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Anatomy II Exam 2 > Common Pelvic Viscera, Innervation, And Vasculature > Flashcards

Common Pelvic Viscera, Innervation, And Vasculature Flashcards

1
Q

What are the peritoneal spaces/fossa of the female?

A
  • supravesical fossa
  • paravesical fossa
  • vesicouterine pouch
  • rectouterine pouch
  • pararectal fossa
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2
Q

What allows the bladder to expand in the abdominal wall?

A

-peritoneum from the anterior abdominal wall reflecting loosely over the bladder

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3
Q

What are the peritoneal spaces/fossa in the male?

A
  • supravesical fossa
  • paravesical fossa
  • ureteric fold
  • rectovesical pouch
  • pararectal fossa
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4
Q

What are the two layers of the pelvic fascia?

A
  • parietal: transversalis fascia, membranous

- visceral: loose CT, compressible

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5
Q

What is the prevesical space/retropubic?

A
  • between pubic symphysis and bladder
  • potential space
  • filled with endo pelvic fat and CT
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6
Q

What is the retrorectal/presacral space?

A
  • between sacrum and rectum

- potential space

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7
Q

What is the endopelvic fascia do?

A

-condenses to form ligaments

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8
Q

What ligaments are found in the body cavity?

A
  • pubovesical ligaments
  • transverse cervical ligaments
  • sacrouterine ligaments
  • pubovesical ligaments (female) or puboprostatic ligaments (male) -> condensations of visceral endopelvic fascia
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9
Q

What is the rectovesical septum?

A
  • separates the rectum from the prostate and the seminal vesicles
  • condensed endopelvic fascia
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10
Q

What ischioanal abcesses?

A

-infections from within the anal canal, pelvic infections, etc can spread into the ischioanal fossa. Infection can spread through the superficial and deep postanal spaces to the other side

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11
Q

Describe the ureters.

A
  • retroperitoneal
  • muscular tubes
  • peristalsis pushes urine toward the bladder
  • several sets of blood vessels and nerves
  • 3 places where urinary calcului catch
  • cross the pelvic brim where the common iliacs bifurcate
  • enter the bladder wall obliquely
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12
Q

What is the relationship between the ureter and the uterine artery?

A

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

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13
Q

Relationship between the ureter and ductus deferens in the male.

A

-ductus deferens crosses anterior to the ureter, ureter goes inferior to the ductus to enter the bladder

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14
Q

Where is the urinary bladder?

A

-located in the retropubic space inferior to the peritoneum and posterior to the pubic symphysis

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15
Q

What the structures of the bladder?

A
  • apex
  • base
  • body
  • neck
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16
Q

Describe the bladder.

A
  • walls of the bladder are primarily detrusor muscles
  • inside of the bladder is lined with transitional epithelium that form rugae when empty
  • the trig one is an internal smooth thickened area defined by the openings of the 2 ureters and the urethra
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17
Q

What vessels supply the superior bladder?

A

-superior vesical a from the internal iliac

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18
Q

What vessels supply the inferior/posterior bladder?

A
  • inferior vesical a (male)

- vaginal or inferior rectal a (female)

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19
Q

What is the innervation of the bladder and inferior ureters???

A
  • T11-L2
  • superior. Hypogastric plexus
  • inferior hypogastric plexus
  • vesical n plexus
  • parasympathetics are motor to the detrusor m
20
Q

What are the four parts of the male urethra?

A
  1. Intramural part
  2. Prostatic urethra
  3. Membranous urethra
  4. Spongy urethra
21
Q

Name the 4 male features of the urethra.

A
  • urethral crest
  • urethral sinus
  • seminal colliculus
  • prostatic utricle
22
Q

Describe the female urethra.

A
  • begins at the internal urethral orifice of the bladder
  • no internal urethral sphincter
  • passes through the pelvic diaphragm, external urethral sphincter and perineal membrane
23
Q

Where is the rectum?

A

-between sigmoid colon and anal canal

24
Q

How many rectal folds are there?

A

3 (superior, intermediate, inferior)

25
Q

What is the rectal ampulla?

A
  • dilated terminal part of rectum
  • superior to ano-rectal junction
  • a line joining the tops of the anal columns
26
Q

What does the puborectalis part of the levator ani form?

A

-a sling at the anorectal junction and forms the anorectal angle

27
Q

What is the anorectal line?

A

-a line joining the tops of the rectal columns

28
Q

What is the pectinate line?

A

-a line joining the inferior ends of the anal valves

29
Q

What is superior to the pectinate line?

A
  • superior rectal artery
  • internal venous plexus drains superiorly
  • lymphatics drain to internal iliac nodes
  • nerves are visceral
  • pain fibers travel with parasympathetics to S2-3
30
Q

What is inferior to the pectinate line?

A
  • inferior rectal artery
  • internal venous plexus drains into inferior rectal veins
  • lymphatics drain to superficial inguinal lymph nodes
  • nerves are somatic so canal is sensitive to pain, touch, and temperature
31
Q

Pelvic arteries

A

-ovarian a
+from aorta, cross anterior to ureter, over the bifurcation of the common iliac arteries, run in the suspensory ligament

-median sacral a
+from aorta, at bifurcation

-iliolumbar a -> anastomoses with the deep circumflex iliac arteries

-superior rectal a
+from inferior mesenteric

32
Q

What are the veins of the pelvis?

A
  • rectal plexus (internal and external)
  • vesical plexus
  • prostatic plexus (male)
  • uterine plexus (female)
  • vaginal plexus (female)

ALL DRAIN INTO INTERNAL ILIAC VEINS

33
Q

Superior rectal veins empty into what?

A

Inferior mesenteric vein -> portal vein

34
Q

Middle rectal vein empties into what?

A

Internal iliac veins -> IVC

35
Q

Inferior rectal veins drain into what?

A

Internal pudental veins -> internal iliac

36
Q

What may causes hemorrhoids?

A
  • may be related to cirrhosis or high bp
  • internal hemorrhoids are prolapsed rectal mucosa containing veins of the internal rectal plexus -> prolapse into anal canal and strangulate
  • external hemorrhoids are clots in veins of the external rectal venous plexus (fed by branches of the inferior rectal veins) -> usually caused by increased abdominal pressure if straining
37
Q

Where do the prostate and uterus drain into? What does the bladder drain into? What do perineal structures drain into? LYMPHATICS

A
  • Prostate and uterus: internal iliac nodes
  • bladder: external iliac nodes
  • perineal: superficial inguinal nodes
38
Q

What are the branches of the pudental nerve in the male?

A
  • perineal nerve
  • posterior scrotal nerves
  • dorsal nerve of penis
39
Q

Branches of pudental nerve in female.

A
  • dorsal nerve of clitoris
  • deep perineal nerve
  • superficial perineal nerve
  • dorsal nerve of clitoris
  • perineal nerve
40
Q

What are the sympathetics of the pelvis?

A
  • sacral plexus
  • on the pelvic surface of the piriformis muscle
  • lumbosacral trunk (L4-S5)
  • sacral splanchnics -> sympathetics
  • coccygeal plexus
41
Q

Autonomic so and afferents of the pelvis.

A
  • superior hypogastric plexus
  • hypogastric nerves

-inferior hypogastric plexus
+made up of pelvic plexuses (rectal, prostatic, vesical, uterovaginal)

-pelvic splanchnics
+parasympathetics, S2-4

42
Q

What is the inferior part if the vagina innervated by?

A

-somatic branches from internal pudental n

43
Q

What is the middle and superior part so fat evaginations innervate by?

A

-visceral n
+uterovaginal plexus
+sympathetics from lumbar splanchnics
+parasympathetics from S2-4

44
Q

What does the pelvic pain line follow?

A
  • follows the peritoneum
  • pain from viscera above the line follows sympathetics
  • pain from viscera below the line follows parasympathetics
45
Q

How does the peritoneum lie?

A
  • peritoneum lies over pelvic structures so they are not covered on all sides
  • peritoneum forms folds over some structures
  • peritoneum forms fossa or pouches

Anatomy II Exam 2 (7 decks)

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