Pelvic Viscera Flashcards

1
Q

How do the ureters enter the pelvis minor?

A

pass over pelvic brim from retroperitoneal, just anterior to internal iliac vessels

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2
Q

What crosses over the ureters in males?

A

vas deferens

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3
Q

What crosses of the ureters in females?

A

uterine A

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4
Q

The ureters travel posteroinferiorly to lie above ___________as they approach the bladder

A

levator ani

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5
Q

What angle do the ureters enter the bladder at?

A

posterosuperior angle

–>immediately above seminal vesicles and inferior to vas deferens in males

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6
Q

What prevents retrograde flow of urine into ureters?

A

intramural portion of ureters–>one way flap

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7
Q

What spinal levels detect pain in ureters?

A

T10-L2

–>referred ipsilateral to lower abd quadrant and groin

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8
Q

The mucosa of the bladder are loosely attached except at the ___

A

trigone (neck of bladder)

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9
Q

Describe the location of the urinary bladder

A

anteroinferior par of pelvis minor

below peritoneum

resting on pelvic diaphragm

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10
Q

Why can a needle be placed above the pubic symphysis to collect urine?

A

as bladder fills, it ascends in the abdomen–> can obtain urine via this method without entering abd cavity

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11
Q

How many muscle layers make up the bladder?

A

3 detrusor smooth muscle

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12
Q

In males, what is the peritoneum of the bladder reflected over the superior surface of?

A

peritoneum reflected from the bladder over superior surface of VAS DEFERENS and SEMINAL VESICLES

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13
Q

What separates the base of the bladder from the rectum?

A

base of bladder= posterior

vas deferens and seminal vesicles

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14
Q

What peritoneal recess separates the bladder from the rectum in males?

A

rectovesical pouch

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15
Q

Where is the apex of the bladder?

A

anterior

–>where neck jxns with urethra

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16
Q

What part of the bladder rests on the prostate gland?

A

neck of bladder

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17
Q

What sphincter prevents retrograde flow of semen into bladder during ejaculation?

A

internal urethral sphincter within the neck of the bladder

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18
Q

What lie posterior to the bladder in females?

A

vagina

uterine cervix

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19
Q

What lie superior to the bladder in females?

A

fundus and body of uterus

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20
Q

What peritoneal pouch is located between the superior surface of the bladder and the uterus?

A

vesicouterine pouch

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21
Q

What holds the neck of the bladder in position in males and females?

A

males: puboprostatic L
females: pubovesical L

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22
Q

What surrounds the lateral surfaces of the bladder?

A

vesical fascia that contains vesical venous plexus

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23
Q

What are the 4 parts of the male urethra?

A

1: intramural (through bladder wall)
2: prostatic (prostate gland)
3: membranous urethra (UG diaphragm)
4: penile/spongy (penis that terminates at ext urethral orifice)

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24
Q

What is contained in the posterior wall of the prostatic urethra in males?

A

urethral crest

2 prostatic sinuses
–>where prostatic ducts empty

seminal colliculus
–>rounded eminence of crest

prostatic utricle
–>homologous to uterus and vagina

openings of ejaculatory ducts just lateral to utricle

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25
What surrounds the membranous urethra in males that is part of the UG diaphragm?
external urethral sphincter | -->relaxes during urination and ejaculation
26
Describe the passage of the female urethra to the external urethral opening
passes anterioinferiorly from internal urethral orifice of bladder POSTERIOR to pubic symphysis -->external urethral orifice in the vestibule of vagina
27
What are BL paraurethral glands on either side of urethra homologs to?
prostate gland
28
Where do the paraurethral ducts open?
near external urethral orifice
29
What compresses the urethra in females?
external urethral sphincter in urogenital diaphragm
30
What is a thick tube that is the continuation of the epididymis?
vas deferens
31
Describe the anatomical position of the vas deferens
ascends in spermatic cord, passes through inguinal canal, in contact with parietal peritoneum as it approaches bladder -->crosses ureter so it is superior to the seminal vesicle -->medial portion expands to form ampulla and joins duct of seminal vesicle to form ejaculatory duct
32
What joins to form the ejaculatory duct?
- ampulla of vas deferens - duct of seminal vesicle near the neck of the bladder
33
What are seminal vesicles?
accessory sex glands that produce seminal fluid (fructose), constitutes majority of semen -->coiled tubes on the posterior surface of bladder b/t vas deferens and prostate gland
34
What is the pathway of the ejaculatory ducts?
pass anteroinferiorly through prostate gland to open on seminal colliculus in prostatic urethra
35
Where is the prostate gland?
surrounds prostatic urethra
36
What is the largest accessory gland in males?
prostate gland | -->walnut sized
37
Is the prostate gland made of glandular or muscular tissue?
BOTH-->fibromuscular 2/3 glandular 1/3 muscular fibrous tissue in anterior lobe R and L lobes have muscular tissue
38
What comprises 20% of semen?
milky, alkaline fluid from prostate -->helps neutralize acidity of vaginal secretions
39
What is the main source of energy for sperm?
fructose
40
What surrounds prostate gland?
visceral pelvic fascia -->dense fascial sheath
41
Describe the shape of the prostate gland
conical - >base near neck of bladder - ->apex adjacent to UG diaphragm - -->anterior, posterior and lateral surfaces
42
What space is anterior to the prostate gland?
retropubic space -->filled with fat
43
What is posterior to the prostate gland?
ampulla of rectum
44
What is inferolateral to the prostate gland?
levator ani M
45
What is benign prostatic hypertrophy?
enlargement of posterior middle portion of prostate -->narrows prostatic urethra **usually older men
46
Where does 50% of all cancers originate in males?
prostate gland -->mets to lymph or spine, liver and lungs
47
What pea-sized accessory sex glands are located in the UG diaphragm lateral to the membranous urethra?
bulbourethral glands
48
What is the passage/action of bulbourethral glands?
pass through perineal membrane to penetrate bulb of penis-->opens into proximal spongy urethra -->produces mucous secretion that is released prior to ejaculation to lubricate urethra
49
What are on either side of the vagina?
levator ani and broad ligaments of uterus
50
What is anterior to the vagina?
bladder and urethra
51
What lie posterior to the vagina?
rectouterine pouch rectum anal canal
52
What are the subdivisions of the vagina?
anterior fornix posterior fornix 2 lateral fornices
53
What fornix of the vagina is the deepest subdivision r/t peritoneum forming rectouterine pouch?
posterior fornix
54
Where is the uterus located?
pelvis minor
55
Where is the cervix of the uterus located?
between bladder and rectum
56
What is the external and internal os?
internal os: internal opening into cervix external os: opening in cervix next to vagina
57
What surrounds the external os?
vaginal fornix
58
What are the layers of the uterus?
1: perimetrium - ->peritoneum 2: myometrium - ->smooth muscle 3: endometrium - ->epithelium with glands
59
What is the anteroinferior surface of the uterus r/t>
urinary bladder
60
What is the posterosuperior surface of the uterus r/t?
intestines
61
What are the R and L borders of the uterus a/w?
broad ligaments of uterus
62
Describe the round L of the uterus
side of uterus to deep inguinal ring-->traverses inguinal canal -->terminates in subq of labia majora after passing through superficial inguinal ring
63
Describe the transverse or lateral cervical ligament of the uterus
from cervix and lateral vaginal fornices to lateral walls of pelvis minor
64
Describe uterosacral L of uterus
sides of cervic toward sacrum b/t peritoneum and levator ani
65
What are the parts of the broad L of uterus?
**2 layers of peritoneum draped over uterine tubes** 1: mesometrium attached to uterus 2: mesosalpinx a/w uterine tubes (oviducts) 3: mesovarium a/w ovary
66
Describe the pathway of the broad L of uterus
from sides of uterus to lateral walls and floor of pelvis
67
Where are the ovaries located?
near later wall of pelvis minor in ovarian fossa -->posterior side of broad ligament
68
What is the fxn of the ligament of the ovary?
attaches medial portion of ovary to lateral angle of uterus
69
What is the fxn of suspensory ligmanet of ovary?
thickening of CT that contains ovarian vessels and nerves -->from lateral wall of pelvic cavity to ovary
70
Where is an epidural given?
L3-4 -->bathes pain fibers from cervix, superior vagina and pudendal N
71
How is a mother with epidural aware of uterine contractions?
epidural numbs everything EXCEPT pain fibers from the uterine body--> will still be aware of contractions
72
What block would you use if the mother can still feel uterine contractions?
pudendal nerve block (S2-4) **doesn't block pain from superior birth canal -->with epidural, is only aware of contractions