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Anatomy - Repro Flashcards

1
Q

3 structures of the male perineum

A

External genitalia (urethra, scrotum, penis)
Perineal muscles
Anal canal

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2
Q

3 structures of femae perineum

A

External genitalia
Perineal muscles
Anal canal

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3
Q

The perineum can be divided into two triangular areas - which triangle is inferior to the pubic symphysis?

A

Urogenital triangle

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4
Q

Which triangle lies anteroinferior to the coccyx?

A

Anal triangle

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5
Q

Borders of the pernieum

A 
Anterior - pubic symphysis
Anterolateral - pinferior pubic and ischial rami
Lateral - Ischial tuberosity
Posterolateral - Sacrotuberous ligament
Inferior - sacrum and coccyx
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6
Q

Roof of the perineum

A

Pelvic floor

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7
Q

Base of the perineum

A

Skin and fascia

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8
Q

Anterior, lateral and posterior surface borders of perineum

A

Mons pubis in females, base of penis in males
Medial Surface of thighs
Integluteal cleft

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9
Q

Contents of the anal triangle

A

Anal aperture
External anal sphincter muscle
Ischioanal fossae

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10
Q

Contents of ischioanal fossae

A

Fat and connective tissue

Expansion of anal canal during defecation

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11
Q

Which nerves supplies somatic fibers to the whole perineum?

A

Pudendal (S2-S4)

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12
Q

A thin sheet of deep fascia stretches between right and left sides of the pubic arch below the pubic symphysis. What is the name of this fascia and what structure is affixed to it?

A

Perineal membrane

External genitalia

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13
Q

Layers of the urogenital triangle deep to superficial?

A 
Deep perineal pouch
Perineal membrane
Superficial perineal pouch
Penrineal fascia
Skin
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14
Q

The deep perineal pouch lies between which structures?

A

Deep fascia of pelvic floor muscles and the perineal membrane

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15
Q

Structures within deep perineal pouch?

A

Part of the urethra
External urethral sphincter
Vagina

+bulbourethral glands
+deep transverse perineal muscles in MALES

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16
Q

What perforates the perineal membrane?

A

Urethra

and vagina

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17
Q

The superficial perineal pouch is a space between which structures?

A

Perineal membrane and superficial perineal fascia

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18
Q

Structures within the superficial perineal pouch

A 
Erectile tissues for penis and clitoris
Ischiocavernous muscle
Bulbospongiosus
Superficial transverse perineal muscles
Great vestibular glands (Bartholin's)
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19
Q

What is the superficial perineal pouch bound to posteriorly?

A

Perineal body

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20
Q

Where is the perineal body within the perinuem>

A

Center

At junction of urogenital and anal triangle

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21
Q

What is the perineal body made up of?

A

Skeletal muscle, smooth muscle, collagenous and elastic fibres

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22
Q

Which muscles attach to the perineal body?

A 
Levator ani
Bulbospongiosus
Superficial and deep transverse muscles
External anal sphincter muscles
External urethral sphincter muscle fibres
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23
Q

Which structure supports the posterior vaginal wall against prolapse?

A

Perineal body

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24
Q

Vascular supply to the perineum

A

Internal pudendal artery

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25
Actions of external anal sphincter
Constricts anal canal suring peristalsis Resists defecation Supports and fixes perineal body/pelvic floor
26
Innervation of external anal sphincter
Pudendal nerve
27
Innervation of bulbospongiosus
Muscular branch of perineal nerve | Branch of pudendal
28
Function of bulbospongiosus
Support and fixes perineal body/pelvic floor Male - compresses bulb of penis Assists erection - compress outflow of deep perineal vein - push blood from bulb to body
29
Innervation of ischiocavernosus
Branch of pudendal
30
Function of ischiocavernosus
Maintain erection - compress outflow veins, push blood from root or clit into body
31
Innervation of superficial transverse perineal muscle
Muscular branch perineal Branch of pudendal Dorsal nerve of penis/clit Terminal branch pudendal
32
Function of superficial/deep transverse perineal muscles
Support and fix perineal body Support abdominal muscle viscera Resist increased intra-abdominal pressure
33
Innervation of external urethral sphincter
Muscular branch perineal Branch of pudendal Dorsal nerve of penis/clit Terminal branch pudendal
34
Function of external urethral sphincter
Compress urethra to maintain urinary continence | Demale - urethrovaginal sphincter portion also compresses vagina
35
Clinical significance of perineal body
Childbirth and prolapse
36
What procedure can prevent excessive tearing of perineum and perineal muscles in labour?
Episiotomy | Mediolateral
37
What can occur in perineal pouches following trauma or surgery?
Urethra traverses the pouches Traumatic/Surgical injury of urethra Pouches Infiltrated by urine
38
The external urethral sphincter is found in which space?>
Deep perineal pouch
39
Is the external urethra sphincter voluntary or involuntary?
Voluntary
40
Innervation of external urethral sphincter
Terminal branch of pudendal S2-4
41
Is the internal urethral sphincter voluntary or involuntary?
Involuntary
42
Innervaton of internal urethral sphincter?
T10-L2
43
3 parts of the male urethra?
Intramural Prostatic Intermediate
44
Which part of the male urethra do the bulbourethral glands secrete to?
Spongy
45
What can happen if the prostate of elderly mean becomes enlarged?
Urinary retention
46
Which is the widest part of the male urethra?
Prostatic
47
Which is the narrowest part of the male urethra?
Intermediate
48
What lies within the pudendal canal
Internal pudendal artery Pudendal nerve Pudendal vein Nerve to obturator internus
49
Clincial significance of content of ischio anal fossae?
Fat and loose CT Site of infection - collection of pus; difficult to treat Leads to abscess
50
The pudendal canal enters the ischioanal fossae though which foramen?
Lesser sciatic
51
What can occur if a mass/abscess bursts from ischioanal fossae?
Generates fistulae
52
Which structures constitue the birth canal?
Vagina Cervix Vulva
53
Three layer of the uterus
Perimetrium - outer serous coat Myometrium- muscular Endometrium- inner mucuous coat
54
Which layer of the uterus is shed in menstruation?
Endometrium
55
How does the uterus divide as pregnancy advances?
Into upper and lower segment physiologically
56
What area of the uterine body does the lower segment develop from?
Area between cervix and uterus
57
Where is the uterus opened at caesarean section?
Transverse incision into lower segment for delivery of baby
58
Describe the normal postion of the uterus
Anteflexed | Anteverted
59
Define anteflexed with reference to the uterus
Uterine body bent anteriorly relative to the cervix
60
Define anteverted with reference to the uterus
Uterus tipped anterosuperiorly relative to axis of vagina
61
What can happen if the position of the uterus is retroflexed and retroverted in early pregnancy?
Uterine prolapse | Prevalent if pelvic floor damaged
62
Why is knowledge of the position of the uterus crucial in surgical management of miscarriage?
Minimise risk of perforation of uterus with instrumentation
63
What are the fornices of the vagina?
Recess around protruding cervix Anterior Posterior Lateral
64
Through which vaginal fornix can you access the rectouterine pouch?
Posterior | Clinically significant for procedures
65
4 ligaments for anchoringg uterus and cervix in pelvis
Ligament of ovary Suspensory ligament of ovary Round ligament of uterus Broad ligament
66
Which ligament is the cardinal ligament of the uterus>
Lateral cervical
67
Function of broad ligament
Support uterus, attaches cervix to lateral pelvic walls | Contains uterine artery and vein
68
Supports of the uterus
Pelvic diaphragm Pelvic fascia - lateral cervical and uterosacral ligament Round ligament of uterus
69
4 parts of the uterine tube
Infundibulum Ampulla Isthmus Intramural or uterine part
70
Which part of the uterine tube is the longest and widest?
Ampulla
71
Fertilisation occurs in which part of the uterine tube?
Ampulla
72
What is meant by tubal pregnancy?
Ectopic | Blastocyst implants in mucosa of tube (ampulla)
73
What might a cornual ectopic be?
Implantation in cavity of rudimentary horn of uterus which may/ may not communicate with uterine cavity
74
Changes to the ovary with pregnancy and menopause
Displaced position | Atrophied and fibrous in menopause
75
2 ligaments associated with ovary
Ligament of ovary | Suspensory ligament
76
Attachment of ligament of ovary
Uterus to ovary
77
Attachment of suspensory ligaments
Ovary to lateral pelvic wall
78
Aterial supply to gonads and genitalia
Gonadal and internal iliac arteries
79
Internal iliac arteries and gonadal arteries branch from which vessel?
Aorta
80
At what vertebral level do the gonadal arteries originate?
L2
81
Which ligament does the ovarian artery descend within?
Suspensory to supply ovaries via broad ligament
82
Which vessel does the ovarian artery freely anastomose with?
Uterine artery
83
Where do the gonadal veins drain into?
Left renal vein | Right IVC
84
The uterine artery crosses over which structure at the level of the ischial spine
Ureter | Water under the bridge
85
Which structure can be accidentally injured during hysterectomy?
Ureter
86
Which lymph nodes receive lymph from the ovary?
Lumbar
87
Which lymph nodes receive lymph from the fundus and upper uterine body?
Pre-aortic
88
Which lymph nodes receive lymph from most of the uterine body?
External iliac
89
Which lymph nodes receive lymph from the uterine cervix and upper vagina?
Internal iliac and sacral
90
Which lymph nodes receive lymph from the lower vagina?
Superficial inguinal
91
Breasts extend from which ribs
2nd to the 6th
92
Deep surface of the breat is related to which 3 musces
Pectoralis major Serratus anterior Rectus abdmonis
93
Blood supply to the mammary gland
Branches of subclavian and axillary arteries
94
Lymphatic drainage of the breast
Axillary Pectoral Supraclavicular

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