Female and Male genitalia Flashcards
greater pelvis
-includes:
-pelvic brim and
-ilium of the hip bones
lesser pelvis
-true pelvis
-inlet
-pelvic cavity
-obturator internus
pelvis structure: male vs female
-male:
-thicker and heavier
-greater pelvis is deeper
-lesser pelvis is narrow and deep
-pelvic inlet (superior pelvic aperture)- heart shaped
-pelvic outlet (inferior pelvic aperture)- comparatively small
-pubic arch and subpubic angle (degree)- narrow (<70 degrees)
-obturator foramen- round
-acetabulum- large
-female:
-thinner and lighter
-greater pelvis is shallow (child birth)
-lesser pelvis is wide and shallow
-pelvic inlet (superior pelvic aperture)- oval or rounded
-pelvic outlet (inferior pelvic aperture)- comparatively large
-pubic arch and subpubic angle (degree)- wide (>80 degrees)
-obturator foramen- oval
-acetabulum- small
female pouches
-vesico-uterine pouch
-recto-uterine pouch -> rectovesical pouch in males
pelvic floor muscles
-3 walls:
-antero-inferior wall
-lateral walls
-posterior (posterosuperior) walls
-pelvic floor:
-levator ani -> puboprostaticus, pubovaginalis, puborectalis, pubococcygeus, iliococcygeus
-coccygeus
-obturator internus
-piriformis
autonomic nerves of pelvis
-pelvis has 4 roots/routes
-sacral sympathetic trunks- sympathetic
-hypogastric plexuses- sympathetic
-pelvic splanchnic nerves- parasympathetic
-periarterial plexuses- sympathetic
pelvic arteries and veins
-arteries:
-internal iliac arteries: anterior and posterior division
-ovarian arteries- off aorta
-median sacral artery
-superior rectal artery
-veins:
-internal iliac veins
-ovarian veins- feeds back into left renal
-medium sacral vein
-superior rectal vein
-internal vertebral venous plexus
lymphatic drainage of pelvic
-4 primary groups:
-external iliac lymph nodes-
-internal iliac lymph nodes
-sacral lymph nodes
-common iliac lymph nodes
-highly interconnected -> many can be removed without disturbing drainage -> BUT can allow cancer to spread from pelvis and into abdomen
female lymphatic drainage
-lumbar nodes- gonads, common iliac nodes -> ovary, uterine tube, fundus of uterus
-inferior mesenteric- superior rectum, sigmoid, descending, pararectal nodes
-internal iliac- base of bladder, inferior pelvic ureter, anal canal above pectinate line, inferior rectum, middle and upper vagina, cervix, body of uterus
-externa iliac- anterosuperior pelvis -> superior bladder, upper vagina, cervix, lower body of uterus
-superficial inguinal- external genitalia/anus, outer skin, tip of uterus
-deep inguinal- clitoris
-sacral- inferior rectum and vagina
-pararectal- superior rectum
lymphatic drainage of male pelvis
-lumbar- urethra, testis, epididymis
-inferior mesenteric- top of rectum, sigmoid, descending, pararectal
-internal iliac- external and internal iliac lymph nodes
-external- prostatic urethra, prostate, base of bladder, inferior ureter, inferior seminal gland, cavernous bodies, anal canal above pectinate, inferior rectum
-superficial inguinal- perineum, skin of penis, scrotum, anus, anal canal inferior pectinate
-deep inguinal- glans penis, spongy urethra
-sacral- inferior rectum
-pararectal- superior rectum
male pelvis
-ductus (vas) deferens
-seminal glands
-ejaculatory ducts
-prostate
-bulbo-urethral glands- fluid production of mucous like secretion enters through urethra during arousal -> changes pH of urethra for fluid transmission
prostate
-walnut sized gland
-surrounds prostatic portion of urethra
-glandular portion- 2/3
-fibromuscular portion- 1/3
-dense fibrous capsule -> incorporates nerves and veins
-fibrous prostatic sheath
-ligaments that support prostate
-base that lies close to neck of bladder
-apex
-muscular anterior surface
-isthmus- lies anterior to urethra
-urethral sphincter muscle
-divided into right and left lobes
-prostatic ducts- lie on either side of seminal colliculus
-prostate produces fluid with 15-30% of volume being makeup of semen
manual exam of prostate
-for nodules or enlargement (hypertrophy)
-prostate palpated for changes in tissue consistency via rectum
autonomic innervation
-ductus deferens, seminal glands, ejaculatory ducts, and prostate -> richly innervated by sympathetic
-symp- ejaculation/orgasm
-parasympathetic- penile erection
-presynaptic parasympathetic fibers from S2-S4 spinal cord segments traverse pelvic splanchnic nerves which also join inferior hypogastric pelvic plexus
-somatic supply to musculature
female pelvis
-uterus - cervix
-walls of uterus (outer to inner)- perimetrium, myometrium, endometrium (lining)
-fallopian tubes
-ovaries
-vagina
ligament of ovary and round ligament of uterus
-ligament of ovary- attaches uterus posteroinferior to uterotubal junction
-round ligament of uterus- anteroinferiorly to uterotubal junction -> anchors anteriorly
-these ligaments are vestiges that have occurred during descent of ovary into developmental position
broad ligament of uterus and suspensory ligament
-broad ligament of uterus- double layer of peritoneum (mesentery) -> extends from sides of uterus to lateral wall and down to floor of pelvis -> centers uterus
-broad ligament gives lateral support*
-contain ovaries, uterine tubes, vasculature and related structures
-suspensory ligament of ovary- between layers of broad ligament and surrounds ovarian vessels
->conveys ovarian vessels, lymphatic and nerves that goes to ovary
cervix
-narrow inferior portion of uterus which protrudes into vagina and surrounds external os
-fibrous structure
-small amount of smooth and elastin
-uterus goes into cervix via internal os
relationships of the uterus
-peritoneum covers body of fundus of uterus anteriorly and superiorly BUT NOT cervix
-vesicouterine pouch- separates uterine body from urinary bladder (covered by peritoneum)
-no peritoneum between inferior uterus body (isthmus) / cervix and bladder -> direct connection -> cancer can spread
-rectouterine pouch- between uterine body, supravaginal part of cervix and rectum
blood supply to ovaries and uterine tubules
-arterial:
-ovarian arteries
-ascending branches of uterine arteries
-venous:
-pampiniform plexus of veins
-ovarian vein
uterine tubes
-fallopian tubes
-extend lateral from uterine horns
-open into peritoneal cavity near ovaries
-lies in the mesosalpinx of the free edges of the broad ligament
-position of tubes and ovaries is variable during stages of life
-often asymmetric
-4 parts:
-infundibulum- funnel shaped distal end, finger-like process called fimbriae, spread over medial surface of ovary
-ampulla- widest and longest part
-isthmus- thick walled, enters into uterine horn
-uterine- short intramural segment that passes through wall of uterus and opens through uterine ostium into uterine cavity
egg travel
-during follicular release the ovum or egg moves along fallopian tube -> enter into uterus
-fertilization - implantation into uterine wall
ovary
-almond shaped
-located near attachment of broad ligament to the lateral pelvic walls
-suspended from both by peritoneal folds -> mesovarium (posterosuperior aspect of broad ligament) and suspensory ligament of the ovary from the pelvic wall
-the ligament of ovary- attaches ovary to uterus
autonomic innervation of uterus, vagina, ovaries
-descend along the ovarian vessels from ovarian plexus and from uterine plexus
-visceral afferent pain fibers ascend retrogradely with sympathetic fibers of ovarian plexus and lumbar splanchnic nerves to cell bodies in T11-L1 spinal sensory ganglia
-visceral afferent reflex fibers follow parasympathetic fibers retrogradely through uterine and inferior hypogastric plexuses and pelvic splanchnic nerves to cell bodies in S2-S4 spinal sensory ganglia
male and female perineum artery supply
-internal iliac artery gives off -> internal pudendal ->
-internal pudendal -> inferior rectal and perineal
-terminal branch of perineal -> posterior scrotal or labial and artery of bulb of penis or vestibule
-terminal branches of internal pudendal -> deep artery of penis or clitoris and dorsal artery of penis or clitoris
-femoral artery -> external pudendal, superficial, and deep branches