Lecture 1 - Pelvic Contents Flashcards
What is the bladder?
Muscular sac with a partial covering of peritoneum, ‘stuck’ against the pubic bones.
What makes up the bladder?
Transitional epithelium, with rugae.
What happens to the bladder as it fills?
It raises into the suprapubic region.
What is the urachus and where is it located?
It is the apex of the bladder, located posterior to the pubic symphysis.
What is the trigone?
The triangular base of the bladder, a trigone internal area of smooth mucous membrane.
Where does the urethra exit/enter the bladder?
The trigone.
What are the muscles of the bladder?
Muscular coat of smooth muscle, known as the detrusor. Also has the sphincter vesicae at the neck of the bladder.
Is the sphincter vesicae a full circle?
No, it is incomplete.
What is the neck of the bladder held in place by in males?
Puboprostatic ligament.
What is the neck of the bladder held in place by in females?
Pubovesical ligament.
What is the arterial supply of the bladder in males?
A superior and inferior vesicle artery from each side (branches of the internal iliac artery).
What is different about the arterial supply of the bladder in females compared to males?
The inferior vesicle artery usually corresponds to the vaginal artery in females.
What is the venous drainage of the bladder?
The vesicle plexus, which drains to the internal iliac vein.
What is the nerve supply to the bladder?
Autonomic nervous system - Inferior hypogastric plexus.
Where does lymph drain to from the ureters?
Lumbar, common/external/internal iliac nodes as they descend towards the bladder.
Where does lymph drain to from the bladder?
Mainly internal iliac (some superior to external iliac, some from neck to sacral nodes).
Where does lymph mainly drain to from the urethra?
Internal iliac.
Where else can lymph drain to from the urethra in females?
Some to sacral nodes.
Where else can lymph drain to from the urethra in males?
Spongy urethra to deep inguinal nodes.
Where is the rectum positioned?
3rd sacral vertebrae to tip of coccyx.
What type of peritoneum covers the upper 3rd of the rectum?
Visceral peritoneum.
What part of the middle 3rd of the rectum does peritoneum cover?
Anterior surface.
Does the lower 3rd of the rectum have peritoneum?
It is infraperitoneal (underneath peritoneum, only its superior surface is covered in parietal peritoneum).
What is the arterial supply of the rectum and where do the arteries branch from?
Superior rectal artery (from the inferior mesenteric), middle rectal artery (from internal iliac artery), and inferior rectal artery (from internal pudenal).
What is the venous drainage for the rectum and where do the veins drain to?
Superior rectal vein (to portal vein), middle rectal vein (to internal iliac vein), and inferior rectal vein (to internal pudendal vein).
Where does lymph from the superior rectum drain to?
Aortic nodes at L3 (inferior mesenteric).
Where does lymph from the interior rectum drain to?
Internal iliac nodes.
Where does lymph from the anal canal superior to the pectineal line drain to?
Internal iliac nodes.
Where does lymph from the anal canal inferior to the pectineal line drain to?
Superficial inguinal nodes.
What is a fibroid?
A tumour grown on the uterus.
What is the broad ligament of the uterus?
A sheet of peritoneum that extends from the lateral pelvic walls on both sides, and covers internal female genitalia anteriorly and posteriorly.
What does the broad ligament of the uterus do?
Carries vessels, nerves and lymphatics.
What is the round ligament of the uterus?
A ligament that connects the front part of the womb to the groin, where the lower limb meets the pelvis.
What does the round ligament do?
Potential lymph pathway, support the uterus during pregnancy.
What is anteversion of the uterus?
Uterus bends forwards over the long axis of the vagina (tilts towards your abdomen).
What is anteflexion of the uterus?
Long axis of uterus is bent forward at the cervix opening with long axis of the vagina.
What is the function of the ovaries?
To produce ova and secrete hormones.
What are the ovaries attached to the broad ligament?
By mesovarium.
What is the arterial supply of the ovaries?
Abdominal aorta (ovarian artery at L2).
What is the venous drainage of the ovaries?
The ovarian vein to the inferior vena cava on both right and left sides, and the renal vein on the left side.
What nervous supply do the ovaries have?
Aortic plexus.
What is the ovarian ligament?
Connects the ovary to the lateral surface of the uterus.
What is the suspensory ligament of the ovary?
Connects the ovary to the wall of the pelvis.
Where does lymph from the ovaries drain to?
Aortic nodes at root of aortic artery (L2).
Where does lymph from the vagina drain to?
Internal iliac then superficial inguinal nodes.
Where does lymph from the inferior part of the uterus drain to?
Internal iliac nodes (some to sacral nodes).
Where does lymph from the superior part of the uterus drain to?
External iliac nodes (via broad ligament).
Where does lymph from the uterine tubes drain to?
Superficial inguinal nodes.
