, hepatic flexure of the colon.

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8
Q

The left kidney is close to what structures?

A

Kidney is close to the the stomach, spleen, pancreas, and splenic flexure.

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9
Q

What muscle is medial to the kidneys?

A

Psoas

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10
Q

The kidneys are surrounded by what? Are they retroperitoneal or intra?

A

The kidneys are retroperitoneal and they are surrounded by renal fascia

The fascia is a perinephric (perineal) fat.

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11
Q

The True (lesser) and false (greater) pelvis are separated by what?

A

Separated by the pelvic inlet

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12
Q

The dermatomal sacral segments of the pelvis are what?

A

S3 to S5

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13
Q

The skeletal muscle in the perineum and pelvic floor including urethra and anal sphincters are innervated by what?

A

Innervated by S2-S4

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14
Q

Much of the somatic motor and sensory innervation of the pelvis is innervated by what nerve?

A

Pudendal nerve - s2-s4

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15
Q

Where do you numb the pelvis in a female?

A

Go through the vagina and go to the ischial tuberosity and then inject. This will numb the pudendal nerve.

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16
Q

What nerve plexus innervates the pelvis area?

A

Inferior hypogastric (pelvic) plexus - has SNS, PSNS, and visceral afferent components

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17
Q

What blood vessel does the pelvis get its blood from?

A

Basically from the internal iliac artery, anterior and posterior branches.

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18
Q

Deep pelvic structures drain into what lymph chains?

A

Deep pelvic structures drain into the internal and external iliac chains.

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19
Q

Deep perineal structures drain into what chain?

A

Deep perineal structures drain into the internal iliac chain.

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20
Q

Superficial structures like the penis, scrotum, clitoris, labia majora drain into what?

A

Drain into the superficial inguinal nodes.

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21
Q

Other superficial perineal structures - like the glans penis, glans clitoris, labia minors, and the inferior end of the vagina drain into what?

A

Drain into the deep inguinal nodes and the external iliac chain.

22
Q

The ovaries and related uterine structures and the testes (the lymphatic accompany the gonadal arteries) drain into what NODES?

A

Drain into the lateral and pre-aortic nodes.

23
Q

Gluteal nodes drain into what?

A

Drain into the internal iliac chain

24
Q

Drainage from the lower extremities drains into what nodes?

A

Superficial and deep inguinal nodes.

25
Q

Lower abdominal wall, gluteal and superficial areas of the lower limb drain into what?

A

The superficial inguinal nodes

26
Q

What nodes receive drainage from the femoral lymphatic and the perineal areas?

A

Deep inguinal nodes.

27
Q

The key to lymph drainage is that the deep parts of the perineum are drained by the?

A

Internal pudendal chain —> internal iliac nodes —> aortic nodes.

28
Q

The key part to the drainage of the superficial perineum and external genitalia are drained by what nodes?

A

Superficial inguinal nodes —> deep inguinal nodes —> external iliac nodes

29
Q

Extending across the ischiopubic arch is a thick triangular fascia structure that has transverse muscles within is called the?

A

Urogenital diaphragm/perineal membrane and the deep perineal pouch.

30
Q

What are the perforations in the urogenital diaphragm?

A

Male - the urethra

Female - the urethra and the vagina

31
Q

What are the boundaries of the perineum? innervation and blood supply?

A

Includes the urogenital triangle (anterior) and the anal triangle (posterior)

Innervation is the pudendal n and artery is the internal pudendal artery.

32
Q

The perineal membrane is composed of what?

A

Composed of a thick fibrous sheet with a free posterior border.

33
Q

The deep perineal pouch consists of?

A

Contains muscles and neuro-vascular structures within the perineal membrane.

34
Q

The pelvic diaphragm is composed of what muscles?

A

Levator Ani and the Coccygeus muscle

Levator Ani - composed of iliococcygeus muscle, pubococcygeus muscle, and puborectalis muscle.

35
Q

The levator Ani is called the levator sling. It arises from the walls of what?

A

It arises from the walls of the true pelvis, from the posterior pubic bone, from a ligament on the Obturator internist muscle, from the ischial tuberosity.

36
Q

The coccygeus arises from what? Where does it insert?

A

From the ischial spine and sarcospinous ligament and inserts on the sacrum and the coccyx.

37
Q

What are the three muscles that the levator Ani is composed of?

A

Pubococcygeus muscle

Puborectalis muscle - pulls anorectal junction forward to help keep the GI system closed at rectal area (called perineal flexure), helping the anal sphincter muscles. “Muscle of civilization”

Iliococcygeus muscle - which arises from the ilium and the tendonous arch on the obturator internus muscle.

38
Q

What places in the perineal space can abscess form?

A

The ischiorectal (ischialanal) fossa - is called the deep perineal space - abscesses can form here.

39
Q

What two structures come together at the perineal body?

A

The Levator Ani and Perineal Membrane come together at the perineal body.

40
Q

If you have a tear through the perineal body and through the anal sphincter you get what?

A

You get a “cloaca” - a common cavity at the end of the digestive tract for the release of both excretory and genital products in vertebrates

41
Q

The perianal area, - smooth muscle of the internal anal sphincter - is innervated by?

A

Autonomic nervous system (contracts) and PSNS (relaxes).

42
Q

The perianal area - the external anal sphincter - skeletal muscle - is innervated by?

A

Three components - innervated by the inferior rectal branches of the pudendal nerve - a somatic nerve.

43
Q

The transition zone between the rectal mucosa and nonkeratinized squamous epithelium is called what?

A

The anal pecten. Then the anocutaneous line (true skin)

44
Q

The external hemorrhoidal veins go to what?

A

The systemic circulation

45
Q

The internal hemorrhoidal veins go to what?

A

The portal system.

46
Q

As the bladder begins to fill, it lifts what?

A

Lifts the peritoneum up and away from the abdominal wall.

47
Q

What 3 structures support the uterus?

A

Pelvic diaphragm (pelvic floor) - levator ani, coccygeus muscle, and associated fascia

Urogenital diaphragm/perineal membrane

Perineal body

Note: the broad ligament, round ligament, and suspensory ligament of the ovary, and the perineal folds associated with the uterus are not considered to be true uterine support structures. - Just folds of peritoneum, not true support structures.

48
Q

What are the 3 “ligamentous supporting” structures of the uterus?

A

Cardinal ligament - (transverse cervical, Mackenrodt) - fibromuscular fascia from either side of the cervix

Uterosacral ligaments - from the posterior cervix to the sacrum — comprised of the recto-uterine folds - comprised of fibrous tissues and muscular fibers attached to the front of the sacrum.

Anterior pubocervical ligament - from the uterus to the pubic symphysis.

49
Q

T/F the peritoneal folds associated with the uterus are supporting structures?

A

False, - broad ligament, mesovarium, mesosalpinx, round ligament are not true support structures.

50
Q

What are the 3 pouches are associated with folds of the peritoneum in the perineum.

A

Urachus, umbilical folds

Vesicouterine pouch

Rectouterine pouch (douglas)

51
Q

What pouch is a deep pouch posterior to the uterus and anterior to the rectum.

A

Pouch of Douglas. Rectouterine or rectovaginal pouch

My Anatomy Sem 2 (3 decks)

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