Pelvic Organs Flashcards
1
Q
Os Coxa
A
- formed by the fusion of the ischium, ilium, and pubis
2
Q
Acetabulum
A
- socket of the hip joined located at the fusion of the three pelvic bones
3
Q
Four Pelvic Spines
A
ASIS - Anterior Superior Iliac Spine
AIIS - Anterior Inferior Iliac Spine
PSIS - Posterior Superior Iliac Spine
PIIS - Posterior Inferior Iliac Spine
4
Q
Greater Sciatic Notch
A
- indent between PIIS and the iscial spine
5
Q
Lesser Sciatic Notch
A
- indent between the ichial spine and the ischial tuberosity
6
Q
Divisions of the Pelvic Cavity
A
False Pelvis - lower abdominal cavity (between the Iliac crests and the linea terminalis
True Pelvis - below the linea terminalis/pelvic inlet
7
Q
Sections of the Linea Terminalis
A
Pubic Crest → Pectineal Line → Arcuate Line → Sacral Ala → Sacral Promentory
8
Q
Pelvic Anatomical Position
A
- the ASIS and the antero-superior edge of the pubic symphysis are vertical
- true pelvis therefore inferior and posterior to false pelvis
9
Q
Male vs. Female Bony Pelvis
A
Women - Gynecoid Pelvis
- round/oval pelvic inlet
- widely spaced ischial spines
- pubic arch >= 80 degrees
Male - Android Pelvis
- triangular/heart-shaped pelvic inlet
- narrowly spaced ischial spines
- pubic arch <=70 degrees
10
Q
Bones of the Pelvic Wall
A
- sacrum, coccyx, and os coxa
11
Q
Sacrospinous Ligament
A
- extends between the sacrum/coccyx and the ischial spine
12
Q
Sacrotuberous Ligament
A
- extends between PSIS and the ischial tuberosity
13
Q
Obturator Canal
A
- between the obturator membrane and the pubis (passageway between the pelvic cavity and the thigh)
14
Q
Greater Sciatic Foramen
A
Formed by the:
- greater sciatic notch
- sacrospinous ligament
- sacrotuberous ligament
- ischial spine
**major passageway between the pelvic cavity and lower limb
15
Q
Lesser Sciatic Foramen
A
Formed by:
- lesser sciatic notch
- ischial spine
- sacrospinous ligament
- sacrotuberous ligament
**passageway between the perineum and lower limb
16
Q
Obturator Internus Muscle
A
- covers most of the anterolateral pelvic wall
17
Q
Piriformis Muscle
A
- covers most of the posterolateral pelvic wall
18
Q
Pelvic Outlet
A
- diamond-shaped inferior margin of the true pelvis
Boundaries:
- Pubic Symphisis (anterior)
- Ischiopubic Ramus (lateral)
- Ischial Tuberosity (lateral)
- Sacrotuberous ligament (posterior)
- Coccyx (posterior)
**closed inferiorly by the pelvic diaphragm
19
Q
Rectum
A
- most posterior organ
- lacks taeniae coli, epiploic appendices, and haustra
- has transverse folds and the rectal ampulla that supports the fecal matter
20
Q
Anorectal Junction
A
- pulled anteriorly (perineal flexure) by the action of the pelvic diaphragm
- causes anal canal to move posteriorly through the pelvic floor
21
Q
Ureter Travel
A
Anterior to the common iliac veins
Posterior the the gonadal veins
- travel obliquely through the wall of the bladder - allows valvular action (prevents vesicoureteral reflux)
22
Q
Bladder
A
- most anterior organ in the pelvis
- empty - has a pyramid shape
Apex (anterior) - medial umbilical ligament extends from apex to umbilicus
Base (posterior)- trigone on the inside
Neck (inferior)- rests on prostate/pelvic diaphragm
23
Q
Detrusor Muscle
A
- muscle forming the wall of the bladder
24
Q
Trigone
A
- smooth triangular area bw the openings of the ureters (superiorly) and the urethra (inferiorly)
25
**Uvula**
Male - located at the inferior angle of the trigone
- a small protrusion of the prostate into the bladder wall
- enlargement may result from prostratic hyperplasia
26
**Male Urethra**
- ~20cm
- divided into four regions
Preprostatic
Prostatic
Membranous
Spongy
27
**Female Urethra**
- ~3.5cm (short)
- anterior to the vagina
28
**Male Internal Genital Organs**
Testes
Epididymis
Ductus Deferens
Ejaculatory Duct
Urethra
29
**Male Genital Accessory Glands**
Prostate
Two Seminal Vesicles
Two Bulcourethral Glands
30
**Ductus Deferens Path**
Ascends from the Scrotum in the Spermatic Cord → Passes through Deep Inguinal Ring → Crosses External Iliac Artery/Vein → Enters Pelvic Cavity → Crosses Posteror to the Bladder → Crosses anterior to the Ureter
31
**Ampulla of the Ductus Deferens**
- enlargement of the ductus deferens posterior to the bladder → joins the duct of the seminal vesicle to form the ejaculator duct → enters prostate → empties into the prostratic urethra
32
**Seminal Vesicle**
- bliateral accessory gland that lies between the bladder at the rectum
- lateral to the ductus deferens at the base of the bladder
33
**Prostate Location**
- unpaired accessory gland
- surrounds the urethra
- inferior to the bladder
- posterior to the pubic symphysis and anterior to rectum
34
**Inside Prostate**
- posterior wall of urethra is raised → forms _urethral crest_ and _seminal colliculus_
- ducts of prostate empty into the urethral sinus on either side of the crest
35
**Femal Internal Genital Organs**
Vagina
Uterus
Uterine Tubes
Ovaries
Pair of greater vestibular glands
36
**Uterus**
- located between bladder and rectum
- divided into:
_Fundus_ - rounded superior end above uterine tube entrance
_Body_ - between the fundus and cervix
_Cervix_ - fibrous, tubular lower portion that protrudes into the uppermost vagina
37
**Nulliparous**
- female who has not given birth
1/2 corpus and 1/2 cervix
38
**Parous**
- female who has given birth
2/3 corpus
1/3 cervix
39
**Anteverted**
- normal position of the uterus
- tipped anteriorly relative to the axis of the vagina
40
**Anteflexed**
- normal position of the uterus
- bent anteriorly relative to the axis of the cervix so it rests on the bladder
41
**Retroverted**
- uterus that is tilted posteriorly relative to the axis of the vagina
42
**Retroflexed**
- uterus whose fundus is pointing posteriorly so that angle relative to cervix is increased
43
**Round Ligament**
- passes through the deep inguinal ring
- travels in the inguinal canal and terminates in the _labia majora_
- continous with the _proper ligament of the ovary_ where they fuse on the lateral wall of the uterus
44
**Uterine Tube**
Fimbriae - projections off of the infandibulum that catch the egg
Infandibulum - expanded lateral section of the uterine tube that is open to the pelvic cavity
Amulla - lateral 2/3 of uterine tube
Isthmus - medial 1/3 of uterine tube
45
**Ovaries**
- sites of egg production
- mature eggs ovulated into the peritoneal vacity and directed to the infandibulum by the fimbriae
46
**Suspensory Ligament of the Ovary**
- vessels that supply/drain the ovary
- a fold of peritoneum where the vessels travel through from the retroperitoneum
47
**Vagina**
- distensible fibromuscular tube extending from the cervix to the vestibule of the vagina
- usually collapsed except on superior end where cervix holds walls apart
48
**Vaginal Fornix**
- recess formed bw margin of the cervix and the vaginal wall
- _posterior_ - deepest part of the recess and is closely related to the rectouterine pouch
49
**Palpable Structures in Male Rectal Exam**
Prostate
Seminal Vesicles
Ischial Spine
Sacrum
Coccyx
50
Palpable Structures in Female Vaginal Exam
Wall of Vagina
Cervix
Posterior Wall of Bladder
Anterior Wall of Rectum
Ischial Spine
Sacrum
(bladder, ovaries, uterus with second hand)
51
**Pelvic Fascia**
- transversalis fascia that continues inferiorly into the pelvic cavity
_Visceral_ - if in contact with pelvic viscera
_Parietal_ - if in contact with pelvic wall/muscles
52
**Endopelvic Fascia**
- extraperitoneal fascia (bw peritoneum and transversalis fascia) that extends into the pelvis
- contains fat, vessels, and nerves
53
**Peritoneum in the Abdomen**
- reflects off of the pelvic organs (does not form a pelvic layer)
54
**Pubocervical/Pubovesical Ligaments**
- fascial condensation in female
Supports:
- urethra, bladder, and cervix (important for urinary continence)
55
**Transverse Cervical (Cardinal) Ligament**
- anchors the cervix laterally to the pelvis
- uterine vessels travel through
56
**Uterosacral Ligament**
- anchors the cervix and uterus to the sacrum
57
58
**Puboprostatic Ligament**
- endopelvic fascia condensation
- anchors prostate to public bone
59
**Sacrogenital Ligament**
- endopelvic fascial condensation in male
- anchors prostate to sacrum
60
**Exception to "Subperitoneal"**
- most organs in the pelvis are below the peritoneum
Exception = uterus - has a mesentery and is _intraperitoneal_
61
**Rectovesical Pouch**
- recess formed by the reflection of the peritoneum over the bladder and the rectum in the male
62
**Pararectal Fossae**
- spaces along the lateral aspects of the rectum (male and female)
63
**Vesicouterine Pouch**
- shallow recess between the bladder and the uterus
64
**Rectouterine Pouch (of Douglas)**
- deep recess between the uterus and the rectum (adjacent to the posterior fornnix of the vagina)
- when supine, lowest portion of the abdominopelvic cavity - site where infection and fluids often collect
65
**Broad Ligament of the Uterus**
- double layer of peritoneum
- extends from the sides of the uterus to the lateral walls/floor of the pelvis
_Three Parts:_
Mesometrium (body of uterus to body walls)
Mesosalpinx (surrounds uterine tubes)
Mesovarium (forms shelf-like fold supporting ovaries
66
**Proper Ligament of the Ovary**
- attaches the inferior pole of the ovary to the uterus
