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GSSE anatomy > Pelvis > Flashcards

Pelvis Flashcards

1
Q

Muscles of posterior abdominal wall

A

Psoas major
Quadratus lumborum
Iliacus

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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

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3
Q

What emerges from lat aspect of psoas major

A

Iliohypogastric
Ilioinguinal
Lateral femoral cutaneous n
Femoral N

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4
Q

Action of psoas major

A

Hip flexor
Lateral flexor of vertebral column

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5
Q

Nerve supply to psoas major

A

L1-3, mainly L2

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6
Q

Origin & insertion of psoas major

A

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

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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

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8
Q

What runs behind the lateral arcuate lig

A

The subcostal neurovascular bundle

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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)

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10
Q

Nerve supply of iliacus

A

Femoral, L2/3

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11
Q

What is the thoracolumbar fascia

A

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

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12
Q

Abdominal aorta starts

A

T12, b/w crura of diaphragm

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13
Q

Abdo aorta ends

A

L4, divides into 2 common iliac A

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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

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15
Q

Where does the renal A commence

A

L2

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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

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17
Q

How many lumbar As are there

A

4 in number

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18
Q

What do the lumbar arteries give off

A

Posterior and spinal A

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19
Q

Where do common iliac A begin

A

L4, to the L of midline

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20
Q

What crosses the L common iliac

A

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

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21
Q

What does the external iliac A give off

A

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

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22
Q

IVC starts….

A

L5, behind R common iliac A

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23
Q

Which aspects of IVC have valves

A

Only the gonadal V

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24
Q

What does each common iliac vein receive

A

Iliolumbar V
Lateral sacral V
Median sacral V

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25
Q

What are the tributaries to the IVC

A

Common iliac V
Lumbar V
Gonadal V
Renal V
Suprarenal V

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26
Q

Subcostal N and journey

A

T12, from thorax, behind lateral arcuate lig

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27
Q

What are the branches of the lumbar plexus

A

L1 = ilioinguinal, iliohypogastric
L1,2 = genitofemoral
L2,3 = lateral femoral cutaneous *post div
L2,3,4 = femoral (post)
L2,3,4 = obturator (ant)

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28
Q

iliohypogastric supplies

A

Skin in upper buttock
Suprapubic skin

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29
Q

Ilioinguinal nerve supply

A

Ant 1/3rd of scrotum, penis, upper part of groin

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30
Q

Genitofemoral nerve supply

A

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

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31
Q

Lateral cutaneous nerve of the thigh supply

A

L2,3
Iliac fascia, parietal peritoneum of iliac fossa
Lateral side of thigh to knee

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32
Q

Femoral N branches

A

N to pectineus
N to sartoris
N to rectus femoris
N to vatus lateralis, intermedius, medialis
Saphenous n

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33
Q

Saphenous n supply

A

Skin over subcutaneous surface of tibia

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34
Q

Obturator division

A

Anterior , posterior (over adductor brevis)

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35
Q

Anterior div of obturator nerve supplies

A

Adductor brevis
Adductor longus
Gracilis
Medial thigh cutaneously

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36
Q

Post div of obturator nerve supplies

A

Obturator externus
Adductor magnus

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37
Q

What is the order the vessels in obturator foramen

A

Nerve
Artery
Vein

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38
Q

SNS to the pelvis

A

Coeliac plexus
Lumbar trunk

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39
Q

Psns of pelvis

A

Vagus
Pelvic splanchnic, joins inferior hypogastric plexus

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40
Q

What runs in the white ramus communicans

A

Sympathetic preganglionic fibres

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41
Q

What runs in the grey ramus communicans

A

Sympathetic post ganglionic fibres

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42
Q

Posterior relations of kidney

A

Diaphragm
Quadratus lumborum
Psoas
Transversus abdominis
Subcostal V
Subcostal A
Subcostal N
Iliohypogastric N
Ilioinguinal N

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43
Q

Anterior relations of R kidney

A

Peritoneum of hepatorenal pouch
2nd part of duodenum
Hepatic flexure

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44
Q

Anterior relations of L kidney

A

Peritoneum of lesser sac
Peritoneum of greater sac
Body of pancreas, splenic vessels
Splenic flexure

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45
Q

Where does the perinephric fat lie

A

Outside of renal capsule, surrounded by renal fascia

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46
Q

Blood supply to the kidneys

A

Renal arteries, L2

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47
Q

Order of vessels at renal hilum

A

Renal V most anterior
Renal A
Ureter most posterior

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48
Q

Lymph drainage of kidney

A

Para-aortic nodes at L2

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49
Q

Nerve supply of kidney

A

Sympathetic preganglionic cells in T12-L1 and they send preganglionic fibres to thoracic and lumbar splanchnic nerves

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50
Q

How long is the ureter

A

25cm

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51
Q

Narrowest points of ureter

A

Pelvoureteric junction
Pelvic brim
Vesicoureteric junction

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52
Q

Where does the ureter run

A

Arise most post structure in renal hilum
Along tips (medially) of transverse processes
Crosses pelvic brim in sacroiliac joints

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53
Q

What crosses the L ureter

A

Gonadal vessels
L colic vessels
Apex of sigmoid colon

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54
Q

What crosses R ureter

A

Gonadal vessels
R colic vessels
Ileocolic vessels
Root of mesentry

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55
Q

Blood supply of ureter

A

Upper - ureteric branch of renal A
Middle - aorta, gonadal, common iliac, internal iliac A
Lower - branches of inferior and superior vesical and uterine arteries

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56
Q

Lymph drainage of ureters

A

Abdo portion - para-aortic nodes
Pelvic - common iliac, internal iliac LN

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57
Q

Nerve supply of ureter

A

Sympathetic fibres from t10-l1 via coeliac and hypogastric plexus
PSNS fibres from pelvic splanchnic nerves

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58
Q

Development of ureters

A

Mesodermal origin
Ureteric buds from caudal end of mesonephric duct

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59
Q

Features of R suprarenal gland

A

Pyramidal
Lies on diaphragm
Enroaches front of R kidney
Anterior surface overlapped by IVC
In contact with bare area of liver

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60
Q

Features of L suprarenal gland

A

Crescenteric
Medial border of L kidney to above hilum
Lies on L crus

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61
Q

Where do the suprarenal glands lie

A

L = L crus
R = on diaphragm

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62
Q

Lymph drainage of suprarenals

A

Para-aortic nodes

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63
Q

Nerve supply of suprarenals

A

Myelinated preganglionic sympathetic fibres from splanchnic nerves via coeliac plexus (synapse directly with medullary cells

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64
Q

structure of suprarenal gland

A

Medulla
Cortex = 3 zones

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65
Q

What do the components of medulla form

A

Cortex
- zona glomerulosa = aldosterone
- zona fasciculata = cortisol
- zona reticularis = androgen hormones
Medulla
- A, NA, dopamine

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66
Q

Internal iliac artery divisions

A

Posterior - 3
Anterior - 9

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67
Q

Where does the internal iliac arise

A

At bifurcation of common iliac, at L4

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68
Q

Branches of the internal iliac a

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

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69
Q

Posterior divisions of int iliac A

A

Uterine, umbilical, sup vesical
Inferior gluteal, inf vesical, internal pudendal
Obturator a, middle rectal, vaginal A

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70
Q

Ant divisions of internal iliac A

A

Iliolumbar
Lateral sacral
Superior gluteal A

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71
Q

Pelvic brim

A

Pubic crest, pectineal line of pubis, arcuate line of ilium, ala and promontory of sacrum

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72
Q

What angle does the pelvic brim lie at

A

60 degrees

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73
Q

Sex differences b/w pelvis

A

Female = broader, slender
Less acute subpubic angle
Less indentation from promontory
Pubic arch is wider

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74
Q

Muscles of the pelvis

A

Piriformis
Obturator internus
Levator ani
- iliococcygeus
- pubococcygeus
Coccygeus

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75
Q

Piriformis origin and insert

A

Middle 3 pieces of sacrum to insert sup aspect of greater trochanter

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76
Q

Obturator internus origin and insert

A

Obturator membrane, bony margins of foramen and ischial tuberosity
Insert with sacrotuberous lig to ischial tuberosity

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77
Q

What makes up the pelvis floor

A

Iliococcygeus
Pubococcygeus

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78
Q

Where does the iliococcygeus origin

A

Posterior half of tendinous arch
Pelvic surface of ischial spine

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79
Q

Pubococcygeus components

A

Puborectalis
Pubourethralis
Pubovaginalis

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80
Q

Nerve supply of levator ani

A

Sacral plexus branches of S3/4

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81
Q

What makes up levator ani

A

Pubcoccygeus
Iliococcygeus

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82
Q

Origin of coccygeus

A

Tip of ischial spine => coccyx and lowest part of sacrum

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83
Q

Nerve supply of coccygeus

A

Sacral plexus branches S3/4

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84
Q

Blood supply of rectum

A

Superior rectal A
Middle rectal
Inferior rectal
Median sacral A

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85
Q

Venous return of rectum

A

Internal rectal plexus and external rectal plexus forms potential site of portosystemic anastomosis
As some into IMV, some into internal pudendal V

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86
Q

Nerve supply of the rectum

A

Sympathetic - from inferior mesenteric plexus
PSNS - pelvic splanchnics from S2,3,4 via inferior hypogastric plexus (motor to rectal M

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87
Q

Urinary bladder surfaces

A

Apex
Base
Inferolateral surface
Neck
Superior surface

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88
Q

What attaches to apex of bladder

A

Urachus => medial umbi lig => median umbi fold

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89
Q

What aspects of bladder are covered by peritoneum

A

Base (upper portion)
Superior surface

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90
Q

What is the space infront of inferolateral surfaces of bladder

A

Behind pubic symphysis = retropubic space

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91
Q

What is the lowest part of bladder

A

Neck

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92
Q

Internal surface of bladder features

A

Trabeculae
Trigone

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93
Q

What is the trigone

A

2 ureteral orifice and internal urethral orifice below

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94
Q

Blood supply of bladder

A

Superior and inferior vesical A (from Internal Iliac A)

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95
Q

Lymph drainage of bladder

A

External iliac LN
Internal, obturator

96
Q

Nerve supply of bladder

A

PSNS via pelvic splanhnic nerves
SNS from L1,2 via sup and inf hypogastric plexus

97
Q

How is the control of micturition

A

Bladder distends -> afferent impulse via pelvic splanchnics -> stimulate efferent to contract detrusor

High centres inhibit this

98
Q

Prostate surfaces

A

Base
Apex
Anterior
Posterior
Inferolateral

99
Q

What is the highest part of the bladder

A

Base!!!!!

100
Q

What is the lowest part of prostate

A

Apex

101
Q

What separates prostate and rectum

A

Denovilliers fascia

102
Q

Where do the ejaculator ducts enter the prostate

A

Posterior surface, just below bladder, and pass to open into prostatic urethra

103
Q

Zones of the prostate

A

Peripheral
Central
Transition

104
Q

Features of peripheral zone of prostate

A

Surrounds central zone
Commonest site of prostate cancer

105
Q

Most frequent zone for prostate cancer

A

Peripheral zone

106
Q

Where is the zone of BPH

A

Transitional zone

107
Q

Blood supply of prostate glands

A

Inferior vesical A => prostatic branch
Also, middle rectal, internal pudendal
Veins run into a plexus, thus joining vesicoprostatic plexus

108
Q

Lymph drainage of prostate

A

Internal iliac nodes

109
Q

Nerve supply of prostate

A

Acini - PSNS from pelvic splanchnics via inferior hypogastric plexus
Muscle fibres that assist with ejaculation are under SNS from inferior hypogastric plexus

110
Q

What are the features of seminal colliculus

A

Prostatic utricle
Ejaculator ducts (lat to prostatic utricle)

111
Q

What is the prostatic utricle

A

Remnant of paramesonephric ducts

112
Q

Blood supply to ductus deferens

A

Superior vesical A => artery to ductus deferens (note: anastomoses with testicular)

113
Q

Blood supply to seminal vesicle

A

A to seminal vesicles
From inferior vesicle and middle rectal A

114
Q

Nerve supply of ductus deferens & seminal vesicles

A

Smooth muscles of ductus,seminal vesicles by inferior hypogastric plexus (motor symp fibres)

115
Q

Features of the uterus

A

Fundus
Body
Cervix

116
Q

Where do the uterine tubes enter uterus

A

At the cornu

117
Q

What encloses the body of peritoneum

A

Broad ligament

118
Q

What covers post surface of uterus

A

Rectouterine pouch of douglas

119
Q

What are the aspects of uterine tube

A

Isthmus
Ampulla
Infundibulum

120
Q

Blood supply of uterus & uterine tubes

A

Uterine A (int iliac) gives branches to cervix and vagina, anastomosis with ovarian A

121
Q

Lymph drainage from cervix

A

External and internal iliac LN, sacral nodes

122
Q

Lymph drainage of uterus

A

Upper part of body, fundus, uterine tube to para-aortic
Lower part of body = ext iliac nodes

123
Q

Nerve supply to uterus & uterine tubes

A

Inferior hypogastric plexus

124
Q

How is pain from the cervix transferred

A

Via pelvic splanhnic nerves w/ symphathetic nerves to T10 - L1

125
Q

What is the normal position of the uterus

A

Anteflexed

126
Q

What is the most fixed part of the uterus

A

The cervix, due to pelvic diaphragn, visceral pelvic fascia & peritoneal attachments

127
Q

What are the features of broad lig

A

Mesoovarian, mesosalpinx
No supportive features
Holds the suspensory lig of the ovary

128
Q

Round lig of the ovary journey

A

From junction of uterus & uterine tube to deep inguinal ring, to labium majus

129
Q

What blood supply of round lig of uterus

A

Inferior epigastric A

130
Q

Transverse cervical lig attachments

A

Cervix & vaginal fornix to lateral wall of pelvis

131
Q

Uterosacral lig attachments

A

From post cervix below peritoneum embrancing retrouterine pouch and rectum => front of sacrum

132
Q

What is the role of uterosacral lig

A

Keeps cervix braced backwards against forward pull of round lig
Maintains uterine anteflexion

133
Q

What does the lig of ovary attach

A

Ovary to body of uterus

134
Q

Where does the lig of the ovary attach

A

To lower pole of ovary, to the uterus

135
Q

Blood supply to ovary

A

Ovarian A, direct branch of abdo aorta

136
Q

How does the ovarian A reach the ovary

A

Via suspensory ligament

137
Q

Lymph drainage of ovary

A

Para-aortic node
Some via round lig to inguinal nodes

138
Q

Nerve supply to ovary

A

SNS from aortic plexus
PSNS via inferior hypogastric plexus

139
Q

Vagina fornices

A

Anterior, posterior and lateral

140
Q

What part of vagina has peritoneal covering

A

Posterior fornix, via rectouterine pouch

141
Q

Relationship between ureter and vagina

A

Ureter at first adjacent to lateral fornix, then passes across the front of anterior fornix

142
Q

Where are the bartholins glands (vestibular)

A

Vestibule of vagina, below hymen, in posterolateral wall

143
Q

Blood supply of vagina

A

Vaginal A(int iliac)
Support from uterine, inf vesical and middl rectal

144
Q

Venous drainage of vagina

A

Via plexus on pelvic floor to drain internal iliac V

145
Q

Lymph drainage of vagina

A

Ext, internal iliac nodes

146
Q

Nerve supply of vagina

A

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
Q

Female urethral length and features

A

4cm, only has external urethral meatus

148
Q

Blood supply of urethra

A

Upper = inf vesical
Lower = vaginal and internal pudendal A

149
Q

Lymph drainage of urethra

A

Int, ext iliac nodes

150
Q

Nerve supply of urethra

A

Inf hypogastric plexus and perineal branch of pudendal n

151
Q

What is anterior to the internal iliac vessels

A

Ureter, fallopian tube, ovary

152
Q

Posterior relations to internal iliac vessels

A

Internal iliac vein, sacral plexus, SI

153
Q

Lateral relations to internal iliac artery

A

Ext iliac vessels, obturator n, psoas major

154
Q

Medial relations of internal iliac A

A

Parietal peritoneum
Small bowel

155
Q

Where does the internal iliac begin

A

L5/S1 at pelvic brim

156
Q

Divisions of the int iliac A

A

Post - 3
Ant - 9 ish

157
Q

Terminal branch of anterior division of internal iliac

A

Internal pudendal
Inferior gluteal

158
Q

Post branches of int iliac A

A

Iliolumbar
Superior gluteal
Lateral sacral

159
Q

Anterior divisions of int iliac A

A

Umbi
Sup vesical
Inf vesical
Uterine
Vaginal
Middle rectal
Inferior gluteal
Internal pudendal
Obturator

160
Q

Where does the int iliac V start

A

In the greater sciatic notch

161
Q

Where does int iliac V join ext iliac V

A

On medial surface of psoas

162
Q

Tributaries of the int iliac V

A

(Apart from corresponding arterial veins)
Rectal venous plexus
Prostatic venous plexus
Uterine venous plexus
Vaginal venous plexus

163
Q

What communicates the internal iliac V with the vertebral venous plexus

A

Lateral sacral V

164
Q

What forms the sacral plexus

A

Lumbosacral trunk (l4,5)
Upper 4 ant rami of sacrum

165
Q

Divisions of sacral plexus

A

Anterior divisions
Posterior diviisons

166
Q

Anterior divisions of sacral plexus

A

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
Q

What does n to obturator internus supply

A

Obturator internus
Super gemellus

168
Q

Nerve to quad femoris supplies

A

Inf gemellus, hip joint
Quadratus femoris

169
Q

Perineal branch of S4 supplies

A

Puborectalis, pubourethralis, pubovaginalis
Perianal skin

170
Q

Pelvic splanchnic nerve component

A

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
Q

Post divisions of sacral plexus

A

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
Q

What lies anterior to sacral plexus

A

Lateral sacral A + ureter (which passes in front of ALL parietal pelvic peritoneum and viscera)

173
Q

What passes superior to sacral plexus

A

Sup gluteal A

174
Q

What passes inf to sacral plexus

A

Inf gluteal A

175
Q

What emerging nerves are apart of the inferior hypogastric plexus

A

SNS (via sup hypogastric plexus, half are preganlionic, others are sacral symp fibres)
PSNS (from pelvic splanchnics)

176
Q

Where does the inferior hypogastric plexus lie in the male pelvis

A

Lateral to rectum
Posterolateral to seminal vesicle, prostate
Posterior to bladder

177
Q

Where does the inferior hypogastric plexus lie in female pelvis

A

Lateral to rectum, cervix, vaginal fornix
Posterolateral to blader

178
Q

Cutaneous nerve supply of anal region

A

Inferior rectal N (S3,4)
Perineal branch of S4
Coccygeal plexus S5

179
Q

Urogenital cutaneous nerve supply

A

Ilioinguinal N
Dorsal nerve of pudenal
Posterior femoral cutaneous N
Perineal N of pudendal

180
Q

What type of muscle (circular, longitudinal) makes up the anal region

A

ALL circular

181
Q

Components of ext anal sphincter

A

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
Q

Internal anal sphincter formed fro

A

Thickening of inner circular muscle of rectum

183
Q

What is the pectinate line

A

The site of anal valves, which are formed from folds of anal columns, which has glands and sinuses

184
Q

Difference in epidermis of pectinate line

A

Superior to pectinate line = columnar
Inferior = stratified squamous

185
Q

Arterial supply to anal region

A

Above pectinate = superior rectal A (from IMA); medial sacral (aorta), middle rectal (from int iliac)

Lower = inferior rectal (int pudendal A)

186
Q

Venous drainage of anal region

A

Upper = via superior rectal & IMV to portal system

Lower = via inf and middle rectal V to int iliac V

Site of portosystemic anastomosis

187
Q

Lymph drainagae of anal canal

A

Upper = lymph of rectal
Lower = superficial inguinal nodes

188
Q

Nerve supply of anal canal

A

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
Q

What is the nerve that controls external anal sphincter

A

Inferior rectal branch of pudendal N

190
Q

What factors (anatomical) maintain continence

A

Puborectalis
Ext sphincter
Anorectal angle
Abdo pressure
Mucosal cushions

191
Q

Ischiorectal fossa boundaries

A

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
Q

How do the 2 ischiorectal fossae communicate

A

Posteriorly, down in retrosphincteric space within the anococcygeal Lig

193
Q

Where is the pudendal canal

A

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
Q

What is in the pudendal canal

A

Pudendal N
Internal pudendal vessels

195
Q

What is the perineal body

A

Central tendon of perineum

A fibromuscular mass to which multiple muscles gain attachment and within they decussate

196
Q

What muscles attach to perineal body

A

External anal sphincter
Pubovaginalis, pubourethralis
Part of levator ani
Bulbospongiosus
Superificial and deep transverse perineal musclesq=

197
Q

What forms the deep perineal space of the male urodiaphragm

A

Superior fascia and inferior fascial (aka perineal membrane)

198
Q

What is within deep perineal space

A

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
Q

What supplies the external urethral sphincter (sphincter urethrae) in men

A

Perineal branch of pudendal n

200
Q

What forms colles or superficial perineal fascia

A

Scarpas fascia continuation of abdominal wall

201
Q

What are the superficial perineal muscles in men

A

Bulbospongiosus
Ischiocavernosus
Superficial transverse perineal m

202
Q

What n supplies bulbospongiosus m

A

Perineal branch of pudendal N (S2,3)

203
Q

What n supplies ischocavernosus m

A

Perineal branch of pudendal N (S2,3)

204
Q

What n supplies superificial transverse perineal M

A

Perineal branch of pudendal N S2,3

205
Q

How does the internal pudendal A reach the deep perineal pouch, and what are its relationship to other vessels it travels with

A

Passes through pudendal canal
Dorsal N is above it
Perineal n below it

206
Q

Internal pudenda A branches

A

Perineal branch
Artery to the bulb
Deep artery to penis
Dorsal artery

207
Q

What are the terminal branches of pudendal Nerve

A

Dorsal N of penis/clitoris
Perineal N

208
Q

Aspects of the penis

A

Root - bulb & crus
Body
Glans penis

209
Q

What are the parts of the bulb of the penis and what do they do

A

Crus - attaches to perineal memrbane and ischiopubic rami, receives deep artery of the penis; continues as corpus cavernosum

Bulb becomes corpus spongiosum

210
Q

What are the features of a transversely sliced penis

A

2x corpus cavernosum
1x corpus spongiosum, which contains urethra (spongy)

211
Q

What surrounds the corpora of the penis

A

Tunica albuginea, and then outside of this, there is the deep fascia of the penis (Buck’s fascia)

212
Q

What vessels lie deep to the deep fascia of the penis (Bucks)

A

Deep dorsal V, A and nerve

213
Q

Blood supply of the penis

A

Deep artery of the penis
Dorsal artery
Artery to the bulb
*all are branches of internal pudendal A

214
Q

Venous return of the penis

A

Mostly via deep dorsal vein, some via superificial dorsal vein into the vesicoprostatic venous plexus

215
Q

Lymph drainage of the penis

A

Skin = superficial inguinal nodes
Glans and corpora = deep inguinal nodes

216
Q

Nerve supply of penis

A

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
Q

What forms erection (nervous system)

A

PSNS (via pelvic splanchnics)

218
Q

What forms ejaculation (nervous system)

A

SNS and somatic, from T11-L2

219
Q

What are the sections of the male urethra

A

20cm in length, 3 parts
Prostatic
Membranous
Spongy

220
Q

What epithelium lines the urethra

A

Transitional to navicular fossa
Then stratified squamous

221
Q

Narrowest part of male urethra

A

External meatus

222
Q

What nerves supply male urethra

A

Perineal
Inf hypogastric plexus

223
Q

Layers of the scrotum

A

Skin
Dartos
Ext spermatic fascia
Cremasteric
Internal spermatic fascial
Testis with tunica vaginalis (parietal, visceral)
Tunica albuginea

224
Q

Blood supply of scrotum

A

Superficial and deep ext pudendal A (from femoral)
Scrotal branches of perineal A (internal pudendal)

225
Q

Lymph drainage of scrotum

A

Superficial inguinal nodes

226
Q

Nerve supply to scrotum

A

Ant 1/3 = ilioinguinal and genital branch of genitofemoral

Post 2/3 = scrotal branch of perineal (S3), posterior cutaneous femoral N (S2)

227
Q

Joints of the pelvis

A

Sacroiliac
Sacrococcygeal
Pubic symphysis

228
Q

Ligaments of the pelvis

A

Sacrotuberous
Sacrospinous
Iliolumbar lig

229
Q

What type of joints is SI joint

A

Synovial joint

230
Q

What ligaments support SI joint

A

Anterior & posterior SI ligaments
Interosseous sacroiliac lig

231
Q

What type of joint is sacrococcygeal

A

Symphysis

232
Q

What are the ligs support sacrococcygeal joint

A

Anterior and posterior sacrococcygeal lig
Lateral sacrococcygeal lig (forms the foramen for ant rami of 5th sacral N)

233
Q

What type of joint is pubic symphysis

A

Secondary cartilaginous
Each side covered with hyaline cartilage and a fibrocartilage disc b/w

234
Q

What reinforces pubic symphysis

A

Superior pubic lig
Arcuate pubic lig (below)

235
Q

What does sacrotuberous attach to

A

Sacrum, PSIS, PIIS and transverse tubercle of sacrum to ischial tuberosity

236
Q

What are the attachments of sacrospinous lig

A

Lower sacrum and coccyx to spine of ischium

237
Q
A

GSSE anatomy (8 decks)

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