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Regional Anatomy > Pelvic contents > Flashcards

Pelvic contents Flashcards

1
Q

what are the 2 peritoneal pouches in the female

A

rectouterine - Pouch of Douglas
vesicouterine

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2
Q

what is the name of the peritoneum overlying the uterus

A

broad ligament

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3
Q

what is the name of the peritoneal pouch in males

A

vesicorectal pouch

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4
Q

describe the internal surface of the bladder

A

folded into rugae
transitional epithelium

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5
Q

describe the peritoneum of the bladder

A

peritoneum covers the superior surface of the bladder and holds it against the pubic bones

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6
Q

what happens when the bladder fills

A

rugae disappear
rises above the pubic bones into suprapubic region

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7
Q

why might the bladder be seen above the pubic bones and quite large

A

if there was a problem releasing urine during life

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8
Q

how is the relation of the apex of the bladder to the pubic bones maintained

A

small piece of connective tissue called the urachus

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9
Q

what is the urachus

A

embryological remnant of a structure that drained the foetal bladder and joined the umbilical cord

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10
Q

at the base of the bladder there is a small smooth triangular area of smooth mucous membrane called the

A

trigone

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11
Q

what enters/exits at the trigone

A

the 2 ureters enter the bladder and the urethra exits

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12
Q

the muscular wall of the bladder is called

A

detrusor muscle - smooth muscle

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13
Q

the detrusor muscle forms what at the neck of the bladder

A

an incomplete sphincter - sphincter vesicae

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14
Q

describe the sphincter vesicae

A

composed of smooth muscle under ANS not voluntary control

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15
Q

describe the other sphincter in the urinary tract

A

external voluntary sphincter of micturation (urination) in the urogenital diaphragm

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16
Q

the base of the bladder is supported by what

A

ligaments that pass from the pubic bones
- males: puboprostatic
- females: pubovesical

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17
Q

describe the blood supply of the bladder

A

bladder supplied from above by superior vesical arteries (2)
and deeper within the pelvic by inferior vesical artery (1)

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18
Q

where do the superior vescial arteries come from

A

from umbilical branch of anterior division of the internal iliac artery

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19
Q

where does the inferior vesical artery come from

A

branch of the anterior division of the internal iliac artery

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20
Q

what is the inferior vesical artery in females

A

vaginal artery

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21
Q

venous drainage of the bladder is to the

A

vesical plexus and then into the internal iliac veins

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22
Q

what is the nerve supply of the bladder

A

supplied by ANS via the inferior hypogastric plexus

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23
Q

where does the ureter drain lymph

A

lumbar, common iliac, external iliac, internal iliac
(as they descend towards the bladder)

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24
Q

what is the main lymph drainage of the urethra

A

main drainage to the internal iliac

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25
Q

the spongy urethra in males drains where

A

deep inguinal nodes

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26
Q

some of the lymph from female urethra can drain where

A

sacral nodes

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27
Q

what is the main lymph drainage of the bladder

A

main drainage to the internal iliac nodes

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28
Q

lymph from the bladder drains mainly to the internal iliac nodes, but some may go where

A

some superior to external iliac and some lymph from neck of bladder to sacral nodes

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29
Q

how do urinary stones form

A

if there is an issue releasing urine from the bladder the urine may sit in the bladder and the salts present in the urine can accrete to form urinary stones

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30
Q

how are urinary stones seen

A

CT - classic jackstone appearance

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31
Q

where does the sigmoid colon become the rectum

A

as it crosses the 3rd (Fused) sacral vertebrae

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32
Q

when does the rectum become the anal canal

A

tip of the coccyx where it pierces the pelvic floor

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33
Q

the upper 1/3 of the rectum is covered by

A

visceral peritoneum

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34
Q

the middle 1/3 of the rectum is covered by

A

peritoneum on anterior surface

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35
Q

the lower 1/3 of the rectum is

A

infraperitoneal

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36
Q

where does the rectum go between

A

3rd sacral vertebrae to tip of coccyx

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37
Q

the anterior wall of the rectum in males is closely associated with what

A

prostate gland

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38
Q

describe the internal surface of the rectum

A

3 transverse folds with an enlarged area called the rectal ampulla between them

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39
Q

the internal shape of the rectum helps in what

A

storage of faeces before it is excreted via the anal canal

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40
Q

the rectum is supported by what

A

levator ani muscles - specifically puborectalis

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41
Q

describe puborectalis and its function

A

sling of muscle that passes around the rectum and when it contracts it bends the wall of the rectum making it more difficult to pass faeces from rectum to anal canal and therefore maintaining continence

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42
Q

describe the blood supply of the rectum

A

3 arteries:
- superior middle and inferior rectal arteries

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43
Q

where does the superior rectal artery come from

A

inferior mesenteric

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44
Q

where does the middle rectal artery come from

A

internal iliac

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45
Q

where does the inferior rectal artery come from

A

internal pudendal

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46
Q

specifically describe the blood supply of the rectum

A
  • superior rectal artery is a single branch from inferior mesenteric
  • middle rectal and internal pudendal (giving inferior) are bilateral structures as they are branches from internal iliac arteries
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47
Q

the middle rectal arteries and internal pudendal arteries are branches from what

A

internal iliac arteries

48
Q

what does it mean that the rectum is a site of portal systemic anastomosis

A

blood from the superior part of the rectum passes into the portal system via the inferior mesenteric vein but inferior parts of the rectum drain to local veins that drain into the internal iliac veins that are part of systemic system

49
Q

blood from superior parts of rectum drain where

A

passes into portal system via inferior mesenteric vein

50
Q

blood from inferior rectum drains where

A

local veins that drain into the internal iliac veins that are part of the systemic system

51
Q

the superior rectal vein drains where

A

portal system via inferior mesenteric

52
Q

the middle rectal vein drains where

A

internal iliac

53
Q

the inferior rectal vein drains where

A

internal pudendal

54
Q

lymph from the rectum drains where

A

superior parts: pre-aortic nodes at L3 clustered around IMA
lower parts: local pararectal nodes to nodes around internal iliac arteries

55
Q

nerve supply of rectum

A

inferior hypogastric plexus

56
Q

lymph from superior rectum drains where

A

aortic nodes at L3

57
Q

lymph from inferior rectum drains where

A

internal iliac nodes

58
Q

lymph from anal canal superior to pectinate line drains where

A

internal iliac nodes

59
Q

lymph from anal canal inferior to pectinate line drains where

A

superficial inguinal nodes

60
Q

what is the broad ligament

A

fold of peritoneum that overlies the uterus and uterine tubes

61
Q

what does the broad ligament do

A

provides a small degree of support and carries the neurovascular structures of the uterus

62
Q

the main support of the uterus is from where

A

ligaments at the cervix

63
Q

the broad ligament is divided into what 3 areas

A

mesosalpinx
mesovarium
mesometrium

64
Q

what is the function of the mesovarium

A

holds the ovaries to the posterior surface of the broad ligament

65
Q

what is the function of the mesosalpinx

A

supports the uterine tubes

66
Q

what is the function of the mesometrium

A

main part of the broad ligament associated with the body of the uterus

67
Q

the most superior part of the uterus which rises above the entrance of the uterine tubes is called the

A

fundus

68
Q

the walls of the uterus are

A

muscular (myometrium)

69
Q

the myometrium is lined by

A

endometrium

70
Q

describe the endometrium

A

increases and then is shed during each menstrual cycle

71
Q

describe the main part of the uterus

A

body which narrows to form the cervix inferiorly

72
Q

the cervix opens where

A

muscular tube called the vagina

73
Q

what is the area of the uterine tube adjacent to the ovaries

A

fimbrae

74
Q

what is the small narrowed area superior to the cervix

A

internal os

75
Q

what is the small narrowed area inferior to the cervix

A

external os

76
Q

what are the fornices

A

as the cervix bulges into the vagina there are small spaces each side of the cervix called the lateral fornices

77
Q

what is the blood supply of the uterus

A

uterine arteries from anterior division of internal iliac artery

78
Q

the uterine artery anastomoses with what superiorly

A

ovarian artery which supplies the ovaries, fundus of uterus and uterine tubes

79
Q

the uterine artery is where in relation to the ureter

A

superior (bridge over water)

80
Q

what is the name of the narrowing as the uterine tubes enter the uterus

A

isthmus

81
Q

name the parts of the uterine tube from the uterus

A

narrow isthmus to expanded area called ampulla which ends at a wide infundibulum

82
Q

describe the distal part of the uterine tube

A

divided into finger-like fimbrae which help gather the ovum released by the ovary and direct it to the uterine tube

83
Q

how is the ovum briefly suspended in the peritoneal cavity

A

no direct contact between fimbrae and ovary

84
Q

where is the ovum usually fertilised

A

along the uterine tube (ampulla)

85
Q

what is an ectopic pregnancy

A

when a fertilised ovum implants somewhere other than endometrium e.g. uterine tube - can lead to rupture

86
Q

why is the main support for the uterus at the cervix

A

allows uterus to expand and rise into the abdomen during pregnancy but still maintain relationship with the vagina and pelvic floor

87
Q

what are the 3 main ligaments at the cervix

A

transverse cervical (Cardinal)
pubocervical (pubovesical)
uterosacral (sacrocervical)

88
Q

what is the significance of the round ligament of the uterus

A

potential lymph pathway

89
Q

what is the most common uterine position

A

anteverted anteflexed

90
Q

what is anteversion

A

long axis of uterus bent forward on the long axis of vagina

91
Q

what is anteflexion

A

long axis of uterus bent forward at the internal os with the long axis of vagina

92
Q

in anteverted anteflexed the uterus lies over what

A

bladder

93
Q

what supports the uterus to prevent prolapse

A

pelvic floor muscles

94
Q

what part of the pelvic floor gives the main support to the uterus

A

pubococcygeus forms a sling around the vagina (pubovaginalis)

95
Q

what is the equivalent to pubovaginalis in males

A

puboprostaticus

96
Q

support for the uterus comes from where

A

ligaments at cervix
bladder
pelvic floor

97
Q

what is the function of the ovaries

A

ova and hormone production

98
Q

how are the ovaries held in place

A

attached to back of broad ligament by mesovarium

99
Q

what is the arterial supply of the ovaries

A

direct branches of abdominal aorta at L2

100
Q

what is the venous drainage of the ovaries

A

right: veins drain directly into IVC
left: veins drain into left renal vein

101
Q

nerve supply of ovaries

A

aortic plexus

102
Q

what is the ligament of the ovary

A

passes between the uterus and the ovary

103
Q

what is the suspensory ligament of the ovary

A

carries ovarian artery and vein

104
Q

the ovarian and uterine arteries supply

A

the ovaries, uterine tubes and uterus

105
Q

the vaginal artery supplies

A

distal uterus and vagina

106
Q

the vaginal artery is a branch from where

A

either the uterine artery or a direct branch of anterior division of the internal iliac artery

107
Q

the vaginal artery is the equivalent to what in males

A

inferior vesical artery

108
Q

what artery supplies the distal vagina and perineum

A

internal pudendal

109
Q

lymph from where drains to aortic nodes at root of ovarian artery (L2)

A

ovaries
uterine tube
fundus

110
Q

lymph from where drains to the superficial inguinal nodes via the round ligament

A

where uterine tube meets uterus/isthmus

111
Q

lymph from where drains to external iliac nodes via the broad ligament

A

body of uterus

112
Q

lymph from where drains to internal iliac nodes (some to sacral)

A

cervix

113
Q

lymph from where drains to internal iliac then superficial inguinal nodes

A

vagina

114
Q

lymph from body of uterus drains where

A

external iliac nodes via the broad ligament

115
Q

lymph from cervix drains where

A

internal iliac nodes (some to sacral)

116
Q

lymph from vagina drains where

A

internal iliac then superficial inguinal nodes

Regional Anatomy (36 decks)

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