Exam 2: Lecture 11 and 12 Flashcards
What are the bones of the pelvis?
Pelvic bones (2), Sacrum, Coccyx
What 3 fused bones make up the pelvis?
Ilium, Ischium, Pubis
What is the role of the acetabulum of the pelvic bone?
Cup-shaped depression on the lateral surface is the acetabulum – attachment site for femur bone
What is the pubic symphysis?
fibrous joint of where 2 pelvic bones meet anteriorly
What is the role of the ischial spine?
separates the Lesser and great sciatic notch
What part of the pelvic bone do we sit on?
Pubic Tuberosisty
What is the obturator foramen?
Closed off by membrane, and obturator nerve and veins pass through to innervate and supply medial thigh
What nerve innervated the anterior thigh?
femur nerve
What surrounds the obturator foramen?
pubic rami
What is the purpose of the pubic tubercle?
bump on pubis that is the attachment of the inguinal ligament
What parts of the pelvic bones are on the same plane?
The pelvis is tilted anteriorly so that the ASIS and pubic tubercles are in the same vertical plane
What connects the bones of the pelvis with each other?
Anteriorly, they are connected at the pubic symphysis by dense fibrocartilage
What is the role of the pubic tubercle?
bump on pubis that is the attachment of the inguinal ligament
What is the sacro-iliac joint?
where two pelvic bones are connected to the sacrum
What is the role of the ischial spine?
separates the Lesser and great sciatic notch
What is the gender differenced of the pubis?
Men have smaller pubic angle, and women have larger/circular pelvic inlet
What is the role of the inguinal ligament?
Thickening of the external oblique of the abdominal canal that Connects anterior superior iliac spine (ASIS) to the pubic tubercle
What is the pubic angle?
The angle formed by the two pubic bones (pubic arch) anteriorly is the pubic angle
What is the role of the pelvic inlet?
Separates true and false pelvis; true pelvic cavity and abdomen (above is false of the abdominal region and below inlet is true)
What is the role of the pubic rami?
superior and ischial (inferior) ramus surround the obturator foramen
What does the pubic brim separate?
the pelvic inlet
What is the linea terminalis of the pelvis?
ridges on the pelvis
What part of the pelvis is the false/greater pelvis?
above the pelvic inlet, surrounded by wings of the ilium
What is contained in the false pelvis?
Contains digestive organs and is Part of abdominal cavity
What part of the pelvis is the true/lesser pelvis?
below the pelvic inlet and has pelvic outlet and Part of pelvic cavity
What is the role of the pelvic floor muscles?
to keep organs of the pelvis from falling out
How is the pelvic inlet formed?
imaginary plane formed by bony ridges
What is the role of the sacrospinous and sacrotuberous ligaments?
Stabilize pelvic bones/sacrum and prevent upward displacement, and Convert the greater and lesser sciatic notches into foramina (opening)
What is the role of the obturator internus muscles?
Deep gluteal muscle that border pelvis and attaches to femus to move the femur
What is the piriformis muscle?
Deep gluteal muscle that originates on sacrum and move out into pelvic cavity through the lesser sciatic notch to attach to the femur
Where is the point of attachment?
attaches to sacral tuberosity
What is the passageway of the sacrospinous ligament?
crosses sacrotuberous ligament in T-shape and runs from sacrum to the ischial spine
What muscles composed the pelvic floor muscles?
Composed of pelvic diaphragm muscles (levator ani - larger and coccygeal muscle - smaller and in the back)
What is the levator ani muscles?
Sling-like muscle with multiple parts (Kegels)
Extends from coccyx (as anococcygeal ligament) to the pubic bone -Has anal aperture for anal canal and anterior opening (urogenital hiatus) for opening of urethra (+/- vagina)
What is the urogenital hiatus located?
opening for urethra
What is the function of the pelvic diaphragm?
Supports pelvic organs and sphincters of passing through organs and Rectal flexion
What is the post posterior aspect of the pelvis?
rectum
What 2 spinchters control the anal canal?
Internal anal sphincter (smooth muscle, controlled by ANS involuntary) and external anal sphincter (skeletal muscle, controlled by Somatic Volunatry - pudendial nerve)
What nerve controlls the external anal spinchter?
pudendial nerve
What sympathetics control the anal canal below the pectinate muscle?
somatic control from pudendal nerve
What is the portal-caval anastomoses?
one part of anal canal is drained by portal vein and the other goes straight to IVC
What is the blood supply above the pectinate line?
lymphatics goes above internal and below external
What is the blood supply below the pectinate line?
get its supply from middle and inferior rectal anal artery
What is the blood supply to the rectum?
superior rectal artery from the IMA
What is the most anterior structure in the pelvis?
urinary bladder
What is the median umbilical ligament?
fetal remnant between the bladder and ureter that has no real function, but when its not closed off at birth, the baby can leak urine from its belly button
What is the path of the testes?
gonads (develop from abdomen and descend down) sit within the scrotum and produce sperm cells that travel through the epididymis within the scrotum back into the pelvic cavity into ductus defrens which connects spermatic cord to the urethra
What are the capsule layers covers the testes?
covered by capsule (tunica albuginea) and anterior sac of peritoneum (tunica vaginalis) within scrotum
Where is sperm produced?
Seminiferous tubules
Where is sperm mobilized?
epididymis
How is the inguinal canal formed?
Testes pass through abdominal canal, grabbing all the layers of the anterior abdominal wall, forming the inguinal canal
What is the role of the venous plexus in the male reproductive tract?
to drain the testes
Where does the testicular artery drain?
drain into IVC into the right, and into the Left Renal vein on the left
What nerve controls the cremaster muscle?
Gentinofemoral nerve
How does the vas defrens enter the pelvic cavity?
via the inguinal canal
What parts of the male reproductive tract contribute to fluid secretion for ejaculation?
ejaculatory ducts, cowper’s glands and the prostate
What is the path of the ejaculatory ducts?
Ejaculatory ducts pass through the prostate to join the prostatic urethra
Where is the Cowper’s glands located?
Bulbourethral glands (Cowper’s glands) is located underneath prostate in deep perineal pouch and secrete lubricant and pre-ejaculate into penile urethra
What is the vital role of the internal urethra spincter?
internal spinchter is under ANS control and constricts during urination so ejaculation doesn’t happen at the same time (sperm doesn’t enter the bladder and urine in the ejaculator duct
How is the ovary attached to the uterus?
ovarian ligament
How is the FT connected to the uterus?
isthmus
Where does fertilization occur in females?
the ampulla
What is the path of the egg?
fimbria sweep egg into infundibulum and down into the ampulla where fertilization occurs, and once the egg is fertilized, it travels into the isthmus and will implant into the uterus
What is the function of the round ligament?
connects uterus to labia major
What is the round ligament embryological equivalent to in males?
embryologically equivalent to the scrotum
What are the 3 parts of the uterus?
Fundus, body, cervix
What lines the uterine wall?
Endometrium - inner lining
Myometrium - thick smooth muscle layer
Perimetrium - serous membrane covering (peritoneum)
What happens to the myometrium during labor and mensuration?
contracts during mensuration and child birth
What composes the inferior portion of the cervix?
internal and external os, and the cervical canal
What happens to the cervix, and internal and external os during child birth?
During birth, the cervix dilates and thins so that the internal and external os become one (effacement) during child birth
What os can be visualized through a speculum exam?
external os
What is the internal vagina opening?
vaginal vault
What is the external opening of the vaginal canal?
It opens externally as the introitus posterior to the urethral opening
How is the vaginal fornix formed?
a recess formed at the junction of the cervix and vaginal canal
What are the 2 pouches in females?
Rectouterine pouch of Douglas (rectovesical pouch in men) and vesicouterine pouch
What uterine layer is the mesometrium the same as?
the perimetrium
What does the broad ligament cover?
fold of peritoneum runs from lateral pelvic walls over uterus (mesometrium), fallopian tubes (mesosalpinx), and ovaries (mesovarium)
What are the ligaments of the peritoneum?
Suspensory ligament of the ovary (contains ovarian blood vessels), and the Ovarian ligament
What is contained in the cardinal transverse cervical ligament?
uterine artery and vein (different layer of fascia that connects cervix to lateral pelvic wall)
What is the visceral innervation of the pelvis?
pelvic plexuses (inferior hypogastric plexus and subplexuses) which carry sympathetic and parasympathetic (S2-4: pelvic splanchnic) innervation as well as afferent fibers
What does the superior gluteal artery supply?
gluteal region
What does the iliolumbar and lateral sacral artery supply?
back wall of posterior trunk
Where is the medial umbilical ligament from?
bladder
What does the umbilical artery in adults branch into?
gives branch called superior vesicular artery to the bladder and will continues as remnant into the umbilicus ligament and form the medial ligaments
What is the blood supply to the bladder?
superior vesicular artery
What is the blood supply to the rectum?
Middle rectal artery (along with branches from IMA and internal pudendal artery)
What does the inferior vesicular artery supply?
bladder, seminal vesicles and prostates
What is the female equivalent of the inferior vesicular artery?
vaginal artery
What does the obturator artery supply?
inner thigh
What does the internal pudendeal artery supply?
perineum
What does the inferior gluetal artery supply?
gluteal region
What does the ovarian artery supply?
uterus (and other structures); gets tons of blood supply when pregnant
What is the path or the testicular artery?
from the abdominal aorta, it travels in the inguinal canal in the spermatic cord
What is the path or the ovarian artery?
from the abdominal aorta, it travels with the suspensory ligament of the ovary
Where does the left gonadal vein drain into?
left renal vein
Where does the right gonadal vein drain into?
IVC
What is the exception to the lymphatic drainage in the pelvis?
external iliac nodes because there isn’t an external iliac artery.
What are the lymph nodes o the perineum?
Superficial and deep inguinal, Internal and external iliiac, Abdominal, and gonadal nodes
What are the 2 triangles that form the diamond shape region of the perineum?
Urogenital triangle (horizontal) Anal triangle (posterior on oblique plane)
What is the border to the perineum?
Pubic symphysis anteriorly, Coccyx posteriorly, Ischial tuberosities laterally
What is the urogenital triangle an opening for?
opening for urinary and reproductive systems
What is the anal triangle an opening for?
opening for GI system
How is the ischio-fossa and recesses formed?
Because the pelvic diaphragm is curved over the pelvic outlet, but the perineal membrane and ligaments run across at straight planes, the ischio-anal fossae and recesses are formed
What filled the ischio-fossa and recess?
normally filled with fat but infections can form there (space between pelvic diaphragm and angle)
What is the function of the perineal body?
Connective tissue (thickening of perineal membrane) which serves as important attachment point for muscles in the pelvic floor and perineum
Where is the perineal body located?
Between perineal membrane and external anal sphincter
What is the perineal membrane?
Thick connective tissue attached to ischiopubic rami
that Erectile tissue anchor to and Has opening for urethra (and vagina)
What does the perineal membrane separate?
perineal membrane separates the deep and superficial perineal pouches
What surrounds the anal opening?
fat of the ischio-anal fossa
What components comprise the erectile tissues?
Corpora cavernosa, and Corpus spongiosum
What is the corpus spongiosum?
bulb of penis where urethra passes through
What is the corpus cavernosum?
double column that composes the shaft
How is an erection formed?
when parasympathetic signals dilate specific vessels to allow corpura cavernosa to fill with blood
What are the components of the clitoris?
Glans which is opens in the perineum, Body (superiorly), and Crus and bulbs
Where are the bartholin’s glands located?
glands on posterior-lateral side of vaginal opening
What does the Bartholin glands do?
Secrete lubrication (homologous to bulbourethral glands in men)
Where is the ischiocarvenosus pouch muscle located?
Run over crus of erectile tissue near pubic rami
What is the function of the ischiocavernosus pouch muscle?
help direct blood into erectile tissue
Where the bulbospongiosus pouch muscle located?
women - From perineal body around vaginal opening and clitoris
men - bulb of the penis in men
What is the role of the bulbospongiosus pouch muscles?
blood flow direction and responsible for pulsatile ejaculation in men and clearing urine from urethra after urination
What is the role of the superficial transverse perineal pouch muscle?
On posterior side of perineal membrane; support perineal body
What is the pathway of the female urethra?
The urethra extends from the base of the bladder (internal spinchter) to the external opening passing through pelvic floor
What is the role of the female urethra?
urinary function only
What are the 4 components comprising the male urethra?
pre-prostatic and prostatic, membraneous, and penile
What is the difference between the pre-prostatic and prostatic components of the male urethra?
Pre-prostatic – has internal urethral sphincter which is smooth muscle
Prostatic – passes through the prostate, entrance of reproductive system
What is the difference between the membraneous and spongy components of the male urethra?
Membranous – contains external urethral sphincter: skeletal muscle voluntary control
Penile (spongy) – travels through spongy tissue of the penis, enlarges at the tip and ends at the external urethral orifice (meatus)
How is urination controlled?
The bladder is innervated by sensory nerves that sense stretch
The bladder wall contains a layer of detrusor muscle which is activated by the parasympathetic nervous system to contract and expel urine
What is the sympathetic control of urination?
it inhibits urination by relaxing the detrusor muscle and contracting the internal sphincter
What is the vulva?
external female genitalia
What does the labia majora form anteriorly?
surrounds labia minora and forms mons pubis anteriorly
How are the labias separated posteriorly?
posteriorly labia are separated by posterior commissure (over the perineal body)
What is the labia minora?
tissue fold forming frenulum and hood (prepuce) of the clitoris anteriorly
Where is the body of the clitoris found?
under the prepuce
What covers the vestibule?
hymen
What is the hymen?
embryological remnant from vestibula tissue coming together during development) and urethra (anterior to vagina)
What is the moris pubis?
fatty tissue layer on top of vagina
What is the introdus and vestibule?
opening to the vagina
What is the raphe?
has midline embryonic fusion of the scrotum from anus to penis
What are the parts of the penis?
Root - attachment to perineal membrane: crura and bulb
Body – shaft
Glans, and External urethral orifice for opening of urethra
What is prepuce?
foreskin that covers the glands of the penis
What is the colle’s fascia?
the continuum of the scarpa’s fascia (in the perineum) that terminates the the fascia lata of the thigh but does not continue into the anal triangle
What is the dartos fascia?
Smooth muscle rich area covering scrotum/labia majora – wrinkling of scrotum
What is the role of the dartos fascia?
small layer for thermoregulation of male genitlia
What fascia is in the Urogential triangle?
scarpas and campers fascia
What is the course of the pudendal nerve?
exits pelvic cavity through the greater sciatic foramen and reenters through the lesser sciatic foramen
What is the parasympathetic innervation of the urogenital triangle?
cavernour nerves dilates to disallow blood form leaving leading to erection
What is the lymphatics of the external pudendal artery?
supplies skin over the perineum, and is a branch of the femoral artery from the common iliac
Where do the gondal nerves drain into?
up to the abdominal cavity to the nodes around the abdominal aorta
What are the external anatomies of females?
mons pubis, urethral and vaginal openings, labia majora and minora, clitoris
What are the external anatomies of males?
scrotum, raphe, penile shaft and glans, external urethral meatus
