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Human Anatomy II -- Unit 2 -- Zach H. > Common Pelvic Viscera, Innervation, and Vasculature > Flashcards

Common Pelvic Viscera, Innervation, and Vasculature Flashcards

1
Q

What allows the bladder to expand when full?

A

Peritoneum from the anterior abdominal wall reflects loosely over the bladder.

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2
Q

What is the prevesical space (retropubic) filled with?

A

Endopelvic fat and CT

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3
Q

Where is the prevesical space (retropubic) located between?

A

Pubic symphysis and Bladder

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4
Q

Is the prevesical space (retropubic) a potential space?

A

Yes

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5
Q

What is the retrorectal (presacral) space located between?

A

Between sacrum and rectum.

  • a potential space *
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6
Q

What does endopelvic fascia condense to form?

A

ligaments (e.g., sacrouterine ligament)

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7
Q

What ligaments are formed by the condensation of the endopelvic fascia?

A
  • sacrouterine ligament
  • transverse cervical ligament
  • pubovesical ligaments (female)
  • puboprostatic ligaments (male)
  • rectovesical septum (urorectal)
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8
Q

List the peritoneal spaces/fossa of the pelvic region of the male.

A
  • supravesical fossa
  • paravesical fossa(e)
  • ureteric fold
  • rectovesical pouch (fossa)
  • pararectal fossa(e)
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9
Q

What structures does the rectovesical septum (urorectal) separate?

A
  • Rectum from the prostate and the seminal vesicles.
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10
Q

Is the rectovesical septum condensed endopelvic fascia?

A

Yes

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11
Q

What are the peritoneal spaces/fossa of the pelvic region of the female?

A
  • supravesical fossa
  • paravesical fossa(e)
  • vesicouterine puch (fossa)
  • rectouterine puch (fossa)
  • pararectal fossa(e)
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12
Q

Are ureters retroperitoneal?

A

Yes

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13
Q

What does peristalsis of the ureters do?

A

Pushes urine toward the bladder.

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14
Q

What are the 3 places where urinary calculi can catch?

A

> where the ureters cross superior to the external iliac artery and vein (crosses the pelvic brim where the common iliacs bifurcate)

> where the ureters pass inferior to the uterine artery

> where the ureters go inferior to the ductus deferen to enter the bladder

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15
Q

True or False:

the ureter runs medially to the uterine artery and then is crossed by it.

A

True

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16
Q

What is the relationship of the ureter in the male and the ductus deferens?

A

The ductus deferens crosses anterior to the ureter (ureter goes inferior to the ductus) to enter the bladder.

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17
Q

In what space is the urinary bladder located “in”?

A

Retropubic Space, inferior to the peritoneum and posterior to the pubic symphysis.

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18
Q

True or False:
The urinary bladder is located “in” the retropubic space, posterior to the peritoneum and inferior to the pubic symphysis.

A

False - inferior to the peritoneum and posterior to the pubic symphysis.

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19
Q

What are the 4 main areas of the urinary bladder?

A
  • apex
  • base (fundus)
  • body
  • neck
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20
Q

What muscle primarily makes up the walls of the bladder?

A

Detrusor Muscle

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21
Q

What type of tissue lines the bladder and what does it form when the bladder is empty?

A

Lined by transitional epithelium that form rugae when empty.

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22
Q

What is the trigone?

A

Is an internal smooth thickened area defined by the openings of the 2 ureters and the urethra.

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23
Q

In male and female, what artery supplies the superior portion of the bladder?

A

Superior vesical aa. from the internal iliac.

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24
Q

Where does the superior vesical aa. come from that supplies the superior portion of the bladder in males and females?

A

internal iliac a.

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25
In males, what artery supplies the inferior/posterior portion of the bladder?
inferior vesical aa.
26
In females, what artery supplies the inferior/posterior portion of the bladder?
vaginal or inferior rectal aa.
27
Is motor control to the detrusor muscle via parasympathetics or sympathetic?
Parasympathetics are motor to the detrusor muscle.
28
What are the 4 main parts of the male urethra, starting from the bladder and exiting through the penis?
1. intramural part 2. prostatic urethra 3. membranous urethra 4. spongy urethra
29
Study slide 26.
Identify: - urethral crest - urethral sinus - seminal colliculus - prostatic utricle
30
Where does the female urethra begin?
At the internal urethral orifice of the bladder.
31
True or False: | The female urethra has both an internal and external urethral sphincter.
False - female only has external urethral sphincter.
32
What structures does the female urethra pass through?
- pelvic diaphragm - external urethral sphincter - perineal membrane
33
What structures is the rectum located between?
Sigmoid colon and anal canal.
34
What is the rectal ampulla?
Dilated terminal part of rectum. *is a line that joins the tops of the anal columns*
35
Is the rectal ampulla superior or inferior to the ano-rectal junction (line)?
Superior to ano-rectal junction (line).
36
How many transverse rectal folds are found in the rectum?
- superior - intermediate - inferior
37
What do the anal columns do?
Secrete mucous into the anal canal.
38
What muscle forms a "sling" at the anorectal junction and forms the anorectal angle (flexure)?
puborectalis part of the levator ani muscle
39
What degress is the anorectal angle (perineal flexure) at the anorectal junction?
80 degrees
40
What does the anorectal line join?
The tops of the rectal columns.
41
What does the pectinate line join?
The inferior ends of the anal valves.
42
Which artery supplies blood to the rectum superior of the pectinate line?
superior rectal artery *branch off of inferior mesenteric artery*
43
Where do lymphatics drain that are superior to the pectinate line?
To internal iliac nodes.
44
True or False: | Nerves that innervate the rectum superior to the pecinate line are visceral.
True
45
What do pain fibers that supply the rectum superior to the pectinate line travel with?
parasympathetics to S2-S4
46
Which artery supplies blood to the anal canal inferior to the pectinate line?
inferior rectal artery
47
Where do the lymphatics of the anal canal, inferior to the pectinate line, drain to?
To superficial inguinal lymph nodes.
48
Is the anal canal sensitive to pain, touch, and temperature?
Yes - because its innervation is somatic, thus the canal is sensitive to pain, touch, and temperature.
49
Which venous plexus drains the anal canal inferior to the pectinate line and what vein does it empty into?
internal venous plexus drains into inferior rectal veins
50
Which venous plexus drains the rectum superior to the pectinate line and what vein does it empty into?
internal venous plexus drains superiorly
51
Is the internal or external anal sphincter under somatic control?
External anal sphincter. *internal anal sphincter under autonomic control*
52
How are ischioanal abcesses caused?
Infections from within the anal canal, pelvic infections, etc. can spread into the ischioanal fossae. Infections can spread through the superficial and deep postanal spaces to the other side.
53
What arterial system in the body is the most variable?
pattern of branching of the internal iliac artery
54
Does the superior gluteal artery come off of the posterior or anterior division of the internal iliac artery?
posterior division
55
Where does the superior gluteal artery typically exit the pelvis at?
Between the lumbosacral trunk and S1.
56
Which 3 arteries that we are covering come off of the posterior division
- superior gluteal artery - iliolumbar artery - lateral sacral artery
57
What are the branches off of the anterior division of the internal iliac artery?
- obturator artery - (obliterated) umbilical artery - internal pudendal artery - inferior gluteal artery
58
What percentage of people have an "abnormal" or accessory obturator artery?
20%
59
What artery is endangered during hernia surgeries?
Obturator Artery
60
What are the branches off of the obturator artery?
- superior vesical arteries - uterine artery - vaginal artery - middle rectal artery - internal pudendal artery - inferior gluteal artery
61
Where does the inferior gluteal artery typically leave the pelvis at?
Between S2 and S3 of the sacral plexus.
62
Where does the internal pudendal almost always exit the pelvis near?
Near the ischial spine (which is where the coccygeus attaches).
63
In both male and female, which artery supplies the superior portion of the bladder?
superior vesical aa from the internal iliac
64
What artery in men supplies the inferior/posterior portion of the bladder?
inferior vesical aa.
65
What artery in female supplies the inferior/posterior portion of the bladder?
vaginal or inferior rectal aa.
66
Do females have an inferior vesical aa.?
No - only males.
67
What arteries take the place of the inferior vesical artery in females?
vaginal arteries
68
Where does the median (middle) sacral artery come from?
Aorta - at the bifurcation.
69
What arteries does the iliolumbar aa. anastomose with?
deep circumflex iliac arteries
70
Where does the ovarian arteries come from?
Aorta
71
Does the ovarian artery cross anterior or posterior to the ureter?
crosses anterior toe the ureter
72
Where does the ovarian arteries run?
run in the suspensory ligament (infundibulopelvic)
73
Does the ovarian arteries cross over or below the bifurcation of the common iliac arteries?
Over the bifurcation of the common iliac arteries.
74
Where does the obturator artery cross?
Crosses over the pelvic brim along the pubic ramus.
75
Where does the superior rectal artery come from?
Inferior mesenteric artery.
76
Which plexi make up the pelvic plexus?
- rectal plexus - vesical plexus - prostatic plexus (m) - uterine plexus (f) - vaginal plexus (f)
77
Where do all of the pelvic plexus drain into?
Internal Iliac Veins
78
Where does the superior rectal veins empty into?
The inferior mesenteric, which in turn empties into the portal vein.
79
Where does the middle rectal veins empty into?
The internal iliac veins, which empty into the inferior vena cava.
80
Where does the inferior rectal veins drain into?
The internal pudendal veins, which eventually drain to the internal iliac.
81
What conditions can hemorrhoids be related to?
- cirrhosis | - high blood pressure
82
What are internal hemorrhoids?
Prolapsed rectal mucosa containing veins of the internal rectal plexus. **internal rectal veins that prolapse into the anal canal and often strangulate**
83
What are external hemorrhoids?
Clots in veins of the external rectal venous plexus (fed by branches of the inferior rectal veins). **clotted blood in the external rectal veins - usually caused by increased abdominal pressure or straining**
84
In males, where does the lymphatics of the prostate primarily drain to?
Internal iliac nodes.
85
Where do the lymphatics of the bladder typically drain to?
External iliac nodes.
86
Where do the lymphatics of the perineal structures drain primarily to?
Superficial inguinal nodes.
87
Look over the pudendal nerve branches in male and female.
Slides 48 and 49.
88
On which surface of the piriformis is the sacral plexus found?
pelvic surface of the piriformis muscle
89
Are sacral splanchnics sympathetic or parasympathetic?
sympathetic
90
Are pelvic splanchnics sympathetic or parasympathetic?
parasympathetic - S2-S4
91
What innervates the inferior part of the vagina?
Innervated by somatic branches from the internal pudendal nerve.
92
What innervates the middle and superior parts of the vagina and the uterus?
Innervated by visceral nn. > uterovaginal plexus (part of the pelvic plexus) > sympathetics from lumbar splanchnics > parasympathetics from S2-S4 (motor to the uterus and vagina)
93
What supplies motor to the uterus and vagina?
parasympathetics from S2-S4
94
True of False: | The pelvic pain line follows the pertoneum.
True * * pain from viscera above the line follows sympathetics * * pain from viscera below the line follows parasympathetics

Human Anatomy II -- Unit 2 -- Zach H. (9 decks)

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