GU Flashcards
filling of the bladder:
detrusor m:
internal sphincter:
external sphincter:
detrusor m: relaxed → SNS
internal sphincter: contracted → SNS
external sphincter: contracted → voluntary
emptying of bladder:
detrusor:
internal sphincter:
external sphincter:
detrusor: contracted → PSNS
internal sphincter: relaxed → PSNS
external sphincter: relaxed → voluntary
SNS innervation of bladder/urethra
spinal cord → L1-L3
PSNS innervation of bladder/urethra
S2-S4 → pudendal n
external sphincter is under __ control (2)
somatic
voluntary
trigone m is the __ portion
of the __
triangular
bladder floor
ventral trigone is formed by the
internal urethral sphincter
dorsolateral trigone
right and left ureter
male catheterization anatomy
curve upward at 30 degree angle at the prostate
female catheterization anatomy
shorter
no curve
short urethra predisposes to
cystitis
4 parts of male urethra
preprostatic
prostatic
membranous
spongy
course of round ligament
superior lateral uterus → thru inguinal canal → labia majora
when the round ligament is stretched in pregnancy, pain can be felt in the __ (2)
groin
labia majora
supporting structures of the uterus
pelvic diaphragm
urogenital diaphragm/perineal membrane
perineal body
true ligamentous structures
pelvic diaphragm includes (3)
levator ani m
coccygeus m
associated fascia
the perineal body separates the __
and the __
vagina
anus
clinical significance of perineal body
often tear during vaginal delivery → widens gap btw free borders of levator ani on both sides → incontinence
what procedure is sometimes done to prevent 4th/5th degree perineal body tears
episiotomy
true ligamentous structures of uterus (3)
transverse (cardinal)
anterior pubocervical
uterosacral
what ligament runs from either side of cervix to the pelvic wall
transverse (cardinal)
what ligament runs from the uterus to the pubic symphysis
anterior pubocervical
what ligament runs from the posterior cervix to the sacrum
uterosacral
ligamentous structures of the uterus that are NOT true support structures
broad
round
suspensory
peritoneal folds
arterial supply to the ovaries
ovarian a
uterine a
vaginal a
the ovarian a originates from the __
and is contained w.in the __
abd aorta
broad ligament
the uterine and vaginal arteries arise from the
internal iliac a
clinical significance of ovarian a
arises from abd aorta → high pressure → can cause hemorrhage in ectopic pregnancy
venous supply to uterus
myometrial veins → uterine or ovarian veins in broad ligament
arterial supply to testes
testicular a
cremasteric a
course of testicular arteries
abd aort → inguinal canal → scrotum
cremasteric a arises from the __
to the __
external iliac
inferior epigastric a
venous supply to the testes
testicular vein
testicular v drains to __ on the right
and __ on the left
right: IVC
left: renal vein
what structure does the bladder communicate w. embryologically
urachus
the urachus is a hollow canal connecting the fetal __
to the __
bladder
umbilical cord
during fetal development, the urachus becomes the __
median umbilical ligament/fold
the medial umbilical ligament is a remnant of the
umbilical a
the umbilical a is connected to the __ during fetal development
internal iliac
during development:
urachus →
umbilical a →
urachus → median umbilical ligament/fold
umbilical a → medial umbilical ligament
alcock’s canal is same-same
pudendal canal
contents of pudendal canal
pudendal v, a, n
clinical significance of pudendal canal
injection of local anesthetic into canal medial to ischial tuberosity
pudendal block more proximal adjacent to ischial spine will involve
inferior anal n
AND
perineal n
more distal pudendal n block at the level of the ischial tuberosity will involve
perineal nerves
total hysterectomy is removal of
uterus
body
fundus
cervix
SPARES ovaries
what structure must be preserved in a total hysterectomy
suspensory ligament of ovary → for vessel and nerve supply
