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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
Q

In males, what artery supplies the inferior/posterior portion of the bladder?

A

inferior vesical aa.

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26
Q

In females, what artery supplies the inferior/posterior portion of the bladder?

A

vaginal or inferior rectal aa.

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27
Q

Is motor control to the detrusor muscle via parasympathetics or sympathetic?

A

Parasympathetics are motor to the detrusor muscle.

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28
Q

What are the 4 main parts of the male urethra, starting from the bladder and exiting through the penis?

A
  1. intramural part
  2. prostatic urethra
  3. membranous urethra
  4. spongy urethra
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29
Q

Study slide 26.

A

Identify:

  • urethral crest
  • urethral sinus
  • seminal colliculus
  • prostatic utricle
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30
Q

Where does the female urethra begin?

A

At the internal urethral orifice of the bladder.

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31
Q

True or False:

The female urethra has both an internal and external urethral sphincter.

A

False - female only has external urethral sphincter.

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32
Q

What structures does the female urethra pass through?

A
  • pelvic diaphragm
  • external urethral sphincter
  • perineal membrane
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33
Q

What structures is the rectum located between?

A

Sigmoid colon and anal canal.

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34
Q

What is the rectal ampulla?

A

Dilated terminal part of rectum.

is a line that joins the tops of the anal columns

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35
Q

Is the rectal ampulla superior or inferior to the ano-rectal junction (line)?

A

Superior to ano-rectal junction (line).

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36
Q

How many transverse rectal folds are found in the rectum?

A
  • superior
  • intermediate
  • inferior
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37
Q

What do the anal columns do?

A

Secrete mucous into the anal canal.

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38
Q

What muscle forms a “sling” at the anorectal junction and forms the anorectal angle (flexure)?

A

puborectalis part of the levator ani muscle

39
Q

What degress is the anorectal angle (perineal flexure) at the anorectal junction?

A

80 degrees

40
Q

What does the anorectal line join?

A

The tops of the rectal columns.

41
Q

What does the pectinate line join?

A

The inferior ends of the anal valves.

42
Q

Which artery supplies blood to the rectum superior of the pectinate line?

A

superior rectal artery

branch off of inferior mesenteric artery

43
Q

Where do lymphatics drain that are superior to the pectinate line?

A

To internal iliac nodes.

44
Q

True or False:

Nerves that innervate the rectum superior to the pecinate line are visceral.

A

True

45
Q

What do pain fibers that supply the rectum superior to the pectinate line travel with?

A

parasympathetics to S2-S4

46
Q

Which artery supplies blood to the anal canal inferior to the pectinate line?

A

inferior rectal artery

47
Q

Where do the lymphatics of the anal canal, inferior to the pectinate line, drain to?

A

To superficial inguinal lymph nodes.

48
Q

Is the anal canal sensitive to pain, touch, and temperature?

A

Yes - because its innervation is somatic, thus the canal is sensitive to pain, touch, and temperature.

49
Q

Which venous plexus drains the anal canal inferior to the pectinate line and what vein does it empty into?

A

internal venous plexus drains into inferior rectal veins

50
Q

Which venous plexus drains the rectum superior to the pectinate line and what vein does it empty into?

A

internal venous plexus drains superiorly

51
Q

Is the internal or external anal sphincter under somatic control?

A

External anal sphincter.

internal anal sphincter under autonomic control

52
Q

How are ischioanal abcesses caused?

A

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
Q

What arterial system in the body is the most variable?

A

pattern of branching of the internal iliac artery

54
Q

Does the superior gluteal artery come off of the posterior or anterior division of the internal iliac artery?

A

posterior division

55
Q

Where does the superior gluteal artery typically exit the pelvis at?

A

Between the lumbosacral trunk and S1.

56
Q

Which 3 arteries that we are covering come off of the posterior division

A
  • superior gluteal artery
  • iliolumbar artery
  • lateral sacral artery
57
Q

What are the branches off of the anterior division of the internal iliac artery?

A
  • obturator artery
  • (obliterated) umbilical artery
  • internal pudendal artery
  • inferior gluteal artery
58
Q

What percentage of people have an “abnormal” or accessory obturator artery?

A

20%

59
Q

What artery is endangered during hernia surgeries?

A

Obturator Artery

60
Q

What are the branches off of the obturator artery?

A
  • superior vesical arteries
  • uterine artery
  • vaginal artery
  • middle rectal artery
  • internal pudendal artery
  • inferior gluteal artery
61
Q

Where does the inferior gluteal artery typically leave the pelvis at?

A

Between S2 and S3 of the sacral plexus.

62
Q

Where does the internal pudendal almost always exit the pelvis near?

A

Near the ischial spine (which is where the coccygeus attaches).

63
Q

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

A

superior vesical aa from the internal iliac

64
Q

What artery in men supplies the inferior/posterior portion of the bladder?

A

inferior vesical aa.

65
Q

What artery in female supplies the inferior/posterior portion of the bladder?

A

vaginal or inferior rectal aa.

66
Q

Do females have an inferior vesical aa.?

A

No - only males.

67
Q

What arteries take the place of the inferior vesical artery in females?

A

vaginal arteries

68
Q

Where does the median (middle) sacral artery come from?

A

Aorta - at the bifurcation.

69
Q

What arteries does the iliolumbar aa. anastomose with?

A

deep circumflex iliac arteries

70
Q

Where does the ovarian arteries come from?

A

Aorta

71
Q

Does the ovarian artery cross anterior or posterior to the ureter?

A

crosses anterior toe the ureter

72
Q

Where does the ovarian arteries run?

A

run in the suspensory ligament (infundibulopelvic)

73
Q

Does the ovarian arteries cross over or below the bifurcation of the common iliac arteries?

A

Over the bifurcation of the common iliac arteries.

74
Q

Where does the obturator artery cross?

A

Crosses over the pelvic brim along the pubic ramus.

75
Q

Where does the superior rectal artery come from?

A

Inferior mesenteric artery.

76
Q

Which plexi make up the pelvic plexus?

A
  • rectal plexus
  • vesical plexus
  • prostatic plexus (m)
  • uterine plexus (f)
  • vaginal plexus (f)
77
Q

Where do all of the pelvic plexus drain into?

A

Internal Iliac Veins

78
Q

Where does the superior rectal veins empty into?

A

The inferior mesenteric, which in turn empties into the portal vein.

79
Q

Where does the middle rectal veins empty into?

A

The internal iliac veins, which empty into the inferior vena cava.

80
Q

Where does the inferior rectal veins drain into?

A

The internal pudendal veins, which eventually drain to the internal iliac.

81
Q

What conditions can hemorrhoids be related to?

A
  • cirrhosis

- high blood pressure

82
Q

What are internal hemorrhoids?

A

Prolapsed rectal mucosa containing veins of the internal rectal plexus.
internal rectal veins that prolapse into the anal canal and often strangulate

83
Q

What are external hemorrhoids?

A

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
Q

In males, where does the lymphatics of the prostate primarily drain to?

A

Internal iliac nodes.

85
Q

Where do the lymphatics of the bladder typically drain to?

A

External iliac nodes.

86
Q

Where do the lymphatics of the perineal structures drain primarily to?

A

Superficial inguinal nodes.

87
Q

Look over the pudendal nerve branches in male and female.

A

Slides 48 and 49.

88
Q

On which surface of the piriformis is the sacral plexus found?

A

pelvic surface of the piriformis muscle

89
Q

Are sacral splanchnics sympathetic or parasympathetic?

A

sympathetic

90
Q

Are pelvic splanchnics sympathetic or parasympathetic?

A

parasympathetic - S2-S4

91
Q

What innervates the inferior part of the vagina?

A

Innervated by somatic branches from the internal pudendal nerve.

92
Q

What innervates the middle and superior parts of the vagina and the uterus?

A

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
Q

What supplies motor to the uterus and vagina?

A

parasympathetics from S2-S4

94
Q

True of False:

The pelvic pain line follows the pertoneum.

A

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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