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Repro Final Exam > GA-Pelvic Viscera I and II > Flashcards

GA-Pelvic Viscera I and II Flashcards

1
Q

what are the boundaries of the male peritoneum? what does it cover?

A

pelvic peritoneum ends at superior bladder and has several deeper puches

covers bladder, ureters, ductus deferesne, and superior end of seminal gland, up the rectum and sigmoid colon

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2
Q

what is the most inferior point in male anatomy? what does it separate?

A

the rectovesicular pouch

rectum and bladder

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3
Q

what is the endopelvic fascia? what is it made up of?

A

a lining beneath the peritoneum that covers the pelvic organs, pelvic wall, and pelvic floor

continuations of transversalis fascia and ligaments/other thickened fascia?

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4
Q

what are ligaments that make up the endopelvic fascia?

A 
tendinous arch of levator ani
puboprostatic ligament (male)
pubovesicular ligament (female)
lateral ligament of bladder
cardinal ligament (females) 
paracolpium
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5
Q

what is the paracolpium?

A

thickened fascia from the vagina to the tendinous arch

helps support

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6
Q

what are the potential spaces/pouches in the male pelvic region?

A

retrovesicular space (lowest)
paravesicular fossa
retrorectal space
retropubic space (puboprostatic ligament)

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7
Q

which space contains the puboprostatic/pubovesicular ligaments?

A

retropubic space

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8
Q

what are the relationships of the vas deferens?

A

enters the abdominal cavity via deep inguinal ring –> passes superior to literally every structure (emphasis on ureter) –> expands into an ampulla at the posterior bladder –> thins out and goes under bladder medial to seminal vesicle

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9
Q

where are the seminal vesicles located?

A

posterior bladder lateral to where the vas deferens enters

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10
Q

what two structures join together to form the ejaculatory duct?

A

vas deferens . and seminal vesicles

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11
Q

where is the prostate located?

A

inferior to bladder, surrounds prostatic urethra, superior to bulbourethral gland

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12
Q

what nerves innervate the male pelvic organs? testes?

A

sympathetic T10-L2

parasympathetic S2-S4 pelvic splanchnic

visceral afferent with parasympahtetic

testes with sympathetic (T10)

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13
Q

what male organs drain into the internal iliac nodes? 4

A

vas deferens
seminal vesicle
prostate
fundus and neck of bladder

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14
Q

what male organs drain into the external iliac nodes? 2

A

scrotal vas deferens

superior/lateral bladder

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15
Q

what is the path of the ureter?

A

retroperitoneal

exit kidney –> over pelvic brim –> obliquely enter posterior bladder wall

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16
Q

what structures in the male and female are located superior to the ureters?

A

male: vas deferens
female: uterine artery/vein

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17
Q

what supplies blood to the ureter?

A

renal a, gonadal a, aorta, internal iliac branches

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18
Q

what innervates the ureter?

A

preaortic plexus, hypogastric plexus, pelvic splanchnics

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19
Q

what are the parts of the bladder? their relationships?

A

apex-points towards pubis
fundus-opposite apex
body- in between
neck-where urethra starts

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20
Q

what ligaments support the bladder in males? females? which are part of the endopelvic fascia?

A

median umbilical ligament (urachus remnant)

part of endopelvic fascia
lateral ligaments
puboprostatic ligament
pubovesical ligamnet

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21
Q

what supplies blood to the bladder?

A

superior and inferior vesicular arteries

vaginal artery contributes in females

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22
Q

what innervates the bladder? (p and s)

A

sympathetic-superior hypogastric plexus

parasympathetic-pelvic splanchnic/inferior hypogastric plexus

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23
Q

what muscle lines the bladder wall and what innervates it and whats its function

A

detrusor
parasympathetic fibers
contract to expel urine

24
Q

what is the trigone? what is important about it?

A

a triangle formed by two ureters and beginning of urethra

its very sensitive to stretch, relays lots of sensory info

25
Q

what is the difference between male and female urethras?

A

males have spongy, prostatic, and membranous

females only have membranous

26
Q

what is the seminal colliculus?

A

an enlarged area of the prostatic urethra that accommodates incoming fluid from ejaculatory duct and prostate

27
Q

where are the prostatic sinuses located? what does it secrete?

A

in the prostatic urethra lateral to the ridges, alkaline fluid from prostate

28
Q

what innervates the internal urinary sphincter?

A

inferior hypogastric plexus (parasympathetic relaxes)

29
Q

what innervates the external urinary sphincter?

A

deep perineal branch of pudendal nerve (voluntary)

30
Q

what problems can arise from an enlarged prostate, why does this happen?

A

benign growth due to age

can cause urethral obstruction, urinary issues, bladder infections, kidney damage

31
Q

what are the attachments of the ovary and to where do they attach? 3

A

anterior attachment to fallopian tube via mesovarium

medial pole attachment to lateral uterus is ovarian ligament

lateral attachment to lateral pelvic wall is suspensory ligament of ovary

32
Q

starting at the ovary what is the path in the fallopian tube? where does fertilization occur?

A

infindibulum –> ampulla –> isthmius –> intrauterine

ampulla

33
Q

what is the location and parts of the uterus?

A

posterior/superior to bladder

fundus, body, cervix

34
Q

from superficial to deep what are the layers of the uterus?

A

perimetrium, myometrium, endometrium

35
Q

what are the normal positioning angles of the uterus

A

anterverted-angle of vagina and cervix

anteflex-angle of cervix to uters

36
Q

what issues can arise from uterine positioning? sx?

A

can be excessively retroverted or excessively flexed

no impact on fertility, causes back pain/dysuria

37
Q

what is formed when the cervix pushes into the vagina?

A

fornices

38
Q

where does the lymph from the round ligament and fundus drain ?

A

superficial inguinal lns

39
Q

where does the lymph from the ovary/fallopian tubes/fundus drain?

A

lumbar lns

40
Q

where does everything else in the female drain?

A

internal iliac nodes

41
Q

what innervates the female pelvic viscera?

A

inferior hypogastric plexus

42
Q

what is different about the ovarian plexus innervation?

A

innervated by vagus and sympathetic T10/T11

43
Q

Where is the pelvic pain line? what innervates above/below?

A

level of sacral base, inferior limit of peritoneum
above-sympathetic (T12-L2)
below-parasympathetic (pelvic splanchnic)

44
Q

what are the peritoneal folds of the female? what structures are a part of this?

A

two folded layers of peritoneum

rectouterine fold
suspensory ligament of ovary
broad ligament

45
Q

what is the most inferior part of the female peritoneum?

A

rectouterine pouch

46
Q

what 3 ligaments are part of the female endopelvic fascia?

A

cardinal ligament
pubocervical ligament
uterosacral ligament

47
Q

what is contained in the cardinal ligament? function?

A

uterine a/v

main support of uterus

48
Q

what is contained in the pubocervical ligament?

A

superior vesicular a

49
Q

what is contained in the uterosacral ligament? where is it located?

A

middle rectal a/v

found in the rectouterine fold

50
Q

what is contained in the broad ligament?

A 
round ligament
fallopian tube
ovary
uterus
proper ovarian ligament
uterina a/v
ureter
51
Q

what are the three parts of the broad ligament, what do they connecT?

A

mesovarium-ovary to fallopian but closer to ovary
mesosapinx-ovary to fallopian but closer to fallopian
mesometrium-idk

52
Q

what causes uterine prolapse?

A

weakened cardinal ligament or pelvic diaphragm due to pregnancy (mostly), aging, or menopause

53
Q

what does a spinal block anesthesia take sensation away from? what level do you do this?

A

L3-L4 subarachnoid space

everything waist down-
intraperitoneal structures
subperitoneal structures
somatic structures

54
Q

what does a caudal epidural block take sensation away from?

A

epidural space at S5/co

cant feel anything below pelvic pain line
no subperitoneal or somatic sensation

55
Q

what does a pudendal nerve block denervate?

A

somatic sensation

mother can still feel uterine contractions cause cervix and superior vagina still feel pain

Repro Final Exam (7 decks)

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