Internal Pelvic Organs Flashcards

1
Q

What is found in the retroperitoneum?

A

Kidneys
Ureters
Suprarenal/adrenal glands
Great vessels of the abdomen & pelvis

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2
Q

What is found in the deep pelvic space?

A

Bladder
Rectum
Reproductive viscera.

Note:
It is continuous with the retroperitoneum.

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3
Q

What organs is the L kidney surrounded by?

A

Spleen
Pancreas

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4
Q

What ribs are posterior to the kidneys?

A

T11 and T12

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5
Q

Which kidney sits higher in the body?

A

Left kidney

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6
Q

Why is one kidney higher than the other?

A

The liver on the right pushes the kidney down a little because it is so big.

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7
Q

Which fat layer directly sits around the kidney?

A

Perinephric fat

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8
Q

Which fat layer is more superficial to the kidney?

A

Paranephric fat

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9
Q

What separates the perinephric and paranephric fat?

A

Renal fascia

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10
Q

What is the outermost layer of the actual kidney called?

A

Capsule

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11
Q

Describe the path of urine from the renal medulla to the bladder.

A

Renal pyramid => renal papilla => minor calyx => major calyx => renal pelvis => Ureter => bladder

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12
Q

How much of our kidney function can we lose prior to being symptomatic?

A

85%!

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13
Q

What can perinephric abscesses come from?

A

UTIs
Nephric abscesses

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14
Q

What supplies blood to the ureters?

A

Superiorly: renal artery
Abdominal: Gonadal, abdominal aorta, and common iliac
Pelvic: Internal iliac

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15
Q

What should we never do to a ureter’s blood supply?

A

NEVER reflect it away from the ureter!
Ideally, you want to push the ureter medially towards the blood supply.

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16
Q

What do ureters pass posterior to and anterior to?

A

Posterior to gonadal arteries
Anterior to the iliacs

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17
Q

How does the ureter get closed when the bladder is full?

A

The end of the ureter is like a flap, so it gets squished shut when the inside is full.

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18
Q

What is the proximal ureter made of?

A

Muscularis externa.

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19
Q

What is the distal ureter made of?

A

Thickened muscularis externa

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20
Q

What 3 locations do renal calculi typically lodge?

A

Renal pelvis
Crossing the pelvic brim/common iliac vessels
Entering the bladder wall

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21
Q

What kind of scan should we order for kidney stones?

A

KUB without contrast, aka a CT of the kidney, ureters, and bladder without contrast.

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22
Q

What other test can we do to look for kidney stones?

A

Cystoscopy

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23
Q

What muscle controls our bladder?

A

Detrusor muscle

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24
Q

What ligaments attach our bladder to the pubis?

A

Depending on the sex:
Puboprostatic/pubovesical ligaments

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25
Q

What is the trigone of the bladder?

A

It is the smooth part of the detrusor muscle, making a triangle between the two ureteric orifices and the urethra.

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26
Q

What is the line between the two ureteric orifices called?

A

Interureteric crest

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27
Q

What are some big differences between the urethra in a male and female?

A

Males have longer urethras that must pass through a prostate and are surrounded by the corpus spongiosum at the distal end.

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28
Q

What is the area in the center of the urethra when it is passing through the prostate?

A

Prostatic utricle

29
Q

Where are suprarenal glands found?

A

Above the kidneys
Supra = above

30
Q

What is the difference between the right and left suprarenal vein?

A

The left suprarenal vein sits inferior to the suprarenal gland and drains into the left renal vein.

The right suprarenal vein sits medially in the suprarenal gland and drains directly into the IVC.

31
Q

What are the 3 main layers of the suprarenal gland?

A

Capsule
Cortex
Medulla

32
Q

What is made in the suprarenal cortex?

A

All the corticoids

Sugar
Salt
Sex

Glucocorticoids
Mineralcorticoids
Gonadocorticoids

33
Q

What is made in the suprarenal medulla?

A

Epi and NE by chromaffin cells

34
Q

What is the most inferior point of the peritoneal cavity in females? Why is it significant?

A

Rectouterine pouch (of Douglas), found in between the rectum and uterus.

It is the most inferior point, so if someone is standing upright, peritoneal fluid will settle here.

35
Q

What are the two pouches/spaces at the bottom of the peritoneal cavity in females?

A

Vesicouterine pouch
Rectouterine pouch

36
Q

What vessel runs along the lateral umbilical folds?

A

Inferior epigastrics

37
Q

What is the median umbilical fold found near?

A

The bladder

38
Q

What spaces are found next to the rectum in males?

A

Pararectal fossa

39
Q

What is the lowest point of the peritoneal cavity in males?

A

Pararectal fossa

40
Q

If I lay supine, what direction does fluid in the peritoneal cavity tend to move?

A

Superiorly

41
Q

What areas of the peritoneal cavity can have superior fluid movement?

A

The left and right paracolic gutter.

42
Q

What areas of the peritoneal cavity don’t really have superior fluid movement?

A

Left infracolic space

43
Q

Where does fluid in the omental sac tend to come from?

A

Right paracolic space

44
Q

What is retroversion of the uterus vs anteflexion?

A

Version means a shifting of the entire uterus on its base, like a swivel.

Flexion means a bending within the uterus, so like half of it might bend forward or backwards.

45
Q

What does adnexa mean?

A

Stuff near uterus, aka the ovary, fallopian tubes and their vessels/stuff.

46
Q

What covers the ovarian artery and vein as it enters the ovary?

A

Suspensory ligament of the ovary

47
Q

What does the broad ligament connect?

A

Connects the uterus, ovary, and oviduct.

48
Q

What are the 3 subsections of the broad ligament?

A

Mesometrium = connects to uterus
Mesovarium = connects to ovary
Mesosalpynx = connects to the oviduct

49
Q

What is the ovarian ligament leftover from?

A

Gubernaculum

50
Q

What are the two endings of the cervix called?

A

External os, leading to the vagina.
Internal os, leading to the uterus.

51
Q

What is found laterally to the cervix in the vagina?

A

The vaginal fornix

52
Q

What is the top of the uterus called?

A

The fundus

53
Q

What are the yellow looking follicles called?

A

Corpus luteum

54
Q

What part of the uterus contract during childbirth?

A

Myometrium

55
Q

What is the isthmus?

A

The proximal portion of the oviduct, near the uterus.

56
Q

What is the ampulla?

A

The main portion of the oviduct.

57
Q

What is the infundibulum?

A

The ending of the oviduct, splitting into lots of fimbriae.

58
Q

What is the epoophoron?

A

A remnant of the testicular duct, found between the ovary and the oviduct.

59
Q

What ligament covers the area around the bladder at the level of the cervix?

A

Pubocervical ligament

60
Q

What ligament covers the area lateral to the cervix?

A

Transverse cervical ligament (cardinal)

Note:
Contains the uterine vessels

61
Q

What ligament covers the area between the tranverse cervical ligament and rectouterine pouch at the level of the cervix?

A

Sacrocervical ligament

62
Q

What is special about the L ovarian vein?

A

It drains to the L renal vein, not to the IVC directly.

63
Q

What supplies blood to the body of the uterus?

A

The uterine artery

64
Q

What supplies blood to the cervix and vagina?

A

The vaginal artery, a branch off the uterine artery.

65
Q

What are the 4 sections of the male urethra?

A

Coming from the bladder:
Prostatic urethra
Prostatic utricle
Membranous urethra
Spongy urethra

66
Q

What are the ejaculatory ducts squeezed between?

A

The Prostate, exiting out into the prostatic utricle

67
Q

What kind of glands does the spongy urethra contain?

A

Urethral glands of Littre

68
Q

Where do the seminal vesicles and ductus deferens meet?

A

At the top of the prostate to form the ejaculatory duct.

69
Q

What is the inside of the ductus deferens called?

A

The ampulla of the ductus deferens