Grays Review II: Pelvis Flashcards
While inserting a catheter, you accidentally damage teh wall of the membranous portion of the urethra in the deep perineal compartment (urogenital diaphragm). Which structure would most likely be traumatized?
- Bulbospongiosus muscle
- Sphincter urethra
- Corpus cavernosus penis
- Ischiocavernosus muscle
- Opening of bulbourethral duct
Sphincter urethra.
Damaging the membranous portion can cause urine and blood to leak upward into the retropubic space. It’s normally limited inferiorly by the urogenital diaphragm and the urethral sphincter within it, which would be injured.
Hematoma of the perineum spreading to his abdominal wall beneath the superficial fascia. Where should the initial extravasation be located?
This is extravasation of blood and urine from the superficial perineal pouch due to rupture of the spongy urethra.
Between buck’s fascia and the dartos layer.
Pain in the testis can be caused by injury of what nerve?
- Sympathetic fibers to ductus deferens
- Ilioinguinal
- Iliohypogastric
- Genital branch of genitofemoral
- Visceral afferent T10-L2
Afferents of the testis and most of the ductus accompany sympathetics to enter the trunk at T10-L2, with cell bodies in the dorsal root ganglia of those spinal nerves.
(Ilioinguinal is for scrotum and skin at the root of penis, not ductus deferens)
Where are the nerve cell bodies responsible for erection?
In the sacral parasympathetic nucleus (IML)
After falling of his bike, there was blood in the external urethral meatus, and the penis, scrotum, and lower anterior badominal wall were all swollen.
Which of these happened?
- Deep fascia of penis was intact
- Membranous urethra was injured
- Attachment of superficial perineal fascia limited urine flow to the thigh
- Attachment of Colles’ fascia prevented urine flow into the anorectal triangle
- There was urine between Camper’s and Scarpa’s fasciae over the lower abdomen
Attachment of Colles’ fascia prevented urine flow into the anorectal triangle.
Boy damaged his spongy urethra and a tear in the erectil ebodies and Buck’s fascia can cause urine to spill into the superficial perineal pouch. This area is bound by Colles’ fascia inferiorly, the perineal body posteriorly, and perineal membrane superiorly. Attachment of Colles’ fascia to the ischiopubic ramus prevents urine from entering the thigh
A woman has paind uring sex and there’s a Gartner duct cyst on teh lateral wall of the vagina. From which embryonic structure does this cyst take origin?
- Mesonephric tubules
- Paramesonephric duct
- Urogenital folds
- Mesonephric duct
- Sinovaginal bulbs
Mesonephric (Wolffian) duct becomes ureter and collecting tubules in both sexes, but in men it becomes the vas deferens & ejaculatory ducts and in women it becomes the GArtner’s duct, epoophoron, and paroophoron.
(Sinovaginal bulbs form the vaginal plate)
Which of these landmarks is most reliable for identifying the left ureter? The left ureter is…
- anterior to the left common iliac artery
- medial to the left inferior epigastric artery
- anterior to the left gonadal artery
- anterior to the left renal vein
- anterior to the left inferior epigastric artery
Anterior to the common iliac artery
A woman has urinary incontinence. One of her skeletal muscles had a significant tear. Which?
- Pubococcygeus
- Obturator internus
- Piriformis
- Coccygeus
- Iliococcygeus
Pubococcygeus; it’s most associated with the arcus tendineus fascia pelvis and supports the bladder.
Superficial perineal cleft. Which of these fasciae provdie boundaries for this space?
- Camper’s fascia and Scarpa’s fascia
- Perineal membrane and external perineal fascia of Gallaudet
- Colles fascia and external perineal fascia of Gallaudet
- Perineal membrane and superior fascia of the UG diaphragm
Colles fascia and external perineal fascia of Gallaudet
Which of these is in the inguinal canal?
- round ligament of uterus
- Ovarian ligament
- Suspensory ligament of ovary
- Uteirne tubes
- Mesosalpinx
Round ligament of uterus is withint he inguinal canal.
A man has pain from bladder fullness. What is the location of the neuronal cell bodies responsible for pain sensation from the urinary bladder?
- Dorsal root ganglia of spinal cord levels S2,S3, and S4
- The IML of spinal cord levels S2,S3, and S4
- The sensory ganglia of spinal nerves T5-T9
- The preaortic ganglia at the site of origin of the testicular arteries
- Dorsal root ganglia of spinal levels T10-L2
DRG of s2/3/4
Visceral pain fibers below the peritoneal coverage (uterine cervix, vagina, bladder, and urethra) may accompany parasympathetic nerves to the sacral levels of the spinal cord.
Patient has erectile dysfunction. Which of these arteries were most likely compromised?
- External iliac
- Inferior epigastric
- Umbilical
- Internal pudendal
- Superficial and deep circumflex
The internal pudendal artery gives rise to the dorsal and deep artery of the penis.
External hemorrhoids- which of the nerves carries pain sensation from the anus?
- Sacral splanchnic
- Superior hypogastric
- Pelvic splanchnic
- Pudendal
- Ilioinguinal
Pudendal nerve serves the majority of the perineum
Which of the following nerves conveys sensory fibers from the cervix of the uterus?
- Pudendal
- Superior hypogastric
- Pelvic splanchnic
- Sacral splanchnic
- Lesser splanchnic
Pelvic splanchnics
Visceral pain fibers below the peritoneal coverage (uterine cervix, vagina, bladder, and urethra) may accompany parasympathetic nerves to the sacral levels of the spinal cord.
A woman feels pain during a papsmear of her cervix. Which area is most likely to experience referred pain during thsi procedure?
- Perineum and lateral portion of thigh
- suprapubic region
- umbilical reigon
- inguinal region
Pain from this area is mediated via parasympthetic responses and would thus travel to the S2-S4 levels through the pelvic splanchnic nerves bc below peritoneal line.
The S2-S4 levels also provide sensory innervation of perineum and posterior thigh.
