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Block 4 > Pelvis 1 > Flashcards

Pelvis 1 Flashcards

1
Q

The pelvic girdle consists of what 3 bones?

A

2 Os Coxae and Sacrum

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2
Q

The Os Coxae are fused at what joint?

A

The pubic symphysis

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3
Q

The Os Coxae articulate with the Sacrum at joints called….

A

Sacroiliac Joints

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4
Q

Name the 3 foramina in the pelvic girdle.

A

Greater Sciatic, Lesser Sciatic, and Obturator

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5
Q

What is the boundary between the false and true pelvis?

A

The linea Terminalis

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6
Q

What does the Linea Terminalis of the Pelvis consist of?

A

A line that circumscribes S1, the arcuate lines of the Ilium, the pectinate lines of the pubis, and the pubic symphysis.

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7
Q

The inlet of the pelvis is bounded by…

A

Inlet of the Pelvis (Aka Superior Pelvic Aperture) is marked by the linea terminalis.

The Pelvic Outlet (AKA the inferior pelvic aperture)

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8
Q

The false pelvis contains….

A

Intestines

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9
Q

The true pelvis contains…..

A

Urinary, GI, and Reproductive systems, and their associated neurovasculature.

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10
Q

The Posterior wall of the true pelvis is composed of…

A

THe sacrum and coccyx

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11
Q

What comprises the lateral walls of the true pelvis?

A

The Obturator Membrane, sacrotuberous and sacrospinous ligaments, Piriformis muscle, Obturator internus muscle,

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12
Q

The inferior boundary of the true pelvis is comprised of..

A

THe pelvic Diaphragm

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13
Q

What two muscles contribute to the pelvic diaphragm?

A

Levator Ani and Coccygeus

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14
Q

In males, the draping of the peritoneum between the bladder and the rectum forms the….

A

Rectovesical Pouch

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15
Q

In females, what two peritoneal pouches are formed?

A

The VESICOUTERINE pouch between the bladder and the uterus, and the RECTOUTERINE pouch between the posterior wall of the uterus and the rectum.

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16
Q

The female rectouterine pouch is more commonly called…

A

The Pouch of Douglas

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17
Q

What is the clinical significance of the Pouch of Douglas?

A

Lowest point in the abdominopelvic cavity and a common site for collection of infection. Can be perforated through cystoscopic procedures.

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18
Q

At what vertebral level does the rectum begin?

A

S3

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19
Q

What serves as a reservoir for fecal matter within the rectum?

A

The ampulla - the most distal portion of the rectum.

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20
Q

What structure begins distal to the ampulla of the rectum?

A

The anal canal

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21
Q

What is the angle of the perineal flexure? (flexure between the rectum and the anal canal

A

90 degrees (why you sit to poop)

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22
Q

What two muscles aid in fecal continence?

A

EAS and Puborectalis

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23
Q

The anal columns within the anal mucosa overlie what?

A

Terminal branches of superior rectal veins

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24
Q

The ano-rectal junction is demarcated by what?

A

The pectinate line, composed of anal valves connecting anal columns.

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25
Q

What marks the change from the cutaneous zone to the transitional anal canal zone?

A

The anocutaneous line. (White line) Below this line is pigmented with glands.

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26
Q

Venous supply inferior to the pectinate line is portal or caval?

A

Caval

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27
Q

Branches of the superior rectal arteries supply above of below the pectinate line? What about middle and inferior rectal arteries?

A

Superior Rectal arteries (IMA origin) supply ABOVE the pectinate line.

Middle and Inferior Rectal Arteries (Internal Iliac origin) supply BELOW the pectinate line.

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28
Q

Are hemorrhoids of the internal or external venous plexus painful? Where are each of these plexuses located relative to the pectinate line?

A

External Venous plexus hemorrhoids are located below the pectinate line and are painful/bloody.

Internal hemorrhoids are located ABOVE the pectinate line and are bloody/ NOT painful.

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29
Q

Inferior rectal nerves innervate below or above the pectinate line?

A

Below- somatic pain/conscious innervation

30
Q

In males, the neck of the bladder is immediately superior to what?

A

Prostate gland

31
Q

The neck of the bladder is anchored to the pubic bones by what ligaments? (Male/female specific)

A

Males- Pubovprostatic

Female- Pubovesicle

32
Q

The smooth area of the bladder is called….

A

The Trigone

33
Q

What muscle keeps the urethra closed?

A

Internal urethral sphincter

34
Q

The walls of the bladder external to the trigone area are primarily composed of what muscle?

A

Detrussor muscle

35
Q

The detrussor muscle is innervated by….

A

Parasympathetics (Pelvic Splanchnics)

36
Q

What is the purpose of the detrussor muscle?

A

Contracts to expel urine.

37
Q

Describe the 2 phases of micturation.

A

1- Filling Phase. INternal Urethral Sphincter is contracted, Detrussor muscle is relaxed. (Mediated by Lumbar Splanchnics L1-L2)

2- Emptying Phase - IUS relaxed, detrussor muscle contracted (Mediated by Pelvic Splanchinics S2-S4)

38
Q

In males and females, respectively, what crosses the ureters ANTERIORLY?

A

Males- Ductus Deferens

Females- Uterine Artery

39
Q

What 3 constrictions of the ureter can trap a kidney stone?

A

1- Renal Pelvis
2- Pelvic Inlet
3- Bladder wall

40
Q

True/False: The female urethra passes through the pelvic diaphragm, the UG diaphragm, and the superficial compartment before opening to the vestibule?

A

True

41
Q

Compare the lengths of the male and female urethras (in cm)

A

Female: 3-4 cm
Males: 20 cm (give or take)

42
Q

Name the 3 parts of the male urethra.

A

1- Prostatic - surrounded by prostate gland
2- Membranous - passing thru UG dipaphragm
3 - Spongy- within the corpus spongiosum

43
Q

How many angles are present in the male urethra?

A

2, but one is fixed upon manual maneuvering of the penis or erection. Preferably erection.

44
Q

WTF is the prostatic utricle?

A

embryonic remnant within the prostatic urethra (male homolog of the uterus and vagina)

45
Q

Where do Cowper’s glands empty?

A

Into the Spongy Urethra, distal to the prostate gland and UG diaphragm

46
Q

Where do the ejaculatory ducts empty?

A

The prostatic urethra

47
Q

True/False: The ovaries project anteriorly to the Uterus.

A

FALSE” they project posteriorly

48
Q

The sheet-like fold of peritoneum (mesentery) that envelopes the uterus, ovaries, and uterine tubes between its anterior and posterior layers is called…

A

The Broad Ligament of the Uterus

49
Q

The female reproductive system spans both the pelvis and the peritoneum. Where are the internal genitalia located?

A

True Pelvis

50
Q

The female external genitalia are collectively referred to as….

A

The Vulva

51
Q

Name the part of the broad ligament that extends from the lateral pelvic walls to the body of the uterus.

A

Mesometrium

52
Q

What does the Mesosalpinx do?

A

It’s the portion of the Broad ligament of the uterus that suspends the uterine tubes.

53
Q

What is the posterior portion of the Broad ligament called?

A

Mesovarium

54
Q

The suspensory ligament of the ovary is a superior extension of what?

A

The mesovarium portion of the broad ligament

55
Q

To what relationship does “water under the bridge” refer?

A

The anterior crossing of the uterine artery over the ureter.

56
Q

The ovary is enveloped in what part of the broad ligament?

A

The mesometrium.

57
Q

What are the angles of anteversion and alteflexion?

A

Angle of ANTEVERSION is between the cervix and the vagina. (V=vagina)

Angle of ANTEFLEXION is between the cervix and the body of the uterus.

58
Q

Which angle is larger? (most obtuse)

A

The angle of anteflexion (generally 100-110 degrees)

59
Q

Name some supportive elements of the uterus.

A

Bladder
Rectum
Pelvic and UG diaphragms
Round Ligament

60
Q

What happens when the supportive elements of the uterus are weakened?

A

Uterine Prolapse

61
Q

What is contained in the suspensory ligament of the ovary?

A

The ovarian artery/vein/nerve suply

62
Q

What is the location of the suspensory ligament of the ovary relative to the ureter?

A

It is LATERAL to the ureter.

63
Q

What two things does the ovarian ligament connect?

A

There are 2 ovarian ligaments running from the inferior pole of the ovary to the body of the uterus.

64
Q

What portion of the Broad Ligament contains the Ovaries?

A

The Mesovarium

65
Q

What is the usual site of conception?

A

Fallopian (Uterine) Tubes

66
Q

The fallopian tubes remain suspended by the….

A

Mesosalpinx of the broad ligament

67
Q

The fingerlike projections of the fallopian tubes are called….

A

Fimbriae

68
Q

When the embryo implants in a fallopian tube, this is called…..

A

An ectopic pregnancy

69
Q

If you have a speculum exam gone wrong, what will most likely be perforated?

A

The Posterior Fornix of the vagina is directly related to the Pouch of Douglas (Rectouterine pouch). This will most likely be penetrated and the integrity of the abdominal cavity lost.

70
Q

What are the little extensions of the vagina around the cervix called?

A

Fornices

71
Q

In order to perform a pudendal nerve block, what would you do?

A

Inject local anesthetic to the site where the Pudendal nerve crosses the lateral aspect of the sacrospinous ligament near the ischial spine. The ischial spine is palpable.

Block 4 (7 decks)

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