Male and Female Pelvic Viscera

Question 0

What is the retropubic space and what is its significance?

Answer 0

space separating bladder from pubis (connective tissue)

pathway for accessing prostate during surgery

Question 1

What are the four parts of the bladder?

Answer 1

• fundus (base)
• body
• neck
• apex

Question 2

What is the major muscle of the bladder?

Answer 2

detrusor muscle

Question 3

What is the trigone?

Answer 3

-smooth triangle shaped area in bladder, inferior portion, leads toward urethra

Question 4

What is the blood supply of the bladder (differs for males and females)?

Answer 4

males: superior and inferior vesicle arteries
females: superior vesicle and vaginal arteries
males: vesicle and prostatic plexuses
females: vesicle plexus
* these venous plexuses drain into internal iliac vein

Question 5

What innervates the external urethral sphincter?

Answer 5

perineal branch of pudendal nerve

Question 6

What is the innervation of the bladder?

Answer 6

Vesicle plexus

• parasympathetic input from pelvic splanchnic nerves causes relaxation of internal urethral sphincter and detrusor contraction (urinate)
• sympathetic input from sacral splanchnic nerves causes contraction of internal urethral sphincter and detrusor relaxation (no urination, storage)

Question 7

What is the purpose of the rectal folds?

Answer 7

• help support fecal weight

- allow for expulsion of gaseous products without expelling solid waste

Question 8

What is the innervation external anal sphincter?

Answer 8

perineal and inferior rectal branches from pudendal, also some contribution from S4

Question 9

What is the blood supply for the anal canal and rectum?

Answer 9

• superior rectal a.
• middle rectal a.
• inferior rectal a.
• median sacral a.
• veins are the same name

Question 10

What causes hemorrhoids and how can you differentiate between internal and external?

Answer 10

• inflammation/damage to veins in anal canal
• if blood is dark hemorrhoids are external
• if blood is bright red hemorrhoids are internal due to anastomose with arteries

Question 11

What is cryptorchism?

Answer 11

failure of the testis to descend

Question 12

What is the blood supply and innervation of the testis?

Answer 12

• testicular artery (anastomoses with deferential and cremaster a.)
• pampiniform plexus drains into testicular veins (r. vein drains into IVC, l. vein into l. renal vein)
• innervation is testicular plexus (on testicular artery)

Question 13

What is the blood supply and innervation of the ovaries?

Answer 13

• ovarian artery
• ovarian branch of uterine artery
• veins drain into pampiniform plexus, drains into ovarian veins
• r. ovarian vein into IVC
• l. ovarian vein into l. renal vein
• ovarian and pelvic nerve plexuses

Question 14

What are the three parts of the broad ligament?

Answer 14

• mesosalpinx (near fallopian tubes)
• mesovariam (enclose ovaries)
• mesometrium (connect to wall of uterus)

Question 15

What are the other ligaments that attach to the uterus?

Answer 15

• ovarian ligament
• round ligament
• transverse cervical ligament
• uterosacral ligament

Question 16

What is the blood supply and innervation of the uterus?

Answer 16

• uterine arteries
• uterine plexus–>uterine veins–>internal iliac v.
• uterovaginal plexus innervation

Question 17

What is the blood supply and innervation of the vagina?

Answer 17

• vaginal branch of uterine artery
• vaginal branches from internal iliac artery
• artery to the bulb of the vestibule from internal pudendal artery
• vaginal venous plexus-connects to uterine and vesicle plexuses and drains into internal iliac vein
• innervation: upper 3/4 is uterovaginal plexus, lower 1/4 is pudendal nerve