pelvis

Question 1

describe the anatomical and surface borders of the perineum

Answer 1

Question 2

what divides the anorectal and urogenital triangle ?

Answer 2

line between ischial tuberosities

Question 3

what are the contents of the anorectal triangle

Answer 3

anal apeture
external anal sphincter
ischioanal fossae
pudendal nerve

Question 4

where is the perineal membrane?

Answer 4

attaches to inferior pubic rami inferior to levator ani but superior to perineal muscles

Question 5

what is the function of the perineal membrane?

Answer 5

cover urogenital hiatus

Question 6

where is the deep perineal pouch?

Answer 6

between deep pelvic fascia overlying levator ani and perineal membrane

(superior to the perineal membrane)

Question 7

where is the superficial perineal pouch?

Answer 7

between perineal membrane and superficial perineal fascia

inferior to the perineal membrane

Question 8

describe the layers of the superficial perineal fascia

Answer 8

deep fascia - overlies superficial perineal muscles and covers protruding structures such as the penis and clitoris
superficial fascia
- made up of two layers: continuation of scarpers (aka colles fascia here) and campers
(membranous and fatty layer)

Question 9

what is within/passes through the deep perineal pouch in men/women?

Answer 9

both:
- urethra
- EUS

Females:
- vagina

males:
- deep transverse perineal muscles
- bulbourethral glands (within EUS)

Question 10

what passes through/is in the superficial perineal pouch in men/women?

Answer 10

superficial perineal muscles
erectile tissue of penis/clitoris
females only: bartholian glands (aka greater vestibular glands)

Question 11

what is the perineal body and where is it?

Answer 11

fibromuscular mass - marks the boundary between the anorectal and urogenital triangle in both men and women

centre for attachment of pelvic floor muscles (levator ani and superficial perineal muscles)

Question 12

where does the pudendal nerve run?

Answer 12

from sacral plexus
out greater scaitic foramen
back in through lesser sciatic foramen
along the inner surface of the ischial tuberosity - Alcocks canal (with pudendal artery and vein) - pudendal nerve block

Question 13

what are the 3 superficial perineal muscles?

Answer 13

bulbospongiosus
ischiocavernosis
superficial transverse perineal

Question 14

what nerve innervates the levetor ani and superficial perineal muscles?

Answer 14

pudendal nerve

Question 15

what muscles make up the levator ani?

Answer 15

puborectalis
pubococcygeus
iliococcygeus

Question 16

what is the scrotal ligament a remnant of?

Answer 16

gubernaculum

Question 17

where is the dartos muscle?

Answer 17

superficial muscle of the scrotum just deep to the skin

function is to wrinkle the skin of the scrotum to regulate temperature

Question 18

where do the lymphatics of the teste drain to?

Answer 18

para-aortic and lumbar (due to testicular descent)

Question 19

what abdominal muscle does not form part of the spermatic cord?

Answer 19

transversus abdominis

Question 20

label the following

Answer 20

Question 21

what muscles overly the proximal parts of these structures?

Answer 21

bulbospongiosus

ischiocavernosus

Question 22

what is bucks fascia?

Answer 22

continuation of the deep layer of superficial perineal fascia which surrounds the penis holding the erectile tissue together and anchors it

Question 23

draw out the spermatic cord and its contents

Answer 23

Question 24

describe the pathway of sperm

Answer 24

made in the seminiferous tubules
drain into the rete testis then into the epididymis (head)
pass through the body then tail of epididymis into the vas deferens
travel through the vas to the prostatic urethra where the vas joins the urethra
pass out through the urethra

Question 25

label the hemisected pelvis

Answer 25

Question 26

where is the frenulum of the penis?

Answer 26

ventral surface - connect the prepuce to the glans

Question 27

what does the penile suspensoy ligament attach to?

Answer 27

bucks fascia and pubic symphysis

Question 28

label this crossection

Answer 28

Question 29

where does the superficial dorsal vein of the penis drain into?

Answer 29

superficial external pudendal vein -> great saphenous

Question 30

where does the deep dorsal vein of penis drain into?

Answer 30

prostatic plexus -> internal iliac

Question 31

where do the arteries of the penis arise from?

Answer 31

internal pudendal artery

Question 32

describe the difference in bloody supply of the penis and teste

Answer 32

penis and scrotum - internal pudendal artery, drain into internal pudendal vein mainly teste - artery arises directly from aorta, venous drainage into left renal vein and IVC

Question 33

what key structures does the vas pass over?

Answer 33

internal iliac artery and vein | ureter

Question 34

what are bulbourethral glands also known as?

Answer 34

cowpers

Question 35

where are the seminal vesicles in relation to the ampulla of the vas

Answer 35

inferio-lateral

Question 36

where is the ejaculatory duct?

Answer 36

in prostate at the junction of the seminal vesicles with the vas deferens the ejaculatory duct then joins with the urethra (remember IUS prevents retrograde ejaculation back un into bladder here

Question 37

name the parts of the male urethra

Answer 37

pre-prostatic - IUS

Question 38

describe the areas of the prostate

Answer 38

transitional - surrounds proximal urethra peripheral - surrounds distal urethra central - surrounds the ejaculatory duct

Question 39

what are the 3 branches of the pudendal nerve?

Answer 39

Inferior rectal nerve – innervates the perianal skin and lower third of the anal canal. Perineal nerve – innervates the skin of the perineum, labia minora and majora or posterior scrotum. Dorsal nerve of the penis or clitoris – innervates the skin of the penis or clitoris. Thus, responsible for the afferent component of penile and clitoral erection.

Question 40

fill in the missing labels

Answer 40

Question 41

what female structures are analogous to the male bulb of the penis, corpus spongiosum and the glans?

Answer 41

bulb of vestibule and glans of clitoris

Question 42

what is the difference in the structure of the bulb of the vestibule in females and the bulb of the penis in males?

Answer 42

males - joined in the midline | females - divides into 2 around the vestibule

Question 43

fill in the missing labels

Answer 43

Question 44

where do the cardinal ligaments attach?

Answer 44

cervix to lateral walls of pelvis

Question 45

where does the ovarian ligament attach?

Answer 45

ovary to uterus

Question 46

where is the ovarian fossa?

Answer 46

between external and internal iliac vessels on lateral pelvic wall

Question 47

where do the gonadal veins drain?

Answer 47

right - IVC around level of renal vein | left - left renal vein

Question 48

where do the gonadal arteries branch from and travel?

Answer 48

aorta just below left renal vein (which passes over aorta) | travel over the ureters and external iliac vessels

Question 49

where does the uterine artery branch from?

Answer 49

internal iliac (anterior division)

Question 50

what arteries anastamose on the uterus?

Answer 50

uterine and ovarian

Question 51

what is th difference between anteverted and anteflexed?

Answer 51

anteverted - means the cervix is rotated anteriorly relative to the vagina anteflexed means the uterus is rotated anteriorly relative to the cervix

Question 52

what are the male analogous structures of the following? - labia majora - labia minora - glans clitoris and bulb of vestibule - skenes glands - round ligament and ovarian ligament

Answer 52

- labia majora - scrotum - labia minora - penile urethra - glans clitoris and bulb of vestibule - bulb of penis and corpus spongiosum - skenes glands - prostate - round ligament and ovarian ligament - scrotal ligament

Question 53

what is the abdominal ostia in relation to the uterine tubes?

Answer 53

where the infundibulum opens into the peritoneal cavity

Question 54

what are the branches of the posterior division of the internal iliac artery

Answer 54

iliolumbar lateral sacral superior gluteal

Question 55

where does the internal iliac divide into anterior and posterior division?

Answer 55

just above greater sciatic foramen

Question 56

what are the branches of the anterior division of the internal iliac artery

Answer 56

inferior gluteal internal pudendal (out greater sciatic foramen and back in lesser then through adcocks canal) middle rectal vaginal arteries + uterine arteries (inferior vesicle artery in males supplying prostate) obturator artery superior vesicle arteries umbillical artery (medial umbilical ligaments left )

Question 57

describe the location of the urinary bladder

Answer 57

sits directly posteriorly to the pubic symphysis superior to the pelvic diaphragm in the lesser pelvis when full extends into greater pelvis

Question 58

describe the areas of the bladder

Answer 58

fundus = trigone

Question 59

what nerve innervates the EUS in both sexes?

Answer 59

pudendal nerve - voluntary control

Question 60

what nerve causes relaxation of the bladder allowing storage reflex?

Answer 60

hypogastric nerve - sympathetics

Question 61

what nerves cause contraction of the detrusor allowing the micturition reflex?

Answer 61

pelvic nerves - parasympathetics

Question 62

where is the superior boundary of the rectum?

Answer 62

S3 - within the true pelvis where there is no longer a sigmoid mesentery - this is rectum note here how the rectum curves to the right, then left then back to the right due to the transverse flexures

Question 63

what forms the border between the rectum and anal canal?

Answer 63

pectinate (dentate) line

Question 64

what is the significance of the pectinate line?

Answer 64

different embryological origins above - hindgut below - ectoderm