Final Review Flashcards
What type of tissue covers the perimetrium of the uterus?
serosa
What part of the broad L of the uterus does the round L of the uterus pass through?
mesometrium
What are the glands in the female perineum called?
greater vestibular glands: posterior to bulbs of vestibule
lesser vestibular glands: secrete mucus btw external urethral orifice and vaginal orifice
What is the level of the ilioinguinal nerve?
What relevant branch comes from it?
L1
anterior scrotal/labial N
What is the spinal level of genitofemoral N?
What relevant branch comes from it?
L1-L2
genital branch –> to scrotum/labia
What levels make up obturator N?
L2-4
What spinal levels make up the lumbosacral trunk?
L4-5
What spinal levels make up posterior femoral cutaneous N?
What relevant branch arises from it?
S1-3
perineal branch to scrotum/labia
What muscles does the deep perineal n innervate?
deep transverse perineal
superficial transverse perineal
ischiocavernosus
bulbospongeosus
What are the branches of the coccygeal plexus?
anococcygeal N
nerve to levator Ani (S4)
nerve to coccygeus m (S4, 5)
How does pain run in the pelvis?
with parasympathetic pelvic splanchnics –> ventral rami of sacras spinal nerves –> dorsal root and dorsal root ganglion –> synapse in dorsal horn of spinal cord
What is the intermesenteric plexus and what does it form/supply?
mixed S and PS
input from superior mesenteric and aortic plexuses
forms periarterial plexus –> follows gonadal As –> ovarian plexus
feeds S into Inferior mesenteric and superior hypogastric
What is the superior hypogastric plexus and what does it produce/innervate?
ONLY sympathetic
input from lumbar splanchnic Ns
produces ureteric plexus and testicular plexus
sends hypogastric Ns to Inf hypogastric plexus
Where can you see the hypogastric Ns?
Can see it superior and anterior to anterior sacral rami
feeds lateral to medial to inf hypogastric plexus
What parasympathetically innervates the descending and sigmoid colon?
inferior hypogastric plexus
What nerves are only parasympathetic?
cavernous Ns
from uterovaginal plexus or prostatic plexus –> work to produce erections
What are the branches of the prostatic plexus?
cavernous Ns (only PS)
Nerves of the ductus deferens
Nerves of the ejaculatory ducts
Nerves of the seminal vesicles
How do visceral sensory fibers from the uterus, cervix, and vagina travel?
from fundus and body of Uterus: w/ sympathetic fibers of uterovaginal plexus
From cervis and upper vagina: w/ Parasympathetics
What branches of the femoral A are relevant?
superficial and deep external pudendal A –> anterior scrotal/labial A
What is the internal rectal venous plexus?
superior most anastomosis of the superior, middle, and inferior rectal Vs
What is the external rectal venous plexus?
inferior most anastomosis of the superior, middle, and inferior Rectal Vs
What N innervates the external urethral sphincter M?
What muscles are associated w/ it and are also innervated by the same nerve?
dorsal N of clitoris/penis
compressor urethrae m
urethrovaginal sphincter M
What N innervates the external anal sphincter m?
inferior rectal N
What are the small muscles branching from pubococcygeus?
levator prostatae
pubovaginalis
puboperinealis
puboanalis
What nerves innervate the levator ani ms?
n to levator ani M (S4)
inferior rectal N
branches of coccygeal plexus
What nerve innervates coccygeus M?
ner to the coccygeus (S4,5, branches of coccygeal plexus)
What is the interureteric fold?
superior limit of the trigone
What is vesical fascia?
loose connective tissue surrounding the detrusor M
What are the contents of the spermatic cord?
ductus deferens
testicular A
A of ductus deferens
cremasteric A
Pampiniform plexus of veins
genital branch of genitofemoral N
What are mural granulosa cells?
become highly steroidogenic
remain in the ovary after ovulation to differentiate into the corpus luteum
What causes the breakdown of the follicle wall to release an egg during ovulation?
before ovulation, follicle presses against wall of ovary to form bulge = stigma
LH surge –> inflammatory cytokines and hydrolytic enzymes from theca and granulosa cells –> breakwon follicle wall, tunica albuginea, etc
What produces angiogenic factors to increase blood supply to a corpus luteum?
granulosa cells
What happens to thecal cells after follicular atresia?
thecal cells persist and repopulate the cellular stroma of the ovary
have LH receptors and ability to produce androgens
collectively called the interstitial gland of the ovary
What is the diagonal conjugate diameter?
from inferior edge of pubic symphysis to sacral promontory
What structure is often damaged in anterior-posterior crush injuries of the pelvis?
urinary bladder
Where is the pudendal canal located in the ischiorectal fossa?
lateral wall
contains pudenal N and internal pudendal A
What lobes are commonly involved in BPH?
middle lobes (central zone)
Which pelvic floor muscle is likely to tear during childbirth if the perineum tears?
pubococcygeus
What is a good landmark to find the left ureter?
anterior to left common iliac A
What ligaments provide direct support to the uterus?
cardinal ligament
uterosacral ligament
What is the most typical position for the uterus?
anteflexed and anteverted
What is contained in the pubocervical L?
superior vesicle artery and vein
What is contained in the male urogenital diaphragm?
membranous urethra
bulbourethral glands
deep transverse perineal m
external urethral sphincter
What is contained in the female urogenital diaphragm?
deep tranverse perineal m
external urethral sphincter m
compressor urethrae m
sphincter urethrovaginalis m
bulb of the vestibule
greater vestibular glands
What secretes estradiol in the developing follicle?
theca interna
How many days after ovulation does the corpus albicans begin to form?
14
What are the 3 layers from out to in that the sperm needs to get through to get to the oocyte?
corona radiata
zona pellucida
plasma membrane
What are the 3 steps of capacitation?
- uterine and fallopian tubes wash away inhibitory factors from sperm
- membrane becomes permeable to Ca –> tail more powerful and ready to release stuff
- activated sperm
When do sperm express ZP-3 receptors?
only after capacitation
What are the 3 glycoproteins in the zona pellucida and what do they do?
ZP-1 = crosslinker
ZP-2 = blocks polyspermy
ZP-3 = initiates acrosome rxn (then falls off)
What occurs to sperm immediately after it enters the egg?
nucleoli merge and sperm DNA condenses
What are the steps of the cortical Rxn
- ZP-2 –> ZPf –> inhibits entrance of sperm
- ca released –> granules also released and egg completes meiosis II
- Egg activated - sperm DNA condenses, male and femal pronuclei fuse
What are the autocrine growth factor functions of hCG?
stimulates trophoblast growth and development
stimulates placental growth
What cells can secrete prolactin?
decidual cells
What are the most high risk strains of HPV?
16 and 18
