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SF4 Exam 2 > Pelvic Viscera (General and Male) > Flashcards

Pelvic Viscera (General and Male) Flashcards

1
Q

apex of urinary bladder is attached to what?

A

median umbilical ligament

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2
Q

the outflow opening of the bladder is what?

A

internal urethral orifice

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3
Q

urinary bladder is found where

A

retroperitoneal
anterior pelvis
posterior to pubic bones

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4
Q

urinary bladder rest on what in males

A

prostate gland

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5
Q

urinary bladder rest on what in females

A

pelvic diaphragm

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6
Q

retropubic space of Retzius (what is it/what does it do)

A

space with a pad of fat that separates the urinary bladder from pubic bone

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7
Q

fat and fascia around the bladder allows what

A

it to expand

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8
Q

filled bladder can do what to anterior abdominal wall

A

peel peritoneum from the anterior abdominal wall

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9
Q

surgical approach to distended bladder (where can it be done and what about this location is good)

A

can be done above pubis without entering peritoneal cavity

reduces the risk of peritonitis

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10
Q

suprapubic cystostomy

A

suprapubic catheterization to draw urine from bladder if urethral catheterization not possible due to urethral obstruction

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11
Q

the wall of the bladder (what are its properties)

A

muscular and distensible

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12
Q

mucosa lining of the bladder (describe it, what does it allow for)

A

loose and folded to allow for stretching or contraction of bladder wall (except at trigone)

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13
Q

Trigone (what is it)

A

smooth area on inner surface of posterior wall of bladder

shaped like an upside-down triangle

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14
Q

upper corners of the trigone mark waht

A

openings of ureters

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15
Q

Ureters (course in bladder)

A

course through bladder wall obliquely

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16
Q

contraction of the muscles of the bladder wall presents what? (in terms of ureter)

A

reflux of urine from bladder into ureter

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17
Q

the bladder wall constricts the ureter resulting in what?

A

potential site where kidney stone can lodge

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18
Q

lower corner of trigone marks what

A

internal orifice of urethra

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19
Q

the urinary bladder is innervated by what

A 
sympathetic fibers (trigonal muscle and internal sphincter of bladder)
parasympathetic fibers via pelvic splanchnic nerves (detrusor and internal sphincter of bladder)
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20
Q

muscles of bladder (name them)

A

detrusor muscles
internal sphincter of bladder (sphincter vesicae)
trigonal muscle

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21
Q

detrusor muscles (what are they, innervation)

A

three layered, smooth muscular coats of bladder

stimulated by parasympathetic fibers of pelvic splanchnic nerves

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22
Q

internal sphincter of bladder (sphincter vesicae)

what is it, innervation

A

circular smooth muscle surrounding neck of bladder (area above prostate in males) and internal urethral orifice
stimulated by sympathetics
inhibited by parasympathetics

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23
Q

internal sphincter of bladder in females is?

A

rudimentary

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24
Q

internal sphincter of bladder (sphincter vesicae) is under what type of control

A

sympathetics but it is NOT voluntary

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25
Q

micturition (what is it)

A

exertion of urine

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26
Q

micturition (how is it accomplished)

A

contraction of the detrusor muscles and relaxation of the internal sphincter

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27
Q

micturition (is a result of what kind of stimulation)

A

parasympathetics (detrusor contacts and sphincter relaxes)

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28
Q

in infants bladder emptying is what?

A

involuntary reflex

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29
Q

in toilet-trained individuals the bladder emptying reflex is under control of what

A

cerebral cortex

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30
Q

afferents of the bladder are supplied by what

A 
sacral nerves (S2-S4) via pelvic splanchnic nerves
lumbar nerves (L1, L2)
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31
Q

referred pain from bladder is to where?

A

tip of penis (S2-S4)

hypogastric region of anterior abdominal wall (L1)

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32
Q

arterial supply to the urinary bladder is through what

A

superior and inferior vesical arteries

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33
Q

blood drainage from the urinary bladder is through what

A

vesical venous plexus (surrounding neck of bladder) which drain to superior and inferior vesicle veins

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34
Q

vesical veins drain into what

A

internal iliac veins

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35
Q

lymph from the urinary bladder drains where

A

internal iliac nodes

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36
Q

rectum (where does it arise, and course)

A

arises at level of S3 vertebra
follow curve of sacrum
ends near tip of coccyx

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37
Q

rectum (shape)

A

s-shaped with three sharp flexures in coronal plane

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38
Q

anorectal junction is locate where

A

pelvic diaphragm

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39
Q

what is found posterior to the rectum

A

sacrum and coccyx
piriformis
sympathetic trunk

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40
Q

what is found anterior to the rectum in males

A

posterior side of bladder
ductus deferens
seminal vesicles
prostate

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41
Q

Rectovesical Septum of Denonvilliers (what and where is it)

A

fused inferior end of peritoneum

lies between base of bladder and rectum

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42
Q

Rectovesical Septum of Denonvilliers (convenient plane for what?)

A

convienent plane for separating bladder and prostate from rectum when excising cancerous rectum

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43
Q

what is found anterior to the rectum in females

A

vagina

cervix of uterus

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44
Q

Rectoveginal Septum of Denonvilliers (what and where is it)

A

fused inferior end of peritoneum

separates vagina from rectum

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45
Q

Rectovaginal Septum of Denonvilliers (what can it limit)

A

limit the spread of infection or cancer

46
Q

what is found lateral to the rectum

A

ischial spine
ischial tuberosity
sacrotuberous ligament

47
Q

peritoneal coverings of the rectum (what do they cover and where)

A

cover anterior and lateral surfaces of superior 1/3 of rectum
only anterior surface of middle 1/3
lower 1/3 has not peritoneal coverings

48
Q

rectovesical pouch (what is it)

A

in males

it is formed by the reflection of peritoneum from rectum to superior-posterior surface of bladder

49
Q

lowest part of male peritoneal cavity is

A

rectovesical pouch

50
Q

peritoneal exudates (resulting from peritonitis) will drain into where patient is in sitting or supine positions

A

rectovesical pouch

51
Q

Rectouterine Pouch (of Douglas)

A

in females

formed by the reflection of peritoneum from rectum posterior vagina and uterus

52
Q

lowest point in female peritoneal cavity

A

rectouterine pouch

53
Q

peritoneal exudes, acid from perforated duodenal ulcer, or blood from rupture ectopic pregnancy will drain into what if the female is in sitting or supine positions

A

rectouterine pouch

54
Q

transverse rectal folds (what are they and what are they due to)

A

three semicircular horizontal folds of rectal mucosa

due to underlying smooth muscle

55
Q

transverse rectal folds (where are they)

A

two on left (superior and inferior transverse rectal folds)
one on right (middle transverse rectal fold)
located at each of the three sharp flexures of the rectum

56
Q

arterial supply of the rectum is composed of how many arteries what relationship do they have with eachother

A

5 arteries that anastomose with each other
Superior rectal artery (1)
middle rectal arteries (2)
inferior rectal arteries (2)

57
Q

superior rectal artery (where is it from, location)

A

one from inferior mesenteric artery

located posterior to rectum

58
Q

major blood supply from rectum comes from where

A

superior rectal artery

59
Q

middle rectal arteries (where are they from)

A

from internal iliac arteries

sometimes absent

60
Q

inferior rectal arteries (where are they from)

A

from internal pudendal arteries

61
Q

venous drainage from rectum (whats special about it)

A

anastomose forming a connection between portal (superior rectal vein) and and systemic (middle and inferior rectal vein) venous system

62
Q

lymph from the rectum drains to what

A

ascend with superior rectal vessels inferior mesenteric nodes

63
Q

innervation of rectum

A

parasympathetic fibers from pelvic splanchnic nerves via inferior hypogastric plexus
sympathetic fibers from superior and inferior hypogastric plexuses

64
Q

rectal prolapse (what is it)

A

abnormal descent of rectum through anal canal
can occur in young children since sacrum is not curved as in adult
can occur if not enough support from puborectalis muscle of levator ani

65
Q

ductus deferens (path)

A

enters pevis crossing over external iliac artery, crosses over ureter and posterolateral angle of bladder
descends posterior to surface of bladder

66
Q

ampulla of ductus deferens (what is it)

A

dilated distal part of ductus deferens

67
Q

ejaculatory duct (what forms it)

A

formed by terminal part of ductus deferens joining the duct of the seminal vesicle

68
Q

ejaculatory duct (path)

A

peirces surface of prostate gland to enter prostatic urethra (on either side of the out pocketing of prostatic uretrha called prostatic utricle

69
Q

prostatic utricle

A

out pocketing of prostatic urethra where the ejaculatory duct enters

70
Q

seminal vesicle (what and where is it)

A

lobular sac

posterior surface of bladder

71
Q

seminal vesicle ( how is it formed)

A

lateral outgrowth of ductus deferens

72
Q

duct of seminal vesicle does what

A

joins ductus deferens to form ejaculatory duct

73
Q

seminal vesicle (secretes what)

A

thick fluid that contains nutritive substances for sperm

fluid mixes with semen

74
Q

superior border of the seminal vesicle (whats special about it)

A

covered in peritoneum

75
Q

ductus deferens in pelvis has what around it

A

mostly covered by peritoneum

76
Q

prostate gland (what and where is it)

A

large, accessory reproductive gland

surrounds prostatic part of urethra

77
Q

prostate gland (what type of gland)

A

glandular and muscular

78
Q

prostate gland (what does it produce)

A

alkaline secretion added to semen to neutralize the acidity of vagina

79
Q

what is superior to the prostate gland

A

bladder

80
Q

what is inferior to the prostate gland

A

urogenital gap in pelvic diaphragm and urogenital diaphragm

81
Q

wat is posterior to the prostate gland

A

rectum

82
Q

what is anterior to the prostate gland

A

pubic bones with intervening retropubic fat in retropubic space

83
Q

capsule of prostate gland (what is it)

A

fibrous and on the surface of the gland

surrounded by endopelvic fascia

84
Q

lobes of prostate gland (how many are there and what defines them)

A

5 of them defined by passage of urethra and two ejaculator ducts through prostate

85
Q

median lobe of prostate (location)

A

between urethra and ejaculatory ducts

86
Q

common location of benign prostatic hypertrophy (BPH)

A

median lobe of prostate

87
Q

what triggers urination during night (nocturia)

A

median lobe bulging into bladder at internal urethral orifice resulting in dripping of urine into urethra

88
Q

right and left lateral lobes of prostate (location)

A

separated by prostatic urethra

may become enlarged (BHP) and compress urethra

89
Q

Posterior Lobe of Prostate (location)

A

located inferior to ejaculatory duct and posterior to prostatic urethra

90
Q

common site for carcinoma in prostate

A

posterior lobe

91
Q

Anterior Lobe of Prostate (location and contents)

A

located anterior to prostatic urethra

contains little glandular tissue

92
Q

the arteries that supply the prostate come from where

A

inferior vesical artery

93
Q

veins of the prostate drain into what

A

valveless prostatic venous plexus

94
Q

prostatic venous plexus (waht does it drain into and communicate with)

A

drains into internal iliac vein

communicated with vesicle pleases of bladder and internal and external vertebral venous plexuses

95
Q

spread of prostatic carcinoma

A

can potentially spread extensively via venous communications to spinal column and cord and to the brain

96
Q

Route for metastatic prostatic carcinoma to vertebral column and spinal cord

A

prostatic venous plexus→vesical venous plexus→internal iliac vein→lateral sacral vein→internal vertebral venous plexus (vertebral column) and radicular veins (spinal cord)

97
Q

lymph from the prostate gland drains where

A

internal iliac nodes

98
Q

prostatic urethra (compared to rest of urethra is)

A

widest and most dilatable part (no problem inserting Foley catheter at this part)

99
Q

posterior wall of prostatic urethra contains

A

urethral crest
prostatic sinus
seminal colliculus

100
Q

urethral crest (what is it)

A

median ridge of posterior wall of prostatic urethra

101
Q

prostatic sinus (what is it, what does it do)

A

groove on each side of urethral crest

receives 20-30 prostatic ducts

102
Q

seminal colliculus (what is it, what does it do)

A

rounded eminence on urethral crest
has a slit-like orifice leading to small vestigial prostatic utricle and two openings for ejaculatory ducts on either side of prostatic utricle

103
Q

prostatic utricle (what is it)

A

diverticulum from posterior wall of prostatic urethra

104
Q

what is located on each side of orifice to prostatic utricle

A

openings for ejaculatory duct

105
Q

emission (what is it)

A

involuntary discharge of semen

106
Q

emission is dependent on what

A

sympathetic innervation (from spinal level L1) of the ductus deferens, seminal vesicle, and prostate gland

107
Q

sympathetic stimulation during emission does what

A

smooth muscle of ductus deferens contracts to propel sperm towards prostatic urethra
glands of prostate and seminal vesicles release their secretions
internal sphincter of bladder contacts to prevent reflux of semen into urinary bladder

108
Q

iatrogenically-induced sterility (what is it)

A

disruption of sympathetic nerve fibers to ductus deferens and seminal vesicles results in sterility because emission does not occur

109
Q

iatrogenically-induced sterility occurs as a result of what

A

surgery in pelvis

110
Q

iatrogenically-induced sterility (what effect on erection)

A

none- erection is under parasympathetic control

111
Q

surgical enlargement of prostatic urethra (transurethral resection) in patient with BPH can result in what

A

damage to internal sphincter of bladder damage to internal sphincter of bladder resulting in reflux of semen into bladder

SF4 Exam 2 (13 decks)

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