Anatomy part 1 Flashcards by Heo Mun Ho

Identify the

sacral promontory
ala of sacrum
arcuate line of ilium
pecten pubis
pubic tubercle
pubic crest

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What is the inferior pelvic outlet bounded by

anteriorly
laterally
posteriorly

Anterior - pubic arch

Lateral - ischial tuberosities + sacrotuberous ligaments

Posterior - tip of coccyx

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Lesser pelvis also known as the

True pelvis

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Compared to males, the following features of the female pelvis are

greater pelvis - depth
lesser pelvis - width + depth
pelvic inlet - shape
pelvic outlet - size
subpubic angle

shallower
wider + shallower
oval/round
larger - to allow baby to exit
>90 degrees

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Sacroiliac is what type of joint

Synovial plane

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Pubic symphysis is what type of joint

Secondary cartilaginous

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Muscles forming these walls of the pelvic cavity

lateral
posterior
floor

Lateral - obturator internus
Posterior - piriformis
Floor - levator ani + coccygeus

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What nerve network lies on piriformis (posterior wall of pelvis)

Sacral plexus

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What are the 3 parts of levator ani + collective functions of the levator ani

Puborectalis
Pubococcygeus
Iliococcygeus

Support abdominopelvic organs and maintain faecal + urinary continence

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2 functions of the pelvic floor

Support the abdominopelvic organs

Urinary + faecal incontinence

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Innervation of pelvic floor

Sacral plexus

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Define a

cystocele

- rectocele

Cystocele - prolapse of bladder into vagina (anterior prolapse)

Rectocele - prolapse of anterior wall of rectum into posterior wall of vagina (posterior prolapse)

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How does childbirth injure pelvic floor

Weakens levator ani and pelvic fascia due to stretching and can also alter position of bladder neck and urethra leading to urinary incontinence

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Why may an episiotomy (incision of the perineum and the posterior vaginal wall) be done during childbirth

To enlarge vaginal opening so baby can come out easier + prevent severe tear of perineum

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Major arterial supply to the pelvis is from branches of which arteries

Branches of the right and left internal iliac artery

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Main artery supplying the perineum

Internal pudendal (branch of internal iliac)

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Which branch of the internal iliac supplies some of the pelvic muscles, ilium and head of femur

Obturator artery

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Which branches of the internal iliac supplies the seminal glands, prostate + rectum

Middle + inferior rectal

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Which branch of the uterine artery supplies the vagina and base of bladder

Vaginal artery

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Which branch of the internal iliac supplies the uterus

Uterine artery

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Which branches of the abdominal aorta supply the testes/ovaries

Gonadal artery (testicular and ovarian respectively)

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Which part of the rectum drains into the portal circulation

Upper 2/3 –> superior mesenteric vein –> liver

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Which part of the rectum drains into the systemic circulation

Lower 1/3 –> middle rectal vein –> IVC

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Why may haemorrhoids be associated with liver cirrhosis

Liver cirrhosis increases portal pressure so venous drainage won’t be as efficient therefore leading to swollen engorged veins in the rectum –> haemorrhoids

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Which venous plexus does the prostatic venous plexus communicate with on its posterior surface What is the significance of this

Vertebral venous plexus Route of bone metastasis in prostate cancer as the prostatic venous plexus drains into the internal iliac vein which connects with the vertebral venous plexus

Ilioinguinal nerve provides somatic innervation to what in males/females (only want sensory answer, not motor)

Sensation to - Anteromedial thigh - Males - skin over root of penis - Females - labia majora

Genitofemoral nerve has 2 branches - genital branch and femoral branch What does each branch supply

Genital branch - motor to cremaster muscle and provides sensation to anterior scrotal skin Femoral branch - sensation to medial surface of superior thigh

Clinical significance of the genitofemoral nerve

Cremasteric reflex - contraction of the cremaster muscle when medial surface of superior thigh touched because their nerve supplies are connected

Pudendal nerve arises from plexus what and has what nerve roots

Sacral plexus S2-4

Bony landmarks for pudendal nerve when performing a pudendal nerve block during labour

Ischial spines

Pudendal nerve descends from sacral plexus and leaves the pelvis through the greater sciatic foramen, crosses sacrospinous ligament then re-enters pelvis via lesser sciatic foramen After re-entering the pelvis, it accompanies the internal pudendal artery and vein through what canal

Pudendal canal (also known as Alcock’s canal – a structure formed by the fascia of the obturator internus muscle)

Pudendal nerve innervates what (motor + sensory)

Motor - levator ani - bulbospongiosus - ischiocavernosus - external urethral sphincter Sensory - skin of external genitalia - skin of perineum - peri-anal skin

Sympathetic innervation of the pelvis arises from what plexus

Superior hypogastric plexus (Sacral splanchnic nerves)

Parasympathetic innervation of the pelvis arises

S2-S4 nerves (pelvic splanchnic nerves)

4 primary lymph nodes in the pelvis receiving drainage of the pelvic organs

External iliac Internal iliac Sacral Common iliac

External iliac lymph nodes receive lymph from

Inguinal lymph nodes - MAINLY Middle/anterior pelvic organs - external genitalia, vagina, cervix, uterus

Internal iliac lymph nodes receive lymph from

Inferior pelvic organs - e.g. prostate Gluteal region Deep perineum

Sacral lymph nodes receive lymph from

Posteroinferior pelvic organs

Components of the male genital (external + internal)

External - penis - urethra - scrotum Internal - testes - epididymis - vas deferens - seminal vesicles - prostate - bulbourethral glands

In males, the gonads (testes) are located outside the abdominopelvic cavity but remain connected to the structures located within the abdominopelvic cavity Why is this?

To keep temperature optimal for sperm production as scrotum are a cooler temp which enzymes of spermatogenesis work better at

Inguinal canal carries the spermatic cord What are the main contents of the spermatic cord

Blood vessels - testicular artery, cremasteric a + v Nerves - genitofemoral nerve Vas deferens Lymph vessels

Outer fibrous layer of the testes

Tunica albuginea

What is the peritoneal sac covering the testes called (covers the tunica albuginea) + what are the 2 layers of it

Tunica vaginalis Visceral and parietal layer

What material is present between the 2 layers of the tunica vaginalis

Serous fluid

What is a hydrocele and haemtocele

Collection of serous fluid or blood respectively in the cavity of the tunica vaginalis

Arterial supply of testes

Testicular arteries - L2

The testicular arteries travel retroperitoneally and cross what 2 structures near the pelvic brim

Ureter | External iliac artery

Venous drainage of testes is via what plexus

Pampiniform plexus

Function of the pampiniform plexus

Part of thermoregulatory system to keep testes at a constant temp

Right testicular vein drains into Left testicular vein drains into

IVC Left renal vein

What is a varicocele

Swelling of the veins of the pampiniform plexus

Testes lymphatic drainage (2)

Lumbar | Para-aortic

Function of vas deferens

Carries sperm from the epididymis to the seminal vesicles, when it joins the duct of the seminal vesicles it becomes the ejaculatory duct

Pathway of sperm production

Produced by testes --> travels to epididymis to mature --> carried by vas deferens to seminal vesicles where the ejaculatory duct is formed --> prostatic urethra --> membranous urethra --> further secretions added by bulbourethral glands into penile urethra

Bulbourethral glands empty their secretions into which part of the urethra

Penile/spongy

Prostate lymphatic drainage (1)

Internal iliac nodes

Seminal vesicle lymphatic drainage (2)

External + internal iliac nodes

Scrotum lymphatic drainage (1)

Superficial inguinal nodes

Penis lymphatic drainage (2)

Superficial + deep inguinal nodes

Special feature in the histology of testes

Interstitial Leydig cells between tubules - produce testosterone

Special feature in the histology of prostate

Eosinophilic masses called corpora amylacea in older men

Majority of the male genital tract is lined by what epithelium

Pseudostratified columnar

Contents of lesser sciatic foramen (3)

Pudendal nerve Internal pudendal artery + vein Obturator internus

Contents of greater sciatic foramen (formed by sacrotuberous and sacrospinous ligaments) - nerves - vessels - muscles

Nerves - sciatic, superior/inferior gluteal, pudendal and others Vessels - superior/inferior gluteal a + v, internal pudenal a + v Piriformis - separates it into 2 halves

Anatomy part 1 Flashcards

(64 cards)