Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

HD2 > Anatomy Practical 1 > Flashcards

Anatomy Practical 1 Flashcards

1
Q

When the pelvis is correctly positioned where is the ASIS in relation to the pubic symphysis? Where is the inguinal ligament>

A

Vertical line above

Inguinal ligament perpendicular to floor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 3 apertures in the pelvic wall?

A

Obturator Canal - artery, vein nerve
Greater Sciatic Foramen - Piriformis, Sciatic nerve, pudendal nerve, sup. and inf. gluteal NAV
Lesser Sciatic Foramen - pudendal and tendon of obturator internus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What makes up the anterior wall of the pelvic inlet?

A

Pubic bones - pubic symphysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What makes up the lateral wall of the pelvic inlet?

A

Sacrospinous ligament - covered by coccygeus and obturator internus muscles (lateral rotator of thigh originating from internal aspect of obturator foramen passing to femur greater trochanter)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What makes up the posterior wall of the pelvic inlet?

A

Sacrum coccyx, piriformis muscles and covering of fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What makes up the inferior wall of the pelvic inlet?

A

Pelvic floor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which nerves form the sacral plexus?

A

S1-S4 join lumbosacral L4,5

Lies on anterior surface of piriformis muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the branches of the pelvic part of the sympathetic trunk?

A
  • gray rami communicantes (join spinal nerves, distributed to periphery)
  • fibres to join hypogastric plexus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Where is the superior hypogastric plexus?

A

Anterior to sacral promontory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What does the superior hypogastric plexus contain?

A

Sympathetic, sacral PS and visceral afferent fibres

Forms R. and L. hypogastric nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Where does the inferior hypogastric plexus lie?

A

On either side of the rectum

Formed by hypogastric nerve from superior plexus and pelvic splanchnic nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Where does lymph from sigmoidal colon travel?

A

Inferior mesenteric nodes along IMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the nerve supply of the sigmoid?

A

Autonomic from hypogastric plexus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the blood supply to the sigmoid?

A

IMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a volvulus?

A

Sigmoid colon rotate around its mesentery

- may correct spontaneously or rotation may continue until blood supply to sigmoid completely shut off

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Where does the rectum begin?

A
  • anterior to S3
  • inferiorly passes ending at tip of coccyx pierces pelvic floor and continuous with anal canal
  • lower rectum dilated = rectal ampulla
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which parts of the rectum does the peritoneum cover?

A

Anterior and lateral surfaces of first 1/3
Anterior surface of middle 1/3
Lower devoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What produces the anorectal angle?

A

Puborectalis portion of levator ani muscle forms sling at junction of rectum with anal canal pulling this part of bowel forward

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the blood supply to the rectum?

A

Superior middle and inferior rectal arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What forms the superior rectal artery?

A

IMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What forms the middle rectal artery?

A

IIA (internal iliac artery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What forms the inferior rectal artery?

A

Pudendal artery

Anastomoses with middle rectal artery at anorectal junction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Where does the superior rectal vein drain?

A

Hepatic portal vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Where do the middle and inferior rectal veins drain?

A

Caval system - internal iliac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the porto-systemic shunt in the rectum?

A

Superior rectal vein into hepatic portal vein and middle and inf. rectal veins into internal iliac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Where does the common iliac artery divide into the external and internal iliac arteries?

A

At the pelvic brim

anterior to the sacroiliac joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the course of the internal iliac artery?

A

Passes down into pelvis to GSF where it divides into anterior and posterior divisions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the branches of the internal iliac’s anterior division?

A 
Umbilical (to vas deferens, superior vesicle artery)
Obturator
Inferior Vesicle
Middle rectal
Inferior gluteal
Uterine (female)
Vaginal (female)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the branches of the internal iliac’s posterior division?

A

Iliolumbar
Lateral sacral
Superior gluteal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is involuntary loss of urine after intra-abdominal pressure increased associated with?

A

Weakening of:

  • medial and lateral pubovesical ligaments
  • pubovesical fascia at urterovesical junction
  • levator ani
  • functional integrity of urethral sphincter
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What does the pubocervical ligament attach?

A

Cervix to anterior pelvic wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What does the transverse and cardinal ligaments attach?

A

Cervix to lateral pelvic wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What does the uterosacral ligament attach?

A

Cervix to uterosacral ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What does uterine prolapse occur as a lack of support of?

A

Transverse cervical/cardinal ligament
Uterosacral ligament
Levator Ani

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Where is the vesico-uterine pouch?

A

Anteriorly between bladder and uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Where is the recto-uterine pouch?

A

Also called pouch of douglas

  • posteriorly between uterus and rectum
  • lower point in the female pelvis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Where does the bladder expand as it fills?

A

Superiorly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is the shape of an empty bladder?

A

3 sided pyramid - apex, base, superior surface and 2 inferolateral surfaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Where is the apex of the bladder?

A

Directed towards pubic symphysis

Continues superiorly up anterior abdominal wall to umbilicus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Where is the base of the bladder?

A
  • inverted triangle
  • faces posteroinferiorly
  • 2 ureters enters bladder at 2 corners of base
  • urethra drains inferiorly from lower corner
  • smooth mucosal lining firmly attached to underlying SM of wall but everywhere else mucosa loosely attached and folded
  • trigone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is the trigone?

A

Smooth triangular area between openings of ureters and urethra on inside of bladder

42
Q

Where is the inferolateral surface?

A

Between levator ani muscles of pelvic floor and adjacent obturator internus

43
Q

Where is the neck of the bladder?

A
  • surrounds urethra origin
  • most inferior part of bladder
  • fixed
  • anchored by fibromuscular bands (pubovesicular ligaments in women)
44
Q

Where is the bladder at birth?

A

Abdominal

Descends with age until after puberty where assumes adult position

45
Q

What are the major components of the reproductive tract?

A

Ovaries
Uterus
Vagina
Clitoris

46
Q

What is the normal position of the cervix?

A

Angles forward on the vagina

- forms fornix as bulges into vagina

47
Q

Where do the ovaries develop?

A

High on posterior abdominal wall like the testes

  • descend before birth bringing vessels, lymphatics and nerves
  • stop on lateral wall of pelvic cavity unlike the testes
48
Q

What is the function of the ovaries?

A

oogenesis

49
Q

Where do ovulated mature eggs travel?

A

Into peritoneal cavity -> uterine tube openings (infundibulum with fimbriae) -> ampulla -> ishmus -> joins uterus body

50
Q

What is the function of the infundibulum?

A

Facilitates collection ovulated eggs from ovary

51
Q

What is the function of the ampulla?

A

Fertilisation

52
Q

What is the broad ligament?

A

Peritoneal fold suspending uterus and uterine tubes

53
Q

What is the ovarian ligament?

A

Holds ovaries close to uterus

54
Q

What is the round ligament?

A

Reflects uterus keeping it anteverted and anteflexed as it passes through inguinal canal to labia majora

55
Q

What is the landmark for administrating a pudendal nerve block?

A

Ischial spine

56
Q

What supplies blood to the uterus?

A

internal iliac -> uterine artery

57
Q

What does the uterine artery supply blood to?

A

Uterus

Vaginal via vaginal artery

58
Q

What supplies blood to the ovaries?

A

Abdominal aorta -> ovarian artery

Enlarges in pregnancy to augment uterine blood supply

59
Q

What does the ovarian artery anastomose with?

A

Uterine artery

Travel in suspensory ligament of ovary as cross pelvic inlet

60
Q

What makes up the clitoris?

A

2 coprora cavernosa

Glans clitoris embedded in CT perineum

61
Q

What is the bulb of vestibule?

A

Attached to glans clitoris by thin bands of erectile tissue

62
Q

What are the Bartholin’s Glands?

A

Lie on either side of vagina opening underneath bulb of vestibule
- produce secretion during sexual arousal

63
Q

What is the male equivalent of Bartholin’s Glands?

A

Bulbourethral glands in men

64
Q

What is the lymph drainage of the pelvis?

A
  • lymph nodes along internal iliac artery and branches -> into nodes associated with common iliac arteries -> lateral aortic and lumbar nodes (lateral abdominal aorta) -> lumbar trunks -> thoracic duct at T12
65
Q

What is the lymph drainage of the ovaries and uterine tubes?

A

Via vessels accompanying ovarian arteries -> lateral aortic and lumbar nodes

66
Q

What is the perineum?

A

Area between anus and scrotum/vulva

67
Q

What is the anterior boundary of the perineum?

A

Pubic symphysis

68
Q

What is the superior border of the perineum?

A

Pelvic floor/diaphragm
Perineal membrane
Deep perineal pouch

69
Q

What is the lateral border of the perineum?

A

Ischial tuberosity

70
Q

What is the posterior border of the perineum?

A

Tip of coccyx

71
Q

What is the perineum divided into?

A

2 triangles

  • anterior: urogenital triangle
  • posterior: anal triangle
72
Q

What does the urogenital triangle contain?

A

Urinary and reproductive system

73
Q

What does the anal triangle contain?

A

Anus and external sphincter

74
Q

What is the major nerve and blood supply to the perineum?

A

Pudendal

75
Q

What is the difference in the planes of the 2 triangles of the pelvic floor?

A

Urogenital triangle is quite horizontal whilst anal triangle is more vertical

76
Q

What does the deep perineal pouch contain?

A

Proximal urethra
SM mass/deep transverse perineal muscle in men
Dorsal neurovasculature of clitoris

77
Q

Where is the superficial perineal pouch?

A

Between perineal membrane and membranous layer of superficial fascia
Contains erectile tissue of clitoris and skeletal muscles

78
Q

What does the superficial pouch contain?

A
  • Clitoris and associated muscle (ischiocavernosis)
  • bulb of vestibule and bulbospongiosis
  • greater vestibular glands
  • deep perineal branch of internal pudendal vessels and nerve
  • superficial transverse perineal muscle
79
Q

What is the perineal body?

A

Posterior border of the urogenital triangle and peroneal membrane

  • CT structure
  • Muscles of pelvic floor and perineum attach
  • deep transverse perineal muscles intersect here
80
Q

Where does the deep perineal pouch lie?

A

Between levator ani and perineal membrane

81
Q

Where does the superficial perineal pouch lie?

A

Superficial to deep perineal pouch

82
Q

What is the crus?

A

Forms the corpus cavernosa in males and clitoris in females (erectile tissue)

83
Q

How does clitoral erection occur?

A

Stimulation of PS fibres carried by splanchnic nerves from anterior rami cause arteries in corpora cavernosa to relax = blood filling

84
Q

What position must patients be in when examining the female pelvis?

A

Lithotomy Position

Supine - hips and knees flexed to 90 degrees, feet together and knees fall laterally

85
Q

What is done in a female pelvic examination?

A
  • External genitalia examine (vulva): separate labia majora and minora inspecting for anatomical anomalies/discharge/genital warts
  • speculum insert into vagina and insert whilst rotating so blades parted allowing good visualisation of cervix, vaginal fornices and external os of uterus
  • remove speculum slowly inspecting walls of vagina for prolapse evidence
86
Q

What is a ‘pap’ smear test used for?

A

Pre-malignant cervical lesions

  • offered to all ladies between 25-64
  • HPV causes cervical cancer in almost all cases
87
Q

How is a bimanual technique carried out?

A
  • examine uterus
  • index and middle finger places in posterior fornix of vagina applying gentle pressure on cervix
  • Other hand palpate fundus of uterus in suprapubic region
  • palpate right and left iliac fossae for ovaries = impalpable unless pathological
88
Q

What anaesthetic is offered during childbirth?

A
  • regional anaesthesia = patient remains conscious throughout labour
  • pudendal and caudal blocks mean patient can still take part in labout
  • general anaesthesia reserved for emergencies
89
Q

What is spinal anaesthesia?

A

Inserted into CSF at L3/L4

90
Q

What is pudendal nerve block?

A

Pudendal nerve (S2-S4) bathed in local anaesthetic agent

91
Q

What is a caudal epidural block?

A

Catheter placed in sacral canal enabling administration of agent to S2-S4 spinal nerve roots

92
Q

What are fibroids?

A

Most common benign tumours in women

  • myometrium and surrounding CT
  • asymptomatic but can cause dysmennorhoea/mennorhagia/painful sexual intercourse/urinary frequency and urgency
93
Q

What are the common locations of fibroids?

A

1) Submucosal
2) Subserosal
3) Intramural
4) Other - cervical, round ligament, broad ligament

94
Q

How are fibroids diagnosed?

A

USS
MRI
Biopsy

95
Q

How are fibroids treated?

A

1) Nothing
2) Medical - analgesia, COCP, progesterone intra-uterine devices
3) Radiological - embolization, radio-frequency ablation
4) Surgery - hysterectomy, uterine artery ligation

96
Q

What structures commonly fall into/through vagina?

A

Bladder, uterus, rectum, bowel

97
Q

When is prolapse more likely to occur?

A
  • older as supporting structures weaken post menopause
  • delivered large babies
  • long pushing phases of labour
  • smoking, obesity, CT disorders, upper respiratory disorders, repetitive strain injuries
98
Q

What are the types of prolapse?

A
  • uterine
  • cystocele (bladder into vagina)
  • rectocele (rectum into vagina)
  • enterocele (small bowel into vagina)
  • urethrocele (urethra into vagina)
  • vaginal vault (post hysterectomy)
99
Q

What are symptoms of a rectocele?

A

Difficulty passing stool
Constipation
Faecal incontinence

100
Q

What are symptoms of cysto and uretoceles?

A

Incomplete bladder emptying and stress incontinence

101
Q

What is stress incontinence?

A

Loss of small urine volumes during coughing/laughing/straining/exercising
Activities which increase intra-abdominal pressure = pressure transmitted downwards onto bladder
- pelvic floor muscles and external sphincter contract to prevent urine leakage
- physical changes from pregnancy/childbirth/menopause all contribute to weakened pelvic floor muscles = increased risk of urine leakage

102
Q

Treatment for stress incontinence?

A

Lifestyle changes - weight loss, pelvic floor exercises

Surgery - restore normal pressure transmission during periods of increased intra-abdominal pressure

HD2 (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions