Pelvic anatomy Flashcards
How many layers exist in the urogenital triangle and name them.
4
Deep perineal pouch
Perineal membrane
Superficial perineal pouch
Perneal fascia
What is contained within the deep perineal pouch?
Part of the urethra, external urethral sphincter and vagina
What is the function of the perineal membrane?
Site of attachment of muscles of external genitalia
What is contained within the superficial perineal pouch?
Erectile tissues of penis and clitoris
Ischiocavernosus, bulbospongiosus and superficial transverse perineal muscles
Bartholins glands
What makes up the perineal fascia?
Deep layer
Superficial layer - subdivided into deep (continuation of Scarpa’s fascia) and superficial (continuation of Camper’s fascia)
What is the perineal body?
The strong muscular structure that anchors the perineal muscles, sphincter muscles and levator ani
What separates the greater and lesser sciatic foramen?
Sacrospinous ligament
Which structure divides the greater sciatic foramen, into two further foramina?
Piriformis
What are the three bones that make up the pelvis?
Ilium
Ischium
Pubis
What is the name of the cartilage that connects the three pelvic bones at the acetabulum?
Triradiate cartiliage
Which bone makes up the obturator foramen and what is transmitted?
Ischium
Obturator nerve, artery and vein
What are is the greater and lesser pelvis and what does it contain?
Greater (false) pelvis is superior and contains the lower abdominal viscera
Lesser (true pelvis) is inferior and consists of the pelvic cavity and viscera
Separated by the pelvic inlet
What are the borders of pelvic brim (boundaries of the inlet)?
Posterior - sacral promontory
Lateral - Illiopectineal line
Anterior - pubic symphysis
What are the borders of the pelvic outlet?
Posterior - tip of coccyx
Lateral - ischial tuberosities and inferior margin of sacrotuberous ligament
Anterior - public arch
Which muscles attach to the coccyx?
Gluteus maximus, levator ani and anococcygeal raphe
What type of cartilage lines the sacroiliac joint and what type of joint is it?
Hyaline cartilage
Synovial joint
What are the major muscles of the pelvic floor?
Puborectalis, pubococcygeous, illioccoccygeous and coccygeous
What cell types lines the urethra?
Stratified columnar epithelium
What is the blood supply to the male urethra?
Prostatic urethra = inferior vesical artery
Membranous urethra = bulbourethral artery (internal pudendal artery)
Bulbous urethra = internal pudendal artery
Which glands lie on either side of the female urethra and are homologous to the male prostate?
Skene’s glands
Which vessels supply by the scrotum?
Anterior scrotal arteries - external pudendal
Posterior scrotal arteries - internal pudendal
Veins follow arteries draining into the external pudendal veins
What is the nerve supply to the scrotum?
Anterior and anterolateral - genital branch of genitofemoral nerve and ilioinguinal nerve (anterior scrotal nerves)
Posterior aspect - perineal branches of the pudendal nerve and posterior cutaneous femoral nerve (posterior scrotal nerves)
What is the function of the bulbourethral glands (Cowper’s glands)?
Contribute to the final volume of semen by providing a lubricating mucus secretion: lubrication, clears out urethral contents ready for ejaculation, helps to neutralise acidity
Which muscle forms the glans penis?
Corpus spongiosum lies inferiorly and forms the head
What are the fascial coverings in the penis?
Superficial (Colle’s) fascia lies under the skin and is a continuation of Scarpa’s fascia
Deep (Buck’s) fascia lies deeper and binds the corpus cavernousa and spongiosum together
Tinea albuginea created a roff over corpus spongiosum
Which arteries supply the penis?
Dorsal and deep penile arteries
Bulbourethral artery
All branches of the internal pudendal artery
Venous is via deep and superficial dorsal penile veins which drain into prostatic plexus
What is the broad ligament formed from and what does it cover?
Peritoneum
Covers the ovaries posteriorly only, fallopian tubes and surround uterus
What are the two ovarian ligaments and their features?
Ovarian ligament - connects the ovary to the side of the uterus
Suspensory ligament of ovary - connects the ovary to the lateral abdominal wall and contains ovarian vessels and nerves
What ligament is a remnant of the embryonic gubernaculum?
Round ligament of uterus - connects the uterine horns to the labia majora
Which ligament contains the uterine arteries and nerves?
Cardinal ligament of the uterus
Provide support for the cervix and lateral fornix of the vagina
What does water under the bridge refer to in regards to pelvis anatomy?
Ureter runs under uterine artery 1cm laterally to the internal cervical os, and care must be take during hysterectomy.
Ovarian arteries cross at the level of the pelvic brim
What are the branches of the anterior division of the internal iliac artery (anti-clockwise)?
Obturator artery
Umbilical artery (gives rise to superior vesical artery)
Inferior vesical artery
Vaginal and uterine arteries (in females)
Middle rectal artery
Internal pudendal artery
Inferior gluteal artery
What are the branches of the posterior division of the internal iliac artery?
Superior gluteal artery
Iliolumbar artery
Lateral sacral arteries
Which veins drain into the external iliac veins?
Inferior epigastric
Deep circumflex iliac veins
Which veins drain into the internal iliac veins?
Correspond with arterial branches of internal iliac:
Superior and inferior gluteal veins
Middle rectal vein
Vesicular veins
Vaginal and uterine veins
Lateral sacral veins
Obturator vein
Internal pudendal vein
What is Alcock’s canal?
AKA pudendal canal, contains pudendal nerve and internal artery and vein. Runs anterosuperior through the pelvis
What are the sensory branches of the pudendal nerve?
Inferior rectal
Perineal
Dorsal nerve of penis/clitoris
In men, which inferior structure cross the ureters anteriorly?
Vas deferens
