female pelvic anatomy Flashcards
spinal block inserted into
sub-arachnoid space T5/6
spinal block used when
c section
epidural administered where
below cauda equina, epidural space
does pudendal nerve block affect lower limbs
no
pudendal nerve affects
perineum, external anal sphincter
anaestthetic injected into labia majora deadens which nerve
pudendal
asis is vertically aligned with…
pubic symphysis
inguinal lig runs between
asis and pubic tubercle
what blood vessels run alongside pudendal nerve and what does it wrap around
internal pudendal artery and vein
sacrospinous ligamen
what does blood supply to pelvis come from, what does it split into
common iliac artery
internal and external iliac artery
external iliac artery becomes
femoral artery
what branches of internal iliac artery leave the pelvis (4)
gluteal x 2
obturator
internal pudendal
what 3 major branches of internal iliac stay within the female pelvis
superior vesicular (top of bladder)
uterine artery
middle rectal
superior vesicle artery supplies and is abranch of
top of bladder
umbilical artery
vaginal artery is a branch of
uterine artery
sacroiliac joint fracture which artery in danger
superior gluteal
A superior gluteal
B obturator
what muscle does the sacral plexus overlie
piriformis
which muscle overlies obturator foramen
obturator internus
which muscle is the sling muscle which has to relax for defaecation
puborectalis
what are the 3 muscles of the levator ani
pubococcygeus
iliococcygeus
puborectalis
what is perineum
area below the pelvic floor
what sits just below the perineal membrane
erectile tissues
what is a cyst at the back of the vulva
Bartholin cyst
in female, bulbospongiosus covers
crural bulb
in female ischiocavernosus covers
crura
what is the perineal body
tough fibrous tissue that a lot of the perineal muscles anchor into
what sort of nerve is the pudendal
somatic
ovarian artery is a branch of
abdominal aorta
what other vessel is at risk in hysterectomy
ureter
what vessel does ureter travel under
uterine arteru
what is fundus of the uterus
top
how do you access pouch of douglas for sampling
posterior fornix of vagina
gubbernaculum in females becomes
round lig and ovarian liga
what are these and how does it happen
cystocele
recotocele
bladder or rectum collapse into vagina
what is somatic vs visceral nerves
somatic mostly responds to outside stimuli
visceral mostly respond to internal stimuli
uterus intra or extraperitoneal
intra
top of uterus, where does the pain travel
lower T upper L
what sort of med is epidural
analgesic, not total nerve block
open book fracture, SI joint and pubic symphyssis
borders of pelvic inlet
Sacral promontory and ala (posterior border)
- Lines terminals (a combination of the arcuate line on inner surface of ilium and pectineal line on superior pubic ramus) (lateral border)
- Pubic symphysis (anterior border)
borders of pelvic outlet
Tip of the coccyx (posterior border)
- Ischial tuberosities (lateral border)
- Inferior border of the sacrotuberous ligament (posterolateral border)
- Pubic arch (anterior border)
iliac crest which spinal level
L4
anterior branch of internal iliac which branches
Obturator
Middle rectal
Superior vesicular
Uterine
Inferior vesicular/vaginal
Inferior gluteal
Pudendal
Often my sexy underwear is inside pants
posterior branch internal iliac artery which branches
Superior gluteal
Lateral sacral
Ilioilumbar
The rectum receives blood supply from three separate arteries. What are they
What bony landmark can be used to locate the pudendal nerve?
ischial spine
A: coccygeus
B: Iliococcygeus
C: Pubococcygeus
D: Punorectalis
E: tendinous arch of levator ani
F: obturator internus
How is the normal position of the uterus usually described?
anteverted and anteflexed
what does retroverted uterus specifially mean
not anteverted therefore in line with vagina. (doesn’ have to be backwards of vagina)
what does water under a bridge refer to
uterine artery passes over ureter
prolapse with uriniary problem is probably
cystocele
1) pampinoform (test.venous) plexus
2 vas deferens
3. test artery
4. head of epidydimus
5. tunica albigunea
6.tunica vaginalis
what is tunic albigunea
layer encapsulating semi-neferous tubules and interstitium
what and where (normally) and why is bag of worms (disgusting)
varicocele, left testicle, drains into l renal artery so more likely to block than rhs which drains into IVC
varicocele is associated with malignancy of which organ. which cancer?
kidney, renal cell carcinoma
absent cremaster reflex, what condition, what nerve
testicular torsion, GF nerve
how many urethral sphincters in men
2
how many urethral sphincters in women
2
where is internal urethral sphincter in men
membranous portion
transurethral resection of the prostate. One complication of TURP is retrograde ejaculation. Presence of this complication is most likely to represent damage to which structure?
IUS
what is cut in vasectomy
vas deferens
upper anal canal, what epithelium
columnar
upper anal canal lymphatic drainage
iliac nodes
lower anal canal lymphatic drainage
superficial iliac nodes
perineal membrane lies between
superficial and deep perineal pouches
Atherosclerosis of which artery is most likely to cause erectile dysfunction?
internal iliac -> internal pudendal
what is herniated sac containing both CSF and nerves and parts of the spinal cord
myelominingocele
what is myelominingocele
herniated sac containing both CSF and nerves and parts of the spinal cord
what is meningocele
sac containing CSF and meninges only
Mildest and most common form of spina bifida in which one or more vertebrae have malformed. It rarely causes serious sequelae. Can present with a small tuft of hair or dimple or birth mar
spina bifida occulta
what is Encephalocoele
is the herniation of meninges and brain tissue outside the cranium usually, but not always, in the midline
What is the name given to dilation of the cerebral ventricles? (pathology)
hydrocephalus
two main areas difficulties pointing towards autism diagnosis
Difficulties in social communication
- Restrictive and repetitive behaviours
tx of hypoxic ischaemic encephalopathy
cool the baby to 34 degrees
