Pelvic viscera practical

Question 1

What is the recess created by the peritoneum between the bladder and rectum called?

Answer 1

Rectovesicular

Question 2

Describe the course of the ductus deferens from its origin in the scrotum to the termination into the ejaculatory duct near the prostate gland.

Answer 2

The ductus deferens follows an extraperitoneal course through pelvis from deep inguinal ring to posterior prostate. The terminal part of the ductus deferens is dilated (ampulla). The ductus deferens joins with the seminal glands to form the ejaculatory duct, which travels almost vertically through the prostate and enters prostatic urethra then into the membranous urethra.

Question 3

What are the anatomical relationships of the seminal glands?

Answer 3

The seminal gland is located posterior to the urinary bladder, inferior the the ampulla of the ductus deferens and superior to the prostate gland.

Question 4

What are the anatomical relationships of the prostate gland?

Answer 4

The prostate gland surrounds the prostatic urethra. It is inferior the the urinary bladder.

Question 5

What is the relationship of the ejaculatory ducts of the prostate to the urethra?

Answer 5

The ejaculatory ducts are located posterior to the urethra. Ejaculatory ducts drain into the seminal colliculus just below the utricle.

Question 6

Which part/s of the prostate gland is/are palpable on digital rectal examination?

Answer 6

Anterior and middle lobes.

Question 7

What are the gross anatomical parts of the uterus?

Answer 7

the inferior part of the uterus is the cervix, above the cervix is the body of the uterus (the fundus is the most superior part of the body). The opening from the vagina into the cervix is the external uterine os (opening) between the superior cervix and body of uterus is the internal uterine os.

Question 8

Define the terms anteflexion and anteversion of the uterus.

Answer 8

Anteversion refers to the position of the uterus in which its long axis is bent forward on the long axis of the vagina.

Anteflexion refers to the position in which the long axis of the body of the uterus is bent forward on the long axis of the vagina at the internal os.

Question 9

Which structure attaches the ovary to the uterus?

Answer 9

The ovarian ligament proper.

Question 10

What are the parts of the uterine tubes?

Answer 10

1. Intramural 2. Isthmus 3. Ampulla 4. Indunfibulum with fibrae

Question 11

Describe the course of the round ligament from the uterus to where it terminates in the labia majora.

Answer 11

The round ligament arises from the uterus and passes through the deep inguinal ring, passes through the inguinal canal and terminates in the labia majora.

Question 12

Identify and list the mesenteries including ‘ligaments’ of the uterus, uterine tubes, and ovaries.

Answer 12

The broad ligament is divided into three components: 1) Mesometrium (mesentery of the uterus) 2) Mesovarium (mesentery of the ovum) 3) Mesosalpinx (mesentery of the uterine tubes) Other ligaments include the suspensory ligament of the ovary, the ovarian ligament proper and the round ligament.

Question 13

What is the recess between the bladder and uterus called?

Answer 13

Vesicouterine

Question 14

What is the recess between the uterus and rectum called?

Answer 14

Rectouterine

Question 15

What is the relationship of the posterior fornix of the vagina to the peritoneal cavity, and what the clinical relevance?

Answer 15

Note the peritoneal cavity can be accessed via the vagina via the thin wall of the posterior fornix into the rectouterine pouch.

Question 16

Describe the course and major anatomical relationships of the ureters (right and left).

Answer 16

Retroperitoneal, descending into the pelvis near bifurcation of common iliac vessels, the ureters travel though the bladder wall obliquely therefore the detrusor muscle acts like a sphincter preventing backflow up the ureter. In the male the ureter enters the base of bladder posterolaterally between ductus deferens and seminal vesicle. In the female the ureter travels 1-2 cm lateral to cervix of uterus before entering the superolateral aspect of the bladder

Question 17

What is the name of the smooth muscle of the bladder?

Answer 17

Detrusor muscle

Question 18

Describe the anatomy of the bladder.

Answer 18

The posterior surface (the base) contains the trigone, a triangle formed by the two ureters entering the bladder superiorly and one urethra exiting inferiorly. The trigone is less expansible than the rest of the bladder so as not to damage these structures. The apex is anterior and is attached to median umbilical ligament. The neck is inferior and leads to the urethra. It also has a superior surface and two inferolateral surfaces

Question 19

Compare and contrast the anatomical relationships of the bladder in the male and female.

Answer 19

In both males and females

Superior: peritoneal cavity, small intestine and sigmoid colon.

Inferior: pelvic and urogenital diaphragms.

Posterior: rectovesicular pouch, rectum.

Anterior: pubic bones, rectus abdominis.

Lateral: hip bone, pelvic wall.

In males: the prostate and genital ducts are inferior.

In females: the uterus, vesicouterine pouch are superior. The cervix and vagina are posterior.

Question 20

What are some of the structural differences between the rectum and sigmoid colon?

Answer 20

The rectum does not have haustra or teniae coli or mesentery - instead it has a continuous band of longitudinal muscle. The rectum has folds, which act as valves to store faeces.

Question 21

Compare and contrast the anatomical relationships of the rectum in the female and male.

Answer 21

Male: prostate and urinary bladder is anterior.

Female: uterus, cervix and vagina are anterior.

Both: posterior is the sacrum and coccyx. Inferior in the levator ani muscle. Superior is the sigmoid colon.

Question 22

What is the name of the peritoneal pouch between the rectum and the urogenital structures in males and females?

Answer 22

rectovesical (m) and rectouterine (f)