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ENDO/REPRO-1 Exam Two > Exam Two - high yield for Funk's Anatomy > Flashcards

Exam Two - high yield for Funk's Anatomy Flashcards

1
Q

Relaxin (hormone)

A

Produced by the placenta, acts on the pubic symphysis and SI joints (increases pelvic dimensions for parturition)

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2
Q

Differences b/w male and female pelvis:

A

Males: Thick and heavy, deep greater pelvis, narrow and deep lesser pelvis, heart shaped (robust sacral promontory) and narrow pelvic inlet, smaller pelvic outlet, pubic arch and subpubic angle narrow (80 degrees)

Females: developed for parturition

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3
Q

Obstetric (true) conjugate (dimensions/measurement)

A

Sacral promontory to the midpoint of the pubic symphysis (shortest fixed distance of the pelvic inlet)… “measurement of hindrance of vaginal delivery”

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4
Q

Diagonal conjugate (dimensions/measurement)

A

sacral promontory to inferior margin of symphysis

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5
Q

Anatomical conjugate (dimensions/measurement)

A

From sacral promontory to the top of the pubic symphysis (lower portion of pubic symphysis)

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6
Q

The tendinous arch of levator ani thickens _________ and serves as an attachment site for __________.

A

posteriorly

pelvic diaphragm

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7
Q

Muscles of the pelvic diaphragm

A

1) coccygeus (posteriorly)
2) levator ani (anteriorly)
a. puborectalis
b. pubococcygeus
c. iliococcygeus

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8
Q

What muscles reinforce the central opening of the levator ani (different in males/females)

A

Puboprostaticus in males

Pubovaginalis in females

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9
Q

All the reproductive viscera in the male is considered __________.

A

Subperitoneal

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10
Q

Clinical correlation with rectovesical pouch?

A

Fluid pools here (the rectovesical pouch/fossa is the lowest point of the abdominal peritoneal cavity in the male) (can develop rectovesical abscess here)

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11
Q

What is another name for the recto-uterine pouch?

A

Pouch of Douglas (this is where peritoneal fluid pools in females; it is also where ectopic pregnancies develop/implant most frequently)

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12
Q

All of the muscles in the pelvis are covered by ________ fascia.

A

Membranous (including piriformis)

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13
Q

What is the thickening around the levator ani hiatus called?

A

The tendinous arch of pelvic fascia (don’t get this confused with the tendinous arch of levator ani; both are membranous fascia, but their locations differ)

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14
Q

The tendinous arch of the pelvic fascia creates a ________.

A

Sling

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15
Q

What structure in the female pelvis conveys the uterine vessels?

A

Cardinal ligament (aka transverse cervical ligament) …. a thickening of the endopelvic fascia

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16
Q

Where does the common iliac arteries branch to form the external and internal iliac arteries?

A

Level of LV5/SV1

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17
Q

Main complication of SI joint dislocation?

A

Disruption/laceration of internal iliac artery

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18
Q

Three branches of posterior division of the internal iliac artery? (3)

A

1) Iliolumbar artery (supplies lumbar aa. to lumbar vertebrae and cauda equina)
2) Lateral sacral arteries (usually two)
3) Superior gluteal artery (exits pelvis through greater sciatic foramen, usually superior to piriformis m.)

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19
Q

Anterior divison branches in females? (7)

A

1) Umbilical artery (remains patent post-natally; provides superior vesicle arteries; becomes occluded to form the medial umbilical ligament)
2) Obturator artery (courses along lateral wall and passes through obturator canal to medial thigh)
3) Uterine artery (“very large”, courses thru to the cervix, just superior to the ureter “directly above”; supplies female reproductive viscera)
4) Vaginal artery (course to the vagina inferior to the ureter)
5) Middle rectal a.
6) Inferior gluteal a.
7) Internal pudendal artery (major artery to the perineum; last branch of internal iliac artery; reenters perineum through lesser sciatic foramen)

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20
Q

Anterior division branches in males?

A

1) Superior gluteal artery
2) Umbilical artery (gives rise to the artery of the ductus deferens)
3) Obturator artery (exits to the lower limb)
4) Inferior vesicle artery (“very large, usually always there”; course forward to the prostate, urinary bladder, and all of the internal reproductive viscera; takes place of uterine and vaginal artery of females)
5) Middle rectal artery
6) Inferior gluteal artery
7) Internal pudendal artery

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21
Q

The iliolumbar artery forms anastomoses with:

A

1) lower lumbar aa. (from abd aorta)

2) deep circumflex a. (branch of ext iliac a.)

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22
Q

Rectal anastomosis?

A

Middle and inferior rectal ateries anastomose with the superior rectal artery

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23
Q

The prostatic venous plexus connects directly into _________ venous plexus. Why is this important?

A

Baston’s; hematogenous spread of CA into Baston’s venous plexus, into vertebrae or CNS (no bueno)

24
Q

Portal-caval anastomosis within pelvis?

A

…

25
Q

What nerve provides motor and sensation to the perineum?

A

Pudendal nerve (S2/3/4)… it is “the nerve of the perineum… somatic”

26
Q

Camper’s fascia in males becomes ________.

A

Mostly smooth muscle, called Dartos fascia

27
Q

What is the membranous fascia found in the urogential triangle?

A

Colles fascia (perineal fascia)

28
Q

In the male, Colles, Dartos and Scarpa’s fascia all blend together superficially in the perineum to make the __________.

A

superficial fascia

29
Q

***The perineal membrane separates the _________ from the ________.

A

***deep space from the superficial space

30
Q

The deep space of the perineum sits between the _______ and ________.

A

superior fascia and the perineal membrane

31
Q

What courses through the pudendal canal (Alcock’s)?

A

The pudendal nerve, perineal nerve, and the internal pudendal artery and vein.

32
Q

Branches of the internal pudendal artery:

A

1) Inferior rectal artery
2) Perineal artery (major artery of superficial space, ends in posterior scrotal/labia arteries)
3) Artery of the bulb in males, artery of the bulb of the vestibule in females
4) Dorsal and deep arteries of the penis

33
Q

The internal pudendal artery runs thru the _______.

A

forward thru the deep space

34
Q

What are the three major branches of the pudendal nerve?

A

1) Inferior rectal (anal) nerve (provides external anal sphincter with motor innervation)
2) Perineal nerves (provides superficial and deep branches going to each space; provides all motor innervation to the UG triangle, some sensory info)
3) Dorsal nerve of the penis/clitoris (purely sensory, courses forward through the deep space to the sex organs)

35
Q

What is commonly used in medical forensics?

A

The different types of pelvic girdles (shape of pelvic inlet can reveal gender and ethnicity)

36
Q

Anterior portion of SI joint (between auricular surfaces) is _________

A

synovial (not smooth… they are ridged for stability and strength)

37
Q

Posterior portion (between tuberosities) of SI joint is a _________

A

syndesmosis

38
Q

Oblique conjugate

A

SI articulation to iliopectineal eminence

39
Q

The uterine artery forms anastomoses with:

A

the ovarian a. (arises from abd aorta, below the renal aa., courses through the suspensory ligament of the ovary)

40
Q

The artery of the ductus deferens forms anastomoses with:

A

the testicular a. (arises from abd aorta, below the renal aa., courses through the deep inguinal ring and within the spermatic cord)

41
Q

The middle rectal (and inferior rectal) arteries form anastomoses with:

A

the superior rectal a. (arises from inferior mesentery a. (provides branches to rectum)

42
Q

The inferior gluteal artery forms anastomoses with:

A

the deep femoral aa. (medial circumflex femoral branches, participates in cruciate anastomosis)

43
Q

The lateral sacral artery forms anastomoses with:

A

the median sacral artery (from abd aorta, just prior to its bifurcation)

44
Q

Smooth muscle layer of Darto’s fascia is derived from ______ fascia

A

Camper’s

45
Q

In the female, _______ fascia forms the bulk of the labia majora (skin fold) and mons pubis

A

Camper’s

46
Q

Describe the perineal body in both males and females

A

It is a connective tissue structure that lies “dead center” in the perineum, directly posterior to the vagina, provides the site of attachment for muscles of the perineum, erectile tissue, and structural support… this can be torn during vaginal deliver (can cause prolapse of pelvic/perineal structures)

Perineal body is referred to as the central tendinous point in males (same structure, same function, just doesn’t tear as often)

47
Q

What vertebral level does the rectum begin?

A

About SV3 (rectosigmoid junction)

48
Q

Two main ligaments of the bladder (+ function)?

A

1) Puboprostatic ligament (attaches neck to pubic bone)
2) Lateral ligament of bladder (thickening of endopelvic fascia)

***In females, these two structures also support the uterus

49
Q

Three sites of ureteral obstruction from calculus:

A

1) Renal pelvis/ureteric junction
2) Passage over pelvic brim
3) Entry into urinary bladder

50
Q

What is the male homologue of the uterus?

A

Prostatic utricle

51
Q

Boundaries of the anal triangle?

A

Ischial tuberosity to ischial tuberosity (posterior triangle to coccyx)

52
Q

Boundaries of the ischioanal fossa?

A

Posterior = sacrotuberous ligament, gluteus maximus
Anterior = posterior border of UG diaphragm
Lateral = obturator internus
Medial = external anal sphincter and anal canal
Medial superior = levator ani

53
Q

What structure in females is a homologue to the prostate?

A

Skene’s glands

54
Q

What is an episiotomy?

A

An incision of the perineum (through the posterior wall of vagina) during delivery in order to prevent tearing

55
Q

Structures cut with a midline episiotomy incision:

A 
Perineal body
Bulbospongiosus
Superficial transverse perineal
External anal sphinter (spared with mediolateral incision)
Deep transverse perineal
Urethrovaginalis 
Levator ani

ENDO/REPRO-1 Exam Two (5 decks)

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