Pelvic Viscera - I

Question 1

In males, how far inferior does parietal peritoneum extend?

Answer 1

About 2 cm above the seminal vesicles.

Question 2

Rectovesicular pouch is between:

Answer 2

Bladder and rectum

Question 3

Retropubic space is between:

Answer 3

Pubis and bladder

Question 4

Retrorectal space is between:

Answer 4

Rectum and sacrum

Question 5

Where is endopelvic fascia and what does it cover?

What is it continuous with?

Answer 5

Beneath peritoneum.
Covers viscera, pelvic floor and pelvic wall.
Continuous w/ transversalis fascia.

Question 6

Thickening of endopelvic fascia results in: (5)

Answer 6

Tendinous arch of levator ani
Lateral L of bladder
Puboprostatic L (male) or pubovesical L (female)
Cardinal L (transverse cervical L)
Paracolpium

Question 7

What is the function of the cardinal L (transverse cervical L)?

Answer 7

To support the cervix

Question 8

What is the paracolpium?

Answer 8

Thickened fascia from lateral vagina to tendinous arch.

Question 9

What is the prostate between?

Answer 9

Below bladder and above perineal membrane

Question 10

What does the ureter run with in M and FM?

Answer 10

M - inferior to vas deferens

FM - w/ uterine a.

Question 11

What is the blood supply to the ureter?

Answer 11

Branches of renal as, gonadal as, aorta and internal iliac as.

Question 12

Innervation of the urethra (3)

Answer 12

Preaortic plexus, hypogastric plexus and pelvic splanchnic ns.

Question 13

Orientation of bladder (apex, fund us, neck)

Answer 13

Apex points to pubis symphysis.
Fundus points posteriorly.
Neck points inferiorly.

Question 14

Median umbilical L goes from:

Answer 14

Apex of bladder to umbilicus.

Question 15

What ligament supports the bladder?

Answer 15

Lateral L of the bladder

Question 16

Detrusor m.

Answer 16

Lines bladder and continues to the IUS and up into ureteric sphincters.

Question 17

IUS is made of:

What is the innervation?

Answer 17

SM from detrusor m.

ANS —> inferior hypogastric plexus

Question 18

EUS is made of:
Where is it located?
What is the innervation?

Answer 18

Skeletal m.
Mostly at level of membranous urethra, but extends upward around prostatic urethra.
Somatic. Deep perineal branch of pudendal n.

Question 19

Urethral crest

Answer 19

Posterior ridge on urethra as it goes thru the prostate.

Question 20

Seminal colliculus

Answer 20

Enlarged area on crest where both ejaculatory ducts open.

Question 21

Prostatic utricle is a remnant of:

Answer 21

Paramesonephric system

Question 22

Prostatic sinuses

Answer 22

Depressions on sides of ridges where prostatic glands open and secrete an alkaline fluid.

Question 23

How much of the prostate is gland vs fibromuscular tissue?

Answer 23

2/3 gland

1/3 fibromuscular tissue

Question 24

Where do prostatic ducts empty?

Answer 24

Into the prostatic sinuses

Question 25

Blood supply to the prostate

Answer 25

Branches of inferior vesical a. and middle rectal a.

Question 26

Innervation of the prostate

Answer 26

Prostatic plexus from inferior hypogastric plexus

Question 27

Benign hypertrophy of prostate

Answer 27

Prostate projects into the bladder and impedes urination.

Leads to nocturia, dysuria, and urgency of urination.

Question 28

Benign hypertrophy of prostate increases one’s risk of:

Answer 28

Cystitis (kidney infection) and kidney damage

Question 29

How do malignant prostate masses feel on DRE?

Answer 29

Hard and irregular in shape.

Question 30

Route of vas deferens (4)

Answer 30

Enters abdomen via deep inguinal ring.
Passes superiorly to all other structures.
Passes superior and medial to the ureter.
Joins seminal duct, then urethra.

Question 31

Seminal vesicles shape and location:

Answer 31

BL lobulated sacs lateral to ampulla of vas deferens.

Question 32

What 2 things make the ejaculatory duct?

Answer 32

Duct of seminal vesicle and vas deferens.

Ejaculatory ducts are BL.

Question 33

Blood supply to seminal vesicles

Answer 33

Branches of superior and inferior vesicular as.

Question 34

Innervation of male reproductive organs:

• > SNS
• > PSNS
• > visceral afferent fibers

Answer 34

SNS: from T10-L2
PSNS: pelvic splanchnic ns.
Visceral afferent fibers: most travel w/ PSNS fibers to S2-S4, except for testes travel w/ SNS to T10.

Question 35

Where does lymph from vas deferens and inferior part of seminal vesicles drain?

Answer 35

Internal iliac nodes

Question 36

Where does the scrotal part of the vas deferens drain?

Answer 36

External iliac nodes

Question 37

Where does lymph from the prostate drain?

Answer 37

Mostly to internal iliac nodes, but some to the sacral nodes.

Question 38

Where does lymph from the bladder drain (superolateral part and fundus/neck)?

Answer 38

Superolateral part to the external iliac nodes.

Fundus and neck drain to the internal iliac nodes.

Question 39

Cystoscopy

Answer 39

Endoscopic evaluation of bladder.

Used to make bladder dx of CA.