Pelvis Flashcards
Where do the testes start off?
Retroperitoneal
What is the superficial inguinal ring made from?
A gap in external obliques aponeurosis
Where is the deep inguinal ring?
1.25cm about inguinal ligament, halfway between the pubic tubercle and ASIS
Which artery does the inferior epigastric artery come off?
external iliac artery
Where is the superficial inguinal ring?
1.25cm above the pubic tubercle
How long is the inguinal canal?
C. 4cm
What is the deep inguinal ring made from?
A U-shaped condensation of transversalis fascia
What forms the anterior boundary of the inguinal canal?
external oblique aponeurosis
What forms the posterior boundary of the inguinal canal?
Transversalis fascia and conjoint tendon (int oblique and transversus abdo)
What forms the superior boundary of the inguinal canal?
conjoined muscles of internal oblique and transversalis fascia
What forms the inferior boundary of the inguinal canal?
The inguinal ligament and lacunar ligament
Where does the inferior epigastric artery lie in relation to the inguinal canal?
Posteriorly and medial to the deep inguinal ring
What are the group of testicular veins called?
Pampiniform plexus
What are the layers that surround the teste? - inside to outside
tunic albuginea, tunica vaginalis, internal spermatic fascia, cremaster muscle, external spermatic fascia, dartos muscle
What is the tunica vaginalis formed from?
Peritoneum
What is the internal spermatic fascia formed from?
Transversalis fascia
What is the cremaster muscle formed from?
Internal oblique muscle
What is the external spermatic fascia formed from?
External oblique muscle
What is the dartos muscle formed from?
Scarpa’s (and some campers) fascia
In females what is the equivalent of the dartos muscle?
Labia majora
Which layer of the abdominal wall does not form a part of the testes fascial layers?
Transversus abdominis
What are the three arteries of the spermatic cord?
testicular artery, artery of the Vas, Cremasteric artery
What are the three veins of the spermatic cord?
Testicular vein, vein of Vas, cremasteric vein
What are the three nerves of the spermatic cord?
genital branch of the genitofemoral, inguinal branch of ilioinginal, sympathetics
What are the three other structures of the spermatic cord?
Vas Deferens, lymphatics, Processus Vaginalis
What is the epididymus?
A convoluted tube running from the superior to inferior pole of the testis, on posterior surface of the testis
What is the function of the epididymus?
Storage and maturation of sperm
What is the tunica albuginea?
The innermost covering of the testis
What is the processus vaginalis?
Continuation of the peritoneum into the testis, tube that is usually obliterated
What is buck’s fascia?
The thick fascial layer that surrounds the penis to prevent too much blood from entering the penis during erection
What are the three cylinders of tissue that make up the shaft of the penis?
corpora cavernosum x2 and corpora spongiosum
What is the glans penis made up of?
Corpora spongiosum tissue
Which cylindrical tissues cause the penis to become hard?
Corpora cavernosum
Which cylindrical tissue causes the penis to become erect?
Corpora spongiosum
Where does the urethra lie in the penis?
Inside the corpora spongiosum
What is the navicular fossa?
The dilatation and slit-opening of the urethra in the penis
What are the borders of the urogenital triangle/perineum?
Inferior pubic rami and ischial tuberosities
What are the borders of the ano-rectal triangle?
ischial tuberosities and the coccyx
What is the membrane that covers the area of the urogenital triangle called?
perineal membrane
What is the layer underlying the perineal membrane called?
Deep perineal pouch
Where do the corpora cavernosum arise from?
The area between the inferior pubic rami and perineal membrane
What is the name of the muscle surrounding the crura cavernosa?
Ischio-cavernosus
Where is the crura spongiosus?
A circular erectile tissue at the base of the penis
What erectile tissue makes up the labia majora?
bulbospongiosa
Which parts of the vulva are hair-bearing?
Labia majora are hair bearing
minora and clitoris are not
What is the clitoris made from?
The junction between all different bits of erectile tissue
What is the scrotums parallel in the female?
labia majora
What is the nerve supply to the skin of the superior part of the vulva?
Ilioinguinal nerve - L1
What is the nerve supply to the skin inferior to the urethra?
Sacral nerve - S2
What nerve does sensation to the anal canal and anus?
S5
What are the nerve roots of the pudendal nerve?
S2-S4
What are the anatomical borders of the perineum?
pubic symphysis, tip of coccyx, inferior pubic rami, inferior ischial rami, sacrotuberous ligament, roof: pelvic floor, base: skin
What line divides the urogenital and anal triangle?
A theoretical line between the two ischial tuberosities
What structures are contained within the deep perineal pouch?
External urethral sphincter, part of the urethra, part of the vagina in women, bulbourethral glands in men
What is the perineal membrane?
A layer of tough fascia for attachment of external genitalia. separates deep and superficial perineal pouches
What structures are contained within the superficial perineal pouch?
Erectile tissues that form the penis and clitoris, ischiocavernosis, bulbospongiosus and transverse perineal muscles, bartholin’s glands
What are the two superficial layers of fascia?
superficial layer - continuous with Camper’s fascia
Deep layer - Colle’s fascia - continuous with Scarpa’s fascia
What is the perineal body?
A fibromuscular mass, the point of attachment for muscle fibres from the pelvic floor and perineum
Where is the perineal body?
Between the vaginal opening and anus in women and penis and anus in men
What is the blood supply to the perineum?
Internal pudendal artery
What is the nerve supply to the perineum?
pudendal nerve (S2,3,4 keeps your penis off the floor)
What ligament separates the sciatic foramina?
sacrospinous ligament
What structures pass through the greater sciatic foramen?
superior gluteal NVA, sciatic nerve, pudendal nerve, inferior gluteal NVA, nerve to obturator internus and nerve to quadratus femoris
What structures pass through the lesser sciatic foramen?
Inferior pudendal AV, pudendal nerve, obturator internus tendon, nerve to obturator internus
What is the path of the pudendal nerve through the sciatic foramina?
Leaves pelvis via greater sciatic foramen, re-enters via lesser sciatic foramen, enters pudendal canal
What are the three parts of the hip bone?
Ilium, pubis, ischium
What is the name of the cartilage that joins the parts of the hip bone in children?
Triradiate cartilage
What is the name of the area of the pelvic bone where the femur joins?
acetabulum
What is the name of the indentation on the posterior surface of the ilium?
Greater sciatic notch
What are the four spines of the ilium?
ASIS, PSIS, AIIS, PIIS
What is the mid-inguinal point?
halfway between ASIS and pubic symphysis
What is the mid-point of the inguinal ligament?
halfway between ASIS and pubic tubercle
What can be palpated at the mid-inguinal point?
Femoral pulse
What are the three parts to the pubic bone?
Pubic body, superior and inferior pubic rami
What is the name of the hole made by the superior and inferior pubic rami?
Obturator foramen
What structures pass through the obturator foramen?
Obturator nerve, artery and vein
What are the attachments of the sacrospinous ligament?
ischial spine, sacrum
What are the attachments of the sacrotuberous ligament?
Sacrum to ischial tuberosity - forming lesser sciatic foramen
What are the contents of the femoral triangle?
Femoral VAN, inguinal lymph nodes, lateral cutaneous nerve, great saphenous vein, femoral branch of the genitofemoral nerve
What artery supplies the prostate?
Inferior vesical artery
What is the lymphatic drainage of the prostate?
Internal iliac nodes
What is the true pelvis?
The area below the pelvic brim
What is the greater/false pelvis?
Superior to the pelvic brim, area within pelvic bones, supports lower abdominal viscera
What is the plane of the pelvic inlet?
An imaginary plane that separates the pelvic and abdominal cavity
What is the pelvic diaphragm?
Also known as the pelvic floor, a group of muscles that hold the pelvic organs in place - coccygeus and levator ani
Where is the pelvic inlet?
The space between the greater and lesser pelvis
What does the gubernaculum become in males and females?
M - Scrotal ligament
F - Round ligament
Which vein does the pampiniform plexus of veins come from?
Vein of the Vas/testicular
How long does sperm take to mature?
2.5 months
What is the pathway of sperm to the urethra?
Seminiferous tubules, rete testis, epididymus, vas deferens, ejaculatory duct
What are the four parts of the male urethra?
prostatic, membranous, bulbous, penile
What are the walls of the pelvic diaphragm made from?
Floor: levator ani, coccygeus
Lateral: obturator internus
Posterior: Piriform
What is the hole in the piriform muscle called?
The greater sciatic foramen
What sits immediately below the pelvic diaphragm?
Perineum
What does the dorsal artery of the penis supply?
The glans penis
What do the deep arteries of the penis supply?
Corpus cavernosum
What does the perineal artery supply?
Bulbospongiosus and ischiocaverosus
What does the internal pudendal artery supply?
Perineum, rectum, erectile bodies, anal and urogenital region
Which structures pass through the pudendal canal?
Internal pudendal artery, internal pudendal veins, pudendal nerve
Where is the pudendal canal?
On the medial surface of obturator internus, a sheath derived from the fascia of obturator internus
Where does the sympathetic and parasympathetic nerve supply to the pelvis come from?
Para: pelvic splanchnic
Symp: sacral plexus
What are the branches of the pudendal nerve?
Inferior rectal, perineal (posterior scrotal nerve), dorsal nerve of the penis/clitoris (PID)
What does the inferior rectal nerve do?
Anal sphincter
What does the perineal nerve supply?
ischiocaverosus, bulbospongiosus and levator ani muscles, urethral sphincter, skin of perineum
What does the dorsal nerve of the penis do?
supply to skin of penis/clitoris. responsible for erection
What does the tunica albuginea of the penis cover?
The corpus cavernosum and spongiosus muscles
What are the fascial layers of the penis - external to internal?
Skin, dartos fascia, bucks fascia, tunica albuginea
where is the bulbourethral gland situated?
In the bulb of the penis
What is the frenulum of the penis?
The connection between the glans penis and the foreskin
What are the three muscles that make up levator ani?
Puborectalis, pubococcygeus, iliococcygeus
The seminal gland recieves its blood supply from what arteries?
Inferior vesical, middle rectal
The efferent ducts are between which structures?
The epididymus and rete testes
Which nerve exits through the greater sciatic foramen and re-enters through the lesser sciatic foramen?
Internal pudendal nerve
What are the nerve roots of the obturator nerve?
L2-L4
Where is sympathetic innervation to detrusor from?
The superior and inferior hypogastric plexuses
where do the gonadal veins drain into?
Right into IVC, left into left renal vein
Which blood vessels form a major anastamosis in females and not in males?
The gonadal (ovarian artery) and uterine artery
The seminal gland recieves its blood supply from what arteries?
Inferior vesicle and middle rectal - it sits on the posterior inferior surface of the bladder
Erection of the penis or clitoris would be affected by bilaterally cutting which nerve?
Pelvic splanchnic
A surgeon opened the external oblique aponeurosis just cranial to the inguinal ligament. He then located a nerve that ran a course parallel to the inguinal ligament and disappeared deep to the external spermatic fascia. This had to be which nerve?
Ilioinguinal
Rupture of the membranous during a catheterization can cause urine to extravasate into the what?
deep perineal space
