Pelvic Viscera Flashcards
Characteristics of the Ureters
Retroperitoneal organs
10 inches long and enter the pelvis minor by passing over the pelvic brim anterior to the internal iliac vessels
in the male the ductus deferens crosses the ureters wile in the female the uterine artery crosses over the ureter
ureters enter the wall of the bladder at its posterosuperior angle
intramural portion of the ureters in the wall of the bladder form a one way flap valve that prevents retrograde flow of urine
Pain fibers from T10-L2 somatic cord levels
pain from the ureters is referred ipsilaterally to the lower abdominal quadrant and the groin
Characteristics of the male urinary bladder
-Located in antero-inferior pelvis minor
superior surface covered by peritoneum
shaped like the bow of a boat
Base is poster related to the seminal vesicles and vas deferens in males
Apex is anterior
Neck is where it joins the urethra
Neck rests on prostate gland
-held in position by the puboprostatic ligamens
Peritoneal recess (rectovesical pouch seperates the bladder from the rectum)
contains an internal urethral sphincter in neck of male bladder
Openings in the floor of bladder area known as the trigone
- internal urethral orifice
- two ureteric orifices
what do the lateral surfaces that surround the the bladder contain
Surrounded by vesical fascia that contain a vesical venous plexus
Characteristics of the female urinary bladder
POsitioned anterior to uterine cervix and vagina
positioned inferior to body and fundus of uterus
neck of bladder does not contain internal urethral sphincter (according to moore)
vesicouterine pouch between the uterus and the bladder
neck is held in position by the pubovesical ligaments
what are the four parts of the male urethra
1) intramural portion in bladder wall
- contains the internal urethral sphincter
2) Prostatic urethra passes through prostate gland
3) membranous urethra
- narrowest portion
- passes through the urogenital diaphragm
4) spongy penile urethra
- passes through the bulb, body, and glans of corpus spongiosum penis
where does the male urethra terminate?
at the external urethral orifice
Characteristics of the prostatic urethra
3 cm long and begins at bladder neck as it passes through the prostate from base to apex
Widest and most dilated portion of the entire urethra
On posterior wall is a longitudinal ridge called the urethral ridge and on each side of the ridge are grooves called the prostatic sinus
the prostatic glands open into these grooves
on the summit of the urethral crest is a depression called the prosttic utricle and this is analog to the uterus and vagina and at the edge of the utricle are the openings of the two ejaculatory ducts
Characteristics of the female urethra
Female urethra is 1 and 1/2 inches long
surrounded by external urethral sphincter located in urogenital diaphragm
external urethral orifice in vestibule of vagina anterior to vaginal orifice
what are the paraurethral glands?
In females the paraurethral glands are located on either side of the urethra
these glands are homologous to prostate gland
their ducts open near the external urethral orifice
Vas Deferens characteristics
Continuation of epididymis
contained in permatic cord
Passes through the inguinal canal
crosses the ureter
lies superior to seminal vesicle
Joins duct of seminal vesicle to form ejaculatory duct
Moves sperm by peristalsis
Characteristics of the seminal vesicles
Coiled tubes 6 inches long
located posterior to bladder between vas deferens and the prostate
accessory sex glands produce majority of seminal fluid
ducts join with vas deferens to form ejaculatory ducts
characteristics of Ejaculatory ducts
Ejaculatory ducts formed buy union of ducts of seminal vesicles and vas deferens
these ducts pass through the prostate to enter the prostate gland to enter the prostatic urethra
they open on the seminal colliculus
Characteristics of the prostate gland
Largest accessory sex gland in the male and consists of 2/3s glandular and 1/3 muscular tissue
Alkaline secretions comprise 20% of semen
surrounded by dense fascial sheath
base is adjacent to bladder
apex adjacent to urogenital diaphragm
Anterior is the retropubic space
Posterior is the ampulla of the rectu,
laterally is the prostatic venous plexus
also contains the prostatic urethra
What is benign Prostatic hperplasia
BPH results from narrowing of the prostatic urethra that can be diagnosed by digital rectum examination and ultrasonography
Can be treated with drugs or surgery to increase diameter of the urethra
Symptoms:
- Hesitancy
- difficulty in emptying bladder
- weak urinary system
- waking up during the night to urinate
- terminal and post-void dribbling
- sensation of incomplete emptying of bladder
Prostate cancer metastasis
50% of male cancer in the USA originates in prostate gland
Metastic cells may enter the prostatic venous plexus or lymph nodes and will metastize to other olcations in the body, most often to the bone
can lead to pulmonary metastasis due to prostate cancer
characteristics of bulbourethral glands
A pair of bulbourethral glands is located in the male urogenital diaphragm
These accessory sex glands produce a mucous secretion which lubricates the urethra prior to ejaculation
Their ducts penetrate the perineal membrane to enter the bulb of the penis
Characteristics of the rectum
Continuous with sigmoid colon
continuous with anal canal
Partially covered with peritoneum
Bilateral pararectal fossae
Distal portion forms ampulla
Three lateral flexures correspond to three internal foldings
-superior, intermediate, inferior
begins at S3
lies anterior to sacrum and coccyx
80 degree postero-inferior flexure
Peritoneal coverings of the rectum
upper 1/3 covered on anterior and lateral surfaces
Middle 1/3 covered on anterior surface only
Function of the Pararectal fossae?
Bilateral fossae allows rectum to expand as it fills with feces
Characteristics of the vagina
Muscular tube surrounds uterine cervix forming fornices
4 subdivisons of the fornix
- 2 lateral
- anteior
- posterior
‘Posterior fornix related to rectouterine pouch
bladder and urethra anterior to vagina
rectum and ana canal posterior to vagina
characteristics of the vaginal orifice
Orifice that lies between the labia minora and is posterior to urethra
space between labia minor is vestibule of vagina
Characteristics of the Uterus
Uterus consists of fundus, body, and cervix
fundus lies above openings of uterine tubes
body and fundus comprimise 2/3s
cervix comprises 1/3
cervix has 2 openings
-internal os and external os
Three layers of tissue:
- endometrium
- myometrium
- perimetrium
anatomical relationships of the uterus
Anterior inferior is the bladder
postero superior is the intestines
What are the 4 Uterine ligaments
Round ligament: extends from side of uterus to pass through the inguinal canal and terminate in labia majorum
Uterosacral ligament: extends from side of cervix toward sacrum
Broad ligament: extends from side of uterus to lateral pelvic wall and floor of pelvis
- Mesometrium: attached to uterus
- mesosalpinx: attached to uterine tube
- mesovarium: attached to ovary
Transverse cervical ligament extends from cervix and lateral vaginal fornix to lateral wall of pelvis
characteristics of the uterine tubes?
Muscular tubes 4-5 inches long
Open into peritoneal cavity
lies in the mesosalpinx
Parts of the uterine tubes
- Infundibulum: funnel shaped end opens into the peritoneal cavity and includes fimbriae
- Ampulla: widest and longest part
- Isthmus: short; joins uterus
- uterine part: intramural portion opens at uterine ostium
what is the pelvic pain line?
anesthesia for childbirth when using a pudendal nerve block for somatic innervation S2-S4 of the perineum distal to vagina and anal canal
Structures below the pain line:
- distal rectum
- anal canal
- uterine cervix
- vagina
- bladder
characteristics of the ovaries?
Almond shaped organ located in ovarian fossa
Broad ligament is anterior to ovaries
Mesovarium attaches anterior ovary to posterior layer of broad ligament
Ligament of ovary attaches medial ovary to lateral angle of uterus
Suspensory ligament of ovary attaches lateral ovary to lateral wall of pelvic cavity that contains the ovarian vessels nerves and lymphatics
