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AANATOMY > Male pelvis > Flashcards

Male pelvis Flashcards

1
Q

What is the sacral promonotory and ala of the sacrum?

A
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2
Q

What is the arcuate line (OF THE ILIUM)?

(Not same as the arcuate line of the rectus sheath)

A
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3
Q

What is the pecten pubis also called?

Where is it located?

A

AKA Pectineal line

Ridge on the superior ramus of the pubic bone

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4
Q

Describe the location of the pubic crest.

What attaches here?

A

Medial to the pubic tubercle

Gives attachment to:

rectus abdominis

external oblique muscle

pyramidalis muscle.

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5
Q

What are the boundaries of the pelvic outlet

A

Anterior -> pubic symphysis

Anterolaterally -> pubic rami

Posteriolaterally -> sacrotubeorus ligaments

Posteriorly -> coccyx

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6
Q

Which parts of the pelvis are termed the true and false pelvis?

A

True below inlet

False above inlet

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7
Q

How do the greater and lesser pelvis (pelvis major and minor) differ in male and female?

A

Greater pelvis:

  • Female: Shallow
  • Male: Deep

Lesser Pelvis:

  • Female: Wide and Shallow
  • Male: Narrow and Deep
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8
Q

What is the shape of the pelvic inlet and outlet like in men and women?

A

Pelvic inlet:

  • Female: Oval and rounded
  • Male: heart shaped

Pelvic outlet:

  • Female: Comparatively large
  • Male: comparatively small
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9
Q

How does the subpubic angle differ between males and females?

A

Female: Obtuse

Male: Acute

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10
Q

How do the obturator foramens differ between men and women?

A

Females -> oval

Male -> round

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11
Q

How does the acetabulum differ in men and women?

A

Females -> small

Men -> large

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12
Q

What type of joints are the sacroiliac and pubic symphysis joints?

A

Sacroiliac joint -> synovial plane

Pubic symphysis -> secondary cartilaginous

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13
Q

What are the walls of the pelvic cavity?

A
  • Antero-inferior wall
    • (formed by the bodies and rami of the pubic bones and the pubic symphysis)
  • Two lateral walls
  • Posterior wall
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14
Q

Which muscle occupies the lateral pelvic wall?

A

Obturator internus

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15
Q

Which muscle is present on the posterior wall of the pelvis?

A

Piriformis

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16
Q

Which nerve network lies on the muscle forming the posterior wall of the pelvis?

A

Sciatic

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17
Q

What forms the pelvis floor?

A

Levator ani + ischiococcygeus

Levator ani = puborectalis, pubococcygeus, iliococcygeus

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18
Q

What is a raphe?

A

A groove in an organ or tissue

Marks the line where two halves fused in the embryo

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19
Q

What are the perineal and anococcygeal bodies?

A

Pernieal body -> firbomuscular mass that lies in the middle of the pernieal membarne that maintains the integrity of the pelvic floor

Anococygeal mass -> musculotendinous mass that lies between the coccyx and the anal canal

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20
Q

What is the function of the pelvic diaphragm/ floor

A
  • Support of abdominopelvic viscera
  • Resistance to increases in intra-abdominal pressure
  • Urinary and fecal continence
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21
Q

What is the innervation of the pelvic diaphragm/ floor?

A

PUDENDAL NERVE

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22
Q

Damage to the pelvic floor during childbirth is common and potentially damaging.

Why?

A

Weakening of levator ani and pelvic fascia

This alters position of the neck of the bladder and urethra

Can cause urinary stress incontinence

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23
Q

What is an episiotomy and why does it minimise damage during childbirth?

A

Enlarges vaginal opening by cutting into muscular area between vagina and anus (perineum)

Usually medio-laterally

Reduces…

Excessive tearing of pelvic floor

Spread of tears

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24
Q

Name 3 parts of the alimentary system that are present in the pelvis

A

Rectum

Anal canal

Transverse colon

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25
Q

Branches of the right and left internal iliac artery distribute blood to most of the pelvic organs, perineum and gluteal region except what?

A

Gonads (testes and ovaries)

Upper part of rectum

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26
Q

The venous drainage of the pelvis structures consists of which 5 different veins?

A

Internal iliac veins

Superior rectal veins

Median sacral vein

Gonadal veins

Internal vertebral venous plexus

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27
Q

Which part(s) of the rectum drain into the portal and systemic circulation?

A

Superior = portal

Middle and inferior = systemic

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28
Q

The veins along the sides and base of the prostate join to form the prostatic venous plexus.

With which venous plexus does the prostatic venous plexus communicate on its posterior side?

A

This drains into the internal vertebral venous plexus.

Cancer commonly spreads through this route from prostate to vertebral bodies

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29
Q

Which nerve supplies skin at the root of the penis in the male and the labia in the female?

A

Ilioinguinal nerve

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30
Q

What nerve root does the ilioinguinal nerve originate from?

A

L1

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31
Q

The ilioinguinal nerve enters the inguinal ring where?

A

Superficial inguinal ring

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32
Q

What is the nerve root of the genitofemoral nerve?

A

L1-L2

(genitofemoral nerve lies on the illiopsoas

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33
Q

The genitofemoral nerve enters the inguinal canal where?

A

Deep inguinal ring

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34
Q

What structures in the male are supplied by the genital branch of the genito-femoral nerve?

A

Anterior scrotum and cremaster muscle

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35
Q

What is the clinical significance of the loss of the genital branch of the genitofemoral nerve?

A

Cremaster reflex lost -> no temperature control of testes

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36
Q

What plexus does the pudendal nerve arise from?

A

Sacral plexus

37
Q

What two muscles in the reproductive organs does the pudendal nerve supply?

A

Bulbospongiosus and ischiocavernosus muscles

38
Q

From which segmental level(s) does the pudendal nerve arise?

A

S2-S4

39
Q

How does the pudendal nerve travel from pelvis to perineum?

(why is it important to know this?)

A

Via the gluteal region

This arrangement is essential to understand in bilateral pudendal nerve block for pain relief during childbirth

40
Q

What bony landmark do you look for when performing a pudendal nerve block during labour?

A

Ischial spine

41
Q

Sympathetic fibres from L1-L2 travel via what plexus to supply the vas deferens, seminal vesicles, prostate and epididymis in the male?

A

Hypogastric plexus

42
Q

What nerves supply sympahethic and parasympathetic innervation to the female genital tract?

A

Sympathetic -> pelvic and ovarian plexus

Parasympathetic -> pelvic splanchnic nerves (S2, S3 and S4)

43
Q

What innervates erectile tissue in both male and female?

A

Parasympathetic fibres from S2, S3 and S4 via the hypogastric plexus

44
Q

What forms erectile tissues?

A

Tissues with numerous vascular spaces that may become engorged with blood

45
Q

Name the 4 primary node groups in the pelvis

A

Common iliac lymph nodes

External iliac lymph nodes

Internal iliac lymph nodes

Sacral lymph nodes

46
Q

The external iliac lymph nodes drain what?

A

Inguinal lymph nodes

Adductor region of thigh

Superior part of the anterior and middle pelvic organs

47
Q

The internal lymph nodes drain what?

A

Gluteal region

Deep perineum

Inferior pelvic viscera

48
Q

What do the sacral lymph nodes drain?

A

Rectum

Posterior wall of pelvis

(posteroinferior pelvic viscera)

49
Q

What do the common iliac lymph nodes drain?

A

external & internal iliac LNs

Sacral LNs

50
Q

What 3 categories can the reproductive organs be grouped into?

A
  1. Gonads:
    • Testes or ovaries
    • Where gametes or sex cells are produced
    • Site for the production of important sex hormones
  2. External genitalia
  3. Internal genitalia
    • Tube system for conveying gametes
    • Accessory glands which support the gametes and lubricate the copulatory organs
51
Q

What is included in the male internal reproductive organs?

A

Testis

Vas deferens

Seminal glands

Prostate

Epididymis

Bulbourethral glands

52
Q

In the male the gonads are located outside the abdominopelvic cavity, but remain intimately connected to the structures located there.

What purpose does this serve?

A

Temperature regulation

53
Q

What are the main contents of the spermatic cord?

A

Vas deferens

Pampiniform plexus

Cremaster muscle

Testicular artery

Genitofemoral nerves

Lymphatics

54
Q

The ovoid testes are suspended in the scrotum by what?

A

Spermatic cords

55
Q

What is the tough outer fibrous layer of the testis?

A

Tunica albuginea

56
Q

The tunica vaginalis is a peritoneal sac covering the testis.

What are the two layers of the tunica vaginalis?

A

Parietal and visceral

57
Q

What material is present between the two layers of tunica vaginalis?

A

Fluid lubricating layers

58
Q

Increase in blood between the two layers of tunica vaginalis is called what?

A

Haematocoele

59
Q

What vertebral level fo the testicular arteries arise from the abdominal aorta?

A

L2

60
Q

Name two important structures the testicular arteries pass near the pelvic brim before they travel through the inguinal canal

A

Ureters

Inferior parts of the external iliac arteries

61
Q

What is the term used for the 8-12 anastomosing veins associated with the testis?

A

Pampiniform Venous Plexus

62
Q

What is the function of the pampiniform venous plexus?

A

Venous return and temperature regulation of testes

63
Q

Into which vein does the right and left testicular vein drain?

A

Right = IVC

Left = Left renal vein

64
Q

Which two lymph node groups recieve lymph from the testis?

A

Right and left lumbar

Para-aortic lymph nodes

65
Q

Describe the route of the vas deferens

A

arises from the tail of the epididymis

traverses the inguinal canal

enters the pelvis by crossing over the external iliac vessels.

Terminates by joining the duct of the seminal gland to form the ejaculatory duct

66
Q

WHat secretions are produced by the seminal vesicles?

A

65-75% of seminal fluid

Thick alkaline fluid

(Rest produced by prostate)

67
Q

What is the clinical significance of drainage from the prostatic venous plexus?

A

Gives passage to parasympathetic fibres

which give rise to the cavernous nerves that convey the fibres that cause penile erection

68
Q

What are the Bulbourethral (Cowper’s) Glands?

A

These are small, paired structures located in the urogenital diaphragm which empty into the penile/ spongy urethra.

They produce mucus like secretions which enter the urethra during sexual arousal, contributing less than 1% of semen

69
Q

What is the lymphatic drainage of the prostate?

A

Internal iliac and sacral nodes

70
Q

What is the lymphatic drainage of the seminal vesicle?

A

External iliac

71
Q

What is the lymphatic drainage of the scrotum?

A

Superficial inguinal

72
Q

What is the lymphatic drainage of the penis?

A

Superficial and deep inguinal

73
Q

What are the histological features of the testes (seminiferous tubules)?

A

Convoluted tubules sectioned in various planes.

4-8 layers of cells.

Spermatozoa in the lumen.

Leydig cells in the interstitial spaces between tubules

74
Q

What are the histological features of the prostate?

A

Serous aveloi with infolding epithelium.

Trabeculae of muscular stroma

Amorphous eosinophilic masses, called corpora amylacea, in the elveoli in older men

75
Q

What are the histological features of the seminal vesicle?

A

No sperms in the lumen

Highly recessed and irregular lumen forming crypts and cavities giving a honey combed appearances

Well developed muscular externa

76
Q

What are the histological features of the ductus deferens?

A

Lumen Stellate in shape

A thick walled muscular tube

Epithelial lining and its supporting lamina propria are thrown into longitudinal folds

77
Q

What imaging is this and what is it showing

A

USS

Shows the testes (right) and epididymis

78
Q

What is this imaging and what is it showing

A

USS of testes

Yes there is a mass in it but who gives a fuck

79
Q

What imaging is this and what are the arrows pointing to

A

MRI

Green -> Bladder

Orange -> seminal vescile

Blue -> anal canal

80
Q

What image is this and what is the arrow pointing to

A

MRI

Prostate

81
Q

What is the function of the crmaster and dartos muscles?

A

Thermoregulation of the testes

82
Q

What is this and label 1, 2 & 3

A

Speramtic cord

1- Internal spermatic fascia

2- cremaster muscle

3- External spermatic fascia

83
Q

What is number 8

A

Tunica albuginea

84
Q

Why is the left testicular cancer more dangerous than the right?

A

As the left testicual (gonadal) vein drains into the left renal vein, so the cancer can spread to the kidenys more easily

85
Q

What are the fluids secreted by the prostate, seminal vesciles and bulbourethral galnds

A

Prostate -> liquid rich in citric acid and proteolytic enzymes (lquifies coagulated semen)

Seminal vesicle -> thicc alkaline fluid that contains fructose, prostaglandins, fibrinogen and Vit. C

Bulbourethral glands -> Mucous like secretions during sexual arousal (pre-cum)

What prostatic fluid contains

Fructose

Vit. C

Fibrinogen

Prostaglandins

86
Q

What are the sympathetic (L1-L2) and parasymapthetic (S2-S4) responses for sexual activivity in a man

(erection, emission, ejaculation, emission)

A

Erection -> parasympathetic

Emission -> sympahetic

Ejaculation -> paraympathetic & sympathetic

Remission -> sympathetic

For ejaculation:

Parasympathetic -> contraction of external uertheral sphincter

Symaphetic - contraction of internal urethral sphincter

87
Q

What does the inguinal canal contain

A

Ilio-ingunial nerves

Inguninal LN

Spermatic cord

Spermatic cord contains

Genito-femoral nerve

Testicular artery

Vas deferens

Panpiniform plexus
Cremaster muscle

88
Q

How do the gonadal arteries travel

A

Retroperitoneally

AANATOMY (20 decks)

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