Pelvic viscera Flashcards
What are the boundaries of the pelvis?
- Pelvic inlet (superiorly)
- Pelvic wall (anteriorly, posteriorly, laterally)
- Pelvic floor (inferiorly)
What are the branches of the internal iliac artery?
Parietal branches:
- Superior/inferior gluteal arteries (buttocks/gluteal region)
- Obturator artery (inner leg)
- Internal pudendal artery (perineum)
Visceral branches:
- Superior/inferior vesical arteries (bladder)
- Middle rectal artery
- Uterine artery (uterus)
What are the peritoneal reflections in females?
- Recto- uterine pouch (of Douglas)
- Vesico-uterine pouch
What is the peritoneal reflection in males?
Rectovesical pouch
What structure make up the pelvic walls?
Bones:
- Hip (innominate) bone – Ilium, pubis, ischium
- Sacrum
- Coccyx
Muscles:
- Piriformis
- Obturator internus
Ligaments:
- Sacrospinous ligament
- Sacrotuberous ligament
Which muscles make up the pelvic diaphragm?
- Levator ani
- Coccygeus
What are the surfaces if the bladder?
- Superior
- Base
- Inferolateral (x2)
What is the smooth muscle in the wall of the baldder called?
Detrusor muscle
What are corners of the bladder?
- Apex: Attaches to the median umbilical ligament
- Lateral horns: Attachments of the ureters
- Inferior horn: Attachment of the urethra
What are the ligaments associated with the neck of the bladder?
- Men: Puboprostatic ligaments
- Women: Pubovesical ligaments
What is the blood supply to the bladder?
Arterial:
- Superior/inferior vesical arteries (from internal iliac)
- Uterine artery (female)
Venous;
- Vesical plexus (internal iliac veins)
- Prostatic plexus (males)
What is the innervation of the bladder?
- Parasympathetic: Pelvic splanchic (S2-4)
- Sympathetic: L1-2 (male, closes bladder neck during ejaculaton)
Where does the rectum begin?
S3
What is the structure of the rectum?
- Valves of Houston: Made up of mucosa and circular muscle
- Covered anteriorly and posteriorly by 2 bands of longitudinal muscle
How long is the rectum?
12 cm
What are the peritoneal relationships of the rectum?
Superior 1/3: Anterior and lateral
Middle 1/3: Anterior only
Inferior 1/3: No peritoneum
What is the pathway of the rectum?
- Begins as continuation as sigmoid colon
- Turns anteriorly at coccyx
- Turns posteriorly at pelvic diaphragm
What is the blood supply of the rectum?
- Superior rectal artery
- Middle rectal artery
What is the innervation of the rectum?
- Parasympathetic: Pelvic splanchnic (S2-4)
- Sympathetic: L1-2
What are the structures present in the verumontanum?
- Prostatic utricle
- Ejaculatory ducts
- Prostatic ducts
What is the blood supply of the prostate glands?
Arterial:
- Inferior vesical artery
2 Middle rectal artery
- Internal pudendal artery
Venous: Prostatic plexus
What structures does the vas deferens pass on along its path?
- Inguinal canal (superficial/deep ring, in spermatic cord)
- Inferior epigastric vessels (anterior)
- External iliac vessels (posterior)
- Medial umbilical ligament (posterior)
- Obturator neurovascular bundle
What is the blood supply of the vas deferens?
Artery to the vas (superior vesical artery)
What is the innervation of the vas deferens?
- Intrapelvic: Pelvic splanchnic
- Spermatic cord: Same as testes
