Pelvic Viscera Flashcards

1
Q

Characteristics of the Ureters

A

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

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2
Q

Characteristics of the male urinary bladder

A

-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
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3
Q

what do the lateral surfaces that surround the the bladder contain

A

Surrounded by vesical fascia that contain a vesical venous plexus

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4
Q

Characteristics of the female urinary bladder

A

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

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5
Q

what are the four parts of the male urethra

A

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

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6
Q

where does the male urethra terminate?

A

at the external urethral orifice

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7
Q

Characteristics of the prostatic urethra

A

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

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8
Q

Characteristics of the female urethra

A

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

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9
Q

what are the paraurethral glands?

A

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

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10
Q

Vas Deferens characteristics

A

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

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11
Q

Characteristics of the seminal vesicles

A

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

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12
Q

characteristics of Ejaculatory ducts

A

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

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13
Q

Characteristics of the prostate gland

A

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

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14
Q

What is benign Prostatic hperplasia

A

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
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15
Q

Prostate cancer metastasis

A

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

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16
Q

characteristics of bulbourethral glands

A

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

17
Q

Characteristics of the rectum

A

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

18
Q

Peritoneal coverings of the rectum

A

upper 1/3 covered on anterior and lateral surfaces

Middle 1/3 covered on anterior surface only

19
Q

Function of the Pararectal fossae?

A

Bilateral fossae allows rectum to expand as it fills with feces

20
Q

Characteristics of the vagina

A

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

21
Q

characteristics of the vaginal orifice

A

Orifice that lies between the labia minora and is posterior to urethra

space between labia minor is vestibule of vagina

22
Q

Characteristics of the Uterus

A

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
23
Q

anatomical relationships of the uterus

A

Anterior inferior is the bladder

postero superior is the intestines

24
Q

What are the 4 Uterine ligaments

A

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

25
Q

characteristics of the uterine tubes?

A

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
26
Q

what is the pelvic pain line?

A

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
27
Q

characteristics of the ovaries?

A

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