Pelvis Flashcards

1
Q

Muscles of posterior abdominal wall

A

Psoas major
Quadratus lumborum
Iliacus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Psoas major - where does the nerves that pass through arise

A

From the front: genitofemoral N
Lateral: ilioinguinal, iliohypogastric, lat femoral cutaneous & femoral
Medial = obturator & lumbosacral trunk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What emerges from lat aspect of psoas major

A

Iliohypogastric
Ilioinguinal
Lateral femoral cutaneous n
Femoral N

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Action of psoas major

A

Hip flexor
Lateral flexor of vertebral column

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Nerve supply to psoas major

A

L1-3, mainly L2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Origin & insertion of psoas major

A

T12-L5 bodies, IVD, transverse processes
Into lesser trochanter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Quadratus lumborum origin & insert

A

Origin from Transverse process of L5 from strong iliolumbar lig to upper 4 lumbar vertebra and inferior border of 12th rib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What runs behind the lateral arcuate lig

A

The subcostal neurovascular bundle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Iliacus origin & insert

A

Upper 2/3rds of iliac fossa to inner lip of iliac crest and Ant sacroiliac lig
Inserts into psoas (lesser trochanter)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Nerve supply of iliacus

A

Femoral, L2/3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the thoracolumbar fascia

A

Deep investing membrane covering deep muscles of trunk, with 3 layers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Abdominal aorta starts

A

T12, b/w crura of diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Abdo aorta ends

A

L4, divides into 2 common iliac A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the branches of the abdo aorta

A

3 single ventral arteries - coliac, SMA, IMA
Paired branches to viscera
— suprarenal, renal, gonadal
Paired branches to abdo wall
- inferior phrenic, lumbar A
Median sacral A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Where does the renal A commence

A

L2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How do the subcostal A enter the abdomen

A

Arise from thoracic aorta
Travel under lateral arcuate lig, over lumbar fascia, behind kidney in neurovascular plane IO and TA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How many lumbar As are there

A

4 in number

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What do the lumbar arteries give off

A

Posterior and spinal A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Where do common iliac A begin

A

L4, to the L of midline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What crosses the L common iliac

A

Ureter
Inferior mesenteric (sup rectal) vessels
Sympathetic contributions to superior hypogastric plexus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What does the external iliac A give off

A

2 branches - inferior epigastric
Deep circumflex
Then enters inguinal lig = femoral A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

IVC starts….

A

L5, behind R common iliac A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Which aspects of IVC have valves

A

Only the gonadal V

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What does each common iliac vein receive

A

Iliolumbar V
Lateral sacral V
Median sacral V

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are the tributaries to the IVC
Common iliac V Lumbar V Gonadal V Renal V Suprarenal V
26
Subcostal N and journey
T12, from thorax, behind lateral arcuate lig
27
What are the branches of the lumbar plexus
L1 = ilioinguinal, iliohypogastric L1,2 = genitofemoral L2,3 = lateral femoral cutaneous *post div L2,3,4 = femoral (post) L2,3,4 = obturator (ant)
28
iliohypogastric supplies
Skin in upper buttock Suprapubic skin
29
Ilioinguinal nerve supply
Ant 1/3rd of scrotum, penis, upper part of groin
30
Genitofemoral nerve supply
Motor fibres to cremaster m Sensory fibres to spermatic fascia, tunica, skin on scrotum, mons pubis/labia Supplies skin over upper part of femoral triangle
31
Lateral cutaneous nerve of the thigh supply
L2,3 Iliac fascia, parietal peritoneum of iliac fossa Lateral side of thigh to knee
32
Femoral N branches
N to pectineus N to sartoris N to rectus femoris N to vatus lateralis, intermedius, medialis Saphenous n
33
Saphenous n supply
Skin over subcutaneous surface of tibia
34
Obturator division
Anterior , posterior (over adductor brevis)
35
Anterior div of obturator nerve supplies
Adductor brevis Adductor longus Gracilis Medial thigh cutaneously
36
Post div of obturator nerve supplies
Obturator externus Adductor magnus
37
What is the order the vessels in obturator foramen
Nerve Artery Vein
38
SNS to the pelvis
Coeliac plexus Lumbar trunk
39
Psns of pelvis
Vagus Pelvic splanchnic, joins inferior hypogastric plexus
40
What runs in the white ramus communicans
Sympathetic preganglionic fibres
41
What runs in the grey ramus communicans
Sympathetic post ganglionic fibres
42
Posterior relations of kidney
Diaphragm Quadratus lumborum Psoas Transversus abdominis Subcostal V Subcostal A Subcostal N Iliohypogastric N Ilioinguinal N
43
Anterior relations of R kidney
Peritoneum of hepatorenal pouch 2nd part of duodenum Hepatic flexure
44
Anterior relations of L kidney
Peritoneum of lesser sac Peritoneum of greater sac Body of pancreas, splenic vessels Splenic flexure
45
Where does the perinephric fat lie
Outside of renal capsule, surrounded by renal fascia
46
Blood supply to the kidneys
Renal arteries, L2
47
Order of vessels at renal hilum
Renal V most anterior Renal A Ureter most posterior
48
Lymph drainage of kidney
Para-aortic nodes at L2
49
Nerve supply of kidney
Sympathetic preganglionic cells in T12-L1 and they send preganglionic fibres to thoracic and lumbar splanchnic nerves
50
How long is the ureter
25cm
51
Narrowest points of ureter
Pelvoureteric junction Pelvic brim Vesicoureteric junction
52
Where does the ureter run
Arise most post structure in renal hilum Along tips (medially) of transverse processes Crosses pelvic brim in sacroiliac joints
53
What crosses the L ureter
Gonadal vessels L colic vessels Apex of sigmoid colon
54
What crosses R ureter
Gonadal vessels R colic vessels Ileocolic vessels Root of mesentry
55
Blood supply of ureter
Upper - ureteric branch of renal A Middle - aorta, gonadal, common iliac, internal iliac A Lower - branches of inferior and superior vesical and uterine arteries
56
Lymph drainage of ureters
Abdo portion - para-aortic nodes Pelvic - common iliac, internal iliac LN
57
Nerve supply of ureter
Sympathetic fibres from t10-l1 via coeliac and hypogastric plexus PSNS fibres from pelvic splanchnic nerves
58
Development of ureters
Mesodermal origin Ureteric buds from caudal end of mesonephric duct
59
Features of R suprarenal gland
Pyramidal Lies on diaphragm Enroaches front of R kidney Anterior surface overlapped by IVC In contact with bare area of liver
60
Features of L suprarenal gland
Crescenteric Medial border of L kidney to above hilum Lies on L crus
61
Where do the suprarenal glands lie
L = L crus R = on diaphragm
62
Lymph drainage of suprarenals
Para-aortic nodes
63
Nerve supply of suprarenals
Myelinated preganglionic sympathetic fibres from splanchnic nerves via coeliac plexus (synapse directly with medullary cells
64
structure of suprarenal gland
Medulla Cortex = 3 zones
65
What do the components of medulla form
Cortex - zona glomerulosa = aldosterone - zona fasciculata = cortisol - zona reticularis = androgen hormones Medulla - A, NA, dopamine
66
Internal iliac artery divisions
Posterior - 3 Anterior - 9
67
Where does the internal iliac arise
At bifurcation of common iliac, at L4
68
Branches of the internal iliac a
Post - iliolumbar, lateral sacral, superior gluteal A Ant - obturator a, inferior gluteal A, umbilical A - uterine A, vaginal A, superior vesical A - inferior vesical, middle rectal, internal pudendal
69
Posterior divisions of int iliac A
Uterine, umbilical, sup vesical Inferior gluteal, inf vesical, internal pudendal Obturator a, middle rectal, vaginal A
70
Ant divisions of internal iliac A
Iliolumbar Lateral sacral Superior gluteal A
71
Pelvic brim
Pubic crest, pectineal line of pubis, arcuate line of ilium, ala and promontory of sacrum
72
What angle does the pelvic brim lie at
60 degrees
73
Sex differences b/w pelvis
Female = broader, slender Less acute subpubic angle Less indentation from promontory Pubic arch is wider
74
Muscles of the pelvis
Piriformis Obturator internus Levator ani - iliococcygeus - pubococcygeus Coccygeus
75
Piriformis origin and insert
Middle 3 pieces of sacrum to insert sup aspect of greater trochanter
76
Obturator internus origin and insert
Obturator membrane, bony margins of foramen and ischial tuberosity Insert with sacrotuberous lig to ischial tuberosity
77
What makes up the pelvis floor
Iliococcygeus Pubococcygeus
78
Where does the iliococcygeus origin
Posterior half of tendinous arch Pelvic surface of ischial spine
79
Pubococcygeus components
Puborectalis Pubourethralis Pubovaginalis
80
Nerve supply of levator ani
Sacral plexus branches of S3/4
81
What makes up levator ani
Pubcoccygeus Iliococcygeus
82
Origin of coccygeus
Tip of ischial spine => coccyx and lowest part of sacrum
83
Nerve supply of coccygeus
Sacral plexus branches S3/4
84
Blood supply of rectum
Superior rectal A Middle rectal Inferior rectal Median sacral A
85
Venous return of rectum
Internal rectal plexus and external rectal plexus forms potential site of portosystemic anastomosis As some into IMV, some into internal pudendal V
86
Nerve supply of the rectum
Sympathetic - from inferior mesenteric plexus PSNS - pelvic splanchnics from S2,3,4 via inferior hypogastric plexus (motor to rectal M
87
Urinary bladder surfaces
Apex Base Inferolateral surface Neck Superior surface
88
What attaches to apex of bladder
Urachus => medial umbi lig => median umbi fold
89
What aspects of bladder are covered by peritoneum
Base (upper portion) Superior surface
90
What is the space infront of inferolateral surfaces of bladder
Behind pubic symphysis = retropubic space
91
What is the lowest part of bladder
Neck
92
Internal surface of bladder features
Trabeculae Trigone
93
What is the trigone
2 ureteral orifice and internal urethral orifice below
94
Blood supply of bladder
Superior and inferior vesical A (from Internal Iliac A)
95
Lymph drainage of bladder
External iliac LN Internal, obturator
96
Nerve supply of bladder
PSNS via pelvic splanhnic nerves SNS from L1,2 via sup and inf hypogastric plexus
97
How is the control of micturition
Bladder distends -> afferent impulse via pelvic splanchnics -> stimulate efferent to contract detrusor High centres inhibit this
98
Prostate surfaces
Base Apex Anterior Posterior Inferolateral
99
What is the highest part of the bladder
Base!!!!!
100
What is the lowest part of prostate
Apex
101
What separates prostate and rectum
Denovilliers fascia
102
Where do the ejaculator ducts enter the prostate
Posterior surface, just below bladder, and pass to open into prostatic urethra
103
Zones of the prostate
Peripheral Central Transition
104
Features of peripheral zone of prostate
Surrounds central zone Commonest site of prostate cancer
105
Most frequent zone for prostate cancer
Peripheral zone
106
Where is the zone of BPH
Transitional zone
107
Blood supply of prostate glands
Inferior vesical A => prostatic branch Also, middle rectal, internal pudendal Veins run into a plexus, thus joining vesicoprostatic plexus
108
Lymph drainage of prostate
Internal iliac nodes
109
Nerve supply of prostate
Acini - PSNS from pelvic splanchnics via inferior hypogastric plexus Muscle fibres that assist with ejaculation are under SNS from inferior hypogastric plexus
110
What are the features of seminal colliculus
Prostatic utricle Ejaculator ducts (lat to prostatic utricle)
111
What is the prostatic utricle
Remnant of paramesonephric ducts
112
Blood supply to ductus deferens
Superior vesical A => artery to ductus deferens (note: anastomoses with testicular)
113
Blood supply to seminal vesicle
A to seminal vesicles From inferior vesicle and middle rectal A
114
Nerve supply of ductus deferens & seminal vesicles
Smooth muscles of ductus,seminal vesicles by inferior hypogastric plexus (motor symp fibres)
115
Features of the uterus
Fundus Body Cervix
116
Where do the uterine tubes enter uterus
At the cornu
117
What encloses the body of peritoneum
Broad ligament
118
What covers post surface of uterus
Rectouterine pouch of douglas
119
What are the aspects of uterine tube
Isthmus Ampulla Infundibulum
120
Blood supply of uterus & uterine tubes
Uterine A (int iliac) gives branches to cervix and vagina, anastomosis with ovarian A
121
Lymph drainage from cervix
External and internal iliac LN, sacral nodes
122
Lymph drainage of uterus
Upper part of body, fundus, uterine tube to para-aortic Lower part of body = ext iliac nodes
123
Nerve supply to uterus & uterine tubes
Inferior hypogastric plexus
124
How is pain from the cervix transferred
Via pelvic splanhnic nerves w/ symphathetic nerves to T10 - L1
125
What is the normal position of the uterus
Anteflexed
126
What is the most fixed part of the uterus
The cervix, due to pelvic diaphragn, visceral pelvic fascia & peritoneal attachments
127
What are the features of broad lig
Mesoovarian, mesosalpinx No supportive features Holds the suspensory lig of the ovary
128
Round lig of the ovary journey
From junction of uterus & uterine tube to deep inguinal ring, to labium majus
129
What blood supply of round lig of uterus
Inferior epigastric A
130
Transverse cervical lig attachments
Cervix & vaginal fornix to lateral wall of pelvis
131
Uterosacral lig attachments
From post cervix below peritoneum embrancing retrouterine pouch and rectum => front of sacrum
132
What is the role of uterosacral lig
Keeps cervix braced backwards against forward pull of round lig Maintains uterine anteflexion
133
What does the lig of ovary attach
Ovary to body of uterus
134
Where does the lig of the ovary attach
To lower pole of ovary, to the uterus
135
Blood supply to ovary
Ovarian A, direct branch of abdo aorta
136
How does the ovarian A reach the ovary
Via suspensory ligament
137
Lymph drainage of ovary
Para-aortic node Some via round lig to inguinal nodes
138
Nerve supply to ovary
SNS from aortic plexus PSNS via inferior hypogastric plexus
139
Vagina fornices
Anterior, posterior and lateral
140
What part of vagina has peritoneal covering
Posterior fornix, via rectouterine pouch
141
Relationship between ureter and vagina
Ureter at first adjacent to lateral fornix, then passes across the front of anterior fornix
142
Where are the bartholins glands (vestibular)
Vestibule of vagina, below hymen, in posterolateral wall
143
Blood supply of vagina
Vaginal A(int iliac) Support from uterine, inf vesical and middl rectal
144
Venous drainage of vagina
Via plexus on pelvic floor to drain internal iliac V
145
Lymph drainage of vagina
Ext, internal iliac nodes
146
Nerve supply of vagina
Lower end = sensory fibres from perineal and post labial branches of perineal Autonomic from inf hypogastric plexus supply blood vessels, smooth muscle of vagina and vestibular glands Upper vagina only sensitive to stretch
147
Female urethral length and features
4cm, only has external urethral meatus
148
Blood supply of urethra
Upper = inf vesical Lower = vaginal and internal pudendal A
149
Lymph drainage of urethra
Int, ext iliac nodes
150
Nerve supply of urethra
Inf hypogastric plexus and perineal branch of pudendal n
151
What is anterior to the internal iliac vessels
Ureter, fallopian tube, ovary
152
Posterior relations to internal iliac vessels
Internal iliac vein, sacral plexus, SI
153
Lateral relations to internal iliac artery
Ext iliac vessels, obturator n, psoas major
154
Medial relations of internal iliac A
Parietal peritoneum Small bowel
155
Where does the internal iliac begin
L5/S1 at pelvic brim
156
Divisions of the int iliac A
Post - 3 Ant - 9 ish
157
Terminal branch of anterior division of internal iliac
Internal pudendal Inferior gluteal
158
Post branches of int iliac A
Iliolumbar Superior gluteal Lateral sacral
159
Anterior divisions of int iliac A
Umbi Sup vesical Inf vesical Uterine Vaginal Middle rectal Inferior gluteal Internal pudendal Obturator
160
Where does the int iliac V start
In the greater sciatic notch
161
Where does int iliac V join ext iliac V
On medial surface of psoas
162
Tributaries of the int iliac V
(Apart from corresponding arterial veins) Rectal venous plexus Prostatic venous plexus Uterine venous plexus Vaginal venous plexus
163
What communicates the internal iliac V with the vertebral venous plexus
Lateral sacral V
164
What forms the sacral plexus
Lumbosacral trunk (l4,5) Upper 4 ant rami of sacrum
165
Divisions of sacral plexus
Anterior divisions Posterior diviisons
166
Anterior divisions of sacral plexus
Tibial part of sciatic nerve (L4 - S3) N to obturator internus (L5, S1-2) N to quad femoris (L4 to S1) Pudendal N (S2,3,4) Perineal branch of S4 Pelvic splanchnic nerves
167
What does n to obturator internus supply
Obturator internus Super gemellus
168
Nerve to quad femoris supplies
Inf gemellus, hip joint Quadratus femoris
169
Perineal branch of S4 supplies
Puborectalis, pubourethralis, pubovaginalis Perianal skin
170
Pelvic splanchnic nerve component
PSNS from ant surface of S2-3 +4 Pass forward into inf hypogastric plexus where they mix with SNS to supply pelvic viscera and distal colon
171
Post divisions of sacral plexus
N to piriformis (S1-2) Perforating cutaneous N (S2-3) Sup gluteal N (L4-S1) Inf gluteal (L5-S2) Common perineal part of sciatic N (L4-S2)
172
What lies anterior to sacral plexus
Lateral sacral A + ureter (which passes in front of ALL parietal pelvic peritoneum and viscera)
173
What passes superior to sacral plexus
Sup gluteal A
174
What passes inf to sacral plexus
Inf gluteal A
175
What emerging nerves are apart of the inferior hypogastric plexus
SNS (via sup hypogastric plexus, half are preganlionic, others are sacral symp fibres) PSNS (from pelvic splanchnics)
176
Where does the inferior hypogastric plexus lie in the male pelvis
Lateral to rectum Posterolateral to seminal vesicle, prostate Posterior to bladder
177
Where does the inferior hypogastric plexus lie in female pelvis
Lateral to rectum, cervix, vaginal fornix Posterolateral to blader
178
Cutaneous nerve supply of anal region
Inferior rectal N (S3,4) Perineal branch of S4 Coccygeal plexus S5
179
Urogenital cutaneous nerve supply
Ilioinguinal N Dorsal nerve of pudenal Posterior femoral cutaneous N Perineal N of pudendal
180
What type of muscle (circular, longitudinal) makes up the anal region
ALL circular
181
Components of ext anal sphincter
Deep, superficial and subcutaneous parts Deep parts are blended with puborectal of levator ani (anorectal ring) Fibromuscular strands pass backwards to coccyx which contributes to anococcygeal lig
182
Internal anal sphincter formed fro
Thickening of inner circular muscle of rectum
183
What is the pectinate line
The site of anal valves, which are formed from folds of anal columns, which has glands and sinuses
184
Difference in epidermis of pectinate line
Superior to pectinate line = columnar Inferior = stratified squamous
185
Arterial supply to anal region
Above pectinate = superior rectal A (from IMA); medial sacral (aorta), middle rectal (from int iliac) Lower = inferior rectal (int pudendal A)
186
Venous drainage of anal region
Upper = via superior rectal & IMV to portal system Lower = via inf and middle rectal V to int iliac V Site of portosystemic anastomosis
187
Lymph drainagae of anal canal
Upper = lymph of rectal Lower = superficial inguinal nodes
188
Nerve supply of anal canal
Inferior rectal branches of pudendal N = ext sphincter and sensory supply of 1-2cm above pectinate down S2 to sphincter urethrae SNS from pelvic plexus to contract int sphincter Pelvic splanchnics to relax int sphincter
189
What is the nerve that controls external anal sphincter
Inferior rectal branch of pudendal N
190
What factors (anatomical) maintain continence
Puborectalis Ext sphincter Anorectal angle Abdo pressure Mucosal cushions
191
Ischiorectal fossa boundaries
Bae = perineal body, muscle of urogenital diaphragm, sacrotuberous lig and gluteus maximus Medial wall = ext anal sphincter of anal canal, sloping levator ani muscles Lateral wall = ischial tuberosity with obturator internus Sharp apex = where medial and lateral walls meet
192
How do the 2 ischiorectal fossae communicate
Posteriorly, down in retrosphincteric space within the anococcygeal Lig
193
Where is the pudendal canal
Lower lateral wall of ischioanal fossa, overlies obturator internus and medial side of ischial tuberosity Formed by splitting obturator fascia Conducts from lesser sciatic notch to deep perineal pouch above perineal membrane
194
What is in the pudendal canal
Pudendal N Internal pudendal vessels
195
What is the perineal body
Central tendon of perineum A fibromuscular mass to which multiple muscles gain attachment and within they decussate
196
What muscles attach to perineal body
External anal sphincter Pubovaginalis, pubourethralis Part of levator ani Bulbospongiosus Superificial and deep transverse perineal musclesq=
197
What forms the deep perineal space of the male urodiaphragm
Superior fascia and inferior fascial (aka perineal membrane)
198
What is within deep perineal space
Membranous urethra Internal pudendal vessels Dorsal n of penis Perineal n at the sides Paried bulbo urethral glands Sphincter urethrae Deep transverse perineal muscles
199
What supplies the external urethral sphincter (sphincter urethrae) in men
Perineal branch of pudendal n
200
What forms colles or superficial perineal fascia
Scarpas fascia continuation of abdominal wall
201
What are the superficial perineal muscles in men
Bulbospongiosus Ischiocavernosus Superficial transverse perineal m
202
What n supplies bulbospongiosus m
Perineal branch of pudendal N (S2,3)
203
What n supplies ischocavernosus m
Perineal branch of pudendal N (S2,3)
204
What n supplies superificial transverse perineal M
Perineal branch of pudendal N S2,3
205
How does the internal pudendal A reach the deep perineal pouch, and what are its relationship to other vessels it travels with
Passes through pudendal canal Dorsal N is above it Perineal n below it
206
Internal pudenda A branches
Perineal branch Artery to the bulb Deep artery to penis Dorsal artery
207
What are the terminal branches of pudendal Nerve
Dorsal N of penis/clitoris Perineal N
208
Aspects of the penis
Root - bulb & crus Body Glans penis
209
What are the parts of the bulb of the penis and what do they do
Crus - attaches to perineal memrbane and ischiopubic rami, receives deep artery of the penis; continues as corpus cavernosum Bulb becomes corpus spongiosum
210
What are the features of a transversely sliced penis
2x corpus cavernosum 1x corpus spongiosum, which contains urethra (spongy)
211
What surrounds the corpora of the penis
Tunica albuginea, and then outside of this, there is the deep fascia of the penis (Buck’s fascia)
212
What vessels lie deep to the deep fascia of the penis (Bucks)
Deep dorsal V, A and nerve
213
Blood supply of the penis
Deep artery of the penis Dorsal artery Artery to the bulb *all are branches of internal pudendal A
214
Venous return of the penis
Mostly via deep dorsal vein, some via superificial dorsal vein into the vesicoprostatic venous plexus
215
Lymph drainage of the penis
Skin = superficial inguinal nodes Glans and corpora = deep inguinal nodes
216
Nerve supply of penis
Skin = posterior scrotal and dorsal N (from pudendal N) S2 is the dermatome Ejactulation for bulbocavernosum and ischiocavernosum is perineal N (from pudendal) SNS from L1 via sup and inf hypogastrics for ejaculation PSNS via pelvic splanchnics for erection
217
What forms erection (nervous system)
PSNS (via pelvic splanchnics)
218
What forms ejaculation (nervous system)
SNS and somatic, from T11-L2
219
What are the sections of the male urethra
20cm in length, 3 parts Prostatic Membranous Spongy
220
What epithelium lines the urethra
Transitional to navicular fossa Then stratified squamous
221
Narrowest part of male urethra
External meatus
222
What nerves supply male urethra
Perineal Inf hypogastric plexus
223
Layers of the scrotum
Skin Dartos Ext spermatic fascia Cremasteric Internal spermatic fascial Testis with tunica vaginalis (parietal, visceral) Tunica albuginea
224
Blood supply of scrotum
Superficial and deep ext pudendal A (from femoral) Scrotal branches of perineal A (internal pudendal)
225
Lymph drainage of scrotum
Superficial inguinal nodes
226
Nerve supply to scrotum
Ant 1/3 = ilioinguinal and genital branch of genitofemoral Post 2/3 = scrotal branch of perineal (S3), posterior cutaneous femoral N (S2)
227
Joints of the pelvis
Sacroiliac Sacrococcygeal Pubic symphysis
228
Ligaments of the pelvis
Sacrotuberous Sacrospinous Iliolumbar lig
229
What type of joints is SI joint
Synovial joint
230
What ligaments support SI joint
Anterior & posterior SI ligaments Interosseous sacroiliac lig
231
What type of joint is sacrococcygeal
Symphysis
232
What are the ligs support sacrococcygeal joint
Anterior and posterior sacrococcygeal lig Lateral sacrococcygeal lig (forms the foramen for ant rami of 5th sacral N)
233
What type of joint is pubic symphysis
Secondary cartilaginous Each side covered with hyaline cartilage and a fibrocartilage disc b/w
234
What reinforces pubic symphysis
Superior pubic lig Arcuate pubic lig (below)
235
What does sacrotuberous attach to
Sacrum, PSIS, PIIS and transverse tubercle of sacrum to ischial tuberosity
236
What are the attachments of sacrospinous lig
Lower sacrum and coccyx to spine of ischium
237