Applied Anatomy Flashcards
Label the bones of the anterior and posterior view of the pelvis using the labels below:
coccyx hip bone ilium pubis ischium ilium pubis sacrum ischium pubic symphysis sacrum
1 = sacrum 2 = ilium 3 = pubis 4 = ischium 5 = pubic symphysis 6 = sacrum 7 = hip bone 8 = ilium 9 = pubis 10 = ischium 11 = coccyx
Pelvic fractures are common occurrences. What part of the pelvis are generally damaged?
1 - pubic and ischium rami
2 - ileum
3 - acetabulum
4 - sacroiliac joint
1 - pubic and ischium rami
Pelvic fractures are common occurrences. What 2 joints in the pelvis are most likely to be dislocated due to trauma?
- sacroiliac joint
- pubic symphysis joint
What time periods are women more susceptible to dislocation/damage to the sacroiliac and pubic symphysis joints?
- before & during menstruation (due to hormones)
- pregnancy & childbirth, menopause (preparation for birth and hormones)
- abnormal weight-bearing (carrying babies on hips, can also affect men)
What is a hysterectomy?
- surgical removal of the uterus
- can also involve removal of the cervix, ovaries, fallopian tubes, and other surrounding structures
A hysterectomy is a surgical removal of the uterus, that can also involve removal of the cervix, ovaries, fallopian tubes, and other surrounding structures. What is an important tube that runs closes to the uterine artery that must be kept in mind during a hysterectomy?
1 - inguinal canal
2 - alcocks canal
3 - ureter
4 - fallopian tube
- ureter
- runs over and then under (close to cervix) the uterine artery
- remember water under the bridge (ureter carries water)
An episiotomy is where a cut (incision) is made through the area between your vaginal opening and your anus called the perineum. Which nerve is generally anaesthetised during this procedure?
1 - obturator nerve
2 - sciatic nerve
3 - femoral nerve
4 - pudendal nerve
4 - pudendal nerve (called pudendal nerve block)
- this nerve supplies pain sensation to perineum
An episiotomy is where a cut (incision) is made through the area between your vaginal opening and your anus called the perineum. The pudendal nerve is generally anaesthetised during this procedure, called the pudendal nerve block, as this nerve supplies pain sensation to perineum. What anatomical landmark is used to identify where to inject the needle?
1 - ischial tuberostiy
2 - ischial spine
3 - ASIS
4 - PSIS
2 - ischial spine and sacrospinous ligament
What are the 2 terms used to described the orientation of the vagina, cervix and fundus?
- anteflexed = fundus and body point forward relative to cervix
- anteverted = uterus is angled forward relative to vagina
The 2 terms used to described the orientation of the vagina, cervix and fundus are:
- anteflexed = fundus and body point forward relative to cervix
- anteverted = uterus is angled forward relative to vagina
What term is used to describe what occurs in 20% of females where the uterus tilts backwards instead of forwards?
- retroverted
If a catheter is not placed through the urethra, as it may be in for a prolonged period of time. Where would it be placed?
1 - through femoral triangle
2 - through inguinal canal
3 - suprapubic
4 - inferiorpubic
3 - suprapubic catheterisation (above pubic symphysis)
- below the peritoneum cavity
Label the parts of the uterus
vaginal fornix cervix ovary fundus body of uterus vagina fallopian tube endometrium myometrium cervical canal
1 = fundus 2 = body of uterus 3 = cervix 4 = vagina 5 = ovary 6 = fallopian tube 7 = endometrium 8 = myometrium 9 = cervical canal 10 = vaginal fornix
What are uterine fibroids, also called leiomyomas?
- leio = smooth
- myo = muscle
- mas = tumour
- benign muscle tumours that form in the uterus
What are the most common form of tumours in females?
1 - uterine fibroids
2 - endometrial
3 - ovarian
4 - cervical
1 - uterine fibroids, also called leiomyomas
- leio = smooth
- myo = muscle
- mas = tumour
- benign muscle tumours that form in the uterus
What is the external os?
- site where uterine cells (columnar) and vaginal cells (squamous) meet
- cellular proliferation occurs here and is at risk of hyperplasia
What are the most common symptoms associated with uterine fibroids, also called leiomyomas?
1 - heavy menstrual bleeding, abdominal pain, frequent urination, glycosuria
2 - heavy menstrual bleeding, back pain, frequent urination, dyspareunia
3 - light menstrual bleeding, back pain, frequent urination, dyspareunia
4 - heavy menstrual bleeding, pelvic pain, unable to urinate, dyspareunia
2 - heavy menstrual bleeding, back pain, frequent urination, dyspareunia
- heavy menstrual bleeding (if located on submucosa)
- back pain = press on nerve
- frequent urination = compress urethra/ureter
- dyspareunia = pain during sexual intercourse
What is a cervical smear?
- sample is taken from the external os site of the cervix
- external os is where cervical cancer most commonly occurs
What is a hydrocele?
- fluid collection in the tunica vaginalis which wraps around the testicles
- can be present standing and lying down, but more obvious when standing
A hydrocele is when fluid collects in the tunica vaginalis which wraps around the testicles. What is the most common cause for this to occur?
1 - testes descends into scrotum and take peritoneal with it
2 - trauma damages the peritoneal wall and fluid leaks down into scrotum
3 - infection in scrotum causes fluid to accumulate
4 - fluid leads from urethra back into the scrotum
1 - testes descends into scrotum and take peritoneal with it
- as testes move down into the scrotum they bring the lining of the abdominal cavity with it allowing some fluid to fill the scrotum
- at birth the sac surrounding the testicles (tunica vaginalis) seals
- if the sac does not seal it can allow fluid from abdomen into the scrotum
What is a hematocele?
- haemorrhage into the tunica vaginalis space
- usually as a result of traumatic or surgical injury or testis tumour
What is testicular torsion?
- spermatic cord, which provides blood flow to the testicle, rotates and becomes twisted
- twisting cuts off the testicle’s blood supply and causes sudden pain and swelling
- medical emergency
What is benign prostatic hyperplasia?
- cells of prostate undergo hyperplasia and increase the size of the prostate
- the increased size of the prostate compresses the urethra and reduces urine flow
- occurs in the transitional zone of the prostate
What is cryptorchidism mean?
- crypto =greekfor hidden
- orchis = greek for testis
- refers to the absence of a testis from the scrotum, generally because it has not descended into the scrotum causing infertility
What is cystitis?
- inflammation of the lining of the bladder
What is varicocele?
- enlargement of the veins within the scrotum
- can cause low sperm production and decreased sperm quality and infertility
- more obvious when standing
Varicocele is enlargement of the veins within the scrotum that can cause low sperm production and decreased sperm quality and infertility. is this more common in the left or right testes and why?
- left testicle
- has to drain into the left renal vein
What is the name of the loose network of small veins found within the male spermatic cord, that ultimately will go on to form the testicular veins?
1 - hypophyseal portal system
2 - scrotal portal system
3 - pampiniform plexus
4 - testicular portal system
3 - pampiniform plexus
The peritoneum is the tissue that lines the abdominal wall and covers most of the organs in your abdomen. This covers the superior surfaces of the pelvic organs. What are the 2 pouches that are formed in females?
1 - uterovesical pouch (between bladder and uterus)
2 - rectouterine pouch (between uterus and rectum)
The peritoneum is the tissue that lines the abdominal wall and covers most of the organs in your abdomen. This covers the superior surfaces of the pelvic organs. What is the name of the pouch that is formed in males?
- rectovesical pouch
What is the lowest point of the abdominal cavity where fluid could collect causing infection in males and females?
- females = rectouterine pouch (pouch of douglas)
- males = rectovesicle pouch
If there is fluid in the rectouterine pouch, how can this be drained without opening a patient up with surgery?
1 - via umbilicus
2 - via the vagina
3 - via rectum
2 - via the vagina
The peritoneum is the tissue that lines your abdominal wall and covers most of the organs in your abdomen. This peritoneum lines the superior surface of the major pelvic organs, specifically the uterus, bladder and rectum. It also creates a 2 layered fold over the uterus creating a number of ligaments that are important for providing structure and support to the uterus. Label the 4 key ligaments of the uterus using the labels below:
Broad ligament
Uterine-Ovarian ligament
Round ligament
Uterosacral ligament
1 - Round ligament
2 - Uterine-Ovarian ligament
3 - Broad ligament
4 - Uterosacral ligament
There is a fibrous median raphe in the floor of the pelvis, which extends between the coccyx and the margin of the anus that is composed of fibers of the levator ani muscle that unite with the muscle of the opposite side, muscle fibres from external anal sphincter, and fibrous connective tissue. What is this fibrous median called?
1 - Coccygeus
2 - Iliococcygeus
3 - Puborectalis
4 - Anococcygeal raphe
4 - anococcygeal raphe
What are mesenteries?
- the mesentery is a double fold of peritoneal tissue
- it suspends tissues to walls for stability
- it provides a conduit for blood vessels, nerves and lymphatics
The mesenteries are double folds of peritoneal tissue that suspends tissues to walls for stability and provide a conduit for blood vessels, nerves and lymphatics. The broad ligament that covers the uterus has 3 mesenteries, label them using the labels below and what each one supplies:
mesovarium
mesosalpinx
mesometrium
1 = mesosalpinx = associated with uterine tubes 2 = mesometrium = associated with the uterus 3 = mesovarium = associated with the ovaries
The folds of the peritoneum encapsulate the majority of the uterus, ovaries and fallopian tubes providing support and holding the female reproductive organ in place. What ligament contributes to maintaining the anteverted position (pointing towards the vagina) of the uterus and where does it insert?
1 - broad ligament attaches to the uterus, through inguinal canal and to the labium majora
2 - round ligament attaches to the uterus, through inguinal canal and to the labium majora
3 - suspensory ligament attaches to the uterus, through inguinal canal and to the labium majora
4 - ovarian ligament attaches to the uterus, through inguinal canal and to the labium majora
2 - round ligament attaches to the uterus, through inguinal canal and to the labium majora
- helps maintain the anteverted position of uterus
The round ligament is a cordlike structures in the pelvis that help support the uterus by connecting the front of the uterus to the groin region. Where does the round ligament attach to?
- proximally = cornu (horn) of uterus
- distally = through inguinal canal and attaches to labia majora
The round ligament is a cordlike structures in the pelvis that helps support the uterus by connecting the front of the uterus to the groin region and helps maintain the anteverted position of uterus. it attaches to the cornu of the uterus and the labia majora. The round ligament is a remnant of embryological development from what?
1 - gubernaculum
2 - allantoic duct
3 - gonadal ridge
4 - mesonphric duct
1 - gubernaculum
The gubernaculum is a remnant of embryological development that goes on to form the round ligament, a cordlike structures in the pelvis that helps support the uterus by connecting the front of the uterus to the groin region and helps maintain the anteverted position of uterus. What is the early function of the gubernaculum?
- guide the gonads in males and females from the abdomen to the pelvis
During pregnancy the round ligament can be stretched. What can this cause for the mother?
1 - heavy bleeding
2 - pain and cramping
3 - miscarriage
4 - back pain
2 - pain and cramping
What is endometriosis?
1 - endometrium tissue of the uterus migrates to other area of the body
2 - endometrium tissue hypertrophies
3 - endometrium tissue atrophies
4 - endometrium develops adeomas
1 - endometrium tissue of the uterus migrates to other area of the body
- tissue similar to the tissue that normally lines the inside of your uterus, called the endometrium grows outside your uterus
- once this tissue migrates somewhere other that the endometrium, this is called endometriosis
Endometriosis is where tissue similar to the tissue that normally lines the inside of your uterus, called the endometrium grows outside your uterus. The tissue migrates to other parts of the uterus. What are the 3 most common areas this tissue migrates to?
1 - ovaries, round ligament, fallopian tubes
2 - ovaries, round ligament, broad ligament
3 - round ligament, fallopian tubes, vagina
4 - large intestines, round ligament, fallopian tubes
1 - ovaries, round ligament, fallopian tubes
Endometriosis is where tissue similar to the tissue that normally lines the inside of your uterus, called the endometrium grows outside your uterus. The tissue migrates to other parts of the uterus, most commonly the ovary, fallopian tubes or round ligament. As these are cells that are similar to those cells found in the endometrium, these cells posses receptors, such as estrogen receptors. What can this mean during the menstrual cycle?
- this tissue will go through proliferation and secretion
- angiogenesis will occur causing bleeding, which will collect in this area
- bleeding in this areas can cause severe pain
The cardinal ligaments are situated along the inferior border of the broad ligament and house the uterine artery and uterine veins.These ligaments arise from the side of the cervix and the lateral fornix of the vagina. They provide an extensive attachment on the lateral pelvic wall at the level of the ischial spines. Label the 3 key ligaments using the labels below:
transverse ligament
pubocervical ligament
uterosacral ligament
1 = pubocervical ligament 2 = transverse ligament 3 = uterosacral ligament
The cardinal ligaments are situated along the inferior border of the broad ligament and house the uterine artery and uterine veins. These ligaments arise from the side of the cervix and the lateral fornix of the vagina. They provide an extensive attachment on the lateral pelvic wall at the level of the ischial spines and the 3 key ligaments are:
transverse ligament
pubocervical ligament
uterosacral ligament
Which of these ligaments is the strongest?
- transverse ligament
- has to be as it sits in the middle supporting the weight of the uterus
The cardinal ligaments are situated along the inferior border of the broad ligament and house the uterine artery and uterine veins. These ligaments arise from the side of the cervix and the lateral fornix of the vagina. They provide an extensive attachment on the lateral pelvic wall at the level of the ischial spines and the 3 key ligaments are:
transverse ligament
pubocervical ligament
uterosacral ligament
The transverse ligament is the strongest and provides substantial support to what structure, and what is the clinical importance of this?
- extensive support to the uterus
- if damaged during surgery can cause problems such as prolapse, can be repaired in surgery though
The pelvic outlet also called the inferior pelvic aperture, defines the lower margin of the lesser (true) pelvis. This can be subdivided into 2 regions, what are these 2 regions called?
- anal triangle
- urogenital triangle
The pelvic outlet also called the inferior pelvic aperture, defines the lower margin of the lesser (true) pelvis. This can be subdivided into 2 regions called
- anal triangle
- urogenital triangle
What closes off these 2 triangles?
- pelvic diaphragm
The pelvic diaphragm closes off the urogenital and anal triangles. What are the 2 groups of muscles that make up the pelvic diaphragm?
1 - obturators and coccygeus
2 - levator ani and coccygeus
3 - piriformis and coccygeus
4 - levator ani and obturators
2 - levator ani and coccygeus
The pelvic diaphragm closes off the urogenital and anal triangles and is composed of 2 muscles groups, the levator ani (puborectalis, pubococcygeus, and iliococcygeus.) and coccygeaus. Labels the muscles of the levator ani and coccygeus on the image below:
pubococcygeus
coccygeus
puborectalis
iliococcygeus
1 = puborectalis 2 = pubococcygeus 3 = iliococcygeus 4 = coccygeus
The pelvic diaphragm closes off the urogenital and anal triangles and is composed of 2 muscles groups, the levator ani and coccygeaus. What are the main functions of pelvic diaphragm?
- supports pelvic organs and vagina
- supports the orifices: rectum, urethra, / vagina
- prevent incontinence (urinary & faecal)
The pelvic diaphragm closes off the urogenital and anal triangles and is composed of 2 muscles groups, the levator ani and coccygeaus. Which somatic nerves innervate the pelvic diaphragm?
1 - L4-S4
2 - L5-S2
3 - S1-S4
4 - S2-S5
4 - S2-S5
The perineum is the space between the anus and genitals, extending from either the vaginal opening to the anus or the scrotum to the anus. This can be damaged and torn during trauma, most commonly during pregnancy. What is the surgical procedure used to repair this?
- episiotomy
What are the 4 most common causes of damage to the pelvic floor and perineum in women?
1 = pregnancy orchildbirth, during hysterectomy 2 = pelvic surgery (perineal approach) 3 = episiotomy (trauma to perineal body) 4 = tumours (fibroids)
What are the 4 most common causes of damage to the pelvic floor and perineum in men?
- heavy lifting
- obesity
- chronic cough, constipation, vomiting
- trauma
What is the strongest ligament in the body?
1 - iliofemoral ligament
2 - sacrotuberous ligament
3 - ischiofemoral ligament
4 - pubofemoral ligament
2 - sacrotuberous ligament
If the pelvic floor and diaphragm is damaged or weakened, what are some of the most common consequences?
- fullness or pressure inside vagina
- prolapse of the vagina or uterus
- inability to empty bladder or bowel with straining
- incontinence (loss of bladder control)
- dysparunia (pain during sex) or reduced sensation during intercourse
- backache
What is the important relationship between the ureter and the uterine artery that is important in surgery?
- ureters goes over the top of the uterine artery = water over bridge
- ureters goes under the uterine artery = water under the bridge (at level of cervix)
The gubernaculum is remnant of embryology development that helps guide the gonads into pelvic region. What will the gubernaculum then become in the scrotum?
1 - outer layer of the scrotum
2 - inner layer of the scrotum
3 - scrotal ligament attaching the testes to the scrotum
4 - part of spermatic cord
3 - scrotal ligament attaching the testes to the scrotum
The gubernaculum is remnant of embryology development that helps guide the gonads into pelvic region. The gubernaculum then forms a scrotal ligament attaching the testes to the scrotum. If this does not develop correctly, what emergency situation can arise in males?
1 - hydrocele
2 - varicocele
3 - testicular torsion
4 - haematocele
3 - testicular torsion
