Cobine: Male Pelvis Flashcards
The pelvis is divided into 2 regions
superior/greater (false) pelvis
inferior/lesser (true) pelvis
The inlet of the pelvic is continuous with the (blank) and is encircled by bone; the outlet is formed by the boundaries of the (blank)
abdominal cavity; perineum
General functions of the pelvis:
- contains/supports these organs
- anchoring site for (blank)
- connects axial and appendicular skeletons, locomotion, and attachment site for muscles.
bladder, rectum, anal canal, most of reproductive tract; external genitalia
What is the part of the bony pelvis called where it articulates with the femur?
acetabulum
Most superior portion of the bony pelvis; 3 features of this portion
ilium; iliac crest, anterior superior iliac spine; greater sciatic notch
Posterior and inferior portion of the bony pelvis; 3 features of this portion
ischium; ischial spine, ischial tuberosity; lesser sciatic notch
Anterior and inferior portion of the bony pelvis; 1 feature of this portion
pubis; pubic tubercle
Differences between the male and female pelvis
- in males, iliac wings less flared
- in males, pelvic inlet more anteroposterior, as opposed to transversely oval in female (heart-shaped)
- pubic arch (subpubic angle) narrower
- pubic symphysis deeper (taller)
- ischial tuberosities INVERTED vs EVERTED in female
- narrower interpubic disc
- more curved sacrum
The female pelvis is generally (blank) to accomodate the passing baby during parturition
broader
What two structures (anterior –> posterior) define the true (obstetrical) conjugate (distance)
from sacral promontory (anteriorly) to posterosuperior margin of pubic symphysis (posteriorly)
Between promontory and top of pubic symphysis ~11-12 cm
sagittal inlet, also called obstetric or true conjugate
Maximum transverse diameter of pelvic inlet
11.5-13cm
Distance between ischial spines - ~9cm
bispinous outlet
Between tip of coccyx and inferior margin of pubic symphysis – ~10cm
sagittal outlet
Measured during pelvic examination as distance between the sacral promontory and the inferior margin of the pubic symphysis (approximation of sagittal inlet/obstetric conjugate measurement)
Diagonal conjugate
Female pelvic changes during pregnancy
Cavity of interpubic disc increases, increasing size of lesser pelvis and flexibility of pubic symphysis
Increased sex hormones + relaxin levels cause relaxation of pelvic ligaments
Coccyx can move more posteriorly
Greater relaxation = less stability
Does the true diameter of the pelvis change during pregnancy?
NO!
Thickened ligaments at the superior and inferior margins of the symphysis
interpubic disc
A heart-shaped pelvis, which is narrow at the front is called (blank). An almost round pelvis, which is more ideal, is called (blank).
android; gynecoid
Pelvic organs in the male
- urinary bladder
- ureter
- rectum
- ductus deferens
The peritoneum continues down from the anterior abdominal wall at the level of the (blank); covers superior surface of (blank); moves 2cm inferiorly/posteriorly; covers (blank) superiorly; lines the (blank) fossa posteriorly; covers the anterior and lateral sides of the (blank); and becomes sigmoid mesocolon at (blank)
pubic bone; bladder; seminal vesicles; rectovesicular; rectum; S3
Aninflammation of theperitoneum, may result frominfection or from a non-infectious process; untreated, sepsis. Where are places where fluid can accumulate in the event of infection?
Peritonitis; deep recesses like the rectovesical pouch
The rectum does not have these two things.
It has (blank) transverse rectal folds.
This portion receives and holds fecal material.
These arteries supply the rectum.
teniae, fatty appendages
3
ampulla
superior, middle, and inferior rectal arteries
When the bladder is empty, where is it located?
When the bladder is full, where is it located?
lesser pelvis; greater pelvis
What allows for distensibility of the bladder?
retropubic space
This structure is present at the neck of the bladder and prevents retrograde transport of semen
urethral sphincter
Fundus of the bladder is separated from the rectum by the (blank) and ampullae of the ductus deferentes laterally
seminal glands
The bladder neck is anchored by a pair of fibromuscular bands connecting it and the pelvic urethra to the pubic bone – In females, (blank) ligaments, in males, (blank) ligaments. These ligaments work with the perineal membrane & associated muscles to support the bladder.
pubovesical ligaments; puboprostatic ligaments
What supplies the anterosuperior portion of the bladder?
What supplies the fundus and neck of the bladder?
What other arteries are involved?
superior vesical arteries; inferior vesical arteries; obturator arteries and inferior gluteal arteries
Pelvic veins follow the course of all branches of the internal iliac artery EXCEPT the (blank) and (blank) arteries
umbilical; iliolumbar
Veins drain into the (blank) veins which in turn drain into the common iliac veins
internal iliac
What is the venous plexus that supplies the bladder? What is the venous plexus that supplies the prostate? What is unique about these two plexuses?
vesical venous plexus; prostatic venous plexus; they are continuous
Vesical venous plexus mostly drains bladder through the inferior vesical veins into the (blank) veins
internal iliac
Envelops fundus of bladder, prostate, seminal glands, ductus deferens, inferior ureter and receives blood from the deep dorsal vein of the penis (which drains the erectile tissue
vesical venous plexus and prostatic plexus
The ureter enters the pelvic cavity by crossing the pelvic brim superior to the iliac vessels, passing over the (blank) of the common iliac artery into internal and external iliacs and enters the bladder at an oblique angle
bifurcation
Where does the ductus deferens cross in relation to the ureter and the bladder?
ductus deferens crosses OVER the ureter as the ductus deferens travels POSTERIOR to the bladder
Testes Epididymides Ductus deferentes Seminal glands Ejaculatory ducts (combination of the vas deferens and the seminal vesicles) Prostate Bulbourethral glands
Male internal genital organs
Do seminal glands store sperm? What do they secrete?
NO; secrete thick alkaline fluid containing fructose and a coagulating agent
The duct of the seminal gland joins the (blank) to form the ejaculatory duct
ductus deferens
Blood supply to seminal glands
vesical and middle rectal arteries and veins
How many lobes does the prostate gland have?
5 lobes: anterior, posterior, right and left, median
Lobe of prostate: also called the isthmus, lies anterior to the urethra, little glandular tissue
anterior lobe
Lobe of prostate: lies posterior to the urethra, and INFERIOR to the ejaculatory duct, palpable with rectal exam
posterior lobe
Lobe of prostate: lies BETWEEN the urethra and ejaculatory ducts, projection of this lobe is partially responsible for the formation of the uvula that can project into the internal urethral orifice and cause bladder problems in males
median lobe
Blood supply of prostate gland
inferior vesical, middle rectal, internal pudendal arteries
What drains the prostate gland? What is this continuous with?
prostatic venous plexus (drains to internal iliac veins); continuous with vesical venous plexus and the internal vertebral venous plexus
4 portions of urethra
- preprostatic
- prostatic
- membranous
- spongy
Secretions from the ductus deferens and seminal vesicles are mixed by convergence of their ducts into the (blank). The ejaculatory ducts then converge and open on the (blank) by slit-like openings within the opening of the prostatic utricle.
ejaculatory ducts; seminal colliculus
Prostatic ducts empty into the (blank) urethra after the termination of the ejaculatory ducts
prostatic
Secretions from the bulbourethral glands enter the (blank) urethra through their ducts which are located distal to the external urethral sphincter
spongy
Sperm is made in the (blank), passes into the (blank) and (blank) where it can be stored. During emission, it travels up the ductus deferens to its (blank). Sperm join with secretions from the seminal gland in the (blank). Secretions are added from the (blank) and (blank) glands.
testis; epididymis; ductus deferens; ampulla; ejaculatory duct; prostate; bulbourethral
Sperm is ejaculated with seminal secretions from the penis by the (blank), leaving the penis at the (blank)
urethra; external urethral orifice
Generate 60% of total semen volume; secretes ALKALINE semen
seminal vesicles
What are these components of semen from the seminal vesicles
- nutrition
- protection
- motility/protection
- clotting, keeps semen inside female repro tract
- fructose
- ascorbic acid
- prostaglandins
- fibrinogen
Generates 20% of total semen volume; generates SLIGHTLY ACIDIC semen
prostate gland
What are these components of?
Zinc – stability of chromatin
Citric Acid – protection
Acid Phosphatase - elevated in prostate cancer
Prostate Specific Antigen (PSA) – liquefies semen, dissolves cervical mucus, elevated in prostate cancer
Pro(fibrinolysin) – liquefies coagulated semen
prostate gland semen
These two components of prostate gland semen are elevated in prostate cancer
acid phosphatase; prostate specific antigen
Contribute less than 1% of total semen volume; made up of galactose, mucus, PRE-EJACULATE, phosphate and bicarb buffers
bulbourethral gland
common after middle age affecting almost every male; the enlarged prostate projects into the bladder and impedes urine flow by obstructing the prostatic urethra; common symptoms include nocturia, dysuria, and urgency
benign hypertrophy of the prostate
What lobe of the prostate is most commonly enlarged?
median
Most common lobe for prostatic carcinoma?
posterior prostatic lobe
Prostate cancers metastasize both through (blank) routes and via (blank) routes
lymphatic (internal iliac and sacral lymph nodes to more distant lymph nodes); venous (internal vertebral venous plexus to the vertebrae and brain)
What 3 things make up the linea terminalis?
- pectineal line
- arcuate line
- sacral promonotory
