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anatomy of the abdomen adn pelvis > male pelvis and perineum > Flashcards

male pelvis and perineum Flashcards

1
Q

describe the difference between the male and female pelvis

A

female- inlet = oval
wider pubic angle

male - inlet heart - transverse narrower
sub-pubic angle - smaller

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2
Q

describe the orientation of the pelvis

A

ASIS and pubic tubercles are in the same plane

greater and lesser pelvises are continuous

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3
Q

describe the peritoneum and the pelvic fascia

A 
parietal peritoneum continues into the pelvic cavity - doesn't reach the pelvic floor 
pelvic viscera (except uterine tubes) are not completely covered by the peritoneum

space between pelvic wall and the peritoneum not covered by the viscera contains the pelvic fascia
pelvic facia condensations form ligaments - supporting viscera like cervix, vagina, prostate
form the pelvic flow

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4
Q

what are the contents of the male pelvic cavity

A

ureter (most in abdomen), bladder urethra

genital organs - prostate, ductus deferens, seminal vesicles, bulbourethral glands

rectum

caecum, appendix, sigmoid colon and ileum - in the false pelvis

vessels nerves and lymphatics

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5
Q

what shape is the true pelvis

A

wedge

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6
Q

describe the male pelvic ORGANS

A

prostate gland surrounds 1st (prostatic) part of urethra

ductus deferens from testes passes through the inguinal canal - then over and behind the urethra through the prostate

seminal vesicles on back of bladder - open into ductus deferens between the ampulla and the ejaculatory duct

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7
Q

relationship of the male bladder and the prostate

A

the male bladder sits on the prostate - transfixed by the prostatic part of the urethra

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8
Q

which muscles line the walls of the pelvis

A

obturator internus

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9
Q

action of the bulbourethral glands

A

secrete clear fluid

lubricate the urethra

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10
Q

what forms the semen

A

the secretions from the ductus deferens (sperm), seminal vesicles, prostate

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11
Q

where do the ductus deferens end

A

ampulla - large space

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12
Q

what is the ejaculatory duct composed of

A

ductus deferens and the seminal vesicles

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13
Q

describe the prostatic urethra and its features

A

internal urethral sphincter - sm - invol

prostatic utricle - blind ended sac - wall of urethra

openings of ejaculatory ducts

external urethral sphincter - skeletal muscle

internal urethral sphincter

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14
Q

nervous supply in an erection

A

PNS, SNS, sympathetic

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15
Q

describe the internal urethral sphincter

A

sm - well organised in males
closed during ejaculation by sympathetic stimulus - don’t want seminal fluid to go to urinary bladder

PNS - relaxes the sphincter

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16
Q

list the 4 parts of the male urethra

A

preprostatic part - 1.5cm

prostatic part 2.5cm

membranous part 2cm

spongey part 15cm

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17
Q

what determines the size of the catheter for males

A

the external sphincter

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18
Q

describe the arterial supply to the male pelvis

A

common iliac -> internal and external iliac arteries
external -> legs
internal -> pelvic viscera:
inferior vesicle artery -> prostate, bladder, ductus deferens
superior vesical arteries -> to bladder and ductus deferens

testes from testicular artery from the abdominal aorta

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19
Q

describe the perineum

A

diamond shape area
between the pubic symphesis, ischial tuberosities and coccyx
divided into the anterior - urogenital and posterior - anal triangles

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20
Q

posterior compartment of the perineum

A

ischio-anal fossae - fat filled spaces separating anal canal and levator ani from the pelvic wall -> expansion of the pelvic walls
infection

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21
Q

anterior triangle of the perineum

A

divided into superficial/deep parts by the perineal membrane 2

above the membrane is the deep pouch

22
Q

clinical relevance of the deep and superficial perineal pouches

A

if the urethra is ruptured on one side of the membrane - the urine will accumulate on that side but you wont see it on the other side

23
Q

what is the perineal membrane

A

thick - triangular fascia structure attached to the pubic arch - posteriorly free margin
anteriorly - small gap

24
Q

action of the bulbospongious muscle

A

when contracts it expels the last bit of urine is expelled

25
Q

perineal body

A

all muscles come to this anchor point

26
Q

what does the ischiocavernosus muscle cover

A

the crus of the penis

27
Q

what runs through the corpus spongiosum

A

the urethra

28
Q

what is the corpus cavernosum

A

erectile tissue

29
Q

median erectile muscle in males and females

A

male - corpus spongiosum - bulb of the penis

female - divides around the vestibule -> vestibular bulbs

30
Q

lateral erectile tissue

A

corpora cavernosae - attached to ishiopubic rami

31
Q

what is formed when the lateral and median erectile muscles meet

A

form shaft/head of penis/clitoris in females

32
Q

what type of muscle surround erectile tissue

A

skeletal muscle

33
Q

where do the bulbourethral glands and ducts open into the urethra

A

below the perineal membrane

34
Q

where do the accessory glands open into the urethra

A

above the perineal membrane

35
Q

arteries of the rectum

A

superior rectal artery
medial rectal artery
inferior rectal artery

upper and middle from the inferior mesenteric artery

2 pairs from the internal iliac artery

36
Q

venous supply of the rectum

A

similar to artery

porto-systemic venous anastomosis around lower rectum and anal canal

37
Q

describe the ichioanal fossa

A

on lateral side - pudencal canal - pudencal artery, vein and nerve through

main source of nerve and blood supply to the structures in the perineum

38
Q

layers of the wall of the testes

A

external spermatic fascia - extension of oblique aponeurosis

chremasteric fascia - from internal oblique

internal spematic fascia - extension of tranversalis fascia

39
Q

blood supply of the testes

A

testicular artery - from below renal artery of the of abdominal aorta
R drains into IVC
L drains into L renal vein -> R angle

40
Q

what is the conjoint tendon

A

transversus abdominus and internal oblique

41
Q

contents of the spermatic cord

A

genital branch of the ilioinguinal nerve

ductus deferens

42
Q

where does the corpus spongiosum go

A

into the glans

43
Q

describe the path of the corpus cavernosum

A

from the roots to the ischiopubic ramus to the posterior of the glans

44
Q

what is the deep fascia of the penis

A

it wraps around the erectile tissue - keeping it all in a tight cylinder - otherwise it wouldn’t work

45
Q

blood supply of penis

A

from internal peduncle artery - from internal iliac

the dorsal arteries -> deep arteries (supply corpus cavernosa) when enter the tissue -> engorgement

dorsal artery - supplies the skin and the connective tissue

artery of the bulb supplies the bulb, corpus spongiosum, glans, urethra

helcine arteries - supply the cavernous spaces - coiled, when relax they allow blood to accumulate, this is caused by PNS innervation

46
Q

describe the nerves of the pelvis

A

ANS only
sympathetic from T10-L2 via hypogastric plexus
PNS from 2S2-S4 outflow

sensation is visceral = referred to suprapubic region and perineum

47
Q

plexuses of the pelvis

A

superior hypogastric plexus
R and L inferior hypogastric plexus

PNS joins the inferior hypogastric plexus

48
Q

somatic nerve function of the pelvis

A

sensory - dorsal nerve of the penis - sensory to penile skin, glans

motor - to perineal muscles bulbospongiosus and ischicavarnosus - voluntary - causing ejectulation

49
Q

PNS

A

vasodilation of arterioles in erectile tissue - male and female
secretion in prostate bulbourethral glands

50
Q

sympathetic

A

contraction of SM of epidymis (wall of the prostate gland), vas deferens, seminal vesicles, prostate causing emission
contraction of the internal urethral ssphincter to prevent reflux of semen

51
Q

nerves of the perineum

A

somatic - mainly sacral
most important - pudendal S2-4
supplies all perineal skeletal muscles

sensory to penis, lower urethra, lower rectum and anal canal

anatomy of the abdomen adn pelvis (8 decks)

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