Commentary - Anatomy GUT Women and Mens Health Flashcards
The bony pelvis is composed of the ____ and _____. Which are separated by the ______.
True and false pelvis
Arcuate line
Describe the positioning of the pelvic inlet.
Tilted 50-60 degrees forwards
What are the margins of the pelvic outlet?
The pubic symphysis, ischiopubic rami, ischial tuberosity, sacrotuberous ligaments, and the coccyx
What structures are found above the piriformis muscle?
Greater sciatic foramen, superior gluteal vessels and nerve
What structures are found below the piriformis muscle?
Inferior gluteal nerve and vessels, internal pudendal nerve, pudendal nerve, and sciatic nerve.
What structure separates the greater sciatic foramen from the lesser?
Sacrospinous ligament
What structures pass through the lesser sciatic foramen?
Internal pudendal vessels and nerve
Dermatomes of the perineum?
Sacral segments S3 to S5
Nerve roots to skeletal muscles of perineum and pelvic floor?
S2 to S4
What is the major nerve of the perineum?
the pudendal nerve
Site of a pudendal nerve block?
Inside of the ischial tuberosity
Is the inferior hypogastric plexus visceral afferent, PSNS, or SNS?
All 3
Blood is supplied to the pelvis by?
Internal iliac artery, which splits into an anterior and posterior trunk
What perineal structure is not supplied by the internal iliac artery?
Penis
The urogenital diaphragm/perineal membrane is composed of?
Thick triangular fascia with muscles inside
The pelvic diaphragm is composed of?
Levator ani (iliococcygeus, pubococcygeus, and puborectalis) Coccygeus muscle
The urogenital hiatus is a space formed between?
Muscles of the levator ani
What passes through the urogenital hiatus?
Urethra and vagina
What is the perineal body?
The junction of the levator ani and perineal membrane
Is the internal anal sphincter smooth or skeletal muscle?
Smooth
What controls the internal anal sphincter?
PSNS
Is the external anal sphincter smooth or skeletal muscle?
Skeletal
What muscles compose the external anal sphincter?
Deep, superficial, and subcutaneous external anal sphincter muscles
What is the anal pecten?
Transition from rectal mucosa to nonkeratinized squamous epithelium
What is the anocutaneous line?
Transition from nonkeratinized squamous epithelium to keratinized squamous epithelium (true skin)
The superior rectal veins drain into?
The portal system
The middle and inferior rectal veins drain into?
The caval system
What ligaments have a substantial role in supporting the uterus?
Cardinal ligament
Uterosacral ligaments
Anterior pubocervical ligament
What are the other names of the cardinal ligament of the uterus?
Transverse cervical or Mackenrodt ligament
What non-ligamentous structures play a significant role in support of the uterus
Pelvic diaphragm
Urogenital diaphragm
Perineal body
What ligaments of the uterus are not considered to be uterine support structures?
Broad ligament of the uterus
Round ligament of the uterus
Suspensory ligament of the ovary
Peritoneal folds
What artery runs through the broad ligament of the uterus?
The ovarian artery
Where does the ovarian artery arise from? What is the clinical significance?
The aorta
It has very high pressure and if ruptured from an ectopic pregnancy, hemorrhage is of concern.
The uterine artery arises from?
The internal iliac artery
Most dependent portion of the abdomen in a female?
Male?
Female - rectouterine pouch (of douglas)
Male - rectovesical pouch
What are the “supporting” (but not truly supporting) structures of the ovaries?
mesovarium
suspensory ligament of the ovary
ligament of ovary (continuous with round ligament of the uterus)
Deep pelvic structures drain into what lymphatic vessles?
Internal and external iliac chains
Deep perineal structures drain into what lymphatic vessels?
internal iliac chain
Penis, scrotum, clitoris, and labia drain into what lymphatic vessels?
deep inguinal nodes and external iliac chain
Glans penis and glans clitoris, labia minora, and the inferior end of the vagina drain into what lymphatic vessels?
deep inguinal nodes and external iliac chain
The ovaries and testes drain into what lymphatic vessels?
lateral and pre-aortic nodes
The gluteal nodes drain into what lymphatic vessels?
internal iliac chain
The lower extremities drain into what lymphatic vessels?
superficial and deep inguinal nodes
The key to lymphatic drainage of the perineum is that deep parts of the perineum drain into ?
Internal pudendal chain > internal iliac nodes > aortic nodes
The key to lymphatic drainage of the perineum is that superficial parts of the perineum and external genitalia drain into?
Superficial inguinal nodes > deep inguinal nodes > external iliac nodes
What is a hysterosalpingogram?
Injection of contrast into the cervical os to see the uterine cavity and fallopian tubes
What is primary vesicoureteral reflux?
Immaturity with a short ureteral tunnel through bladder wall or congenital anomaly with no tunnel at all
What is secondary vesicoureteral reflux?
Posterior urethral valves or neurogenic dysfunctional bladder
What specific type of cancer is indicated by painless hematuria?
Urinary tract transitional cell malignancy
Dilated urinary collecting systems, calyces, infundibula, renal pelvis, or ureters secondary to obstruction describes what condition?
Hydronephrosis
Enlarged ovaries with thick sclerotic capsules and abnormally high number of follicles decribes?
PCOS = Stein-Leventhal syndrome
Doppler ultrasound showing no blood flow to the ovaries describes what condition?
Ovarian torsion
What mass in the ovary can develop organs, teeth, hair, fat, ect.?
Dermoid cyst
A palpable nodule bulging into the umbilicus, that is not a hernia is known as?
It is a sign of?
Sister Mary Joseph sign
It is a sign of malignancy
Is a cystadenoma benign or malignant?
How about a carcinoma of the ovary?
Cystadenoma - benign
Carcinoma of the ovary - malignant
Which of the following is the most likely cause of postmenopausal bleeding?
a) Bladder Cancer
b) Endometrial carcinoma
c) Uterine leiomyoma
d) Foreign body
b) endometrial carcinoma
Carcinoma of the cervix is concerning because?
Direct invasion into paracervical and parametrial areas.
A bulge in the anterior vaginal wall is consistent with ______, while a bulge in the posterior vaginal wall is consistent with _______
cystocele
rectocele
The hollow canal connecting the fetal urinary bladder to the umbilical cord is called the?
Urachus
The urachus becomes what ligament/fold during development?
Median umbilical ligament/fold
What is the medial umbilical ligament?
The remnant of the umbilical artery
