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LSS Anatomy of the Abdomen, Pelvis and Perineum > lecture 5 male pelvis > Flashcards

lecture 5 male pelvis Flashcards

1
Q

female vs male pelvis: shape of inlet (important)

A

oval/round vs narrow/heart shaped

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2
Q

female vs male pelvis: sub pubic angle (important)

A

wide (>80) vs narrow (50-60)

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3
Q

female vs male pelvis: ischial spines

A

not projecting medially vs projecting medially

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4
Q

female vs male pelvis: false pelvis

A

shallow vs deep

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5
Q

female vs male pelvis: true pelvis

A

wide shallow and cylindrical vs narrow deep and tapering

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6
Q

female vs male pelvis: distance between symphysis pubis and anterior margin of acetabulum:diameter of acetabulum

A

1/>1 vs <1

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7
Q

in the anatomical position of the pelvis (appears tilted downwards and backwards), what are in the same plane

A

ASIS and pubic tubercle

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8
Q

in the anatomical position of the pelvis, what are continuous

A

greater and lesser pelves

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9
Q

patietal peritoneum in pelvis: does it enter

A

yes but doesn’t reach pelvic floor

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10
Q

is pelvic viscera completely covered by peritoneum, and what is the structure of the viscera

A

no except uterine tubes (part of uterus covered), forming several folds and pouches

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11
Q

what does the space between pelvic wall and peritoneum not covered by viscera contain

A

pelvic fascia

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12
Q

what do pelvic fascial condensations form and what is its role

A

form ligaments which support viscera like cervix, vagina and prostate

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13
Q

contents of male pelvic cavity (contents from GI, urinary and reproductive systems)

A

part of ureter, bladder urethra; prostate ductus deferens, seminal vesicles, bulbourethral glands; rectum; some of abdominal GIT spills into greater pelvis (e.g. caecum, appendix, parts of sigmoid colon and ileum); vessels, nerves and lymphatics

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14
Q

pathway of sperm in pelvis

A

ductus deferens from testis, inguinal canal, over, behind ureter, enters urethra through prostate

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15
Q

where does the boundary of the pelvis and perineum occur in relation to curvature of urethra

A

between the two normal curvatures, with the axes just enclosing the anal canal opening (rectum within pelvis); contains penis and testis

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16
Q

what structures in male pelvis can be felt in digital rectal examination of a healthy man

A

prostate gland, seminal vesicles if calcified

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17
Q

which of the two bends of the male urethra can be straightened before passing a catheter

A

2nd bend (1st below prostate gland cannot be straightened so catheter must be negotiated carefully as passes from perineum to pelvis)

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18
Q

what part of the utethra does the prostate gland surround

A

1st (prostatic) part

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19
Q

where do seminal vesicles on back of bladder open into ductus deferens

A

between ampulla of ductus deferens and ejaculatory duct

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20
Q

where do levator ani muscles hang

A

from pelvic walls to superior fascia of urogenital diaphragm

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21
Q

what muscle forms lining of pelvic cavity

A

obturator internus

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22
Q

what does the bladder “sit” on

A

prostate

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23
Q

where are bulbourethral glands located

A

either side of urethra in between superior and inferior fascia of urogenital diaphragm, above perineal membrane

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24
Q

what do bulbourethral glands produce

A

clear secretion to lubricate urethra

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25
Q

what are bulbourethral glands above

A

root of penis (including corpus cavernosum on either side which all contain erectile tissue and bulbospongiosus), central is through which urethra runs

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26
Q

what is root of penis attached to

A

perineal membrane

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27
Q

duct of ductus deferens

A

1 on each side; bring sperm from testis and ends in large ampulla

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28
Q

duct of seminal vesicle

A

1 on each side; produce secretions

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29
Q

what happens when both ductus deferens and seminal vesicle join

A

sperm and secretions mix together and form ejaculatory duct (1 on each side) which opens into prosthetic urethra

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30
Q

what is present at neck of bladder

A

smooth muscle internal urethral sphincter (involuntary by sympathetic nervous system) - well developed in males so during ejactuation seminal fluid doesn’t enter bladder

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31
Q

what nervous systems are involved in ejaculation

A

somatic, sympathetic and parasympathetic

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32
Q

where does urethra go through to reach skeletal external urethral sphincter, and what is within this

A

prostatic urethra, within which are ejaculatory duct and prostate gland openings

33
Q

where can tip of urethral canal become lodged in

A

prostatic utricle (small, blind-ending space on urethra wall) within prostatic urethra

34
Q

sections of urethra and length (from start to end)

A

preprostatic (1.5cm down), prostatic (2.5cm down), membranous (2cm down and 1st bend horizontally), spongy (15cm to external urethral orifice)

35
Q

where are 4 areas of narrowing or obstruction for catheter

A

external urethral orifice (navicular fossa is narrowest; if it can go through here can go through entire urethra), 1st bend immediately below external urethral sphincter, prostatic part

36
Q

arterial supply of male pelvis: inferior vesical artery and branches

A

from anterior internal iliac artery to prostate (prostatic branch), bladder and ductus deferens (also supplied by superior vesical artery)

37
Q

where do testis arterial supply come from

A

testicular artery from abdominal aorta

38
Q

what marks the diamond shape of male perineum anatomical bony landmarks

A

pubic symphysis, ischial tuberosities, coccyx

39
Q

what marks the diamond shape of male perineum in living anatomy in lithotomy position

A

thighs when person lies on back with thighs flexed and abducted (laterally)

40
Q

what triangles is perineum divided into

A

anterior (urogenital) and posterior (anal)

41
Q

what is present in posterior (anal) compartment

A

ischio-anal fossae

42
Q

what are the ischio-anal fossae

A

fat-filled spaces separating anal canal and levator ani from pelvic walls

43
Q

what potential spaces is the anterior (urogenital) triangle divided into by perineal membrane

A

below: superficial; above: deep spaces (“pouches”); if urethra ruptures in superficial space, it becomes urine filled and enlarged

44
Q

embryology of urogenital triangle

A

by default develops male but after 6 weeks if no Y chromosome will develop as female

45
Q

male vs female: urogenital triangle (perineal membrane)

A

penis vs vagina and cervix

46
Q

male vs female: anal triangle

A

no difference

47
Q

what separates perineal spaces (pouches)

A

perineal membrane

48
Q

structure of perineal membrane

A

thick, triangular fascial structure attached to pubic arch; posteriorly has free margin and anteriorly has small gap

49
Q

where is deep perineal space located

A

above perineal membrane, below fascia of pelvic diaphragm

50
Q

where is superficial perineal space located

A

below perineal membrane and perineal fascia

51
Q

male superficial perineal structures (all muscles are skeletal but are usually involuntary)

A

superficial transverse perineal muscle; bulb of penis (median erectile tissue covered by bulbospongiosus muscle; contains corpus spongiosum erectile tissue), crus of penis either side of bulb (lateral erectile tissue covered by ischiocavernosus muscle attached to ischiopubic ramus; contains corpus cavernosum erectile tissue), meet to form body of penis (contains single corpus spongiosum with urethra running through) up to glans of penis; all anchor to perineal body above superficial transverse perineal muscle

52
Q

in females what does median erectile tissue divide round to form

A

vestibule to form vestibular bulbs

53
Q

what do medial and lateral erectile tissues meet to form in females

A

clitoris

54
Q

deep perineal structures of males

A

bulbourethral glands (above perineal membrane) and ducts open into urethra

55
Q

common structures in anal triangle in males and females

A

rectum, anal canal

56
Q

blood supply of rectum and anal canal

A

upper: superior rectal artery; middle: middle rectal artery; (both upper and middle from inferior mesenteric arteries) lower: inferior rectal artery (from internal iliac artery)

57
Q

significance of similar venous drainage to blood supply of rectum and anal canal

A

important portal-systemic venous anastamosis around lower rectum and anal canal

58
Q

ischioanal fossa inferior to perineal membrane on either side of rectum

A

fat-filled space which allow recto-anal and vaginal expansion; lateral wall is pudendal neuro-vascular bundle supply perineum, including lower rectum (careful during surgery)

59
Q

male reproductive tract

A

testis in scrotum → vas deferens → superficial inguinal ring → inguinal canal → deep inguinal ring → vas deferens → ampulla joins duct of seminal vesicle → becomes ejaculatory duct → joins urethra in prostate gland

60
Q

% of secretion from prostate and seminal vesicles

A

60% secretion from prostate, 40% from seminal vesicles; testis only bring sperm

61
Q

significance of prostate in ejaculation

A

fibromuscular tissue contracts

62
Q

structures in spermatic cord (superficial to deep) and from which muscle

A

external spermatic fascia (from external oblique) → internal spermatic fascia (from transversalis fascia) → cremasteric fascia (from internal oblique)

63
Q

testicular artery supply

A

from gonadal artery below renal artery from abdominal aorta

64
Q

testicular veins drainage

A

right drains into inferior vena cava, left drains into left renal vein

65
Q

testis and associated structure

A

spermatozoa produced in seminferous tubules then moved to rete testis; go through efferent ductules to head, then body, then tail of epididymis, where stored until ejaculation where it goes through vas deferens

66
Q

erectile tissues in penis

A

single cylinder of corpus spongiosum with spongy urethra traversing its length (glans part of corpus spongiosum), corpus cavernosum (paired on either side and ends at glans); wrapped in fascia

67
Q

skin of penis

A

above have prepuce/foreskin, below have frenulum/prepuce

68
Q

which part of corpus cavernosa attac to ischiopubic rami

A

crura (legs)

69
Q

blood supply of penis (from internal iliac)

A

main from internal pudendal artery from internal iliac; deep artery supplies corpus cavernosa; dosral artery supplies skin and connective tissue; artery of bulb supplies bulb, corpus spongiosum, glans and urethra

70
Q

branches supply cavernous spaces

A

usually coiled (helicine arteries)

71
Q

effect of parasympathetic stimulation on helicine arteries

A

relax causing blood flow

72
Q

nerves of pelvis

A

autonomic; sympathetic from T10-L2 via superior hypogastric plexus; parasympathetic from S2-S4 via inferior hypogastric plexus

73
Q

where is pelvic pain referred

A

subrapubic region and perineum (somatic)

74
Q

sensory somatic pudendal nerve from S2-S4: sensory and motor

A

sensory: dorsal nerve of penis to penile skin, glans; motor: perineal muscles bulbospongiosus and ischicavernosus causing ejaculation and external urethral sphincter (skeletal)

75
Q

parasympathetic nerves from S2-S4 functions

A

vasodilation of arterioles in erectile tissue, secretion in prostate and bulbourethral glands

76
Q

sympathethic nerves L1-L2 function

A

contraction of smooth muscles of epididymis, vas deferens, seminal vesicles, prostate causing ejaculation; contraction of internal urethral sphincter to prevent reflux of semen

77
Q

what does erection parasympathetic pathway allow

A

pudendal artery to dilate so blood flows into cavernous spaces of erectile tissue

78
Q

during secretion what is stimulated

A

parasympathetic ganglia on prostate, seminal vesicles and other glands

LSS Anatomy of the Abdomen, Pelvis and Perineum (10 decks)

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