Pelvic floor and genital organs Flashcards
Which 3 muscles form the pelvic floor?
- Levator ani
- Ischiococcygeus / coccygeus
- External anal sphincter
What are the 3 parts of the levator ani?
iliococcygeus, pubococcygeus, puborectal
What innervates the levator ani?
Pudendal nerve, anterior rami of spinal nerves S2-S4
What are the 3 parts of the external anal sphincter?
subcutaneous, superficial, deep
What innervates the external anal sphincter?
pudendal nerve, anterior rami of spinal nerves S3-S4
Which umbilical ligament is a remnant of umbilical arteries?
The medial umbilical ligaments
What forms the perineal region?
the urogenital triangle anteriorly and the anal triangle posteriorly
What are the contents of the urogenital trigone in men? (5)
- Paired crus of penis
- Paired ischiocavernosus
- Unpaired bulb of penis
- Unpaired bulbospongiosus
- Paired bulbourethral glands of Cowper
What are the contents of urogenital trigone in women?
- Paired crus of clitoris
- Paired ischiocavernosus
- Paired bulb of vestibule
- Paired bulbospongiosis
- Paired vestibular glands of Bartholin
What is the peritoneal relation of the bladder?
sub peritoneal
What triggers the contraction of the detrusor muscle?
The sacral parasympathetic fibers, which are activated when there is increased tension in the bladder wall
Where is the apex of the bladder when empty / when full
When empty : right behind the pubic symphysis
When full : above pubic symphysis
What is the median umbilical ligament? What is it a remnant of?
ligament extending from the apex of the bladder to umbilicus. It’s a remnant of the urachus (allantois)
What is the trigone of the bladder?
triangle formed by the 2 ureteric orifices and urethral orifice. Its mucosa is not folded.
What is the trigonal area of Pawlik?
the projection of the trigone of the bladder on the anterior wall of the vagina
What is the fold between the ureteric orifices?
Interureteric crest
What is the retrotrigonal fossa?
hollow space between the interureteric crest
What is the retropubic space? What is another name for it?
Space between bladder (peritoneum) and pubic symphysis (transversalis fascia). It’s also called the space of Retzius
What is the vesicoumbilical fascia of Delbet?
A triangular fascia located between the medial umbilical ligaments and median umbilical ligament. It can contain the bladder in its full state.
What pouches does the peritoneum form nea rthe bladder in females and males?
Females : vesicouterine pouch
Males : rectovesical pouch of Proust
What structure can we find between the rectum / bladder or vagina / bladder?
- Retrovesical space of Denonvilliers in males (CT plate)
- Vesicovaginal septum in females (CT plate)
What is sphincter vesicae and its innervation?
single layer of smooth muscle around the neck of the bladder. Sympathetic innervation
What are the trigonal muscles?
Smooth muscle located in the vesical trigone that can control open / closure of the orifices
What are the muscles surrounding the urethra?
Internal urethral sphincter - smooth muscle
External urethral spincter - skeletal muscle
Which arteries supply the bladder? (3+)
- Superior vesical arteries (from umbilical)
- Inferior vesical arteries (from internal iliac)
- Vesical branches of obturator uterine, inferior gluteal and vaginal arteries
Which veins drain the bladder?
- Vesical plexus to vesical veins to iliac vein
- Connection to the pudendal plexus of Santorini
What is the parasympathetic, sensory, motor and sympathetic innervation of the bladder?
Sympathetic : vesical plexus
Parasympathetic, sensory, motor : sacra nerves L2 - S2
What are the parts of the female urethra? (3)
- Intramural
- Pelvic
- Perineal
What are the parts of the male urethra? (4)
- Intramural
- Prostatic (seminal collicle and ejaculatory ducts)
- Membranous / intermediate
- Spongy
What is the ampulla urethra?
dilated segment of spongy urethra for opening of bulbuurethral glands
What is the navicular fossa of urethra?
dilated final segment of the urethra
What is the ischioanal / ischiorectal fossa?
a paired space filled with adipose tissue surrounding the anus. They communicate dorsally.
What are the contents of the ischiorectal / ischioanal fossa? (2)
- pudendal canal of alcock (internal pudendal av and pudendal nerve)
- fat body of ischioanal fossa
At which week is the sec of the fetus determined?
At week 7
What are the boundaries of the ischiorectal / ischioanal fossa?
Mediocranially : external anal sphincter
Laterally : ischial tuberosity and obturator fascia
Dorsally : gluteus maximus, sacrotuberous ligament
Caudally : anal triangle
What is the capsule of the testis?
tunica albuginea : dense CT, forms mediastinum of testis
What is the internal structure of the testis?
- Lobules separated by septa of testis (derived from tunica albuginea)
What is the mediastinum of the testis?
area close to the hilum filled with CT where the rete testis coalesce
What is the arterial supply of the testis?
- Testicular artery (from aorta)
- Artery to ductus deferens (from internal iliac)
- Cremasteric artery (from inferior epigastric)
What is the venous drainage of the testis?
- Pampiniform plexus to testicular veins
- Testicular veins to ICV (right) and to L renal vein i