Pelvic Contents Flashcards
Where does the vesicouterine pouch lie?
Between the uterus and bladder
Where does the rectouterine pouch lie?
Between the uterus and rectum
What forms the broad ligament?
Peritoneum as it passes over the uterus
Where does the vesicorectal pouch lie?
Between the rectum and the bladder
What epithelium is present in the bladder?
Transitional
How is the bladder attached to the pubic symphysis?
Via the urachus
Are there rugae present in the bladder?
Yes but disappear as the bladder fills
What happens to the bladder as it fills?
- Rugae disappear
- Rises to suprapubic region
What is the Trigone?
- Internal base of bladder
- Area of smooth mucous membrane
What enters at the trigone?
Ureters
What exits the trigone?
Urethra
Muscular coats of smooth muscle are located where?
- Detrusor muscle
- Neck circular sphincter vesicae
What type of innervation is present at the sphincter vesicae?
Autonomic innervation
What holds the neck of the bladder in place?
- Puboprostatic ligament (males)
- Pubovesical ligaments (females)
What passes through the urogenital diaphragm?
The urethra
Describe arterial supply to the bladder.
- 2 Superior vesical arteries
- 1 Inferior vesical artery
- From internal iliac artery
What does the inferior vesical artery in males correspond to in females?
Vaginal artery
What division of the internal iliac artery gives the inferior vesical artery (vaginal artery)?
Anterior division
Describe the venous drainage of the bladder.
Vesical plexus drains to internal iliac veins
Describe the innervation of the bladder.
ANS from inferior hypogastric plexus
Where does lymph from the ureter drain to?
- Lumbar
- Common iliac
- Ext/Int iliac nodes
Where does lymph from the urinary bladder drain to?
Main drainage to internal iliac nodes
- some to superior and sacral nodes
Where does lymph from the urethra drain to? (MALE)
- Main drainage to internal iliac
- Spongy urethra to deep inguinal nodes
Where does lymph from the urethra drain to? (FEMALE)
- Main drainage to internal iliac
- Some to sacral nodes
What portion of the rectum is covered by visceral peritoneum?
Upper 1/3rd
What portion of the rectum is located on the anterior surface?
Middle 1/3rd
What portion of the rectum is infraperitoneal?
Lower 1/3rd
Where is the rectum located?
- 3rd Sacral vertebra to tip of coccyx
- Extension of sigmoid colon
What is the function of the rectal ampulla?
Stores faeces.
What is the function of the puborectalis muscle?
Bends wall of rectum (continence)
What is the function of the levator ani muscles?
Support the rectum
Describe the arterial supply of the rectum.
- Superior rectal artery (inf mesenteric)
- Middle rectal artery (int iliac)
- Inferior rectal artery (int pudendal)
Describe the venous drainage of the rectum.
- Superior rectal vein (portal vein)
- Middle rectal vein (int iliac vein)
- Inferior rectal vein (int pudendal vein)
Where does lymph from the rectum drain to?
Superior rectum - aortic nodes L3
Inferior rectum - int. iliac nodes
Anal canal sup. to pectinate line - int. iliac nodes
Anal canal inf. to pectinate line - superficial inguinal nodes
Describe the innervation of the rectum.
Inferior hypogastric plexus
What covers the uterus?
Broad ligament
Describe the broad ligament.
- Peritoneum folds
- Small degree of support
- Neurovascular
What are the 3 parts of the broad ligament?
- Mesometrium
- Mesosalpinx
- Mesovarium
What is the mesometrium?
Main part of the broad ligament
What is the mesosalpinx?
Supports the uterine tubes
What is the mesovarium?
Holds ovaries to posterior surface of the broad ligament
Features of the uterus
What are the main ligaments of the uterus?
- Broad ligament
- Round ligament
What is the function of the broad ligament?
Carries vessels, nerves and lymphatics
What is the function of the round ligament?
Creates potential lymph pathways
What are the 3 support ligaments attached to the cervix?
- Uterosacral
- Pubocervical
- Transverse cervical
Identify the 3 cervical support ligaments
Describe anteversion.
Long axis of uterus bent forward on the long axis of the vagina
Describe anteflexion.
Long axis of uterus bent forward at internal os with long axis of vagina
What is the function of the ovaries?
Ova and hormone production
How are the ovaries attached to the broad ligament?
Attached at the mesovarium
Describe the arterial supply of the ovaries.
Abdominal aorta
- ovarian artery L2
Describe the venous drainage of the ovaries.
- Ovarian vein to IVC on R
- Ovarian vein to left renal vein on L
Describe the innervation of the ovaries
Aortic plexus
What are the 2 ligaments of the ovary?
- Ligament of the ovary
- Suspensory ligament of the ovary
