ANATOMY**Pelvic Organs Flashcards

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1
Q

Peritoneum in males:

  1. Passes from anterior abdominal wall to
  2. Covers what two things
  3. What does it form when it passes onto anterior aspect of rectum
A
  1. Superior surface of urinary bladder
  2. Small part of posterior urinary bladder and upper ends of seminal vesicles
  3. Rectovesical pouch (lowest part of peritoneal cavity)
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2
Q

Peritoneum in females:

  1. Passes from anterior abdominal wall to
  2. What does it form when it passes onto anterior surface of uterus
  3. Where does it go next
A
  1. Upper surface of urinary bladder
  2. Vesicouterine pouch
  3. Goes over uterus and onto anterior aspect of rectum forming rectouterine pouch (of Douglas)
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3
Q

Rectum:

  1. Where does it begin
  2. How does it run
  3. How does it end
A
  1. S3 (as continuation of sigmoid colon)
  2. Follows curvature of sacrum and coccyx
  3. Pierces pelvic diaphragm to become continuous with anal canal
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4
Q

Which part of the rectum has peritoneum

A

Upper part is partially covered by peritoneum; lower part has none

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5
Q

Rectum anatomical relations:

  1. Posterior (2 bones, 3 muscles, 2 nerves)
  2. Anterior upper part of males/females
  3. Anterior lower part of males (4)
  4. Anterior lower part of females
A
  1. Sacrum, coccyx, coccygeus, piriformis, posterior part of levator ani, sacral plexus, and sacral part of sympathetic trunk
  2. Sigmoid colon/coils of ileum that occupy rectovesical pouch/rectouterine pouch
  3. Urinary bladder, ampulla of vas deferens, seminal vesicle, prostate
  4. Vagina
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6
Q

Anterior part of perineum is called

Posterior part of perineum is called

A

Urogenital triangle

Anal triangle

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7
Q

Why is the anal canal not part of the pelvic cavity

A

Anal canal is inferior to pelvic diaphragm (which makes the floor of the pelvic cavity); anal canal is part of the lesser pelvis though

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8
Q

Where does anal canal begin and end

A

Begins at anorectal/perineal flexure and ends at anus

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9
Q

Anatomical relations of anal canal:

  1. Posterior
  2. Lateral
  3. Anterior (males)
  4. Anterior (females)
A
  1. Anococcygeal ligament (body or raphe)
  2. Fat in ischioanal (ischiorectal fossa)
  3. Perineal body, bulb of penis
  4. Perineal body, lower part of vagina
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10
Q

Significance of perineal body

A

Many muscles converge here including levator ani

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11
Q

What is the bulb of the penis

A

Inferior end of corpus spongiosum

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12
Q

Embryology of anal canal:

  1. Upper part
  2. Lower part
A
  1. Originates from hindgut and is derived from endoderm

2. Originates from proctodeum/anal pit and is derived from ectoderm

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13
Q

What is the pectinate line

What is it formed by

A

Represents junction between endodermal and ectodermal parts of anal canal

Wavy line around the circumference of anal canal formed by anal valves

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14
Q

~ectodermal and endodermal parts have different blood, lymph and nerve supply

  1. Arterial supply to upper part of anal canal
  2. Arterial supply to lower part of anal canal
A
  1. Superior rectal artery (continuation of IMA)

2. Inferior rectal artery (branch of internal pudendal artery)

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15
Q
  1. Venous drainage of upper part of anal canal

2. Venous drainage of lower part of anal canal

A
  1. Superior rectal vein (eventually portal system)

2. Inferior rectal vein (eventually IVC)

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16
Q
  1. Dilation of tributaries of superior rectal vein causes?

2. Dilation of tributaries of inferior rectal vein causes?

A
  1. Internal hemorrhoids

2. External hemorrhoids

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17
Q

Lymph drainage of anal canal:

  1. Upper part
  2. Lower part
A
  1. Internal iliac lymph nodes and nodes along superior rectal artery
  2. Superficial inguinal lymph nodes
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18
Q

Innervation of anal canal:

  1. Upper part
  2. Lower part
A
  1. Autonomic innervation
  2. Somatic innervation via inferior rectal nerve (branch of pudendal nerve)

~somatic innervation means lower part is much more sensitive

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19
Q

Internal anal sphincter:

  1. Structure
  2. Location
  3. Innervation
A
  1. Thickening of inner circular layer of smooth muscle fibers
  2. Surrounds upper 2/3 of anal canal
  3. Autonomic innervation (involuntary)
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20
Q

External anal sphincter ~has 3 parts~:

  1. Structure
  2. Location
  3. Innervation
A
  1. Made of skeletal muscle fibers
  2. Surrounds entire length of anal canal
  3. Somatic innervation via inferior rectal nerves (branches of pudendal nerves - voluntary)
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21
Q
  1. Location of empty bladder in adults
  2. Location as it fills in adults
  3. Location of empty bladder in children
A
  1. Pelvic cavity; posterior to pubic bones and pubic symphysis
  2. Superior wall rises up into hypogastric region
  3. Largely above pelvic brim (is abdominal organ)
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22
Q

Shape of urinary bladder

4 parts?

A

3 sided pyramid tilted on its side (so apex does not point up)

Apex, base (fundus), body and neck

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23
Q

Location of following parts of urinary bladder:

  1. Apex
  2. What is apex connected to?
  3. Base (fundus)
  4. Body
  5. Neck
A
  1. Directed anteriorly, posterior to upper margin of pubic symphysis
  2. Umbilicus by median umbilical ligament
  3. Directed posteriorly, triangular - related to rectum, seminal vesicle, and ampulla of vas deferens and vagina
  4. Between apex and base - forms most of bladder
  5. Lowest and most fixed part; where 2 inferolateral and base (fundus) converge
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24
Q

Body of the urinary bladder consists of

A

1 superior and 2 inferolateral surfaces

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25
Q

Body of urinary bladder relations:

  1. Superior surface
  2. Inferolateral surfaces
A
  1. Covered with peritoneum; related to coils of ileum/sigmoid colon (in males) and uterus
  2. Obturator internus and levator ani muscles (same in both sexes)
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26
Q

What does the neck of urinary bladder give rise to

A

Urethra

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27
Q

Structure of most of the interior of bladder

A

Wrinkled/folded except when bladder is distended

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28
Q

What is the vesical trigone

A

Triangular area on the internal aspect of base (fundus) where mucosa is firmly bound to muscular later, so it is always smooth

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29
Q
  1. Superior angles of vesical trigone correspond with

2. Inferior angles of vesical trigone correspond with

A
  1. Ureteric orifices

2. Internal urethral orifice

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30
Q
  1. What is the muscular coat of bladder called?
  2. What is it composed of
  3. What is its innervation
  4. Contraction of this muscle causes
A
  1. Detrusor muscle
  2. Interlacing bundles of smooth muscle fibers
  3. Parasympathetic innervation from S2-4
  4. Emptying of urinary bladder
31
Q
  1. 4 parts of the male urethra

2. Where are they located

A
  1. Preprostatic (intramural), prostatic, membranous, and spongy (penile)
  2. Preprostatic and prostatic are located in pelvic cavity; membranous and spongy are located in perineum
32
Q

Preprostatic part of male urethra:

  1. Passes through?
  2. Surrounded by?
  3. Contraction of this sphincter prevents?
  4. Innervation of internal urethral sphincter?
A
  1. Bladder wall at level of the neck
  2. Circular cuff of smooth muscle (internal urethral sphincter, sphincter vesicae)
  3. Prevents retrograde movement of semen into bladder during ejaculation
  4. Primarily sympathetic innervation
33
Q

Prostatic part of male urethra:

  1. Passes through
  2. How is seminal colliculus formed
  3. Significance of seminal colliculus
  4. What are prostatic sinuses
A
  1. Prostate (from its base to its apex)
  2. Posterior wall of prostatic urethra has longitudinal ridge which widens to form seminal colliculus (smooth eminence)
  3. Has small orifice in midline (opening of prostatic utricle), and ejaculatory ducts open on seminal colliculus (inferior to prostatic utricle; one on each side)
  4. Grooves on each side of urethral crest and seminal colliculus; contain openings of prostatic glands
34
Q

Membranous part of male urethra:

  1. Location
  2. Surrounded by?
A
  1. Deep perineal pouch (shortest part of urethra)

2. Sphincter urethrae (external urethral sphincter) muscle (voluntary)

35
Q

Spongy (penile) part of male urethra

  1. Runs with?
  2. What opens into proximal part?
  3. What does it contain
A
  1. Corpus spongiosum of penis
  2. Bulbourethral glands
  3. Dilatation within glans (navicular fossa)
36
Q

There are 2 pairs of ducts in the undifferentiated state; which duct stays in:

  1. Males
  2. Females
A
  1. Males have mesonephric (wolffian) duct

2. Females have paramesonephric (mullerian) duct

37
Q

Female urethra:

  1. Extends from where to where
  2. How does it run
  3. Surrounded by?
A
  1. Neck of urinary bladder (internal urethral orifice) to external urethral orifice in vestibule, anterior to vaginal orifice
  2. Inferiorly and anteriorly (related anteriorly to pubic symphysis and posteriorly to vagina)
  3. Sphincter urethrae (external urethral sphincter) muscle - voluntary
38
Q

Ductus deferens:

  1. Function
  2. Course
  3. Terminal part is called
  4. Terminal part joins what
A
  1. Carries mature sperm from epididymis to ejaculatory duct
  2. Begins at tail of epididymis, ascends within scrotum toward superficial inguinal ring, then through inguinal canal
  3. Ampulla of ductus deferens (terminal part is dilated)
  4. Ampulla joins seminal vesicle to form ejaculatory duct
39
Q

Anatomical relations of the seminal vesicle

  1. Anteriorly
  2. Posteriorly
  3. Medially
A
  1. Base of urinary bladder
  2. Rectum
  3. Ampulla of ductus deferens (joins this to form ejaculatory duct)
40
Q

What kind of tube is the seminal vesicle?

A

Blind tube- meaning it does not communicate with anything

41
Q

What direction do the following parts of the prostate face?

  1. Base
  2. Apex
A
  1. Base directed superiorly

2. Apex directed anteriorly

42
Q

Anatomical relations of the prostate:

  1. Superior
  2. Inferior
  3. Anterior
  4. Posterior
  5. Lateral
A
  1. Neck of urinary bladder
  2. Sphincter urethrae muscle
  3. Pubic symphysis
  4. Rectum
  5. Levator ani
43
Q

Function of the secretions from the prostate gland

A

Neutralizes the acidity in vagina

44
Q

Function of secretions of the seminal vesicle

A

Contains substances essential for nourishment of sperm

45
Q

Where does the ejaculatory duct run?

A

Through posterior part of prostate, opens into prostatic urethra by a small opening on seminal colliculus, inferior to prostatic utricle

46
Q

Location of the following zones of the prostate:

  1. Central zone
  2. Transitional zone
  3. Peripheral zone
  4. Anterior zone (isthmus)
A
  1. Located around ejaculatory ducts
  2. Located around proximal part of prostatic urethra
  3. Posterior and lateral to central and transitional zones
  4. Anterior to prostatic urethra (no glandular tissue)
47
Q
  1. Which zone of the prostate is the site of BPH

2. Which zone is the usual site of prostatic carcinomas

A
  1. Transitional zone

2. Peripheral zone

48
Q

Mesovarium connects what two things

A

Ovary to posterior layer of broad ligament

49
Q

Before first pregnancy, ovary lies in ovarian fossa and is bounded by which vessels?

A

Bounded by external iliac vessels superiorly and internal iliac vessels posteriorly

50
Q

What are each side of the ovary connected to and what connects them to this?

A

One pole is connected to pelvic brim by suspensory ligament of ovary (infundibulopelvic ligament)
Other pole is connected to uterus by proper ovarian ligament (represents proximal part of the gubernaculum)

51
Q

Fallopian tube

  1. Location
  2. Function (3)
A
  1. In upper border of broad ligament, lateral part arches over ovary
  2. Communicates uterine cavity with peritoneal cavity, place where fertilization occurs, and provides nourishment to fertilized ovum
52
Q

What is the mesosalpinx?

A

Upper part of broad ligament; between uterine tube (superiorly) and ovarian ligament (inferiorly)

53
Q

Parts of the fallopian tube from lateral to medial (4)

A

Infundibulum, ampulla, isthmus, and intramural/uterine

54
Q

Where are the fimbriae located?

A

Infundibulum portion

55
Q

What is significant about the ampulla of fallopian tube

A

It is wide/tortuous and is the site where fertilization usually occurs

56
Q

3 parts of the uterus

A

Fundus, body and cervix

57
Q

What two parts does the cervical canal communicate with and how?

A

Communicates with vagina via external os

Communicates with body of uterus via internal os

58
Q

Define the following:

  1. Version of uterus
  2. Flexion of uterus
  3. Normal position of uterus
A
  1. Angle between vagina and cervix
  2. Angle between body and cervix
  3. Anteversion and anteflexion
59
Q

Broad ligament of the uterus extends from __ to __

A

Lateral border of uterus to lateral pelvic wall

60
Q

Proper ovarian ligament extends from __ to __

A

Ovary to uterus

61
Q

Round ligament of the uterus runs from __ to __

A

Runs forward from uterus (just inferior to uterine tube) to deep inguinal ring (passes through inguinal canal)

62
Q

3 things that help support the uterus (to prevent prolapse)

A

Pelvic diaphragm, perineal body, and ligaments formed by condensations of pelvic fascia

~broad / round ligaments do not provide much support

63
Q

Vagina extends from __ to __

A

Uterine cervix to vestibule (space between labia minora)

64
Q
  1. Anterior wall of vagina is pierced by?

2. Posterior wall is related to?

A
  1. Uterine cervix

2. Related to rectouterine pouch and is covered by peritoneum

65
Q

What is the vaginal fornix?

A

Upper part of vaginal lumen that surrounds cervix

66
Q

Anatomical relations of the vagina

  1. Anterior
  2. Posterior
  3. Lateral
A
  1. Base of urinary bladder and urethra
  2. Rectouterine pouch, rectum, perineal body and anal canal
  3. Ureter and levator ani muscle
67
Q

Lymph drainage:

External iliac nodes receive lymph from? (3)

A

Superifical and deep inguinal nodes and deep lymph vessels of anterior abdominal wall below umbilicus

68
Q

Lymph drainage:

Internal iliac nodes receive lymph from

A

Pelvic organs, perineum, thigh and gluteal region

69
Q

Lymph drainage:

Sacral nodes receive lymph from

A

Posterior pelvic organs and posterior pelvic wall

70
Q

All of the 3 previously mentioned nodes terminate in ?

A

Common iliac nodes

71
Q

Common iliac nodes pass to ?

A

Lumbar (para-aortic or lateral aortic) nodes

72
Q

Pelvic pain line corresponds to?

A

Inferior limit of peritoneum (so organs covered in peritoneum are superior to pelvic pain line, organs not covered in peritoneum are inferior to pelvic pain line)

73
Q

Location of the alimentary canal pain line?

A

Middle of sigmoid colon

74
Q

How do visceral sensory fibers run when

  1. Carrying pain from organs superior to pelvic pain line
  2. Carrying pain from organs inferior to pelvic pain line
A
  1. Follow sympathetic fibers to lower thoracic and upper lumbar segments of spinal cord
  2. Follow parasympathetic fibers to S2-S4 spinal cord segments