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ANAT380 > Module 3: The pelvis and perineum > Flashcards

Module 3: The pelvis and perineum Flashcards

1
Q

What does the bony pelvis consist of?

A

Right and left hip bones, sacrum, coccyx

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2
Q

What is hip bone composed of?

A

Ilium, ischium, pubis

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3
Q

What is the pelvic cavity divided into?

A
  1. Greater (false) cavity
  2. Lesser (true) cavity
    *separated by pelvic brim
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4
Q

Greater cavity

A

Region above pelvic brim

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5
Q

Lesser cavity

A

Below pelvic brim
Contains a pelvic inlet and pelvic outlet

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6
Q

Pelvic floor

A

Wide thin muscular layer of tissue that forms the inferior border of abdominopelvic cavity

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7
Q

Female pelvis

A

Wider and more shallow, with a lager inlet and outlet

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8
Q

Subpubic angle of female pelvis

A

90-100 degrees

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9
Q

Subpubic angle of male pelvis

A

70 degrees

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10
Q

Joints of the pelvis

A
  1. Sacroiliac joint
  2. Pubic symphysis
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11
Q

Symphysis pubis dysfunction

A

Instability of the pubic symphysis at the pelvic joint during pregnancy
Results in increase in symphyseal width and mobility

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12
Q

Symptoms of symphysis pubis dysfunction

A

Difficulty walking, pain localized to pubic area , pain that worsens w weight bearing activities and pain in perineum region

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13
Q

Features of pelvic floor

A

Levator ani
Coccygeus
Urogenital hiatus
Anal aperture

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14
Q

The puborectal sling

A

Attaches to pubic bone and wraps posteriorly around rectum forming the anorectal flexure

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15
Q

What forms the puborectal sling?

A

Fibres of the levator ani muscle group

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16
Q

Pelvic organ prolapse

A

Protrusion of pelvic organs through vaginal wall resulting from weakened pelvic floor that causes a drop of pelvic viscera

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17
Q

Who is pelvic organ prolapse more common in?

A

Females, after birth

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18
Q

What are the structures that may prolapse in females?

A

Bladder, rectum, uterus, cervix, vagina

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19
Q

What are the structures that may prolapse in males?

A

Rectum

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20
Q

Symptoms of pelvic organ prolapse

A

Difficulty initiating urine flow, strain to defecate

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21
Q

Two distinct pouches of the female pelvic peritoneum

A
  1. Vesicouterine pouch
  2. Rectouterine pouch
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22
Q

Vesicouterine pouch

A

Anterior abdominal wall to upper surface of urinary bladder
Anterior surface of uterus

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23
Q

Rectouterine pouch of Douglas

A

Anterior surface of rectum, btwn uterus and rectum

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24
Q

Pouch of the male pelvic peritoneum

A

Rectovesical pouch

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25
Q

Rectovesical pouch

A

Superior surface of urinary bladder to anterior surface of rectum

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26
Q

Pathway of ureter

A
  1. Abdominal wall: crosses over common iliac arteries
  2. Pelvic cavity: enters urinary bladder posteriorly
  3. Pelvic wall
    - Males: ductus deferens cross ureter where ureters drain into bladder
    - Females: each ureter crossed by uterine artery
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27
Q

Urinary tract infection

A

Bacterial infection in any part of urinary system

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28
Q

Why are females at a higher risk of UTI?

A

Shorter urethra- bacteria doesn’t have to travel far to infect bladder

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29
Q

Most common sites of UTI

A

Urethra and bladder

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30
Q

Symptoms of UTI

A

Burning with urination, localized pain at bladder, centre of pelvis and around pubic bone

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31
Q

Sigmoid colon

A

Forms S-shaped loop in upper pelvic cavity, ends at S3, continuous w rectum

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32
Q

Rectum

A

Follows curvature of sacrum (sacral flexure) before turning posteriorly at anorectal flexure, ends at anal canal

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33
Q

Location of rectum in females

A

Posterior to uterus

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34
Q

Location of rectum in males

A

Posterior to bladder

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35
Q

Venous drainage of sigmoid colon and rectum

A

Inferior mesenteric vein

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36
Q

Pregnancy hemorrhoids

A

Occurs in third trimester when veins in lower rectum become large and swollen

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37
Q

Symptoms of pregnancy hemorrhoids

A

Painful and itchy swellings in lower rectum, near anus, constipation, blood in stool if blood vessels rupture

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38
Q

Vas deferens

A

Superior to epididymis
Meets with seminal vesicle to form ejaculatory duct

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39
Q

Location of prostate

A

Inferior to bladder
Anterior to seminal vesicle

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40
Q

Pathway of vas deferens

A

Through inguinal canal with spermatic cord

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41
Q

Epididymitis

A

Bacterial infection of epididymis
Affects testis, epididymis, vas deferens, bladder

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42
Q

Epididymitis in children who havent hit puberty

A

Infection may start in bladder or kidney before spreading through ejaculatory duct to vas deferens to reach epididymis

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43
Q

Symptoms of epididymitis

A

Localized pain of infected testicle, fever, unilateral swelling of testes

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44
Q

Prostate tumor

A

Present in males 50+, as it grows it presses on prostatic urethra and disrupts flow of urine

45
Q

Symptoms of prostate tumor

A

Difficulty urinating, blood in urine/semen

46
Q

Male reproductive vasculature

A

Testicular artery
Artery to vas deferens
Pampniform plexus
Cremaster artery

47
Q

Where does the testicular artery branch off?

A

Abdominal aorta

48
Q

Where does the artery to the vas deferens branch off?

A

Internal iliac artery

49
Q

What is the pampniform plexus?

A

Network of veins that drains venous blood from testis into testicular vein

50
Q

What does the cremaster artery supply?

A

Fascial coverings and muscle of spermatic cord

51
Q

Testicular torsion

A

Testis rotate, twisting the spermatic cord that supplies and drains blood from testis
**age 12-18

52
Q

Symptoms of testicular torsion

A

Sudden, severe pain, swelling, change in scrotum colour (redness/darkening) on affected side of scrotum, localized pain in inguinal region of abdomen

53
Q

Location of vagina

A

Inferior to uterus
Anterior to rectum
Posterior to bladder

54
Q

Ectopic pregnancy

A

Egg attaches somewhere outside of uterus such as in uterine tube

55
Q

Symptoms of ectopic pregnancy

A

Usual pregnancy symptoms at first
Then as embryo grows theres pelvic pain on affected side, and sharp pain if fallopian tubes burst

56
Q

Arterial supply of female reproductive system

A

Ovarian arteries
Uterine arteries
Vaginal branches of uterine and internal iliac arteries

57
Q

Ovarian arteries

A

Lateral branches of abdominal aorta at L1, supply ovaries and distal uterine tubes

58
Q

Uterine arteries

A

Branches of internal iliac arteries, anastomose w ovarian arteries, supply proximal uterine tubes

59
Q

Venous drainage of female reproductive system

A

Right and left ovarian vein
Right and left uterine veins

60
Q

Right and left ovarian vein

A

Right drains into IVC while left drains into left renal vein

61
Q

Uterine veins

A

From a plexus that drains to internal iliac veins

62
Q

Ovarian cysts

A

Fluid filled sac that develops on an ovary, may effect ovaries, mesosalphinx (pelvic peritoneum) and ovarian arteries

63
Q

Symptoms of ovarian cysts

A

Unilateral pelvic pain (dull and heavy) localized to ovary w cyst, pain during intercourse

64
Q

Perineum

A

Diamond shaped area bounded by pubis symphysis anteriorly, ischial tuberosities laterally and coccyx posteriorly

65
Q

What is the perineum divided into?

A

Anal triangle posteriorly and urogenital triangle anteriorly

66
Q

Perineal membrane

A

Separates the urogenital triangle into superficial and deep pouches

67
Q

Pouches of the urogenital triangle

A

Superficial perineal pouch
Deep perineal pouch

68
Q

Superficial perineal pouch

A

Contains muscle, skin, external genitalia

69
Q

Deep perineal pouch

A

Contains urogenital diaphragm, external urethral sphincter and deep transverse perineal muscles

70
Q

Perineal body

A

Fibromuscular mass at centre of perineum that provides attachment for muscles of perineum and strengthens pelvic floor

71
Q

Ischiorectal fossa

A

Wedge-shaped space btwn ischium and anal canal, allows for expansion of anal canal during defecation

72
Q

Pudendal canal

A

On lateral wall of each ischiorectal fossa, formed within obturator fascia, contains pudendal nerve and internal pudendal vessels

73
Q

Ischiorectal abscesses

A

Infection of the anal canal that causes abscesses that perforate laterally through the external sphincter into the lower ischiorectal space

74
Q

Symptoms of ischiorectal abscesses

A

Pain/discomfort when walking and sitting, painful defecation, painful, swollen and tender at site of abscesses

75
Q

Muscles of the penis

A
  1. Ischiocavernosus
  2. Bulbospongiosus
76
Q

Ischiocavernosus

A

Cover 2 cura of the penis at the root

77
Q

Bulbospongiosus

A

Cover bulb of penis

78
Q

Foreskin of penis

A

Thin, loose skin at back of glans

79
Q

Frenulum of penis

A

Fold of skin attaching to foreskin on ventral surface of glans

80
Q

Advantages of having cicumsised penis

A

Reduces risk of bacterial growth that can cause infection or inflammation of foreskin

81
Q

Disadvantages of having circumsised penis

A

Surgical complications such as bleeding, infection; decreased sensitivity at glans due to a loss of nerve endings

82
Q

Balantis

A

Inflammation of foreskin or head of penis due to infection or chronic skin conditions in uncircumsised men

83
Q

Symptoms of balantis

A

Pain, red, swollen penis, sometimes painful urination

84
Q

How is the clitoris attached to the perineal membrane

A

2 cura and 2 vestibular bulbs

85
Q

Parts of the clitoris

A
  1. Body
  2. Glans
86
Q

Body of clitoris

A

Formed by union of right and left crus

87
Q

Glans of clitoris

A

Distal, formed by union of vestibular bulbs

88
Q

Female external genitalia

A

Mons pubis
Prepuce
Frenulum

89
Q

Mons pubis

A

Rounded mass of fatty tissue formed by union of labia majora

90
Q

Prepuce

A

Anterior and superior to clitoris, formed by union of labia minora

91
Q

Frenulum

A

Anterior and inferior to clitoris, fusion of labia minora forms one frenulum

92
Q

Vulvitus

A

Inflammation of vulva (labia majora and minora)

93
Q

Symptoms of vulvitis

A

Redness and swelling in vulva, itching and burning, some cases vulva turns white, cracks or develops fluid filled blisters that break open, ooze and crust over

94
Q

The greater vestibular glands

A

Posterior to vestibular bulbs on each side of vaginal orfice
Produce mucus during sexual arousal, carried by ducts that open at vaginal orfice

95
Q

What are the greater vestibular glands homologous to in males?

A

Bulbourethral glands

96
Q

Muscles of the clitoris

A

Two ischiocavernosus muscles cover the cura
Two bulbospongiosus muscles cover the vestibular bulbs and greater vestibular glands

97
Q

Vasculature of the pelvis and perineum

A

Umbilical artery
Inferior vesicle artery
Internal pudendal artery

98
Q

Umbilical artery

A

Transport deoxygenated blood from fetus to placenta, after birth proximal branches become superior vesical artery that supplies upper part of bladder

99
Q

Inferior vesicle artery

A

Supplies bladder, ureter, seminal vesicles, prostate and ductus deferens

100
Q

How does the internal pudendal artery enter the perineum?

A

Exits through greater sciatic foramen and enters lesser sciatic foramen to perineum through pudendal canal

101
Q

What does the internal pudendal artery supply?

A

Skin and muscles of anal triangle, urogenital triangle and associated erectile bodies

102
Q

Priapism

A

Common side effect of drug use, leads to prolonged (>6hrs) painful erection of penis or clitoris unassociated with sexual arousal

103
Q

Female priapsim

A

Impaired outflow of blood, swollen clit due to inadequate drainage

104
Q

Male priapism

A

Uncontrolled inflow of blood from branches of internal pudendal artery leading to red and swollen glans and shaft of penis

105
Q

Pudendal nerve

A

S2-S4
Main branch of sacral plexus to perineum

106
Q

Where does the pudendal nerve travel?

A

Leaves through greater sciatic foramen, crossing the ischial spine and enters perineum through lesser sciatic foramen

107
Q

Where does the perineal nerve travel?

A

Branch of pudendal nerve that runs from deep perineal pouch to the superficial pouch

108
Q

What does the perineal nerve supply?

A

Sensory and motor innervation to urogenital region

ANAT380 (8 decks)

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