Pelvic Viscera Pt. 1 Flashcards
Lie within the bony pelvis between the pelvic floor and the peritoneum primarily occupying the subperitoneal space
Pelvic viscera
Generally consists of collecting vessels, urinary bladder, uterus, rectal ampulla (connected to excretory tubes), urethra, vagina, and the anorectal junction
Pelvic Viscera
The filling and voiding of the collecting vessels is facilitated by their location in the loose areolar tissue of the
Subperitoneal space
Flow through the excretory tubes is controlled by the
Pelvic and U-G Diaphragms
A pelvic viscera structure that stores urine
Bladder
The bladder consists of a smooth muscle called the
Detrusor
Where is the bladder located?
Posterior to the pubic bone in the retropubic space
What are the 4 parts of the bladder?
- ) Anterior facing apex
- ) Posterior base
- ) Superior surface
- ) Two inferolateral surfaces
The fundus and inferolateral surfaces converge to form the
Neck
Extends from the neck of the bladder and conveys urine from the bladder to the outside of the body
Urethra
A triangular region associated with the base and neck of the bladder
Trigone
Where the bladder neck funnels into the urethra
The base of the trigone
Enters the bladder obliquely at the other two corners of the trigone
Ureters
This design causes the ureteric openings to be closed, acting like a valve during
Bladder contraction
Retains its shape regardless of whether the bladder is distended or empty
Trigone
The rest of the detrusor muscle has
Folds or Rugae
Muscolomembranous tube about 10cm in length
Vagina
Located in a superoposterior direction in the pelvis between the bladder (anteriorly) and the rectum (posteriorly)
Vagina
Enter the anterior wall of the vagina superiorly
Uterus and cervix
Recesses formed around the vaginal portion of the cervix
Vaginal fornices
Can be exploited during a bimanual digital vaginal exam to palpate pelvic visceral structures
Vaginal fornices
The posterior bladder wall can be palpated via the
Anterior fornix
The oviduct, ureters, and ovaries can be palpated via the
Lateral fornices
Can be used to palpate the uterus and access the rectouterine pouch (Pouch of Douglas)
Posterior Fornix
The posterior fornix is covered in part by
Visceral Peritoneum
The vagina opens externally into the
Vestibule of the vagina
Pear shaped, hollow muscular organ consisting of a fundus, body, and cervix
Uterus
The uterus receives the intrauterine openings of the uterine tubes between the
Fundus and Body
Enters the anterior wall of the vagina and is open with the uterus
Cervix
The anatomical position of the uterus within the vagina with respect to the angle at which its cervical portion enters is described as being
Anteverted
The anatomical position of the uterus with respect to the angle between the cervix and the body of the uterus is described as being
Anteflexed
This position reduces the likelihood of
Uterine prolapse
The uterus is further supported by the
Round ligament, transverse cervical ligament, and uterosacral ligaments
Provide a passageway for ovulated eggs to reach the uterus
Uterine tubes
The most distal portion of the uterine tubes, which opens into the peritoneal cavity
Infundibulum
Fertilization typically takes place in the
Ampulla of the uterine tubes
In females, there is a communication between the external environment and the peritoneal cavity that begins with the opening of the vagina in the vestibule and ends with the opening of the uterine tubes in the
Peritoneal cavity
This provides a pathway for microbes like gonnorrhea and chlamydia to cause
Pelvic Inflammatory Disease
These infection can cause scarring and a resultant blockage of the
Uterine tubes
What is done when the patency of the uterine tubes is in question?
Hysterosalpingography
Located against the posterolateral wall of the pelvis
Female gonads
What are the two ligaments of note that are associated with the female gonads?
- ) Proper ovarian ligament
2. ) Suspensory ligament of the ovary
Attatches the ovary to the uterus and a remnant of a caudal genital ligament (gubernaculum testes in the male)
Proper ovarian ligament
A fold of peritoneum elevated by the ovarian artery and veins
Suspensory ligament of the ovary
Extends between the sigmoid colon (S3) and the beginning of the anal canal at the pelvic floor
Rectum
The inferior portion of the rectum becomes dilated, forming the
-Where feces are stored prior to defecation
Rectal ampulla
Palpable through the rectum anteriorly
Cervix
Extends off the anterior abdominal wall to cover the superior surface of the bladder
Parietal peritoneum
Reflects onto the anterior surface of the uterus and covers the posterior surface of the uterus and part of the posterior fornix of the vagina
Parietal peritoneum
The parietal peritoneum then reflects onto the anterior surface of the
Rectum
These reflections of the parietal peritoneum generate which two pouches or spaces?
- ) Vesicouterine
2. ) Rectouterine
Located between the bladder and uterus
Vesicouterine pouch
Located between the uterus and rectum
Rectouterine pouch
Significant in that it is the inferior extend of the peritoneal cavity
Rectouterine pouch
The peritoneum which drapes over the uterus, uterine tubes, and ovaries is called the
Broad ligament
The PROXIMAL 1/3 of the rectum is covered anteriorly and laterally by
Peritoneum
The middle 1/3 ANTERIORLY and DISTAL 1/3 of the rectum is
Subperitoneal
Located between the neck of the bladder and the urogenital hiatus in males
Prostate
The prostate consists of smooth muscle, connective tissue, and glandular cells responsible for producing
Prostatic fluid
The prostate contains the prostatic urethra and receies the ejaculatory ducts from the
Ductus deferens and seminal vesicles
The prostate is divided clinically into which three zones?
- ) Transitional
- ) Central
- ) Peripheral
Surrounds the prostatic urethra
Transitional prostate
Surrounds the ejaculatory ducts of the prostate
Central prostate
Peripheral to and encircling the central and transitional zones
Peripheral prostate
Enlargement of the prostate is common in men over
-Can be either benign or malignant
50
Primarily involves the transitional zone and is characterized by difficulty in urinating and an increased urination frequency
Benign prostatic Hyperplasia (BHP)
Malignant tumors of the prostate preferentially involve the
Peripheral zones
An enlarged portion of the ductus deferens as it approaches the prostate
Ampulla of the ductus deferens
Stores sperm prior to emission
Ampulla of the ductus deferens
The ampulla of the ductus deferens forms the ejaculatory duct with the
Seminal vesicle
Lie immediately lateral to the ampulla of the ductus deferens
-Provide seminal fluid and help nourish sperm
Seminal Vesicle
The duct from the seminal vesicle unites with the duct from the ductus deferens to form the
Ejaculatory duct
Opens into the prostatic urethra posteriorly
Ejaculatory duct
In males, the parietal peritoneum of the anterior abdominal wall reflects onto the
Superior surface of the bladder (posteriorly) and then onto anterior surface of rectum
This creates a single peritoneal pouch in the male called the
Rectovesical pouch
Pelvic branches are supplied primarily with arterial blood from branches of the
Internal iliac artery
Venous return from the pelvic region are to branches of the
Internal iliac vein
Gives branches to the pelvic and perineal viscera as well as the lower limb
Internal iliac artery
The ovarian artery is a branch of the
Abdominal Aorta
The uterine artery has a clinically important relationship with the ureter. What is it?
Ureter crosses INFERIOR to the uterine artery
Lymphatic rainage of the pelvic viscera follows blood vessels primarily to the
Internal iliac lymph nodes
However, lymphatic drainage of the ovaries following the ovarian vessels would drain into the
Aortic lymph nodes
