ANATOMY**Pelvic Organs Flashcards
Peritoneum in males:
- Passes from anterior abdominal wall to
- Covers what two things
- What does it form when it passes onto anterior aspect of rectum
- Superior surface of urinary bladder
- Small part of posterior urinary bladder and upper ends of seminal vesicles
- Rectovesical pouch (lowest part of peritoneal cavity)
Peritoneum in females:
- Passes from anterior abdominal wall to
- What does it form when it passes onto anterior surface of uterus
- Where does it go next
- Upper surface of urinary bladder
- Vesicouterine pouch
- Goes over uterus and onto anterior aspect of rectum forming rectouterine pouch (of Douglas)
Rectum:
- Where does it begin
- How does it run
- How does it end
- S3 (as continuation of sigmoid colon)
- Follows curvature of sacrum and coccyx
- Pierces pelvic diaphragm to become continuous with anal canal
Which part of the rectum has peritoneum
Upper part is partially covered by peritoneum; lower part has none
Rectum anatomical relations:
- Posterior (2 bones, 3 muscles, 2 nerves)
- Anterior upper part of males/females
- Anterior lower part of males (4)
- Anterior lower part of females
- Sacrum, coccyx, coccygeus, piriformis, posterior part of levator ani, sacral plexus, and sacral part of sympathetic trunk
- Sigmoid colon/coils of ileum that occupy rectovesical pouch/rectouterine pouch
- Urinary bladder, ampulla of vas deferens, seminal vesicle, prostate
- Vagina
Anterior part of perineum is called
Posterior part of perineum is called
Urogenital triangle
Anal triangle
Why is the anal canal not part of the pelvic cavity
Anal canal is inferior to pelvic diaphragm (which makes the floor of the pelvic cavity); anal canal is part of the lesser pelvis though
Where does anal canal begin and end
Begins at anorectal/perineal flexure and ends at anus
Anatomical relations of anal canal:
- Posterior
- Lateral
- Anterior (males)
- Anterior (females)
- Anococcygeal ligament (body or raphe)
- Fat in ischioanal (ischiorectal fossa)
- Perineal body, bulb of penis
- Perineal body, lower part of vagina
Significance of perineal body
Many muscles converge here including levator ani
What is the bulb of the penis
Inferior end of corpus spongiosum
Embryology of anal canal:
- Upper part
- Lower part
- Originates from hindgut and is derived from endoderm
2. Originates from proctodeum/anal pit and is derived from ectoderm
What is the pectinate line
What is it formed by
Represents junction between endodermal and ectodermal parts of anal canal
Wavy line around the circumference of anal canal formed by anal valves
~ectodermal and endodermal parts have different blood, lymph and nerve supply
- Arterial supply to upper part of anal canal
- Arterial supply to lower part of anal canal
- Superior rectal artery (continuation of IMA)
2. Inferior rectal artery (branch of internal pudendal artery)
- Venous drainage of upper part of anal canal
2. Venous drainage of lower part of anal canal
- Superior rectal vein (eventually portal system)
2. Inferior rectal vein (eventually IVC)
- Dilation of tributaries of superior rectal vein causes?
2. Dilation of tributaries of inferior rectal vein causes?
- Internal hemorrhoids
2. External hemorrhoids
Lymph drainage of anal canal:
- Upper part
- Lower part
- Internal iliac lymph nodes and nodes along superior rectal artery
- Superficial inguinal lymph nodes
Innervation of anal canal:
- Upper part
- Lower part
- Autonomic innervation
- Somatic innervation via inferior rectal nerve (branch of pudendal nerve)
~somatic innervation means lower part is much more sensitive
Internal anal sphincter:
- Structure
- Location
- Innervation
- Thickening of inner circular layer of smooth muscle fibers
- Surrounds upper 2/3 of anal canal
- Autonomic innervation (involuntary)
External anal sphincter ~has 3 parts~:
- Structure
- Location
- Innervation
- Made of skeletal muscle fibers
- Surrounds entire length of anal canal
- Somatic innervation via inferior rectal nerves (branches of pudendal nerves - voluntary)
- Location of empty bladder in adults
- Location as it fills in adults
- Location of empty bladder in children
- Pelvic cavity; posterior to pubic bones and pubic symphysis
- Superior wall rises up into hypogastric region
- Largely above pelvic brim (is abdominal organ)
Shape of urinary bladder
4 parts?
3 sided pyramid tilted on its side (so apex does not point up)
Apex, base (fundus), body and neck
Location of following parts of urinary bladder:
- Apex
- What is apex connected to?
- Base (fundus)
- Body
- Neck
- Directed anteriorly, posterior to upper margin of pubic symphysis
- Umbilicus by median umbilical ligament
- Directed posteriorly, triangular - related to rectum, seminal vesicle, and ampulla of vas deferens and vagina
- Between apex and base - forms most of bladder
- Lowest and most fixed part; where 2 inferolateral and base (fundus) converge
Body of the urinary bladder consists of
1 superior and 2 inferolateral surfaces
Body of urinary bladder relations:
- Superior surface
- Inferolateral surfaces
- Covered with peritoneum; related to coils of ileum/sigmoid colon (in males) and uterus
- Obturator internus and levator ani muscles (same in both sexes)
What does the neck of urinary bladder give rise to
Urethra
Structure of most of the interior of bladder
Wrinkled/folded except when bladder is distended
What is the vesical trigone
Triangular area on the internal aspect of base (fundus) where mucosa is firmly bound to muscular later, so it is always smooth
- Superior angles of vesical trigone correspond with
2. Inferior angles of vesical trigone correspond with
- Ureteric orifices
2. Internal urethral orifice