EXAM 3

Question 1

The cardinal ligament houses which structures?

Answer 1

Uterine artery and vein

Question 2

What is the purpose of the Ovarian Ligament?

Answer 2

Attaches the ovary to the uterus

Question 3

The infundibular/suspensory ligament houses which structures?

Answer 3

Ovarian artery and vein

Question 4

Name the 3 mesothelial layers of the Broad Ligament.

Answer 4

Mesovarium
Mesosalpinx
Mesometrium

Question 5

What is the purpose of the Mesometrium layer?

What is special about this layer’s size?

Answer 5

Double peritoneum that surrounds the uterus.

It is the largest

Question 6

What is the purpose of the Mesosalpinx?

Answer 6

Overlies the fallopian tubes (uterine tubes)

Question 7

What is the purpose of the Mesovarium?

Answer 7

Attaches the ovary to the broad ligament

Question 8

If the pelvic floor fails, which ligament would support the entirety of the uterus?

Answer 8

Cardinal ligament

Question 9

Name the borders of the perineum

Answer 9

Pubic symphysis
Ischial tuberosities
Coccyx

Question 10

Name the external contents of the urogenital triangle in a female.

Answer 10

Vagina

Urethra

Question 11

Name the external contents of the anal triangle.

Answer 11

Anus

Question 12

In the male and female, which two muscles are important for surrounding genital tissue that fills with blood during sexual arousal.

Answer 12

Bulbospongiosum - covers bulb of vestibule

Ischiocavernosum - covers corpus cavernosum

Question 13

The perineal body is the fibrous attachment site for which muscles.

Answer 13

Levator ani
Superficial transverse perineal
External anal sphincter

Question 14

The Deep Perineal Space encapsulates which structure in the pelvis.

Answer 14

Urogenital (UG) Diaphragm

Question 15

The UG Diaphragm is composed of which structures.

Answer 15

External urethral sphincter

Deep transverse perineal muscle

Question 16

The “bowl on a shelf” analogy is referring to the relative layers of which structures in the perineum.

Answer 16

Levator ani (pelvic diaphragm) is the “bowl” that sits within/on the UG Diaphragm “shelf”

UG Diaphragm is superficial to the Pelvic Diaphragm

Question 17

What structures can be found within the Superficial Perineal Space

Answer 17

Mostly fat

Neurovascular bundles

Question 18

Which deep fascia covers the inner layer of the penile shaft

Answer 18

Buck’s Fascia

Question 19

These continuations of fascia surround the penis and scrotum

Answer 19

Scarpa’s Fascia –> Colles Fascia –> Dartos Fascia

Question 20

If the urethra and Buck’s Fascia are compromised/ruptured, what can occur?

Answer 20

Urine will leak/extravasate from urethra into the superficial space of the perineum –> from umbilicus to thigh

Question 21

If the urethra is ruptured but Buck’s Fascia is intact, what can occur?

Answer 21

Urine will extravasate from the ureter and accumulate in the deep space that surrounds the penis

Question 22

In order to anesthetize the skeletal muscle, skin, and sensation of the female perineum, what procedure can be done?

Answer 22

Transvaginal Pudendal Nerve Block

Question 23

Describe the course of the Pudendal Nerve once it leaves the sacrum

Answer 23

From S2-S4 the nerve exits the greater sciatic foramen, travels around the sacrospinous ligament, enters the lesser sciatic foramen and branches to innervate perineum

Question 24

In males, why is a Transperineal Biopsy of the prostate so painful?

Answer 24

Pelvic floor is innervated by highly sensitive autonomic nerves

Question 25

In males, why is a Transrectal Biopsy/Ultrasound of the prostate less painful?

Answer 25

The rectum is innervated by somatic nerves.

Only feels like dull ache, not painful

Question 26

What is the preferred standard of care when you want to ultrasound/biopsy the prostate?

Answer 26

• Transrectal approach

- Provide prophylactic antibiotics (combat fecal matter introduced to prostate tissue)

Question 27

To perform a Pudendal Nerve block, what structure is used as a landmark?

Answer 27

Ischial spine

Question 28

What is the significance of the Ovarian Fossa in surgeries?

Answer 28

The ureter is so often cut or ligated when performing surgeries near the ovary since it is covered by peritoneum

Question 29

Where is the Ovarian Fossa located?

Answer 29

At the bifurcation of the internal and external iliac arteries

Question 30

What is the other surgical risk when suturing near the ovary?

Answer 30

Risk of ligating the ovarian artery –> the ovary will die within minutes