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Anatomy > Male Pelvis > Flashcards

Male Pelvis Flashcards

1
Q

Where is the pelvic viscera relative to the pelvic pain line?

A

Inferior to it (pelvic pain line runs along inferior border of peritoneum)

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2
Q

What happens to the pelvic fascia when they penetrate the pelvic floor and what is this called?

A

The parietal and visceral pelvic fascia become continuous and thick, forming the tendinous arch

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3
Q

What is the anterior aspect of the tendinous arch of pelvic fascia called in males and females respectively?

A

Puboprostatic ligament (males), pubovesical ligament (females)

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4
Q

Two potential spaces of the male pelvis

A

Rectropubic and rectrorectal

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5
Q

Name the three leaflets of the hypogastric sheath, including alternate names and where each attaches

A

Anteriormost (Lateral ligament of the bladder) - attaches to bladder. Posteriormost (presacral fascia) - attaches to rectum, Middle lamina (rectovesical septum in males runs btwn bladder and rectum, transverse (cardinal) ligament in females, attaches to cervix of uterus)

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6
Q

Where are the ureters relative to the ductus deferens in males?

A

Posterolateral to ductus deferens

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7
Q

List the arteries that send branches to supply the ureter

A

Renal artery, Gonadal artery, Aorta, Common Iliac, Internal Iliac, Superior Vesical, Uterine (f), Middle Rectal, Vaginal (f), Inferior Vesical (m)

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8
Q

Where does the ureter get its innervation from?

A

Adjacent autonomic plexuses

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9
Q

Is the course of the ureter mostly superior or inferior to the pelvic pain line?

A

Superior

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10
Q

What does the bladder rest on?

A

Anteriorly on the pubic bone and symphysis, posteriorly on the prostate (male) or vagina (female)

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11
Q

What holds the neck of the bladder in place?

A

Lateral ligament of bladder and tendinous arch of pelvic fascia

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12
Q

List the four surface and four parts of the bladder

A

Surfaces - Superior, 2 inferolateral, and posterior. Parts - Apex, fundus, body, neck

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13
Q

What three points create the triangular-shaped trigone of the bladder?

A

The two ureteric orafices (superior) and the internal urethral orifice (inferior)

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14
Q

Uvula of the bladder

A

Elevated ridge along the wall of the inferior bladder, in the trigone region

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15
Q

Where is the detrusor muscle and what is the orientation of its fibers?

A

Muscle of the bladder, fibers are scattered in orientation, no particular pattern

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16
Q

What feature of the bladder is present in one sex but not the other, which sex is it present in, and what does it do?

A

The involuntary internal urethral sphincter is present only in males, it prevents reflux of semen into the bladder

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17
Q

Arterial supply to the bladder

A

Superior vesical aa, Inferior vesical aa (m), Vaginal aa (f), Obturator aa, Inferior Gluteal aa

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18
Q

Venous drainage for the bladder

A

Vesical venous plexuses (m/f), also prostatic venous plexuses (m), drain to internal iliac vein (m/f)

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19
Q

What system innervates the detrusor muscles?

A

Parasympathetic (this tells you to go to the bathroom)

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20
Q

Where do visceral afferent fibers leaving the bladder go?

A

Fibers from superior portion of bladder follow sympathetic fibers retrogradely, fibers from inferior portion follow parasympathetic fibers retrogradely (remember pelvic pain line)

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21
Q

Which nervous system helps you not go to the bathroom and which system helps you go to the bathroom?

A

Parasympathetic - go to bathroom, Sympathetic - not now

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22
Q

How long are the male and female urethrae?

A

Male - 18-22 cm, Female - 4 cm

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23
Q

4 parts of the male urethra and the lengths of each

A

Intramural (preprostatic) (1-1.5 cm), Prostatic (4 cm), Intermediate (less than 1 cm), Spongy (15-16 cm)

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24
Q

What are the widest/most distensible and shortest/least distensible parts of the male urethra?

A

Prostatic is widest and most distensible, Intermediate is shortest and least distensible

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25
Q

Into what structure does the female urethra open?

A

Vestibule of vagina

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26
Q

At what vertebral level is the rectosigmoid junction?

A

S3

27
Q

What are the two longitudinal flexures of the rectum and what is the more distal flexure useful for?

A

Sacral and anorectal flexure (important for maintaining fecal continence)

28
Q

List the lateral flexures of the rectum

A

Superior and inferior (left side), intermediate (right side)

29
Q

What causes transverse rectal folds and lateral flexures of the rectum?

A

Thickening of circular muscles

30
Q

The ampulla of the rectum is located where?

A

Superior to pelvic diaphragm (i.e. superior to where levator ani muscles connect)

31
Q

What is immediately superior to the rectum?

A

Peritoneum

32
Q

What is immediately anterior to the superior rectum?

A

Rectovesical pouch (males), Rectouterine pouch (females)

33
Q

What is immediately lateral to the rectum?

A

Pararectal fossae

34
Q

What structures are immediately posterior to the rectum?

A

S3-S5, coccyx, median sacral vessels, sacral sympathetic trunk

35
Q

Give the arterial supply to the rectum and where each artery comes from

A

Superior rectal artery (from IMA), Middle rectal arteries (from Internal Iliac), Inferior rectal arteries (from internal pudendal)

36
Q

How is the pattern of rectal arteries different from that of rectal veins?

A

Its not. Both have a superior, middle, and inferior

37
Q

Rectal venous plexuses

A

Internal (submucosal) and External (subcutaneous)

38
Q

For each of the rectal veins, give the system it ultimately drains to

A

Superior - to Portal system, Middle and Inferior - To Internal Iliac Vein to Caval system

39
Q

Sympathetic innervation of the rectum

A

Hypogastric/pelvic plexuses, and peri-arterial plexuses via superior rectal artery

40
Q

Parasympathetic innervation of the rectum

A

Inferior hypogastric/rectal plexuses

41
Q

What fibers to visceral afferent fibers leaving the rectum follow and to where?

A

Parasympathetic fibers retrogradely to S2-S4 spinal ganglia

42
Q

Which anal sphincter is voluntary and which is involuntary?

A

Internal is involuntary, external is voluntary

43
Q

What is the internal anal sphincter formed from, and which nervous system makes it relax and which makes it contract?

A

Formed by thickening of circular muscles, forced to contract by sympathetic system, forced to relax by parasympathetic system

44
Q

What is the external anal sphincter attached to?

A

Pernieal body (anteriorly), Coccyx via anococcygeal ligament (posteriorly), Puborectalis (superiorly)

45
Q

What is anterior to the prostate gland?

A

Muscular retropubic space

46
Q

What is posterior to the prostate gland?

A

Ampulla of rectum

47
Q

What is along the inferolateral surfaces of the prostate?

A

Levator ani muscles

48
Q

Lobes of the prostate gland

A

Anterior, Left, Right

49
Q

What is another name for the anterior lobe of the prostate?

A

Isthmus

50
Q

Arterial supply to the prostate

A

Inferior vesical arteries (majority of blood supply), middle rectal arteries, internal pudendal arteries

51
Q

Venous drainage of the prostate

A

Prostatic venous plexuses to internal iliac veins (vesical venous plexus and internal vertebral venous plexus also involved)

52
Q

Effects of sympathetic fibers on male internal genital organs

A

Contraction of internal urethral sphincter, rapid contraction of ductus deferens, contraction and secretion of ejaculatory ducts and prostate, ejaculation

53
Q

Primary effect of parasympathetic fibers on male internal genital organs

A

Cavernous nerve causes penile erection

54
Q

Give the number of nerves, vessel pairs, and muscles which pass through the greater sciatic foramen

A

7 nerves, 3 vessel pairs, and 1 muscle

55
Q

Name the nerves which pass through the greater sciatic foramen

A

Sciatic nerve, Superior/inferior gluteal nerves, Internal pudendal nerve, Posterior femoral cutaneous nerve, Nerve to quadratus femoris, nerve to obturator internus (L5, S1)

56
Q

Name the blood vessels which pass through the greater sciatic foramen

A

Superior gluteal artery/vein, Inferior gluteal artery/vein, Internal pudendal artery/vein

57
Q

What muscle passes through the greater sciatic foramen?

A

The piriformis

58
Q

Give the relations of the obturator artery while it is in the pelvis

A

Laterally with the obturator fascia, medially with ureter, ductus deferens, and peritoneum, and it is superior to the obturator nerve

59
Q

Name the nerves which travel through the lesser sciatic foramen

A

Pudendal nerve, nerve to obturator internus

60
Q

Name the blood vessels which travel through the lesser sciatic foramen

A

Internal pudendal artery and vein,

61
Q

Name the miscellaneous (e.g. muscles, tendons, etc) structures which pass through the lesser sciatic foramen

A

Tendon of obturator internus

62
Q

Name the blood vessels that pass through the obturator foramen (via the obturator canal)

A

Obturator artery and vein

63
Q

Name the nerves that pass through the obturator foramen (via the obturator canal)

A

Obturator nerve

Anatomy (77 decks)

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