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1
Q

what are the borders of the pelvic inlet? [1]
what are the borders of the pelvic outlet? [1]

A

Pelvic inlet = from sacral promontry to the anterior part of pubic symphysis

Pelvic outlet = Inferior part of pubic symphysis to posterior coccyx, following the ischium bone round

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2
Q

Difference in the true pelvis and false pelvis?

A

True pelvis = contains all the pelvic organs (vagina, uterus, rectum, bladder, etc)

False pelvis = Despite the ilium being present, it just contains abdominal organs as they are continuous

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3
Q

Differences in the male and female pelvis

A

Male = Smaller sub-pubic angle, heart shaped pelvic inlet

Female = Much wider sub-pubic angle, more circular pelvic inlet

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4
Q

What is the narrowest part of the pelvis in:

  • anterior-posterior view?
  • transverse view?

Are they immobile?

A

Ant-Post: Between sacral promontry + pubic symphysis. This is fairly immobile

Transverse: Between ischial spines, but moves 10-15% in pregnancy as pelvic ligaments between more laxed to allow more room for baby to pass through

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5
Q

name for female shaped pelvis?

A

gynecoid

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6
Q

What covers almost the entirety of the obturator foramen? What passes through the small gap present?

A

Obturator membrane

Obturator nerve, artery, vein passes through small gap present

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7
Q

What passes through the greater sciatic foramen? [5]

A

Sciatic nerve, Superior and inferior gluteal nerve, artery, vein

Pudendal nerve

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8
Q

What passes through the lesser sciatic foramen?

A

Pudendal nerve to innervate the perineum

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9
Q
A
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10
Q

What muscle do the superior and inferior gluteal neurovasculature exit either side of?

A

Piriformis

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11
Q

What spinal roots are the pudendal nerve from

What does it innervate

A

S2-S4

Motor and sensory innervation to perineum

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12
Q

What are the 4 branches from the internal iliac artery that LEAVE the pelvis?

A

Superior Gluteal

Inferior Gluteal

Obturator

Internal pudendal

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13
Q

What are the branches of internal iliac artery that STAY in the pelvis? [4]

A

Superior vesicular (supply bladder)

Inferior vesicular (in men only, to prostate)

Middle rectal (to rectum)

Uterine artery (females only and supplies uterus, leads to another branch called vaginal artery to supply vagina)

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14
Q

Where does the piriformis muscle attach proximally and distally, and what movement does it allow?

A

Attaches proximally to the sacrum, moves through greater sciatic foramen and distally on the greater trochanter

Allows lateral rotation of thigh

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15
Q

Where does obturator internus attach both proximally and distally, and what movement does it allow?

A

Attached to the ischium/obturator membrane proximally and the posterior aspect of femur distally

Allows lateral rotation of the thigh

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16
Q

What two muscles make up the pelvic floor?

A

Coccygeus and Levator Ani

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17
Q

What are the 3 divisions of levator ani and where do they run from/to?

A

Puborectalis- from pubis to rectum

Pubococygenous- from pubis to coccyx

Iliococcygeus - From ilium to coccyx

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18
Q

Describe features of the puborectalis portion of levator ani that is specialised for function

A

This muscle gives a kink to the rectum, adding a right angle between anal canal and rectum which is important for continence

Relaxation of puborectus allows defecation

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19
Q

Where is the perineal membrane in respect to the pelvic floor, and what is attached to the perineal membrane?

A

Perineal membrane is inferior to the muscles of the pelvic floor, and the external genitalia are attached to this perineal membrane

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20
Q

Where do all muscles of the perineum insert onto?

A

perineal body

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21
Q

What is the name of the procedure of cutting the perineal body to prevent further damage from tearing in childbirth, and also to widen the vagina?

A

Episiotomy

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22
Q

What passes through the posterior sacral foramina?

A

Posterior rami which form the sacral plexus

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23
Q

What 3 structures does the genitofemoral nerve innervate (1 in male, 1 in femlae, 1 both)

A
  • *Skin of scrotum** in males
  • *Labia majora** in females (outside bit of vagina)
  • *Cremaster muscle (**muscle of spermatic cord, can raise the testicles)
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24
Q

What nerve supplies the parasympathetic fibres to the pelvic viscera? What are their roots?

A

pelvic splanchnic nerves

S2,3,4

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25
Q

What does sympathetic innervation to the perineum take part in? [2]

A

Filling of the bladder via contraction of internal urethral sphincter and relaxation of detrusor muscle

Stimulates contraction of vas deferens and seminal vesicles

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26
Q

What artery does the inferior epigastric branch from, and is it before or after this artery has passed under the inguinal ligament

A

Inferior epigastric branches from external iliac artery just after it has passed under the inguinal ligament

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27
Q

What nerve, other than the pudendal, passes through the lesser sciatic foramen?

A

Nerve to obturator internus [1]

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28
Q

which of the following is the pubococcygeus

A
B
C
D

A

which of the following is the pubococcygeus

A
B
C
D
​

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29
Q

which of the following is the coccygeus

A
B
C
D
​

A

which of the following is the coccygeus

A
B
C
D
​

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30
Q

which of the following is the puborectalis

A
B
C
D

A

which of the following is the puborectalis

A
B
C
D
​

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31
Q

which of the following is the iliococcygeus

A
B
C
D
​

A

which of the following is the iliococcygeus

A
B
C
D
​

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32
Q

which of the following is most anterior

puborectalis
pubococcygeus
coccygeus
iliococcygeus

A

which of the following is most anterior

puborectalis
pubococcygeus
​coccygeus
iliococcygeus

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33
Q

which of the following is most posterior levator ani muscle?

puborectalis
pubococcygeus
​coccygeus
iliococcygeus

A

which of the following is most posterior levator ani muscle?

puborectalis
pubococcygeus
​coccygeus
iliococcygeus

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34
Q

which of the following is most posterior ?

puborectalis
pubococcygeus
​coccygeus
iliococcygeus

A

which of the following is most posterior ?

puborectalis
pubococcygeus
​coccygeus
iliococcygeus

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35
Q

Action of piriformis?

A

lateral rotation

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36
Q

State the 3 layers of the uterus from the inside –> outwards

A

Endometrium

Myometrium

Perimetrium

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37
Q

label A-C

A

A: **endometrium

B: myometrium

C: perimetrium**

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38
Q

label this xx

A
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39
Q

label this

A
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40
Q

Define the internal and external os of the cervix respectively

A

Internal os = Opening into the uterus

External os = Opening into the vagina

41
Q

What does the ovarian ligament connect?

A

Ovary to wall of uterus

42
Q

What important structure is the uterine artery closely related to at the side of the cervix? When can this be clinically relevant?

A

Uterine artery close to ureter

Need to be careful in hysterectomy as ureter easily damaged

43
Q

Where does the ureter lie in position to the uterine vessels [1]

A

Underneath the uterine vessels

’ Water under the bridge’ as the ureter lies underneath the uterine vessels

44
Q

What vertebral region do the ovarian arteries branch from? [1]
from which artery? [1]

A

L2
abdominal aorta !!

45
Q

Where does the suspensory ligament of the ovary run from-to?

A

From the ovary, and outwards to the lateral abdominal wall

46
Q

What vessels does the suspensory ligament of the ovary carry? [4]

A

Ovarian artery, vein, nerve plexus and lymphatic vessels

47
Q
A
48
Q

What is the round ligament of the uterus?

A

originates at the uterine horns, runs through inguinal canal and then attaches to the labia majora

49
Q

Define the

  • rectouterine pouch
  • vesicouterine pouch
A

60/111

Rectouterine = extension of peritoneum between posterior wall of uterus and rectum

Vesicouterine = extension of peritoneum from the bladder to anterior wall of uterus

50
Q

Which wall of the vagina is longer: anterior or posterior?

A

posterior

51
Q

Describe the route taken by sperm cells from seminiferous tubules -> outside world

A

Testes -> Epididymis -> Vas deferens -> Inguinal canal -> Seminal vesicles at post. bladder –> Ejaculatory duct through prostate –> Urethra

52
Q

Why are females more susceptible to UTIs?

A

shorter uretha

53
Q
A
54
Q

What are the two functions of the urethra? [2]

A

Carry urine from the bladder to the outside world

Carry semen to ejaculate from penis

55
Q

Where are the seminal vesicles located

A

Posterior aspect of bladder

56
Q

Which part of the penis does the urethra run through?

A

Corpus spongiosum

57
Q

State the borders of the perineum

A

Ant = pubic symphysis

Inf = coccyx

Lateral = Inferior ramus of pubis + sacrotuberous ligament

58
Q

The perineum can be divided into 2 triangles by a line drawn between ______?

State the names of the 2 triangles

A

Line drawn between the two ischial tuberosities

Anterior triangle = Urogenital

Posterior triangle = Ana

59
Q

label A [1]

what is its function? [1]

A

helps with expansion during defecation

60
Q

What muscle makes up the lateral walls of the anal triangle? [1]

A

obturator internus

61
Q

State the branches of the pudendal nerve [4]

A

Inferior anal/rectal
Dorsal nerve of penis/clitoris
Perineal
Posterior labial

62
Q
A
63
Q

For pudendal nerve block, what is the bony prominence that is the landmark for the nerve (i.e. where the anaesthetist would inject? [1]

A

ischael spine

64
Q

What is the urogenital triangle bounded by?

A

Anteriorly = pubic arch

Laterally = ischial tuberosities

Imaginary line between ischial tuberosities also separates urogenital triangle from anal triangle

65
Q

where is the urogenital diaphragm? [1]

what is the function of the urogenital diaphragm? [1]

A

Urogenital diaphragm - muscles directly above peroneal membrane within the deep peroneal pouch (sphincter urethrae and deep transverse perineal)

The urogenital diaphragm adds strength around the apertures, which are basically deficits in the pelvic floor.

66
Q

what is the difference between the pelvic floor muscles and urogenital diaphragm?

A

The pelvic floor muscles and urogenital diaphragm are not the same thing.

Pelvic floor muscles create the floor (Levator ani and Coccygeus).

Above the perineal membrane is the urogenital diaphragm. The urogenital diaphragm are all the muscles imbedded within the deep perineal pouch.

67
Q

what is the Deep perineal pouch is space above? [1]

what is the superior boundary of the deep perineal pouch? [1]

A
  • Deep perineal pouch is space above perineal membrane the urogenital triangle
  • State the superior boundary of the deep perineal pouch: levator ani
68
Q

State the superior and inferior boundary of the superficial perineal pouch

A

Superior = Perineal membrane

Inferior = Colles’ fascia

69
Q

State the superior and inferior boundary of the superficial perineal pouch [1]

A

Superior = Perineal membrane

Inferior = Colles’ fascia

70
Q

What muscle surrounds:

corpus spongiosum tissue

corpora cavernosa tissue?

A
  • Bulbospongiosus

= Ischicavernosus

71
Q

What are the right and left crura or the penis? where are they located?

A

These are the two individual bases of the corpus cavernosum tissue, will be surrounded by ischiocavernosus

Located in superficial perineal pouch

72
Q

What are the two muscles present in the scrotum and what does each one do? [4]

A

Dartos muscle = Causes the scrotum to wrinkle up, to increase S.A. and therefore regulate temperature of testes

Cremaster = Causes testes to elevate, occurs during erections

73
Q

What are the 3 columns of erectile tissue in the penis?

A

2 dorsal corpus cavernosa

1 ventral corpus spongiosum

74
Q

Where do the arteries of the penis branch from?

A

Pudendal artery

75
Q

What is bucks fascia?

A

Fascia surrounding all 3 columns of erectile tissue in the penis

76
Q

Where do the superficial and deep dorsal veins of the penis drain to? [2]

A

Superficial –> Saphenous

Deep –> Internal iliac

77
Q

Function of bulbospongiosus in men

A

Compresses urethra to expel final drops of semen and urine

78
Q

Define mons pubis [1]

A

Fatty region on top of the pubic symphysis in women

79
Q

What is the vulva vestibule guarded by?

A

Labia minora

80
Q

Define the hymen

A

This is a membrane that surrounds / partially surrounds the vaginal opening

81
Q

Function of bulbospongiosus in women

A

Contraction of bulbospongiosus in women contracts the vagina

82
Q

Function of ischiocavernosus in women

A

Assists clitoral erection

83
Q
A
84
Q

Function of ischiocavernosus muscle in men [1]

A

Erection

(Also flexes anus in both male and female)

85
Q

Major blood supply to both urogenital and anal triangle?

A

Internal pudenal artery

86
Q

what is the homologue of the scrotum in women

A

labia majora

87
Q

what is the homologue of the glans penis in women

A

glans clitoris

88
Q

Boundaries of anal triangle?

A

Post = Coccyx

Ant = imaginary line between ischial tuberosities

Lateral = Sacrotuberous ligament

89
Q

Define tunica vaginalis

A

The closed sac of peritoneum that covers the sides and anterior aspect of the testis

90
Q

What is the spermatic cord [1]

A

The vas deferens and surrounding connective tissue that runs from the deep inguinal ring to the testes

91
Q

Define tunica albuginea

A

A layer of connective tissue that surrounds the testes, and also the corpora cavernosa

92
Q

Define seminiferous tubules

A

Coiled-threadlike tubules that make up the bulk of the testis and are lined with a layer of epithelial cells from which spermatozoa are produced

93
Q

The duct which conveys sperm from the testicles to the urethra is called WHAT?

A

vas deferens

94
Q

what is this?

what is its function?

A

rete testis

A anastomosing network of delicate tubules that carry sperm from seminiferous tubules –> efferent ductules, which then pass to epididymis

95
Q

what is the highly convoluted duct behind the testes which passes sperm to vas deferens? [1]

A

epididymis

96
Q

Name the vein that drains the testes, and where this vein drains to in left and right testis [2] (theyre different !!)

A

Testicular vein

Right drains to IVC

Left drains to left renal vein

97
Q

where does the following occur?

Sperm acquire the ability to move and fertilise an egg [1]

Stored here until ejaculation [1]

A

Sperm acquire the ability to move and fertilise an egg [1]
epididymus

Stored here until ejaculation [1]
epididymus

98
Q

What does the ejaculatory duct consist of? [2]

A

Ductus deferens and duct of seminal vesicle [2]

99
Q

State the coverings that the testis take as they descend from post. abdominal wall into scrotum, from most deep -> most superficial [3]

A 
Deepest = Transversalis fascia
Middle = Musculature of internal oblique
Superficial = Aponeurosis of external oblique

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