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Anatomy 1 > Pelvic viscera and Peritoneum (Interval 5) > Flashcards

Pelvic viscera and Peritoneum (Interval 5) Flashcards

1
Q

False/greater pelvis boundaries

A

Bound by iliac fossa, sacrum above the sacral promotory, and anterior abdominal wall

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2
Q

What muscle does the false pelvis contain?

A

The iliacus muscle, which sits on the iliac fossa

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3
Q

True/lesser pelvis boundaries

A

Hipbones, sacrum below the sacral promotory, coccyx

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4
Q

What muscles does the true pelvis contain?

A

The obturator internus and piriformis muscles

-these muscles form the lateral walls of the lesser pelvis

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5
Q

Pelvic inlet

A

Separates the greater and lesser pelvis

Oval shaped on F, heart shaped on M

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6
Q

Pelvic outlet and its borders

A

diamond shaped, subdivided into the anal (pubic symphesis) and urogenital (sacrotuberous ligaments) triangles

Borders:

  • inferior aspect of the pubic symphysis
  • ischiopubic rami
  • ischial tuberosities
  • sacrospinous ligaments
  • tip of the coccyx
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7
Q

Subpubic angle

A

made by ischiopubic rami coming together at the pubic symphesis

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8
Q

Perineal body

A

The central tendon of the perineum

Lies in the midline of a coronal plane between the ischial tuberosities

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9
Q

What lies above the pelvic diaphragm?

A

bladder, prostate, proximal urethra, uterus, upper vagina, rectum

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10
Q

What is the urogenital hiatus

A

gap in the pelvic diaphragm where the urethra, vagina and rectum go into the perineum

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11
Q

What muscle makes up the anterior pelvic diaphragm?

A

Levator ani

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12
Q

What muscles make up the levator ani and what are their functions

A

1a. Pubococcygeus muscle
- encircles the vagina and prostate

1b. Puborectalis muscle
- bounds the urogenital hiatus and forms part of the external anal sphincter

  1. Iliococcygeus muscle
    - forms the posterior third of the pelvic diaphragm
    - not much bone attachment because the obturator internus blocks it
  2. “ischio” coccygeus
    - forms the posterior third of the pelvic diaphragm
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13
Q

What fascia covers the obturator internus muscle?

A

The tendinous arch which is a thickening of the fascia covering the obturator internus msucle. The iliococcygeus muscle arises mostly from the tendinous arch

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14
Q

Which spinal nerves have rami that innervate the pelvic diaphragm muscles?

A

Branches of the pudendal nerve (S2,3,4) innervate the skeletal muscle of the pelvic diaphragm

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15
Q

What is the Ischioanal fossa?

A

Encloses the pelvic diaphragm. Is filled with fat and connective tissue

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16
Q

What goes through the ischioanal fossa?

A

The pudendal nerve and the internal pudendal artery and vein course in the lateral wall of the ischioanal fossa through the pudendal canal

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17
Q

What forms the pudendal canal?

A

The fascia covering the obturator internus muscle

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18
Q

What is the coccygeus muscle

A

It attaches laterally to the ischial spine and sacrospinous ligament and medially to the coccyx and sacrum

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19
Q

The horseshoe-shaped indent where the ilium, ischeium and pubis fuse

A

Acetabulum

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20
Q

What is the smallest dimension in the pelvic inlet?

A

(true) obstetric conjugate (sacral promotory to the midpoint of the symphysis)

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21
Q

What are the three conjugates from the sacral promotory to the pubic sympthesis?

A
  1. Obstetric/true conjugate
  2. Diagonal conjugate
  3. Anatomical conjugate
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22
Q

What sphincter does the pelvic diaphragm contain?

A

External anal sphincter

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23
Q

What sphincter does the urogenital diaphragm contain?

A

Sphincter urethrae

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24
Q

How can we measure the size of the pelvic outlet?

A

measure the distance between the ischial tuberosities or the size of the subpubic angle

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25
Q

Is the subpubic angle larger for males or females?

A

Females: 90 degrees
Males: 60 degrees

26
Q

What is the smallest dimention of the lesser pelvis?

A

The distance between the ischial spines

27
Q

Obturator Canal

A

The obturator foramen is usually covered by obturatur internus muscle. This is a small canal nn the obturatur internus muscle through which the obturator nerve, artery and vein go through

28
Q

Pudendal nerves where they come from and what they go through

A

S2-S4, collection of ventral rami that innervate skeletal muscle an sphincter in both pelvic and urogenital diaphragms

Courses in the lateral wall of the ischioanal fossa through the pudendal canal which is formed by the fascia covering the obturator internus muscle

29
Q

Urethral sphincters male vs female

A

Males:

  1. internal urethral sphincter to stop backflow of semen into the bladder-smooth muscle. Just below the prostate
  2. external urethral sphincter in UG diaphragm-skeletal muscle

Females:
Just have #2

30
Q

Trigone

A

Triangle in the bladder made from the ureteric openings and the descent of the urethra

31
Q

What are the pouches of the peritoneum and what is their clinical significance?

A

Males:
1. Retrovesical pouch between the posterior bladder and anterior rectum

Females:

  1. Retrouterine pouch (of Douglas) drapes between the uterus and rectum
  2. Vesicouterine pouch between the posterior bladder and anterior uterus

The ‘recto’ pouches are the lowest points of the pelvis and thus the points where fluid is most likely to collect

32
Q

Water under the bridge

A

Males:
-ureter goes under the ductus deferens

Females:
-ureter goes under the uterine artery

33
Q

Urogenital diaphragm

A

Very thin plane of skeletal muscle. Contains the spincter urethrae. Attaches to the external genitalia.

34
Q

Perineum

A
  • Everything below the pelvic diaphragm

- Contains the urogenital diaphragm and the roots of the external genitalia

35
Q

Deep perineal pouch

A
  • Found between the superior and inferior fascial layers of the UG diaphragm
  • Males: contains membranous part of the urethra and the bulbourethral glands whose ducts open into the penile urethra
  • Females: contains the urethra and the vagina
36
Q

Superficial perineal pouch

A

Contains the crura and bulbs of the penis and clitoris, which consist of erectile tissue

37
Q

Crura

A

2 of them which are attached to the ischiopubic rami and the perineal membrane and continue as the corpora cavernosa into the penis and clitoris

38
Q

Bulb male vs female

A

Male: bulb of the penis lies in the midline, is attached to the perineal membrane and contains the penile urethra

Female: bulb of the vestibule are situated in the wall of the vestibule with the greater vestibular glands. Join at the base of the clitoris

39
Q

What muscles cover the crura?

A

Ischiocavernosus muscles (skeletal, help maintain erection)

40
Q

What muscles cover the bulbs?

A

The bulbospongiosus muscles (skeletal, help maintain erection). Also contract to eject fluid in males during ejaculation and urine during micturition

41
Q

Name the muscles of the penis and where they came from

A

Bulb–>Corpus spongiosum

  • situated on the ventral aspect of the penis
  • surrounds the penile urethra and forms the glans penis

Crura–>Corpora cavernosa

  • two of them
  • situated in the dorsal aspect of the penis
42
Q

What encloses the 3 erectile bodies of the penis?

A

3 bodies=corpus spongiosum and the 2 corpora cavernosa

The deep penil, or buck’s fascia, encloses them, the deep dorsal vein, the dorsal nerves, and the dorsal arteries of the penis

43
Q

List and describe the external genitalia of the female

A
  1. Labia majora
    - contain connective tissue and fat and are the homologues of the scrotum
  2. Labia minora
    - are in the lateral walls of the vestibule
  3. Vestibule
    - chamber into which the urethra and vagina open after passing through the UG diaphragm
44
Q

What is the prostate’s homolog?

A

The paraurethral/Skene’s glands. These lubricate the urethra and the vestibule

45
Q

Name the muscles of the clitoris and where they come from

A

The clitoris consists of the 2 corpora cavernosa, which form both the body and the glans of the clitoris

46
Q

Ductus Deferens

A
  • Arise from the epididymis adjacent to the testis
  • Transverse the inguinal canal
  • Transports sperm produced int he seminiferous tubules of the testies
47
Q

Seminal Vesicles

A
  • Situated lateral to the ductus deferens ont he posterolateral aspect of the bladder
  • Secrete nutrition for seminal fluid
48
Q

Ejaculatory Duct

A
  • Formed when ductus deferens join with a duct of the seminal vesicles just baove the prostate
  • Opens onto the surface of the seminal colliculus in the posterior wall of the prostatic urethra
49
Q

Prostate zones and their tissue types

A

Periurethral

  • Transition zone
  • BPH

Peripheral zone

  • glandular tissue
  • covers the posterior and lateral aspects of the prostate gland (palpated by rectal exam)
  • usually where prostate cancer is

Central Zone
-surrounds the ejaculatory ducts

50
Q

Prostate location

A

Below the bladder, posterior to the pubic symphysis, anterior to the rectum

  • seminal vesicles lie between the prostate and the bladder
  • each seminal vesicle joins its corresponding ductus deferens to form the ejaculatory duct before entering the prostate
51
Q

Describe the innervation of the pelvis

A

T11-L2: Lumbar splanchnic nerves and superior hypogastric plexus (parasympathetic)

S2,3,4: Pelvic splanchnic nerves (parasympathetic) and pudendal nerves (sympathetic)

Perineal nerve: dorsal nerve of the clitoris/penis

Sciatic nerve

Inferior rectal nerve

52
Q

Neurological ‘sex’

A
  1. Erection-pelvic splanchincs
    - dilates vessels in erectile tissues
  2. Secretion-pelvic splanchnics
    - increases secretion production of prostate, seminal and lubricating glands
  3. Emission-lumbar splanchnics
    - contract smooth muscle in ductus deferens and glands as well as urethral and anal sphincters
  4. Climax/Ejaculation-pudendal
    - relax sphincter urethrae and bulbospongiosus msucle
53
Q

Uterus

A
  • Between the bladder and the rectum
  • Smooth muscle
  • Fundus, body, isthmus, cervix
54
Q

Fornix

A

Where the vagina encircles the uterus

55
Q

What is the broad ligament

A

The broad ligament is a fold of peritoneum that forms a mesentery suspending the uterine tubes, the ovaries, and most of the uterus

56
Q

What are the parts of the broad ligament?

A
  1. Mesometrium
    - adjacent to the uterus
  2. Mesosalpinx
    - suspends the uterine tubes
  3. Mesovarium
    - suspends the ovaries
57
Q

What are the ligaments in the broad ligament?

A
  1. Cardinal ligament
    - carries arteries to the cervix and vagina including the uterine artery and vein
  2. Proper ovarian ligament
    - contains nothing
  3. Suspensory ligament
    - In the mesovarium
    - Contains ovary blood supply
58
Q

What is in the round ligament of the uterus?

A

The round ligament of the uterus goes into the inguinal canal and contains the artery of sampson

59
Q

Branches of the internal iliac artery that supply the pelvic viscera

A
  1. Umbilical artery
  2. Uterine artery
    - usually a branch of umbilical artery, passes over ureter
  3. Artery of ductus deferens
  4. Vaginal artery
  5. inferior vesical artery
  6. Middle rectal artery
60
Q

Branches of the internal iliac artery that supply the perineal structures

A
  1. Internal pudendal
    - runs through greater sciatic foramen, crosses ischial spine, passes through lesser sciatic foramen
    - Inferior rectal artery
    - Perineal branch
    - Artery to the bulb and deep artery of the penis and clitoris
    - Dorsal artery of the penis and clitoris
61
Q

Branches of the internal iliac artery that supply the pelvic walls

A
  1. Iliolumbar artery
  2. Lateral sacral artery

Lower limb branches come later including
1. superior gluteal, inferior gluteal, obturator

Anatomy 1 (11 decks)

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