Commentary - Anatomy GUT Women and Mens Health

Question 1

The bony pelvis is composed of the ____ and _____. Which are separated by the ______.

Answer 1

True and false pelvis

Arcuate line

Question 2

Describe the positioning of the pelvic inlet.

Answer 2

Tilted 50-60 degrees forwards

Question 3

What are the margins of the pelvic outlet?

Answer 3

The pubic symphysis, ischiopubic rami, ischial tuberosity, sacrotuberous ligaments, and the coccyx

Question 4

What structures are found above the piriformis muscle?

Answer 4

Greater sciatic foramen, superior gluteal vessels and nerve

Question 5

What structures are found below the piriformis muscle?

Answer 5

Inferior gluteal nerve and vessels, internal pudendal nerve, pudendal nerve, and sciatic nerve.

Question 6

What structure separates the greater sciatic foramen from the lesser?

Answer 6

Sacrospinous ligament

Question 7

What structures pass through the lesser sciatic foramen?

Answer 7

Internal pudendal vessels and nerve

Question 8

Dermatomes of the perineum?

Answer 8

Sacral segments S3 to S5

Question 9

Nerve roots to skeletal muscles of perineum and pelvic floor?

Answer 9

S2 to S4

Question 10

What is the major nerve of the perineum?

Answer 10

the pudendal nerve

Question 11

Site of a pudendal nerve block?

Answer 11

Inside of the ischial tuberosity

Question 12

Is the inferior hypogastric plexus visceral afferent, PSNS, or SNS?

Answer 12

All 3

Question 13

Blood is supplied to the pelvis by?

Answer 13

Internal iliac artery, which splits into an anterior and posterior trunk

Question 14

What perineal structure is not supplied by the internal iliac artery?

Answer 14

Penis

Question 15

The urogenital diaphragm/perineal membrane is composed of?

Answer 15

Thick triangular fascia with muscles inside

Question 16

The pelvic diaphragm is composed of?

Answer 16

Levator ani (iliococcygeus, pubococcygeus, and puborectalis)
Coccygeus muscle

Question 17

The urogenital hiatus is a space formed between?

Answer 17

Muscles of the levator ani

Question 18

What passes through the urogenital hiatus?

Answer 18

Urethra and vagina

Question 19

What is the perineal body?

Answer 19

The junction of the levator ani and perineal membrane

Question 20

Is the internal anal sphincter smooth or skeletal muscle?

Answer 20

Smooth

Question 21

What controls the internal anal sphincter?

Answer 21

PSNS

Question 22

Is the external anal sphincter smooth or skeletal muscle?

Answer 22

Skeletal

Question 23

What muscles compose the external anal sphincter?

Answer 23

Deep, superficial, and subcutaneous external anal sphincter muscles

Question 24

What is the anal pecten?

Answer 24

Transition from rectal mucosa to nonkeratinized squamous epithelium

Question 25

What is the anocutaneous line?

Answer 25

Transition from nonkeratinized squamous epithelium to keratinized squamous epithelium (true skin)

Question 26

The superior rectal veins drain into?

Answer 26

The portal system

Question 27

The middle and inferior rectal veins drain into?

Answer 27

The caval system

Question 28

What ligaments have a substantial role in supporting the uterus?

Answer 28

Cardinal ligament Uterosacral ligaments Anterior pubocervical ligament

Question 29

What are the other names of the cardinal ligament of the uterus?

Answer 29

Transverse cervical or Mackenrodt ligament

Question 30

What non-ligamentous structures play a significant role in support of the uterus

Answer 30

Pelvic diaphragm Urogenital diaphragm Perineal body

Question 31

What ligaments of the uterus are not considered to be uterine support structures?

Answer 31

Broad ligament of the uterus Round ligament of the uterus Suspensory ligament of the ovary Peritoneal folds

Question 32

What artery runs through the broad ligament of the uterus?

Answer 32

The ovarian artery

Question 33

Where does the ovarian artery arise from? What is the clinical significance?

Answer 33

The aorta | It has very high pressure and if ruptured from an ectopic pregnancy, hemorrhage is of concern.

Question 34

The uterine artery arises from?

Answer 34

The internal iliac artery

Question 35

Most dependent portion of the abdomen in a female? | Male?

Answer 35

Female - rectouterine pouch (of douglas) | Male - rectovesical pouch

Question 36

What are the "supporting" (but not truly supporting) structures of the ovaries?

Answer 36

mesovarium suspensory ligament of the ovary ligament of ovary (continuous with round ligament of the uterus)

Question 37

Deep pelvic structures drain into what lymphatic vessles?

Answer 37

Internal and external iliac chains

Question 38

Deep perineal structures drain into what lymphatic vessels?

Answer 38

internal iliac chain

Question 39

Penis, scrotum, clitoris, and labia drain into what lymphatic vessels?

Answer 39

deep inguinal nodes and external iliac chain

Question 40

Glans penis and glans clitoris, labia minora, and the inferior end of the vagina drain into what lymphatic vessels?

Answer 40

deep inguinal nodes and external iliac chain

Question 41

The ovaries and testes drain into what lymphatic vessels?

Answer 41

lateral and pre-aortic nodes

Question 42

The gluteal nodes drain into what lymphatic vessels?

Answer 42

internal iliac chain

Question 43

The lower extremities drain into what lymphatic vessels?

Answer 43

superficial and deep inguinal nodes

Question 44

The key to lymphatic drainage of the perineum is that deep parts of the perineum drain into ?

Answer 44

Internal pudendal chain > internal iliac nodes > aortic nodes

Question 45

The key to lymphatic drainage of the perineum is that superficial parts of the perineum and external genitalia drain into?

Answer 45

Superficial inguinal nodes > deep inguinal nodes > external iliac nodes

Question 46

What is a hysterosalpingogram?

Answer 46

Injection of contrast into the cervical os to see the uterine cavity and fallopian tubes

Question 47

What is primary vesicoureteral reflux?

Answer 47

Immaturity with a short ureteral tunnel through bladder wall or congenital anomaly with no tunnel at all

Question 48

What is secondary vesicoureteral reflux?

Answer 48

Posterior urethral valves or neurogenic dysfunctional bladder

Question 49

What specific type of cancer is indicated by painless hematuria?

Answer 49

Urinary tract transitional cell malignancy

Question 50

Dilated urinary collecting systems, calyces, infundibula, renal pelvis, or ureters secondary to obstruction describes what condition?

Answer 50

Hydronephrosis

Question 51

Enlarged ovaries with thick sclerotic capsules and abnormally high number of follicles decribes?

Answer 51

PCOS = Stein-Leventhal syndrome

Question 52

Doppler ultrasound showing no blood flow to the ovaries describes what condition?

Answer 52

Ovarian torsion

Question 53

What mass in the ovary can develop organs, teeth, hair, fat, ect.?

Answer 53

Dermoid cyst

Question 54

A palpable nodule bulging into the umbilicus, that is not a hernia is known as? It is a sign of?

Answer 54

Sister Mary Joseph sign | It is a sign of malignancy

Question 55

Is a cystadenoma benign or malignant? | How about a carcinoma of the ovary?

Answer 55

Cystadenoma - benign | Carcinoma of the ovary - malignant

Question 56

Which of the following is the most likely cause of postmenopausal bleeding? a) Bladder Cancer b) Endometrial carcinoma c) Uterine leiomyoma d) Foreign body

Answer 56

b) endometrial carcinoma

Question 57

Carcinoma of the cervix is concerning because?

Answer 57

Direct invasion into paracervical and parametrial areas.

Question 58

A bulge in the anterior vaginal wall is consistent with ______, while a bulge in the posterior vaginal wall is consistent with _______

Answer 58

cystocele | rectocele

Question 59

The hollow canal connecting the fetal urinary bladder to the umbilical cord is called the?

Answer 59

Urachus

Question 60

The urachus becomes what ligament/fold during development?

Answer 60

Median umbilical ligament/fold

Question 61

What is the medial umbilical ligament?

Answer 61

The remnant of the umbilical artery