Pelvic Viscea

Question 1

Describe the pathway of the ureter

Answer 1

Will run on psoas and lateral wall and then will pass over the pelvic brim (common illiac bifurcation), will then turn forward to enter the base of the bladder at an oblique angle

Question 2

What structures pass over the urter

Answer 2

The vas deferes in males and the uterine artery in women

Question 3

Describe the trigone

Answer 3

Is a triangle region of the bladder where the ureters enter above and the urethra exits below

Question 4

What structures hold the bladder in place

Answer 4

At the neck of the bladder the pubo-vesicle ligament will attach anterior via the pubic crest and the fascial condesnations (lateral pelvic ligament) will hold the neck to the lateral walls

Question 5

What is the role of the fundas

Answer 5

Will expand to accommodate fluid (Urine)

Question 6

What can be tell from a DRE about the prostate

Answer 6

Size, contour and hardness

Question 7

Which lobe is typically enlarged in BPH

Answer 7

Medial lobe

Question 8

Where does the joining of the seminal and VD occur

Answer 8

They transverse the prostate and exit at the ejaculatory duct

Question 9

In relation to what structures is the prostate located

Answer 9

• Neck of the bladder above

- Roof of the pelvic floor and the perineal membrane below

Question 10

Describe the uterus

Answer 10

Fundus, entrance of uterine tubes, body, isthmus and internal/exteral os.

Question 11

How is the uterus stabilised

Answer 11

Through the attachments of the lateral cervical, uter sacral and the pubo-sacral ligaments

Question 12

What ligament is most important for uterine stabilisaton

Answer 12

Lateral cervical

Question 13

What are the different regions of the uterine tube

Answer 13

Intramural, isthmus, ampulla and then ends in Fimbraie

Question 14

What will wrap around the ovary

Answer 14

The fimbraie to collect eggs when ovulation occurs

Question 15

Where is the ovary located

Answer 15

On the posterior aspect of the broad ligament, also where the common iliac burfurcates on the lateral pelvic wall

Question 16

Where does the peritoneum drape over the uterine tubes

Answer 16

Over the front, top and sides, like a poncho

Question 17

What supports the ovary

Answer 17

The ovarian ligament and the round ligament

Question 18

What is special about the round ligament

Answer 18

remnant of the gobinaculum (female spermatic cord)

Question 19

What is the Fornix

Answer 19

The cupping of the superior aspect around the terminal cervix and the external Os

Question 20

What can be palpated in a per-vaginal exam at the fornix

Answer 20

§ Posterior, can palpate the pouch of douglas and the rectum
§ Anterior, can palpate the bladder
§ Laterally can palpate the lateral structures, possibly cystic ovaries

Question 21

Region of the rectum is defined as

Answer 21

Loss and tenia, one discreet londtudinal muscle bands ad begins at the level of S3. Ampulla will store faeces

Question 22

What arteries supply the pelvis

Answer 22

The anterior and posterior division of the internal iliac, the continueation of the inferior mesenteric artery which turns into superior rectal and the ovarian artery (from the abdominal aorta)

Question 23

What helps to support the superior rectal

Answer 23

The middle rectal

Question 24

What helps to support the Ovarian artery

Answer 24

The Uterine artery

Question 25

What arteries supply the bladder

Answer 25

The superior vesicle and the inferior vesicle (males only to help supply the prostate etc)

Question 26

What arteries supply the vagina

Answer 26

Vaginal artery

Question 27

Describe the nerve supply of the viscera

Answer 27

PNS from pelvic S2-4 and drop into the inferior hypogastric plexus

SNS arise from above (thorocolumbar region) and dump into the superior hypogastric plexus and then intermingle with the inferior plexus, then joined by the PNS

Question 28

What are the branches of the anterior internal iliac artery

Answer 28

Obturator, superior vesicle, inferior vesicle/uterine, middle rectal, internal pudendal to inferior rectal and then the inferior gluteal artery

Question 29

What are the branches of the posterior internal iliac artery

Answer 29

Iliolumbar, lateral sacral and superior gluteal arteries