Pelvic Viscera

Question 1

Ureter Constrictions

Answer 1

Ureteropelvic Junction (UPJ), Where it crosses Iliac artery (near ext/int bifurcation, netters shows distal to), Ureterovesical Junction (UVJ), Where it is crossed by gonadal vessels

Question 2

“Water under the bridge”

Answer 2

Left ureter crosses underneath (inferior) Left uterine artery and vein. Right ureter is superior to right uterine a/v

(Males left ureter inferior to ductus deferens, less clinically significant)

Question 3

Urinary Bladder

Answer 3

Located in retropubic space
Empty: in true pelvis, 4 sided pyramid
Full: protrudes into abdominal cavity (ant & sup), ovoid
Medial and lateral Pubovesical (female) or Puboprostatic (male) ligaments fix neck to lower margin of pubic symphasis

Question 4

Suprapubic Catheter

Answer 4

Used in males with enlarged prostates. Straight into bladder. Does not pierce peritoneum

Question 5

Bladder Trigone

Answer 5

Smooth triangular area in posterior inferior bladder in non-distended state. Between openings for ureters (oblique angle) to neck

Question 6

Internal urethral sphincter

Answer 6

at neck of bladder. thickening of dtrusor muscle. Sympathetic and parasympathetic innervation

Question 7

Sphincter Urethrae

Answer 7

External urethral sphincter. associated with membranous urethra. skeletal muscle, pudendal nerve

Question 8

Parts of male urethra

Answer 8

Preprostatic, Prostatic, membranous (just distal to prostate, deep perineal pouch, spincter urethrae), penile/songy (has openings for bulbourethral glands)

Question 9

Ductus deferens

Answer 9

Begins at end of epididymis, travels in spermatic cord, widens into ampulla posterior to bladder, superior to prostate and joins with seminical vesicle to form ejaculatory duct

Question 10

Tunica Albuginea

Answer 10

dense connective tissue covering seminiferous tubules of testes, gives of septa that seperate testes into lobules

Question 11

Seminiferous tubules

Answer 11

where sperm production takes place

Question 12

Efferent ductules

Answer 12

connects seminiferous tubules to epidiymis

Question 13

Bulbourethral gland

Answer 13

inferior to pelvic diaphram in deep perineal pouch, related laterally to sphincter urethrae

Question 14

Prostate

Answer 14

Golf ball sized
Glandular and fibromuscular tissue
5 lobes, true and false capsule
Base-portion inferior to bladder
Apex-lies along superior fascia of deep perineal pouch
Posterior aspect near ampulla of rectum (digital rectal exam)

Question 15

Benign Prostatic enlargements

Answer 15

usually involve median and lateral lobes

Question 16

Prostatic adenocarcinoma

Answer 16

usually posterior lobe

Question 17

Blood supply of prostate and bladder

Answer 17

Brances of internal iliac artery and veins. However also communication with vertebral venous plexus (of batson) (valvless, metasticis of prostate cancer to CNS)

Question 18

Uterus

Answer 18

Fundus, body, cervix

Anteverted and antiflexed normally relative to vagina

Question 19

Fallopian tube

Answer 19

suspended in mesosalpix

Question 20

Vagina

Answer 20

lower 1/4 innervated by pudendal n, upper 3/4 autonomic