Pelvic Organs Flashcards

1
Q

Os Coxa

A
  • formed by the fusion of the ischium, ilium, and pubis
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2
Q

Acetabulum

A
  • socket of the hip joined located at the fusion of the three pelvic bones
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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

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4
Q

Greater Sciatic Notch

A
  • indent between PIIS and the iscial spine
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5
Q

Lesser Sciatic Notch

A
  • indent between the ichial spine and the ischial tuberosity
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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

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7
Q

Sections of the Linea Terminalis

A

Pubic Crest → Pectineal Line → Arcuate Line → Sacral Ala → Sacral Promentory

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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
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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
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10
Q

Bones of the Pelvic Wall

A
  • sacrum, coccyx, and os coxa
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11
Q

Sacrospinous Ligament

A
  • extends between the sacrum/coccyx and the ischial spine
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12
Q

Sacrotuberous Ligament

A
  • extends between PSIS and the ischial tuberosity
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13
Q

Obturator Canal

A
  • between the obturator membrane and the pubis (passageway between the pelvic cavity and the thigh)
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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

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15
Q

Lesser Sciatic Foramen

A

Formed by:

  • lesser sciatic notch
  • ischial spine
  • sacrospinous ligament
  • sacrotuberous ligament

**passageway between the perineum and lower limb

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16
Q

Obturator Internus Muscle

A
  • covers most of the anterolateral pelvic wall
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17
Q

Piriformis Muscle

A
  • covers most of the posterolateral pelvic wall
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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

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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
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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
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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)
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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

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23
Q

Detrusor Muscle

A
  • muscle forming the wall of the bladder
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24
Q

Trigone

A
  • smooth triangular area bw the openings of the ureters (superiorly) and the urethra (inferiorly)
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25
Q

Uvula

A

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
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26
Q

Male Urethra

A
  • ~20cm
  • divided into four regions

Preprostatic

Prostatic

Membranous

Spongy

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27
Q

Female Urethra

A
  • ~3.5cm (short)
  • anterior to the vagina
28
Q

Male Internal Genital Organs

A

Testes

Epididymis

Ductus Deferens

Ejaculatory Duct

Urethra

29
Q

Male Genital Accessory Glands

A

Prostate

Two Seminal Vesicles

Two Bulcourethral Glands

30
Q

Ductus Deferens Path

A

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
Q

Ampulla of the Ductus Deferens

A
  • 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
Q

Seminal Vesicle

A
  • bliateral accessory gland that lies between the bladder at the rectum
  • lateral to the ductus deferens at the base of the bladder
33
Q

Prostate Location

A
  • unpaired accessory gland
  • surrounds the urethra
  • inferior to the bladder
  • posterior to the pubic symphysis and anterior to rectum
34
Q

Inside Prostate

A
  • 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
Q

Femal Internal Genital Organs

A

Vagina

Uterus

Uterine Tubes

Ovaries

Pair of greater vestibular glands

36
Q

Uterus

A
  • 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
Q

Nulliparous

A
  • female who has not given birth

1/2 corpus and 1/2 cervix

38
Q

Parous

A
  • female who has given birth

2/3 corpus

1/3 cervix

39
Q

Anteverted

A
  • normal position of the uterus
  • tipped anteriorly relative to the axis of the vagina
40
Q

Anteflexed

A
  • normal position of the uterus
  • bent anteriorly relative to the axis of the cervix so it rests on the bladder
41
Q

Retroverted

A
  • uterus that is tilted posteriorly relative to the axis of the vagina
42
Q

Retroflexed

A
  • uterus whose fundus is pointing posteriorly so that angle relative to cervix is increased
43
Q

Round Ligament

A
  • 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
Q

Uterine Tube

A

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
Q

Ovaries

A
  • sites of egg production
  • mature eggs ovulated into the peritoneal vacity and directed to the infandibulum by the fimbriae
46
Q

Suspensory Ligament of the Ovary

A
  • vessels that supply/drain the ovary
  • a fold of peritoneum where the vessels travel through from the retroperitoneum
47
Q

Vagina

A
  • 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
Q

Vaginal Fornix

A
  • 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
Q

Palpable Structures in Male Rectal Exam

A

Prostate

Seminal Vesicles

Ischial Spine

Sacrum

Coccyx

50
Q

Palpable Structures in Female Vaginal Exam

A

Wall of Vagina

Cervix

Posterior Wall of Bladder

Anterior Wall of Rectum

Ischial Spine

Sacrum

(bladder, ovaries, uterus with second hand)

51
Q

Pelvic Fascia

A
  • 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
Q

Endopelvic Fascia

A
  • extraperitoneal fascia (bw peritoneum and transversalis fascia) that extends into the pelvis
  • contains fat, vessels, and nerves
53
Q

Peritoneum in the Abdomen

A
  • reflects off of the pelvic organs (does not form a pelvic layer)
54
Q

Pubocervical/Pubovesical Ligaments

A
  • fascial condensation in female

Supports:

  • urethra, bladder, and cervix (important for urinary continence)
55
Q

Transverse Cervical (Cardinal) Ligament

A
  • anchors the cervix laterally to the pelvis
  • uterine vessels travel through
56
Q

Uterosacral Ligament

A
  • anchors the cervix and uterus to the sacrum
57
Q
A
58
Q

Puboprostatic Ligament

A
  • endopelvic fascia condensation
  • anchors prostate to public bone
59
Q

Sacrogenital Ligament

A
  • endopelvic fascial condensation in male
  • anchors prostate to sacrum
60
Q

Exception to “Subperitoneal”

A
  • most organs in the pelvis are below the peritoneum

Exception = uterus - has a mesentery and is intraperitoneal

61
Q

Rectovesical Pouch

A
  • recess formed by the reflection of the peritoneum over the bladder and the rectum in the male
62
Q

Pararectal Fossae

A
  • spaces along the lateral aspects of the rectum (male and female)
63
Q

Vesicouterine Pouch

A
  • shallow recess between the bladder and the uterus
64
Q

Rectouterine Pouch (of Douglas)

A
  • 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
Q

Broad Ligament of the Uterus

A
  • 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
Q

Proper Ligament of the Ovary

A
  • attaches the inferior pole of the ovary to the uterus