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ORG-SYS 3rd Shift > pelvic cavity > Flashcards

pelvic cavity Flashcards

1
Q

pelvic cavity

A
  • area between pelvic inlet and outlet
  • cavity of the true pelvis
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2
Q

pelvic diaphragm

A

divides pelvic cavity into main pelvic cavity and perineum

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3
Q

(3) contents of pelvic cavity

A

1) lower ends of GI tract
2) distal part of urinary tract
3) internal organs of rep sys. (for reproduction)
- blood supply
- lymphatics
- nerve supply

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4
Q

sigmoid colon length & shape

A
  • 10 to 15 inches long
  • s-shaped
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5
Q

(2) sigmoid colon surface anatomy (continuation/level)

A

1) continuation of descending colon / level of pelvic brim
2) continues with rectum / in front of S3

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6
Q

True/False:
Sigmoid colon have mesenteries called the “sigmoid mesocolon” that attaches it to the posterior wall.

A

true

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7
Q

blood/venous/nerve supply + branches

A

blood: inferior mesenteric art. (sigmoid branch)
vein: inferior mesenteric v. (joins portal vein)
nerve: inferior hypogastric plexus (symp/parasymp)

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8
Q

boundaries of sigmoid colon (AP: male & female)

clue/mnemonic: PREC/SAC/IL

A

Anterior
M: urinary bladder
F: uterus (posterior), vagina (upper part)

Posterior
M: rectum
F: sacrum
MF: ileum (terminal part, lower coils)

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9
Q

(3) clinical condis of sigmoid colon

A

1) volvulus
2) cancer (colon)
3) diverticula

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10
Q

another name for volvulus

A

mesentery twist

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11
Q

volvulus

A
  • extreme mobility > rotates sigmoid colon counterclockwise (around its mesentery)
  • affects blood supply (decreases)
  • cause ischemia (to tissues of intestine) > abdominal pain
  • enlargement of abdomen > fluid/waste products not allowed to pass
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12
Q

(2) treatment of volvulus

A

1) derotate (through surgery)
2) resection (of infected and non-functioning areas/if ischemic)

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13
Q

common site of cancer of large bowel (colon cancer)

A

sigmoid colon

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14
Q

symptom of colon cancer

A

bloody stool

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15
Q

diverticula

A
  • out-pouchings of the wall/mucous membrane of colon
  • complication: diverticulosis/diverticulitis (irritation of portion where feces enter/ > enlarges feces > severe pain/inflammation)
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16
Q

most common cause of left lower quadrant pain

A

diverticula

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17
Q

most common cause of right lower quadrant pain

A

appendicitis

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18
Q

(1) treatment of diverticula

A

1) purely ANTIBIOTICS

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19
Q

(3) sigmoid colon procedures

A

1) sigmoidoscopy (rectum > sigmoid)

2) colonoscopy (e.g. pt comes w/ rectal bleeding/severe abd. pain suspecting there’s a mass)

3) colostomy (feces leaving through STOMA)

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20
Q

sigmoidoscopy

A
  • sigmoid examination under DIRECT vision (for pathologic lesions) through flexible tube
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21
Q

colonoscopy

A
  • DIRECT inspection of ENTIRE colon (including cecum)
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22
Q

colostomy

A
  • surgical procedure (exposed colon/opening of abdomen: STOMA)
  • connects part of colon to anterior abdominal wall
  • colostomy > feces leave pt’s body (through STOMA)
  • maybe permanent or temporary (depending on reasons for use)
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23
Q

length of rectum

A

5 inches

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24
Q

(5) rectum surface anatomy (continuation/level)

A

1) continues with sigmoid (level of S3)
2) continues to tip of coccyx
3) continues with anal canal (penetrates pelvic floor > perineum > end of anus)

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25
Q

rectal ampulla

A

dilated/lower part of rectum

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26
Q

puborectalis muscle

A

forms a SLING at the junction of RECTUM and ANAL CANAL (anorectal angle)

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27
Q

rectum function

A
  • produces anorectal angle
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28
Q

(4) anorectal triangle function

A

1) waste products/water > passes large intestine > become feces
2) goes to sigmoid > rectum (stays here)
3) water is reabsorbed back (where feces form) > hardens
4) puborectalis muscle relaxes > angle becomes straight > feces get out

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29
Q

constipation

A
  • happens when defecation does not take place for days
  • water keeps reabsorbing/feces harden too much
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30
Q

peritoneum

A
  • covers first third (upper 2/3) of rectum ANTERIORLY AND LATERALLY
  • covers middle third of rectum only ANTERIORLY
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31
Q

houston valves/transverse folds

A

SEMICIRCULAR permanent folds of rectum formed by its MUCOUS membrane and CIRCULAR muscle layers

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32
Q

True/False:
Muscular coat of rectum is arranged with inner longitudinal and inner circular layers of smooth muscles.

A

false

t/n: OUTER longitudinal and INNER circular layers of smooth muscles

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33
Q

rectum boundaries (anteriorly/male & female)

A

M upper 2/3:
- sigmoid colon
- coils of ileum (at rectovesical pouch)

M lower 1/3:
- posterior surface of bladder
- vans deference/seminal vesicles (on each side)
- prostate

F upper 2/3:
- sigmoid colon
- coils of ileum

F lower 1/3:
- posterior surface of vagina

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34
Q

rectum boundaries (posteriorly)

A
  • sacrum & coccyx
  • piriformis, coccygeous, & levator ani
  • sacral plexus & sympathetic trunks
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35
Q

blood supply of rectum

A

superior/middle/inferior rectal art.

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36
Q

nerve supply of rectum

A

inferior hypogastric plexuses

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37
Q

True/False:
Inferior hypogastric plexuses is sensitive only to stretch.

A

true

t/n: only stretch, not pain

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38
Q

other name for hirschsprung’s disease

A

primary megacolon

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39
Q

hirschsprung’s disease symptoms

A
  • ENLARGMENT of lumen > inability to pass out meconium
  • UNDERDEVELOPED nervous system (parasympathetic ganglion cells) in the wall of large intestine before birth
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40
Q

megacolon

A
  • enlargement of colon
  • caused by constriction > dilation > trapped stool
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41
Q

(1) treatment of hirschsprung

A

(1) surgical removal of diseased/non-functioning segment of bowel

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42
Q

(2) stages of surgery for hirschsprung

A

1) first stage - colostomy
2) second stage - pull-through procedure (closes stoma)

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43
Q

pull-through procedure

A

repairs colon by CONNECTING functional bowel to anus

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44
Q

kidney color and shape

A

reddish brown, bean-shaped

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45
Q

True/False:
Kidney is an excretory organ.

A

true

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46
Q

True/False:
Left kidney is lower.

A

false

t/n: right kidney is lower, liver on the right side pushes it lower. when diaphragm contracts, it can move the kidneys up and down by about an inch

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47
Q

(3) kidney functions

A

1) excretion of waste products of metabolism
2) controls water and electrolyte balance within the body
3) maintains acid-base (normal ph) of blood

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48
Q

hilum

A

VERTICAL SLIT in medial concave borders of the kidney

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49
Q

structures that enter and exit hilum (most anterior to most posterior)

clue/mnemonic: RV, 2B, U, 3B, LV / SYMPFB
(RV to good 2B trUe, went to 3rd branch of Louis Vuitton / Symp ang Females n Boys)

A

most anterior: renal vein
2nd branch of RA
ureter
3rd branch of RA
lymph vessels

most posterior: sympathetic fibers

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50
Q

renal sinus

A
  • extension of hilum, a large cavity
  • SPACE in the hilum containing renal pelvis
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51
Q

(2) spaces of renal sinus

A

1) minor calyces
2) major calyces

52
Q

minor calyces location

A

end of each papilla

53
Q

calyces formation

A

minor > major > renal pelvis

54
Q

renal pelvis

A

EXPANDED part of ureter

55
Q

cortex (color, inner/outer)

A

part of kidney that is a dark brown outer layer

56
Q

medulla (color, inner/outer)

A

lighter inner layer

57
Q

(4) medulla contents (renals)

A

1) renal pyramids
2) renal papilla (apex/ends of pyramids)
3) renal columns (between adjacent pyramids)
4) medulla rays

58
Q

(5) right & left kidney AP relationships: anterior

A
  • suprarenal gland
  • liver / spleen
  • 2nd part of duodenum / stomach
  • (R) colic flexure / (L) colic flexure
    + coils of jejunum
59
Q

right & left kidney AP relationships: posterior

A
  • diaphragm
  • costodiaphg. process (of pleura)
  • 12th rib / 11th-12th rib
  • psoas/quad lumb./transv. abd.
  • subcostal/iliohypog/ilioing. nerves
60
Q

(6) kidney blood supply w/ landmarks

clue/mnemonic: RSLIAN / Rehab Sci Let’s Inspire and Aspire Internationally!

A
  • renal artery (direct branch from AORTA / level of L2)
  • segmental artery (entering HIL)
  • lobar artery (supplies each renal PYRAMID)
  • interlobar artery (supplies CORTEX)
  • arcuate artery (found at BASES of PYRAMIDS)
  • interlobular arteries (ascends in CORTEX)
61
Q

each kidney has (4)

A

1) fibrous capsule (SURROUNDS kindey outside)
2) perirenal fat (COVERS fib capsule)
3) renal fascia (ENCLOSES kidney & sup glands, continuous w/ fascia transv.)
4) pararenal fat (EXTERNAL to renal fascia, forms retroperiton. fat)

62
Q

suprarenal / adrenal glands

A

yellow retroperitoneal organs on upper pole of kidneys

63
Q

surrounds suprarenal glands

A

renal fascia

64
Q

separates suprarenal gland from kidney

A

perirenal fat

65
Q

(2) parts of suprarenal glands

A

1) cortex
2) medulla

66
Q

suprarenal glands relationship (R)

A
  • pyramid shapes
  • has caps on upper pole
  • lies behind (R) lobe of liver / extends medially behind IVC
67
Q

suprarenal glands relationship (L)

A
  • crescentic shape
  • extends along medial border of (L) kidney / upper pole to hilum
  • lies behind pancreas, lesser sac, stomach
68
Q

suprarenal glands relationship (RL)

A

rests posteriorly on diaphragm

69
Q

cortex functions

A
  • secretes mineral corticoids > control electrolyte balance
  • secrete glucocorticoids > control carbs, fats & protein metabolism
  • secrete sex hormones > testes, estrogen
70
Q

medulla function

A

(produces?) epinephrine and nonepinephrine

71
Q

ureters type of structure

A

abdominal and pelvic structure

72
Q

ureters

A
  • muscular tube that extends from kidney to posterior surface of bladder
  • urine > kidney > renal pelvis > ureter
  • bifurcation at SI joint
  • anterior of IIC artery / level of ischial spine
73
Q

(3) constrictions of ureters

A

1) renal pelvis > ureter
2) pelvic brim
3) > bladder

74
Q

kidney stones

A
  • stones formed in the kidney d/t uric acid crystals or calcium
  • formed stones > w/urine > get stuck > urine doesn’t flow > kidney enlarge
75
Q

ureters arteries (upper/middle/lower end)

A

upper end: renal artery
middle end: testicular artery
lower end: superior vesical artery

76
Q

other name for kidney stones

A

hydronephrosis

77
Q

urinary bladder

A

receptable/storage of urine

t/n: kidney produces, bladder stores

78
Q

urinary bladder shape

A

pyramidal

79
Q

normal capacity of urinary bladder

A

500cc/mL

80
Q

apex of bladder

A

> umbilicus (by median umbilical ligament)

81
Q

base/post surface of bladder

A
  • triangular
  • SL angle
  • joined by ureter and inferior part of urethra
  • ureters pierce > bring urine inside bladder
82
Q

neck of bladder

A
  • male: rests on upper surface of prostate / held in position to the pubic bone by pbp ligaments
  • female: held in position to the pubic bone by pbv ligament
83
Q

trigone

A
  • triangular shape where mucous membrane covers internal surface of BASE of bladder
  • serves as NATURAL SPHINCTER of urine
  • valve-like action / preventing reverse flow of urine toward kidney as it fills
  • where urethra exits (end of trigone)
84
Q

detrusor muscle

A
  • smooth muscle that forms wall of the bladder

t/n: wall is not smooth

85
Q

detrusor muscle functions

A

SNS: fill bladder > relaxed bladder > internal sphincter closed (to fill w/ urine)

PNS: contract detrusor)

86
Q

external sphincter

A
  • smooth muscle controlled by both SNS and PNS
  • controllable
  • striated muscle (why we can hold in our urine)
87
Q

True/False:
Urine can hold twice the normal capacity of 500mL without rupturing.

A

true

t/n: the outflow is obstructed

88
Q

True/False:
The desire to urinate usually starts when bladder reaches around 50% of its working volume.

A

false

t/n: 75%

89
Q

micturition reflex

A
  • initiated when volume of urine bladder reaches 300mL
  • stretch receptors > cns > micturate
  • assisted by raise in intraabd. pressure to expel urine
90
Q

bulbocavernosus reflex

A
  • check if bladder is spastic/flaccid by using anal sphincter (using fingers)
91
Q

(3) common neurologic bladder in SCI patients

A

1) atonic bladder
2) automatic reflex bladder
3) autonomous bladder

92
Q

atonic bladder

A
  • occurs during 1st phase of spinal shock
  • first 47 hrs
  • bladder muscle = relaxed / sphincter = contracted
  • pt not aware bladder is full
  • bladder distended > overflows
93
Q

automatic reflex bladder

A
  • occurs after pt has recovered from spinal shock (lesion above s2-s4)
  • bladder fills and empties reflexly
  • simple reflex occurs every 1-4 hrs
  • common in infants, alzheimer’s, dementia, comatose pts
94
Q

autonomous bladder

A
  • occurs in sacral segment
  • bladder without external reflex control
  • bladder wall = flaccid / bladder capacity = increases
  • causes infection and back pressure effect in ureters and kidneys
95
Q

urethra begins and ends

A

begins: base of bladder / ends: external opening of perineum

96
Q

urethra in women

A
  • short, 4cm long
  • slightly curved
  • opening anterior to skene’s glands
  • UTI is more common
97
Q

urethra in men

A
  • long, 20cm long
  • bends twice > base of bladder > inferior to prostate
  • divided into (4) parts
98
Q

urethra in men (4) parts

A

1) preprostatic (intramural part, 1-1.5cm long)
2) prostatic (widest/most dilatable, 4cm long)
3) membranous (shortest/narrowest, 1-2cm long)
4) spongy urethra (longest/15-16cm/5mm in diameter)

99
Q

vas deferens

A
  • THICK wall tube
  • 18 inches in length
  • ampulla = dilated terminal part
  • > duct of seminal vesicle > form ejaculatory duct
100
Q

deminal vesicle

A
  • 2 lobulated organ about 2 inches long / posterior surface of bladder
  • produce secretion added to seminal fluid
101
Q

ejaculatory ducts

A
  • less than 1 inch in length
  • union of vas deferens and duct of seminal vesicle
  • drain seminal fluid to prostatic urethra
102
Q

prostrate

A
  • unpaired/single fibromuscular glandular organ
  • made of 30-40 numerous gland
  • paraurethral in female
  • produces thin milky fluid added to seminal fluid (at time of ejaculation)
103
Q

(4) lobes of prostate

A

1) anterior (in front of urethra/devoided of glandular tissue)
2) median/middle (between urethra and ejac ducts/upper surface related to trigon)
3) posterior (behind urethra and below ejac ducts)
4) left and right lateral lobes (seprated by vertical groove)

median/middle: rich in glands
posterior: with gland tissue
lateral lobes: has many glands

104
Q

prostatic cancer

A
  • benign enlargement of prostate
  • common in men > 50 yrs
  • imbalance of hormonal control of gland
  • mostly affects posterior lobe (PROS/POST)
105
Q

prostatic cancer signs and complications

A

signs/symptoms:
- intense feeling to micturate
- difficulty in passing urine

treatmnet: removal of part in prostate affected

106
Q

prostatic cancer prevention

A

rectal exam (early detection)

107
Q

bulbourethral glands

A
  • one on each side
  • small, pea-shaped mucous glands
  • > deep perineal pouch (lateral to membranous part of urethra) > bulb of spongy urethra (root of penis)
108
Q

ovary

A
  • oval shaped, 1.5 x 1.75 inches
  • found on lateral wall of pelvis (ovarian fossa)
109
Q

suspensory ligament of ovary

A
  • keeps ovary in place
  • part between mesovarium and lateral wall of pelvis
110
Q

tunical albuginea

A

thin fibrous capsule around ovary

111
Q

ovary function

A
  • produces female sex hormones (estrogen and progesterone)
  • site of egg production (oogenesis)
112
Q

ovary blood supply

A

ovarian artery (from abdominal aorta)

113
Q

True/False:
(R) and (L) ovary has only certain no. of egg cells.

A

true

t/n: ovary released = start of mens / no eg produced = menopause

114
Q

uterine tube

A
  • 4 inches
  • has (4) parts
115
Q

(4) parts of uterine tube/fallopian tube

A

1) infundibulum
- funnel shape lateral projections
- ends w/ fingerlike free edge (fimbriae)

2) ampulla
- widest part of tube where sperm meets egg
(fertilization of ova and sperm)

3) isthmus
- narrowest part (lateral to uterus)

4) intramural part (pierces uterine wall)

116
Q

uterine tube blood supply

A

uterine artery

117
Q

pelvic inflammatory disease

A
  • severe pain in pelvic area
  • pathogen enters body through sexual contact, ascends through uterus > enters uterine tube
118
Q

salpingitis

A

leak of pus (to peritoneal cavity) > pelvic peritonitis

119
Q

pelvic inflamm. disease treatment

A

antibiotics

120
Q

ectopic pregnancy

A

implantation/growth of fertilized ovum OUTSIDE uterine caviry

121
Q

tubal ligation

A

ligation/division of uterine tube as PERMANENT BIRTH CONTROL

122
Q

uterus

A
  • hollow, pear shape organ
  • with THICK muscular coat
  • has (4) parts
123
Q

(4) parts of uterus

A

1) fundus (above entrance of fallop. tube)
2) body (below entrance of uterine tube)
3) cervix (divided to supravaginal/vaginal parts)
4) cavity (triangular/)

124
Q

uterus function

A

site for reception/retention/nutrition of fertilized ovum

125
Q

pelvic female viscera positions

A

anterversion
- long axis (vagina) bent forward > long axis (vagina)

anteflexion
- long axis bent forward > internal os

retroverted
- fundus/body of uterus bent backward > vagina

retroflexed
- body of uterus bent back > cervix

126
Q

body of uterus lies in what plane

A

almost horizontal plane

127
Q

(3) structures of uterus

A

1) muscle wall/myometrium
- THICK smooth muscle
2) endometrium
- MUCOUS MEMBRANE lining body of uterus
3) parametrium
- where uterine CROSSES ureter on each side

ORG-SYS 3rd Shift (4 decks)

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