Class 1: Pelvis & Male Reproductive System Anatomy Flashcards
What are the bony features of a male pelvis?
Narrow pubic arch
Round obturator foramen
Deep pelvis major
Supra-pubic angle <90 degrees
What are the bony features of a female pelvis ?
Wide pubic arch Oval obturator foramen Shallow pelvis major Large pelvis outlet Supra-pubic angle > 90 degrees
Which part of the pelvis is termed true ?
Pelvic inlet
Which part of the pelvis is termed false?
Greater pelvis (bones surrounding the inlet)
What are the borders of the pelvis?
Anterior border
Lateral border
Posterior border
What type of joint is the sacroiliac joint?
Synovial planar joint
Which muscles/structures occupy the lateral pelvic wall?
Obturator internus, ligaments and the piriformis muscle
Which muscle is present on the posterior wall of the pelvis ?
Piriformis muscle and coccygeus muscles
Which nerve network lies on the muscle forming the posterior wall of the pelvis ?
Sacral plexus (S2-S4)
What are the perineal and anococcygeal muscles?
Perineal: Found between the urethra and the vagina/testis and the anus
Anococcygeal: A fibrous median raphe in the floor of the pelvis which extends between the coccyx and the margin of the anus
Give 2 functions of the pelvic diaphragm
1: support abdominal viscera
2: Continence mechanism
What is the innervation of the pelvic diaphragm ?
Pudendal nerve
What is a cystoceole ?
When the supportive tissue between the bladder and the vaginal wall weakens and stretches - the bladder bulges into the vagina.
What is a rectocoele?
A herniation of the front wall of the rectum into the back wall of the vagina - the recto-vaginal septum can become weak over time
Why is a mediolateral episiotomy preferable to a midline episiotimy?
The risk of damage to the anal muscles is much lower - preserve fecal continence
Name the pelvic organs which are part of the urinary system
Pelvic ureter
Urinary bladder
Urethra
Name the pelvic organs which are part of the reproductive system in the male
Ductus deferens
Seminal vesicles
Prostate gland
Name the pelvic organs which are part of the reproductive system in the female
Ovaries
Uterine tubes
Vagina
Uterus
Name the pelvic organs which are part of the alimentary system
Pelvic colon
Rectum
Anal canal
Which organs does the superior and inferior vesicle arteries supply?
The bladder
The seminal gland
Prostate
What is the superior and inferior vesicle artery a branch of?
Internal illiac artery
Which organs does the Gonadal artery supply?
Gonads (Testes and ovaries)
What is the gonadal artery a branch of ?
Abdominal aorta
What organs does the superior rectal artery supply?
The rectum
What is the rectal artery a branch of?
Inferior mesenteric artery
What organ does the uterine artery supply?
The uterus
What is the uterine artery a branch of?
The internal illiac artery
What organ/s does the middle and inferior rectal artery supply?
Middle and inferior aspect pf the rectum
What are the middle and inferior rectal arteries a branch of?
Internal illiac arteries
What organ/s does the vaginal artery supply?
Vagina and base of the bladder
What is the vaginal artery a branch of?
Uterine artery
What organ/s does the internal pudendal artery supply?
This is the main artery to the perineum and provides blood to the external genitals
What is the pudendal artery a branch of ?
Internal illiac artery
The venous drainage of the pelvis consists of what 5 veins ?
Internal illiac veins superior rectal veins median sacral vein Gonadal veins Internal vertebral venous plexus
Which part of the rectum drains into the portal circulation?
The upper and middle 3rds of the rectum via the superior rectal vein and into the portal circulation
Which part of the rectum drains into the systemic circulation?
The lower 3rd of the rectum via the middle rectal vein and into the systemic circulation
What is the significance of understanding the venous drainage of the rectum?
Some medicines can be given rectally instead of PO and still bypass first pass metabolism
With which venous plexus does the prostatic venous plexus communicate on its posterior side? and what is the clinical significance of this ?
pudendal and vesical plexuses
The route of bone metastases in prostate cancer
Where does the ilioinguinal nerve originate and how does it enter the inguinal canal?
L1
Via the superficial inguinal ring
What does the ilioinguinal nerve supply?
The skin at the root of the penis in the male and the labia in the female
Where does the genitofemoral nerve originate ? and how does it enter the inguinal canal?
L1-2
Via the deep inguinal ring
What structures in the male are supplied by the genital branch of the genito-femoral nerve ?
Scrotal skin and cremaster
What is the clinical significance of the genito-femoral nerve ?
Responsible for the cremasteric reflex - Contraction of cremasteric muscle when skin of the superior medial thigh is touched
From which plexus does the pudendal arise ?
The sacral plexus
At which segmental level does the pudendal nerve arise?
S4
What bony landmarks do you think are used when performing a pudendal nerve block during labor?
The ischial spine
How many primary lymph node groups are there in the pelvis ?
4
Which organs in the pelvis does the external illiac lymph nodes drain?
Bladder External genitalia Vagina Cervix Uterus
Which organs in the pelvis does the internal illiac lymph nodes drain ?
Gluteal region
Deep perineum
Inferior pelvic viscera
Prostate
Which organs in the pelvis do the sacral lymph nodes drain?
Rectum and posterior wall of the pelvis
which organs in the pelvis do the common illiac lymph nodes drain?
Drainage from the external, internal and sacral lymph nodes
What are the main contents of the spermatic cord ?
Vas deferens
Nerve
Artery
Venous
What is the tough outer fibrous layer of the testis?
Tunica Albuginea
What are the 2 layers of the tunica vaginalis?
Visceral and parietal
What is present between the 2 layers of tunica vaginalis?
A thin fluid layer - reduces friction between testes and scrotum
What is a hydrocele ?
A collection of fluid within the scrotum
What is a haematocele?
A collection of blood in tunica vaginalis?
At what vertebral level do the testicular arteries arise from the abdominal aorta ?
L2 - above IMA
What is the term used for the 8-12 anastomosing veins associated with the testis?
Pampiriform plexus
What is the function of these veins ?
Temperature regulation
Into which vein does the right and left testicular vein drain?
Right testicular vein - IVC
Left testicular vein - Left renal vein
What is a varicocele?
Distended testicular vein
Which 2 lymph node groups receive lymph from the testis?
Lateral aortic and Pre-aortic
What secretions are produced by the seminal vesicles ?
Semogelin - proteins which make semen sticky
What secretions are produced by the prostate?
Fluid for semen
What secretions are produced by the bulbourethral glands?
Alkaline mucus-like fluid
Which lymph node group drains the prostate?
Internal illiac and sacral nodes
Which lymph node group drains the seminal vesicle?
Internal and external illiac lymph nodes
Which lymph node group drains the scrotum?
Retroperitoneal lymph nodes
Which lymph node group drains the penis?
Inguinal lymph nodes
