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ENR Biweekly 1 > Fields- anatomy of male pelvis and perineum > Flashcards

Fields- anatomy of male pelvis and perineum Flashcards

1
Q

3 bones of pelvis

A

pubis
ischium
ilium

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2
Q

covered by the pectineal ligament and crossed by the femoral v, a, n, medial to lateral

A

pectineal line

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3
Q

how nerves and arteries leave the pelvis and enter the perineum

A

greater and lesser sciatic foramen

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4
Q

a full bladder will extend into ____ pelvis

A

false

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5
Q

b/t the iliopectineal line and the pelvic diaphragm

A

true pelvis

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5
Q

prevents organs from spilling out to the feet

A

pelvic diaphragm

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6
Q

posterior boundary of true pelvis

A

sacrum, coccyx, piriformis m.

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7
Q

floor of the true pelvis

A

pelvic diaphragm

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8
Q

anterior boundary of true pelvis

A

pubic bone

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9
Q

lateral boundary of true pelvis

A

obturator internus m

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10
Q

main innervation of the pelvic diaphragm

A

somatic innervation (skeletal muscle)

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11
Q

innervation of coccygeus/ischiococcygeus of pelvic diaphragm

A

S4-S5 (somatic)

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12
Q

innervation of levator ani of pelvic diaphragm

A

S3-S4 (somatic)

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13
Q

supports male pelvic organs and helps prevent urinary and fecal incontinence

A

pelvic diaphragm

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14
Q

strengthened by Kegel exercise to prevent urinary and fecal incontinence

A

Levator Ani

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15
Q

fascia of the obturator internus muscle from which the iliococcygeus m. takes its origin

A

Arcus Tendineous

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16
Q

3 parts of pubococcygeus muscle

A

puboprostate
puborectalis
pubococcygeus

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17
Q

connects to ischial spine

A

coccygeus muscle

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18
Q

The physician’s diagnosis is injury to the nerves supplying the pelvic diaphragm. What are the muscles and their innervation?

A

Levator Ani: S3, S4
Coccygeus: S4, S5

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19
Q

transports sperm from testis to penis

A

vas deferens

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20
Q

Where the duct of the seminal vesicle joins the vas dererens.
It empties into the prostate gland

A

Ejaculatory Duct

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21
Q

passes behind the ureters

A

vas deferens

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22
Q

where sperm is stored until smooth m. contractions force it out

A

ampulla (vas deferens)

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23
Q

will secrete bicarbonate to increase the pH so sperm can still function in acidic environment of vagina

A

prostate gland

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24
Q

bone is white on CT or MRI

A

CT

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25
Q

arrows

A

seminal vesicle

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26
Q

MRI (?)

A

seminal vesicle

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27
Q

secretion from seminal vesicle that causes lubrication of vagina

A

mucoid material

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28
Q

seminal vesicle secretion that provides nutrients for the sperm

A

fructose

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29
Q

seminal vesicle secretion that enhances sperm migration

A

prostaglandins

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30
Q

seminal vesicle secretion that activates sperm motility

A

calcium

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31
Q

seminal vesicle secretion that is fibrinogen-like clotting protein that coagulates semen when acted on by clotting enzyme secreted by the prostate gland. Causes the semen to stick to the
cervical and vaginal wall.

A

Prosemenogelin

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32
Q

what separates median and posterior lobes of prostate gland

A

ejaculatory duct

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33
Q

what separates anterior lobe from median and posterior lobes

A

prostatic urethra

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34
Q

small bump along prostatic urethra

A

verumontanum

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35
Q

opening in verumontanum

A

prostatic utricle

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36
Q

prostate gland secretion that neutralizes the acid in the vagina

A

bicarbonate and phosphate

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37
Q

prostatic gland secretion that acts on prosemenogelin and coagulates semen

A

clotting enzyme

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38
Q

prostate gland secretion that liquifies coagulated semen

A

serine protease

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39
Q

prostate gland secretion that is nutrient for the sperm

A

citrate

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40
Q

prostate gland secretion that prevents premature capacitation and acromosome reaction of the sperm

A

spermine

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41
Q

secretes mucus and acts as a buffer

A

cowper’s gland/bulbourethral gland

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42
Q

most of the composition of semen

A

seminal fluid

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43
Q

pelvic floor fascia; adheres to prostate posteriorly
aka rectovesical septum

A

Denonvillier fascia

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44
Q

b/t rectum and bladder and prostate gland

A

rectovesical septum (Denonvillier fascia)

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45
Q

b/t rectum and bladder in peritoneum

A

rectovesicular pouch

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46
Q

______following a prostectomy.
The rectum bulges into the space vacated
by the prostate gland & bladder.
This prevents proper filling of the bladder.

A

Rectocele

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47
Q

Frequently associated with prostatectomy, which can result in postoperative deficiency of the Denonvillier fascia

A

Rectocele

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48
Q

bilateral drooping of bladder wall

A

saddle bag sign

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49
Q

A deficiency of _____ can lead to posteriolateral drooping of the bladder wall

A

Denonvillier fascia

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50
Q

supplies pelvis and perineum

A

internal iliac a

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51
Q

bottom R arrow

A

vesicular, prostatic, and seminal vesicle a.

52
Q

where does the caudal portion of prostate drain

A

sacral lymph nodes to aortic all the way up

53
Q

where does the lateral portion of prostate drain

A

internal iliac lymph nodes to common iliac to aortic and up

54
Q

where does cranial portion of prostate drain

A

external iliac to common iliac to aortic and up

55
Q

where do the seminal vesicle and vas deferens drain

A

internal iliac to common iliac to aortic and up

56
Q

most common lobe for BPH

A

median

57
Q

restricts prostatic urethra (bladder wont empty properly)

A

BPH

58
Q

most common lobe for prostate cancer

A

posterior

59
Q

bladder won’t empyt well, urine can back up and damage kidneys due to this

A

prostatitis

60
Q

how to treat prostatitis if it doesnt get better on its own

A

antibiotics

61
Q

releases PSA (prostate specific antigen) into blood

A

prostate gland

62
Q

high levels of _____ can be associated with cancer or prostatitis or other things

A

PSA

63
Q

Symptoms:
Infertility (low semen volume).
Hematospermia (blood in the semen).
Pain when urinating or ejaculating.
Pain in the perineum (groin & anal regions), lower abdomen or back.
Rx: antibiotics

A

seminal vesiculitis

64
Q

during this exam, can palpate an enlarged prostate gland or inflamed seminal vesicle

A

digital rectal exam

65
Q

cause bladder obstruction in males that can
manifest along a spectrum of severity, ranging from disease
incompatible with postnatal life to conditions that have such minimal
impact that they may not manifest until later in life.

A

posterior urethral valve (PUV)

66
Q

This involves taking a piece of tissue from the intestinal tract and adding it to the bladder tissue. This has two intended consequences. One is an increase in bladder volume. And the proportion of the bladder that participates in contractions is reduced, resulting in a decrease in bladder pressure during urination.

A

bladder augmentation

67
Q

The appendix is used to connect the umbilicus to the urinary bladder. The appendix blood supply is preserved.

A

Mitrofanoff appendicovesicostomy

68
Q
A

D.

69
Q

pelvic organ mesenteric structures

A

superior bladder
upper 1/2 of rectum

70
Q

mesenteric structures of pelvic organs referred pain by _____

A

sympathetics (L1, L2)

71
Q

retroperitoneal structures of pelvic organs

A

lower 1/2 rectum
anus
bladder
SV
prostate

72
Q

retroperitoneal structures of pelvic organs referred pain by _____

A

pelvic splanchnics (S2-S4)(parasympathetics)

73
Q

The ______ cell bodies are located in the dorsal root ganglion at spinal cord levels of the lateral horns L1 & L2 (sympathetic) and S2-S4 (parasympathetic)

A

GVA

74
Q

lumbar splanchnics (preganglionic) synapse where

A

inferior hypogastric plexus

75
Q

sacral splanchnics (preganglionic) synapse where

A

inferior hypogastric plexus

76
Q

Important with regards to visceral (referred) pain to dermatomes L1 & L2

A

sympathetic lumbar and sacral splanchnic nerves

77
Q

____ nerves travel to pelvic organs from inferior hypogastric plexus

A

postganglionic sympathetic nerves

78
Q

enter pelvic organs where they synapse in enteric ganglia

A

parasympathetics (pelvic splanchnic nerves)

79
Q

Except for the _______., parasympathetics do not synapse in the inferior hypogastric plexus

A

cavernous n.

80
Q
A

C and D

81
Q

area below pelvic diaphragm

A

perineum

82
Q

_____ consists of:
sphincter urethra m. (skeletal muscle)
covered superiorly and inferiorly
by deep fascia of the sphincter urethra m. fascia

A

UG diaphragm

83
Q

basically is what external genitalia is attaching to

A

UG diaphragm

84
Q

urogenital triangle anterior boundary

A

pubic bone

85
Q

urogenital triangle floor boundary

A

skin

86
Q

urogenital triangle roof boundary

A

perineal membrane

87
Q

urogenital triangle posterior wall boundary

A

perineal body

88
Q

urogenital triangle later wall boundary

A

ischiopubic ramus

89
Q

contents of urogenital triangle

A

scrotum
crus of penis
bulb of penis
internal pudendal a branches and pudendal n.

90
Q

anal triangle anterior wall

A

perineal body

91
Q

anal triangle lateral wall

A

obturator internus m

92
Q

anal triangle medial wall

A

levator ani m.

93
Q

anal triangle posterior wall

A

coccyx

94
Q

contents of anal triangle

A

external anal sphincter m
obturator internus m
levator ani m
internal pudendal a branches and pudendal n branches

95
Q

MRI or CT

A

CT

96
Q

UG Diaphragm – sphincter urethra (skeletal muscle) covered superiorly and inferiorly
by deep fascia of the sphincter urethra fascia

A

deep pouch of urogenital triangle

97
Q

provides foundation for external genitalia

A

inferior fascia of UG diaphragm

98
Q

contents of superficial pouch of UG triangle

A

scrotum
shaft (crus and bulb)

99
Q

muscle that covers crus of penis

A

ischiocavernosus m

100
Q

muscle that covers bulb of penis

A

bulbospongiosus m

101
Q

crus of penis aka

A

corpus cavernosum

102
Q

bulb of penis aka

A

corpus spongiosum

103
Q

blood filled structures of penis

A

“corpus”

104
Q

roof of superficial pouch and floor of deep pouch

A

perineal membrane

105
Q

contents of deep pouch of UG triangle

A

membranous urethra
Cowper’s gland (bulbourethral gland)
sphincter urethra m
deep transverse perineal m
deep dorsal a and nerve

106
Q

Prostate gland with _____ urethra

A

prostatic

107
Q

urogenital diaphragm with the ______ urethra

A

membranous

108
Q

corpus spongiosum with the ______ urethra

A

spongy penile

109
Q

deep pouch of UG triangle 2 main components

A

UG diaphragm
bulbourethral glands
(membranous urethra)

110
Q

superficial pouch main contents

A

bulb and crus of penis
(penile/spongy urethra)

111
Q

in male bulbourethral gland is found where

A

deep pouch

112
Q

in females, homologous gland to bulbourethral gland in males is found where

A

superficial pouch

113
Q

______ leaves the pelvis through greater sciatic foramen and enters perineum through lesser sciatic foramen

A

pudendal a. and n.

114
Q

3 branches of internal pudendal a. that supplies male perineum

A

inferior rectal a
perineal a
dorsal a

115
Q

somatic innervation of the perineum

A

pudendal n. (S2-S4)

116
Q

branch of pudendal n. that carries motor to external anal sphincter & sensory to the anal area. In the anal triangle

A

Inferior rectal n

117
Q

branch of pudendal n. that motor to all skeletal muscles of UG triangle & sensory to the posterior scrotum. In the superficial pouch.

A

perineal n.

118
Q

branch of pudendal n. that carries pure sensory to the glans penis.
In the deep pouch.

A

Dorsal n.

119
Q

Painful sitting
Genital pain
Perineal pain
Pain during intercourse.
Erectile dysfunction.
Difficulty achieving orgasm.
Bladder and bowel dysfunction.
Feeling of urgency to use the toilet

A

pudendal n. neuralgia

120
Q

Nerve entrapment between the sacrospinous and sacro-tuberous ligaments. Inflammation of the piriformis or obturator internus

A

possible causes of pudendal n/ neuralgia

121
Q

drainage for testes and epididymis

A

aortic to lumbar and up

122
Q

penis and scrotum drainage

A

superficial or deep inguinal to external iliac to common iliac to aortic and up

123
Q

PREGANGLIONIC SYMPATHETIC
Sacral Splanchnic nerves (L1-L2) innervation to perineum exit the paravertebral ganglia and synapse in the _________

A

inferior hypogastric plexus

124
Q

PREGANGLIONIC PARASYMPATHETIC
Pelvic Splanchnic nerves (S2-S4) travel to the inferior hypogastric plexus where they _______ and travel to the perineum
via the cavernous n.

A

synapse

125
Q

Postganglionic parasympathetics to the perineum. Cell bodies are
in the inferior hypogastric plexus.

A

cavernous n.

126
Q

parasympathetics role of penis

A

excitement and plateau (erection)

127
Q

sympathetics role of penis

A

orgasm (ejaculation)

128
Q
A

C. and D.

ENR Biweekly 1 (11 decks)

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