Pelvic Contents and Anal and Urogenital Triangles Flashcards
name the two pouches in the female peritoneum
rectouterine and vesicouterine pouches
where is the rectouterine pouch?
between the uterus and rectum
where is the vesicouterine pouch?
between the bladder and the uterus
name the pouch in the male peritoneum
vesicorectal pouch
where is the vesicorectal pouch?
between the rectum and bladder
what layers form the bladder wall? (superficial to deep)
detrusor muscle
mucosa
submucosa
transitional epithelium (uroethelium) arranged into rugae
which part of the bladder lies posterior to the pubic symphysis?
the apex (or urachus)
what muscle acts as both a coat of the bladder and at the neck of the circular sphincter vesicae?
detrusor (smooth) muscle
which part of the bladder does the trigone form?
the triangular non-contractile base
what enters and leaves the bladder at the trigone?
enters: ureters (x2)
exits: urethra
what ligaments hold the neck of the bladder in place in males?
puboprostatic ligaments
what ligaments hold the neck of the bladder in place in females?
pubovesical ligaments
what arteries supply the bladder in females (and where do they arise)?
upper part: superior vesical artery
lower part: vaginal artery
(both from the internal iliac)
what arteries supply the bladder in males (and where do they arise)?
upper part: superior vesical artery
lower part: inferior vesical artery
(both from the internal iliac)
what provides venous drainage of the bladder?
vesical plexus (to the internal iliac)
what provides nervous supply to the bladder?
ANS from the inferior hypogastric plexus
what provides lymphatic drainage of the ureter?
lumbar, common iliac, external iliac and internal iliac nodes as they descend towards the bladder
what provides lymphatic drainage of the urethra in males?
most to internal iliac
spongy urethra to deep inguinal nodes
what provides lymphatic drainage of the urethra in females?
most to internal iliac
some to sacral nodes
what provides lymphatic drainage of the bladder?`
most to internal iliac
some of superior to external iliac
some of neck to sacral nodes
at what vertebral levels are the rectum found?
from S3 to tip of coccyx
what parts of the rectum are covered in peritoneum or otherwise?
upper 1/3rd: covered in visceral peritoneum
middle 1/3rd: peritoneum on anterior surface
lower 1/3rd: infraperitoneal
what muscles surround the rectum?
levator ani
iliococcygeus
puborectalis
what arteries supply the rectum (and where do the arise from)?
superior rectal (from inferior mesentric) middle rectal (from internal iliac) inferior rectal (from internal pudendal)
what provides venous drainage of the rectum (and where do they drain to)?
superior rectal (to portal vein) middle rectal (to internal iliac) inferior rectal (to internal pudendal)
what provides lymphatic drainage of the rectum (and which region do they drain)?
pararectal (superior rectum)
inferior mesenteric (superior rectum)
internal iliac (inferior rectum, superior anal canal to pectinate line)
superficial inguinal nodes (pectineal line to inferior anal canal)
what provides nervous supply to the rectum?
inferior hypogastric plexus
what ligaments support the uterus?
peritoneal ligament broad ligament of the uterus uterosacral (sacrocervical) ligament transverse sacral ligament pubocervical (pubovesical) ligament
what is the mesometrium?
the mesentery of the uterus, constitutes the majority of the broad ligament of the uterus (except the mesosalpinx and mesovarium)
contains the ureter
what is the mesovarium?
portion of the broad ligament that suspends the ovaries
what is the mesosalpinx?
portion of the broad ligament that stretches from the ovary to the uterine tube
what artery supplies the uterine tube and fundus?
ovarian artery
what arteries supply the uterine body and cervix?
uterine artery
anastomoses between the ovarian and uterine arteries
what is the role of the round ligament of the uterus?
create a potential lymph pathway
what does the broad ligament of the uterus carry?
vessels, nerves and ligaments
what positions do the uterus normally lie in?
anterversion and anteflexion
define anteversion of the uterus
the long axis of the uterus is bent forward
and the long axis of the vagina against the urinary bladder
90o
define anteflexion of the uterus
the long axis of the uterus is bent foward and the level of the internal orifice, with the long axis of the cervix
170o
how are the ovaries attached to the broad ligament?
by mesovarim
what ligaments support the ovaries?
ligament of the ovary
suspensory ligament of the ovary (containing the ovarian vessels)
what artery supplies the ovary?
ovarian artery (abdominal aorta @L2)
what provides venous drainage of the right ovary?
ovarian vein to IVC
what provides venous drainage of the left ovary?
ovarian to renal vein
what provides nervous supply to the ovaries?
the aortic plexus
what supplies lymphatic drainage of the ovary, uterine tube and fundus of the uterus?
aortic nodes at root of ovarian artery (@L2)
what supplies lymphatic drainage at the junction of the uterine tube and body?
superficial inguinal nodes
what supplies lymphatic drainage of the body of the uterus?
external iliac nodes (via broad ligament)
what supplies lymphatic drainage of the cervix?
internal iliac nodes (some to sacral)
what supplies lymphatic drainage of cervix and vagina?
internal iliac then to superficial inguinal nodes
what is the route of the vas deferens?
from epididymis of testis
through the inguinal canal in the spermatic cord
joins with the duct from the seminal vesicle to form the ejaculatory duct
enters the prostate to meet the prostatic urethra forming the penile urethra
what is the role of the seminal vesicles?
secretes the liquid component of semen (mostly fructose)
what artery supplies the seminal vesicles?
branches of the inferior vesical artery and the prostatic artery
what is the role of the prostate?
produce proteolytic enzymes and acid phosphatase
what arteries supply the prostate?
internal pudendal, middle rectal and inferior vesical arteries
what provides venous drainage of the prostate?
deep dorsal vein of the penis –> plexus –> internal iliac vein
what provides lymphatic drainage of the prostate?
aortic nodes at the root of the testicular artery (@L2)
what holds the prostate in place?
pubo-prostati ligament
levatore prostate muscles
what forms the wall of the ischioanal (rectal) fossa?
ischial tuberosity and the rectum/anal canal
what forms the roof of the ischioanal (rectal) fossa?
levator ani (pelvic diaphragm)
what forms the floor of the ischioanal (rectal) fossa?
skin
what are the contents of the ischioanal (rectal) fossa?
branches of the pudendal nerve, artery and vein
adipose tissue
what are the boundaries of the anal triangle?
coccyx, sacrotuberous ligaments and a theoretical line between the ischial tuberosities
where is the urogenital triangle found?
anterior half of the perineum
what type of muscle forms the internal anal sphincter?
smooth muscle
what type of muscle forms the external anal sphincter?
skeletal muscle (voluntary)
what do the anal columns contain?
a terminal radicle of the superior rectal vessels, anal sinus related
at what point does the rectum become the anal canal?
when it pierces the pelvic floor
what is the function of the external anal canal?
closes the anus (aided by puborectalis)
where does the external anal sphincter run from and to?
perineal body to anococcygeal ligament
what arteries supply the external anal sphincter?
internal pudendal
inferior rectal
what venous system drains the external anal sphincter?
caval venous system
what drains the lymph from the external anal sphincter?
superficial inguinal nodes
what provides nervous supply to the external anal sphincter?
inferior rectal branch of the pudendal nerve (S2-4)
what two types of fascia are present in the urogenital fascia?
fatty and membranous
what forms the fatty fascia?
Camper’s
superficial layer continuous with the ischiorectal fossa and the thigh
what forms the membranous fascia?
Scarpa’s
deeper layer attached to the posterior border of the urogenital diaphragm and into the labia/scrotum
what happens to camper’s fascia in the scrotum?
replaced by dartos smooth muscle
what is the urogenital diaphragm composed of?
superior layer of fascia (deep, blends with perineal body and membrane)
sphincter urethra and deep transverse perineal muscles
inferior layer of fascia (superficial, the perineal membrane)
what do the posterior layers of the urogenital diaphragm fuse with?
membranous superficial fascia and the perineal body
what is the space between the layers of the urogenital membrane called?
the deep perineal pouch
what does the deep perineal pouch contain in males?
urethra (and membranous urethra) sphincter urethrae deep transverse perineal muscles internal pudendal vessels and branches dorsal nerves of the penis bulbourethral glands penile arteries
what does the deep perineal pouch contain in females?
urethra sphincter urethrae deep transverse perineal muscles internal pudendal vessels and branches vagina dorsal nerves of the clitoris
what gives nervous supply to the deep perineal pouch?
perineal nerve (terminal branch of the pudendal nerve)
where is the superficial perineal pouch?
between the perineal membrane (the superficial fascia of the urogenital diaphragm) and the skin
what muscles are found in the superficial perineal pouch?
ischiocavernosus
bulbospongiousus
superficial transverse perineal
what are the contents of the superficial perineal pouch?
urethra, vagina, clitoris, penis, nerves and vessels and erectile tissue (cruara and bulb of vestibule (females), bulb of penis (male))
what attaches to the perineal body?
external anal sphincter, bulbospongiosus and superficial transverse perineal muscles
what is the perineal body?
a small fibrous structure forming a site of muscle attachment at the posterior margin of the urogenital diaphragm
what are the four parts of the male urethra?
pre-prostatic, prostatic, membranosus and penile (spongy)
what nerves supply the penis and scrotum?
branches of the pudendal:
inferior rectal
perineal (deep, superficial and scrotal branches)
dorsal nerve of the penis
where are the crura, bulb of vestibule and the glands of the female reproductive tract located?
within the superficial peroneal pouch
what nerves supply the clitoris and external genitalia?
dorsal nerve of the clitoris
(branch of pudendal)
perineal nerve
what vessels supply and drain the clitoris?
internal pudendal vessels
what are the contents of the urogenital triangle in females?
in females contains the vagina and associated external genitalia
where is the anal triangle found?
posterior half of the perineum
