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Anatomy 2 > pelvic viscera > Flashcards

pelvic viscera Flashcards

pelvic cavity

1
Q

fpelvis

what are the 3 bony pelvis parts?

A

innominates (hip bones, os coxae)
sacrum
coccyx

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2
Q

pelvis

What are the 3 parts of the innominates of pelvis?

A

ilium
ischium
pubis

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3
Q

label

A
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4
Q
A
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5
Q

what is the normal coccyx mobility degree range?

A

5°-20°

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6
Q

clinical importance

Do all pelvic floor muscles connect into the coccyx?

A

yes

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7
Q

what does nutation mean?

A

nodding (as in anterior pelvic tilt)

occurs in sagittal plane

The sacrum moves forward, down, and rotates to the opposite side of the body. This happens when the sacrum absorbs shock.

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8
Q

What does counternutation mean?

A

moves posteriorly (as in PPT)

occurs in sagittal plane

The sacrum moves backward, up, and rotates to the same side of the body that absorbed the force. The ilium rotates in the opposite direction

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9
Q

there are 2 sacroiliac joints taht are made of what type of cartilage?

A

hyaline cartilage and fibrocartilage

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10
Q

What type of cartilage is hyaline?

A

type II collagen and proteoglycans providing a smooth, low friction surface for joints

most common type of cartilage

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11
Q

what type of cartilages is the pubic symphysis composed of?

A

hyaline cartilge and fibrocartilage

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12
Q

What is fibrocartilage?

A

thickest fibers, that is the strongest and least flexible of the 3 cartilage types

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13
Q
A
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14
Q
A
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15
Q
A
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16
Q

what is the superior border and inferior border of the pelvic cavity/true pelvis

A

superior border: pelvic brim/pelvic inlet
inferior border: pelvicdiaphragm (levator ani)

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17
Q

the pelvic cavity is continous with what other cavity?

A

with abdominal cavity

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18
Q

what is the function of the pelvic inlet?

A

entrance to the birth canal

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19
Q
A
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20
Q

what position of the hips is best to widen pelvic outlet?

A

internal rotation

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21
Q

T/F the coccyx can not be injured during childbirth?

A

false - it can althought it’s rare

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22
Q

what can occur at the pubic symphysis during delivery?

A

diastasis (these people are typically non ambulatory right after birth)

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23
Q

What is the difference in the greater pelvis between male and female?

A

male: deep
female: shallow

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24
Q

what is the shape of the lesser pelvis for male and female?

A

male: narrow, deep, tapering
female: wide, shallow, cylindrical

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25
Q

what is the pelvic inlet shaped like for male and female?

A

male: heart shaped, narrow
female: oval or rounded,wide

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26
Q

What is the size of pelvic outlet for male and female?

A

male: comparatively small
female: comparatively wide

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27
Q

What is the size of pubic arch adn subpubic angle in male and female?

A

male: narrow
female: wide

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28
Q

The uterus is found typically?

A

within pelvic cavity and into greater pelvic

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29
Q

where will the uterus expand into with a growing fetus?

A

abdominal cavity

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30
Q

the uterus is typically found in which position?

A

anteverted

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31
Q

which ligament helps uterus maintain anteveretd position during pregnancy?

A

round ligament

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32
Q
A
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33
Q

what are the 3 parts to the broad ligament?

A
  • mesometrium
  • mesosalpinx
  • mesovarium

  • mesovarium is closes to ovary
  • mesometrium is covering uterus
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34
Q

what is the orgin, insertion of round ligament?

A

origin: uterine cornu of uterus (anterior lateral prtion of uterus)
insertion: runs through inguinal ring and lbends into mons pubis and labia majora

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35
Q

ovarian ligament orgin and insertion?

A

origin: medial to ovary
insertion: posterolateral aspect of uterus (wrapped in mesovarium)

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36
Q

overian suspensory ligament orgin and insertion?

A

origin: folds of pelvic parietal peritoneum from over external iliac arteries along pelvic wall
insertion: ovary and broad ligament

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37
Q

uteroscacral ligament orgin and insertion?

A

origin: base of uterus at the level of the cervix
insertion: anterior border of sacrum

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38
Q

what are 3 signs that endometrial lesions are present?

A
  1. chronic sacroiliac joint pain
  2. worsens with menstrual cycles
  3. pain with intercourse and bowl movements
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39
Q

What are the 4 parts of the fallopian tubes?

A

infundibulum
ampulla
isthmus
uterine part

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40
Q

What does the infundibulum contain?

A

the opening (abdominal ostium) with the fimbriae to encourage oocyte to enter

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41
Q

the sartorius muscle contributes to the formation of?

A

adductor canal - medial boundry
femoral triangle -lateral boundry

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42
Q

What is the ampulla a common site for?

A

widest section - therefore common site for fertilization

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43
Q

isthmus is a narrow portion with?

A

thicker walls as itenters into outerus

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44
Q

uterine part is the portion of the fallopian tubes that?

A

passes through uterine wall into uterus

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45
Q
A
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46
Q

is the ovary connected to the fallopian tube?

A

NO

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47
Q

what is the role of the ovary?

A

to produce oocytes for fertilization

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48
Q

What production is the ovary responsible for?

A

estrogen and progesterone production

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49
Q

an oocyte is swept up into fallopian tube via?

A

fimbriae

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50
Q

what is the pH level of the vagina?

A

4.2-4.8 - acidic

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51
Q

with age the prostate?

A

grows - increased and common site for cancer

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52
Q

the internal and external urethral sphincters are located where in relation to the prostate?

A

IUS: superior to prostate
EUS: inferior to prostate

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53
Q

the gland in the prostate secrete what type of fluid to counteract vaginal canal?

A

alkaline?

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54
Q

Where does sperm come from?

A

epididymis via ductus deferens

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55
Q

what gland secretes seminal fluid?

A

cowpers gland - small glands which open into the urethra at base of penis

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56
Q

what 2 things connect and enter the posterior prostate via ejacultory duct?

A

ductus deferens and seminal vesicles

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57
Q

the seminal vesicfle releases what type of fluid?

A

seminal

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58
Q

the internal anal sphincter is made of what type of muscle? it has what type of control?

A

smooth, involuntary control

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59
Q

external anal sphincter is made of what type of muscle? has what kind of control?

A

skeletal muscle, voluntary control

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60
Q

What are 3 common sites for hemmroids in the anal canal?

A
  1. pectinate or dentate line
  2. internal sphincter
  3. external sphincter
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61
Q
A
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62
Q
A
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63
Q

what are the 3 main arteries and 3 main veins taht supply blood to rectum?

A

ateries: superior, middle, inferior rectal arteries
veins: superior, middle, inferior rectal veins

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64
Q

the bladder is pear shaped and holds up to how many ml of urine?

A

500-600ml

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65
Q

how many ml of urine do you need to feel the first urge to urinate?

A

150ml

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66
Q

how many ml do we usually hold before needed to empty bladder?

A

~300ml

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67
Q

can the bladder expand into abdominal cavity when full?

A

YES

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68
Q

what muscle contracts to expel urine during urination?

A

detrusor muscle

69
Q

waht is the trigone?

A

smooth area of bladder where openings of uerter and urethra enter into bladder

70
Q

what prevents backflow of urine back up to kidney?

A

trigone

small flaps of mucosa cover openings of uereter

71
Q

what is the main symptom of endometriosis?

A

pain

72
Q

what isthe estimated prevalence of endometriosis?

A

10%

73
Q

when are symptoms of endo exasturbated?

A

during menstruation cycle

74
Q

what is the only way to officially diagnose endo?

A

laparoscopic surgery and biopsy of tissues

75
Q

pelvic organ prolapse can be an integrity issue with what type of tissue?

A

ligaments

76
Q

what are 3 important considerations with pelvic organ prolapse?

A
  1. abdominal pressrue managment is necessary
  2. possible history of levator avulsion tear
  3. strainign to empty
77
Q

female perineum

where is the perineum located?

A

inferior to pelbic diaphragm, inferior portion of the pelvic outlet

78
Q

female perineum

what are the boundaries of the female perineum?

A

Antierior: pubic symphsis
posterior: coccyx
lateral: ischial tuberosities

79
Q

perineum

what are the 2 halves of the perineum?

A

urogential triangle
posterior anal triangle

80
Q

female external genitalia

contains what structures?

A

mons pubis
labia major
labia minora
posterior fourchette
clitoris
clitoral hood
vulva
perineal body
vulvar vestibule
urethral opening - meatus
vaginal opening - introitus
hymen
vestibular glands
anus

81
Q

female genitalia

label the parts of the clitoris

A
82
Q

male perineum

describe location of male perineum

A

inferior to pelbic diaphragm
infeiror portion of the pelvic outlet

83
Q

male perineum

what are the boundaries of the male perineum?

A

anterior: pubic symphsis
posterior: coccyx
lateral: ischial tuberosities

84
Q

male perineum

the male perineum contains?

A
  • shaft of penis
  • testicles
  • perineal body
  • anus
85
Q

male genitalia

label male external genitalia

A
86
Q

female genitalia

what are the actions of the superficial pelvic floor (layer 1) in female anatomy?

A

assists in arousal and mataining arousal via connections into clitoris
helps stabilize perineal body
EAS: voluntary bowl control

EAS = external anal schincter

87
Q

female genitalia

what are common disorders of the superficial pelvic floor in females? (layer one)

A
  1. vulvodynia
  2. vaginismus
  3. dyspareunia
  4. inability to achieve or maintain an orgasm
88
Q

female genitalia

what are the actions of the second layer of female pelvic floor?

A

assists in urinary control
assist in closing introitus (vaginal opening)
further support to perineal body

89
Q

female genitalia

what are common pelvic floor disorders associated with layer two in female anatomy?

A

dyspareunia
post-void dribbling
difficulties fully emptying
stream that splits/sprays
vaginismus
**vulvodynia

90
Q

female genitilia

what are the actions of layer three in pelvic floor of female anatomy?

A
  • supports pelvic viscera
  • external urethral urinary sphincter control to assist in emptying and filling of bladder
  • maintains puborectalis angle to assist in bowel control
  • balance
  • load transfer
  • spine stabilization
91
Q

female genitilia

what are common disorders of the third layer of pelvic floor muscles in female anatomy?

A

urinary bowl incontienecy and retention
pelvic organ prolapse
low back pain **
hip pain **
sacroiliac joint pain **

92
Q

female genitilia

what layer of pelvic floor muscles is most commonly associated with pelvic organ prolapse?

A

third layer
(piriformis, coccygeus, levator ani, coccyx, obturator internus, arcus tendoneus levator ani, pubococcygeus, puborectalis, urogenital diaphragm)

93
Q

female genitilia

what are the muscles in the second layer of the pelvic floor in female anatomy?

A

bladder
striated urogenital sphincter complex
vagina
ischipubic ramus
ischial tuberosity
deep transverse perineum
perineal body
vaginal canal
urethra
detrusor muscle

94
Q

female genitalia

what are the muscles in the first layer of pelvic floor in female anatomy?

A

urethral opening
bulvocavernosus
ischiocavernosus
superficial transverse perineum
external anal sphincter (EAS)

95
Q

male genitalia

for the male pelvic floor what is the role of layer one?

A

erection and ejaculation
helps stabilize perineal body
EAS function

96
Q

male genitalia

What are 3 common disorder of the pelvic floor occuring at layer one?

A

peyronies disease (penile fibrosis)
erectile dynfuction
**urinary incontenience

97
Q

male pelvic floor

what is the role of the plevic floor layer 2?

A

urinary control
support to perineal body

98
Q

male pelvic floor

what are 3 disorders associated with the 2nd layer of male pelvic floor?

A

post- void dribbling
difficulties fully emptying
stsream taht splits/sprays

99
Q

male pelvic floor

what is the role of the 3rd male pelvic floor layer?

A

suport of pelvic viscera
ex. urethral urinary sphincter control
maintains puborectalis angle (blowel control)
balance
load transfer
spine stabilization

100
Q

male pelvic floor

what are common disorders of the male pelvic floor 3rd layer?

A
  • urinary/bowel incontinence and retention
  • rectal prolapse
  • LBP**
  • hip pain**
  • SI joint pain **
101
Q

muscles

what muscles consist of the levator ani

A

-iliococcygeus
- puborectalis
- pubococcygeus

102
Q

muscles

what is the musle action of the levator ani?

A

think= elevator

103
Q

muscles

is the coccygeus apart of the levator ani?

A

NO - it does not lift

104
Q

muscles

what shape is the levator ani?

A

bowl/hammack

105
Q

muscles

if the levator ani is hypertonic what is the new shape it takes?

A

flat tarp

106
Q

label

A
107
Q

muscles

what is the action of obturator internus?

A

external hip flexor (or hip abductor when in hip flexion)

108
Q

muscles

what does the obturator internus help stabilize?

A

hip in socket

109
Q

muscles

every single pelvic diaphragm muscle connects the obturator internus via?

A

tendinous arch of levator ani

110
Q

what are the muscles of the perineal body?

mneumonic: BELTS

A

bulbospngiosus
external anal sphincter
levator ani
transverse perineal muscles
sphincter urethrae (small, not seen often)

111
Q

muscles

A
112
Q

muscles

what is the role of puborectalis?

A

sling around the rectum
- puts a “kink” in the rectum to aid in resisting bowel movement

113
Q

muscles

A
114
Q

arteries, veins, nerves

the common iliac artery splits at what level of the intervertebral disc?

A

L5 and S1

115
Q

arteries, veins, nerves

What does the internal iliac artery bifurcate into?

A

anterior and posterior trunks

116
Q

female vaculature, arteries, veins, nerves

the anterior trunk of internal iliac artery has 8 -list them

Under Open Skies Unique Ideas Inspire Mighty Visions

A
  1. umbilical artery
  2. obturator artery
  3. superior vesical arteries
  4. uterine artery
  5. internal pudendal artery
  6. inferior gluteal artery
  7. middle rectal artery
  8. vaginal artery
117
Q

arteries, veins, nerves

What arteries are in the posterior trunk of internal iliac artery?

A

superior gluteal artery

118
Q

arteries, veins, nerves

A
119
Q

arteries, veins, nerves

what arteries are found of the anterior trunk of the internal iliac artery?

Unicorns Often Inspire Imagination Sparkling Magical Ideas Possibilities

A
  1. umbilical artery
  2. obturator artery
  3. internal pudendal artery
  4. inferior gluteal artery
  5. superior vesical arteries
  6. middle rectal rtery
  7. inferior vesical arery
  8. prostatic branch of inferior vesical artery
120
Q

arteries, veins, nerves

pelvic splanchnic nerve are what type of nerves?

A

parasympathetic

121
Q

arteries, veins, nerves

The hypogastric plexus is a mix of what?

A

parasympathetic and sympathetic

122
Q

arteries, veins, nerves

if the nerves are not parasympathetic, or sympathetic then they are?

A

somatic

123
Q

arteries, veins, nerves

Where are the pelvic splanchnic nerves located?

A

S2-S4

124
Q

arteries, veins, nervesarteries, veins, nerves

what does pelvic splanchnic nerves innervate?

A

pelvic organs

125
Q

arteries, veins, nerves

Fibers of the pelvic splanchnic nerve inter via ?

A

inferior hypogastric plexus to reach pelvic viscera

126
Q

arteries, veins, nerves

What is the action of the pelvic splanchnic nerve on organs via parasympathetic system?

A
  • vasodilation for some organs
  • contraction of detrusor (pee)
  • relaxation of internal anal sphincter
  • erection (point)

*think PPP - parasympathetic, pee, point

127
Q

arteries, veins, nerves

what is the action of sympathetic nerves in pelvic viscera?

*think SSS

A
  • internal urethral and internal anala sphincter smooth muscle control (store)
  • moving secretions from epididymis during ejaculation (shoot)

  • think SSS - sympathetic, store, shoot
128
Q

arteries, veins, nerves

where is the sacral plexus located with respect to piriformis muscle?

A

anterior to

129
Q

ANS: hypogastric plexus

the superior hypograstric plexus (L5) feeds into

A

inferior hypogastric plexus

130
Q

ANS: hypogastric plexus/infeiror hypogastric plexus

what level of the spine is the inferior hypogastric plexus?

A

S2-S4

131
Q

ANS: hypogastric/inferior hypogastric plexus

the HG and IHG plexus has sympathetic innervations via? how does it connect between the plexuses?

A

sympathetic trunk
- bidirectional communication between superior and inferior hypogastric plexus via hypogastric nerve

132
Q

ANS: hypogastric/inferior hypogastric plexus

these plexuses have parasympathetic contributions via?

A

pelvic splanchnic nerves

133
Q

somatic nerves

the sacral plexus runs what level of the spine? and has contributions from what 2 levels?

A

S1-S4
L4/L5 contributions

134
Q

somatic nerves

the coccygeal plexus runs what level(s) of spine?

A

S5
S4 contributions

135
Q

sacral plexus

what levels of spine is the sacral plexus? what nerves run with which level?

A

L4-S4
- superior gluteal (L4-S1)
- inferior gluteal (L5-S2)
- sciatic (L4-S3)
- pudendal (S2-S4)

136
Q

sacral plexus

what are the portions of sciatic nerve?

A

fibular portion
tibial portion
posterior femoral

137
Q

sacral plexus

pudendal nerve exits pelvis via?

A

greater sciatic foramen (inferior to piriformis)

138
Q

sacral plexus

pudendal nerve passes over which ligament lateral to ischial spine?

A

sacrospinous ligament

139
Q

sacral plexus

the pudendal nerve enters the pelvis via _________ lateral to obturator internus

A

lesser sciatic foramen

140
Q

sacral plexus

the pudendal nerve passes through what canal?

A

alcocks canal

141
Q

sacral plexus

what can occur at the sacral plexus to cyclists or those with ED ?

A

they can crush their pudendal nerve via alcocks canal

142
Q

sacral plexus

What are the 3 branches of the pudendal nerve?

A
  • dorsal nerve of clitoris or penis
  • the perineal branch
  • the inferior rectal nerve
143
Q

sacral plexus

what are the 3 functions of the pudendal nerve?

A
  • innervates pelvic floor musculature
  • assists in external urethral sphincter tone
  • assists in maintaining erection of clitoris or penis
144
Q
A
145
Q

clinical pearl

if someone metions the toilet seat is the most comfortable seat in the house, what is the likely cause?

A

pudendal neuralgia

does not put pressure on alcocks canal

146
Q

pelvic organs

what level of Delancey pelvic floor support is in direct fusion of the vagina with levator ani muscles, perineal membrane and body?

A

level 3

147
Q

embryology

waht embryonic tissuedevelops into the reproductive system? where do the germ cells come from?

A

intermediate mesoderm
- germ cells come from endoderm lining of the yolk sac to the urogenital ridges

  • the intermediate mesoderm condenses to become the urogenital ridge and gives rise to gonads and ductal systems
  • the primordial germ cells will give rise to gametes
148
Q

embryology

which duct system gives rise tos the uterus and fallopian tubes? which duct system gives rise to the ductus deferens?

A
  • the paramesonehpric (mullerian) ducts
  • The mesonephric (wolffian) duct
149
Q

embryology

What structure is derived from the labioscrotal swellings in females? what about males?

A
  • labia major
  • scrotum
150
Q

embryology

sometime the paramesonephric ducts fail to fuse together completely in female development. What is the name of the resulting condition?

A

the paramesonephric ducts will duplicate the uterus also known as bicornate uterus

151
Q

autonomic nerves of the pelvis

what spinal cord levels give rise to the parasympathetics for the pelvis viscera? what is another name for these nerves?

A

S2, S3, S4 bilaterally
pelvic splanchnic nerves

152
Q

autonomic nerves of the pelvis

what important somatic nerve to the perineum also arises from S2,3,4?

A

pudendal nerve

153
Q

autonomic nerves of the pelvis

waht is the name of the plexus taht gives rise to the postganglionic sympathetics to the pelvic viscera? What are the name for the preganglionic sympathetics that synapse there?

A
  • inferior hypogastric pelxus
  • sacral splanchnic nerves
154
Q

label

A
155
Q

label

A
156
Q
A
157
Q
A
158
Q
A
159
Q
A
160
Q
A
161
Q

the mons pubis contains which ligament?

A

round ligament

162
Q
A
163
Q

in the penis the urethra passes through which structure?

A

corpus spongiosum

164
Q

what part of the broad ligament covers the ovary?

A

mesosalpinx

165
Q

role of ovary

A

produce oocyte for fertilization
responsible for estrogen and progestrone produciton

166
Q

the oocye enters the fallopian tube via?

A

fimbriae

167
Q

what are the 4 parts of the fallopian tubes?

A
  1. infundibulum
  2. ampulla
  3. isthmus
  4. uterine part

from lateral to medial

168
Q

what 3 muscles make up the levator ani

A
  • puborectalis
  • pubococcygeus
  • iliococcygeus

Anatomy 2 (5 decks)

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