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MRCS Anatomy by Sanjid > Pelvis > Flashcards

Pelvis Flashcards

1
Q

Name the branches of the internal iliac artery

A

Anterior division - into PELVIS

1) Superior vesical artery
2) Obturator Artery
3) Vaginal (F) / Inferior vesical artery (M)
4) Uterine (F) / A to Ductus Deferens (M)
5) Middle rectal artery
6) Internal pudendal artery
7) Inferior gluteal artery

Posterior division - mainly MUSCULAR

1) Superior gluteal artery
2) Lateral sacral artery
3) Iliolumbar artery

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2
Q

Where does the ureter enter the bladder?

A

Posterolateral angles of trigone of bladder

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3
Q

How long is the ureter?

A

25-30cm long

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4
Q

What are the different parts of the ureter?

A

1) Abdominal - renal pelvis to pelvic brim
2) Pelvic - pelvic brim to bladder
3) Intravesical/intramural - within bladder wall

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5
Q

Name the 3 constrictions of the ureter

A

1) Pelviureter junction
2) Pelvic brim / crossing over common or internal iliac artery
3) Uretovesicular junction

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6
Q

What is the MAIN arterial blood supply of the ureter?

A

Superior 1/3: Renal artery

Middle 1/3: Gonadal artery

Lower 1/3: Superior vesical artery (will also be supplied by other contributing arteries from the internal iliac artery)

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7
Q

What is the lymphatic drainage of the ureter?

A

Abdominal ureter: aorto-caval and common iliac nodes

Pelvic ureter: Internal and external iliac nodes

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8
Q

How does the ureters descend inferiorly in relation to the psoas muscle?

A

Lateral to medial anterior to psoas muscle running along the transverse processes of the lumbar vertebrae

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9
Q

What are the different parts of the urethra in men and their associated membranous linings?

A

1) Prostatic urethra - transitional cell
2) Membranous urethra - transitional cell
3) Bulbous - psuedostratified columnar cell
4) Pendulous - psuedostratified columnar cell
5) Fossa Navicularis - squamous cell

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10
Q

Which zone of the prostate is affected in BPH?

A

Transitional zone - medial and lateral lobes of prostate

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11
Q

Which zone of the prostate is commonly affected in Prostate Ca?

A

`Peripheral zone - posterior lobe

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12
Q

What is the arterial supply of the prostate?

A

1) Inferior vesical artery
2) Middle rectal artery
3) Internal pudendal artery

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13
Q

What is the venous drainage of the prostate?

A

Prostate venous plexus:

1) Santorini’s plexus - drain into internal iliac vein connecting with the vertebral lumbar veins
2) Batson’s plexus - valveless veins draining the deep pelvic veins into internal venous plexus

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14
Q

What is the nerve supply to the prostate?

A

Inferior hypogastric plexus (autonomic)

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15
Q

What is the lymphatic drainage of the prostate?

A

Anterior lobe:

1) External iliac LN
2) Inferior gluteal LN (part of internal iliac LN)

Posterior lobe:

1) External iliac LN (lateral pathway)
2) Internal iliac LN (latarodorsal pathway)
3) Sacral & common iliac LN (dorsal pathway)

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16
Q

Which lymph nodes do the testes drain into?

A

Para-aortic LN

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17
Q

Which lymph nodes do the gluteal and lateral lumbar regions drain into?

A

Superolateral superficial inguinal LN

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18
Q

Which lymph nodes do the outside of anal canal, external genitalia, skin of penis and scrotum drain into?

A

Superomedial superficial inguinal LN

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19
Q

Which lymph nodes do the glans penis and spongey urethra drain into?

A

Deep inguinal LN

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20
Q

Which lymph nodes does the lower limb drain into?

A

Inferior superficial inguinal LN

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21
Q

What are the components of the pelvic floor?

A
  • *LEVATOR ANI**
    1) Puborectalis
    2) Pubococcygeus
    3) Iliococcygeus
  • *COCCYGEUS**
  • *FASCIA COVERING THESE MUSCLES**
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22
Q

Through which foramen does the pudendal nerve pass through?

A

Greater sciatic foramen

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23
Q

Below which muscle does the pudendal nerve travel passed?

A

Piriformis muscle

24
Q

Which nerve provides innervation to the perineum, pelvic floor and pelvic diaphragm?

A

Pudendal nerve

25
Q

Through which foramen does the pudendal nerve pass into after passing below piriformis muscle?

A

Lesser sciatic foramen

26
Q

Through which canal does the pudendal nerve pass through after passing through the lesser sciatic foramen?

A

Alcock’s / pudendal canal

27
Q

Which nerves are anaesthetised for an episiotomy?

A

Deep and superficial perineal nerves (branches of pudendal nerve)

28
Q

What is Denonvillier’s fascia?

A

Rectogenital fascia

29
Q

What is Waldeyer’s fascia?

A

Rectosacral fascia - keeps inferior hypogastric plexus from rectum

30
Q

Within which fascia is the superficial dorsal penile vein immediately deep to?

A

Superficial / Dartos fascia

31
Q

Within which fascia is the deep dorsal penile vein immediately deep to?

A

Deep / Buck’s fascia

32
Q

Dartos fascia of the penis & scrotum are continuous to which other fascial layers in the body?

A

1) Colles fascia of the perineum

2) Scarpa’s fascia of anterior abdominal wall

33
Q

Buck’s fascia of the penis is continuous to which other fascial layers in the body?

A

1) External spermatic fascia of the penis

2) Aponeurosis of external oblique

34
Q

Between which fascial layers is the deep perineal space situated?

A

Superior & inferior fascia of the urogenital diaphragm

35
Q

Between which fascial layers is the superficial perineal space situated?

A

Inferior fascia of the urogenital diaphragm & superficial fascia of perineum / Colles fascia

36
Q

What is the lymphatic drainage of the superior aspect of the vagina?

A

External iliac LN

37
Q

What is the lymphatic drainage of the middle aspect of the vagina?

A

Internal iliac LN

38
Q

What is the lymphatic drainage of the inferior aspect of the vagina?

A

Superficial inguinal LN

39
Q

What is the innervation of the vagina?

A

Uterovaginal nerve plexus (both parasympathetic & sympathetic)

40
Q

What are the nerves that pass through the greater sciatic foramen?

A

1) Sciatic Nerve
2) Superior and Inferior Gluteal Nerves
3) Pudendal Nerve
4) Posterior Femoral Cutaneous Nerve
5) Nerve to Quadratus Femoris
6) Nerve to Obturator internus

41
Q

What are the vessels that pass through the greater sciatic foramen?

A

1) Superior Gluteal Artery and vein
2) Inferior Gluteal Artery and vein
3) Internal Pudendal Artery and vein

42
Q

What are the boundaries of the greater sciatic foramen?

A

Anterolateral - Greater sciatic notch of the ilium
Posteromedial - Sacrotuberous ligament
Inferior - Sacrospinous ligament and the ischial spine
Superior - Anterior sacroiliac ligament

43
Q

What are the contents of the lesser sciatic foramen?

A

1) Tendon of the obturator internus
2) Pudendal nerve
3) Internal pudendal artery and vein
4) Nerve to the obturator internus

44
Q

What structures pass through the obturator foramen?

A

1) Obturator nerve
2) Obturator artery
3) Obturator vein

45
Q

What are the layers of the scrotum?

A

SUPERFICIAL

1) Skin
2) Dartos fascia and muscle
3) External spermatic fascia
4) Cremasteric muscle and fascia
5) Internal spermatic fascia
6) Parietal layer of the tunica vaginalis

DEEP

46
Q

What is the main structure to provide structural support for the uterus?

A

Central perineal tendon

47
Q

What is the dermatome of the groin?

A

L1

48
Q

What are the 3 fascial layers of the spermatic cord?

A

1) External spermatic
2) Cremasteric
3) Internal spermatic

49
Q

What are the 3 arteries of the spermatic cord?

A

1) Testicular - from aorta
2) Cremasteric - from inf. epigastric
3) Artery of Vas - Inferior vesical

50
Q

What are the 3 veins of the spermatic cord?

A

1) Pampiniform plexus of veins - R side drains to IVC, L side drains to L renal vein
2) Cremasteric vein
3) Vein of Vas

51
Q

What are the 3 nerves of the spermatic cord?

A

1) Ilioinguinal nerve (superficial to spermatic cord)
2) Nerve to cremaster (from genitofemoral nerve)
3) T10/T11 Sympathetic nerves

52
Q

What are the 3 common places for ureteric stones?

A

1) Pelvi-ureteric junction
2) Ureter crosses the bifurcation of common iliac blood vessels
3) Vesico-ureteric junction

53
Q

What parts of the rectum is covered by peritoneum?

A

Upper third - anterior & lateral surfaces
Middle third - anterior surfaces
Lower third - NO PERITONEUM

54
Q

Which nerve roots do the pelvic splanchnic nerve arise from?

A

S2 - S4 (parasympathetic efferent fibres)

55
Q

What structures converge into the perineal body?

A

1) Bulbospongiosus
2) Transverse perineal (DEEP)
3) Transverse perineal (SUPERFICIAL)
4) Ant fibres of levator ani
5) Fibres from urethral sphincter
6) External anal sphincter

56
Q

What structures are in the superficial perineal pouch?

A

1) Transverse perineal pouch (superficial)
2) Bulbospongiosus
3) Ischiocavernosus

MRCS Anatomy by Sanjid (11 decks)

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