Pelvis Flashcards
Scrotal layers
Some Damned Examiner Called It The Testes
Skin
Dartos
External fascia
Cremaster
Internal fascia
parietal layer of Tunica vaginalis
Testes
Blood supply to prostate
Inferior vesical artery (from prostatovesical from internal pudendal + inferior gluteal branches of internal iliac artery)
Which vessel run close to deep inguinal ring
inferior epigastric artery (branch of external iliac)
Sensation to anterior scrotum
ilioinguinal nerve
Sensation to posterior scrotum
pudendal nerve
True vs false pelvis
Pelvic inlet
Posteriorly: S1, Ala of sacrum (wing)
Anteriorly: pubic symphysis
What forms pelvic walls
Sacrospinous and sacrotuberous ligaments
Piriformis and obturator internus muscles
Pelvic floor components
Mainly: levator ani
also:
- coccygeus muscle
- fascia
Muscles of levator ani
pubococcygeus
puborectalis
iliococcygeus
Innervation of levator ani
Pudendal S2-S4
Peritoneum cover in pelvis
Urogenital triangle dermatomes in men and women
Components of pelvic bone
Ilium
Ischium
Pubis
Difference between colon and rectum laproscopically
Rectum lacks DISTINCT taeniae coli muscles, omental appendices and sacculations (haustra)
Anal canal anatomy
Anal mucosa
Above pectinate: columnar
Below pectinate: Non keratinised stratified squamous (anal pecten)
Below anocutanous line/white line: stratified squamous
Structures that cross ureters in pelvis
Male: ductus deferens
Female: uterine artery
Arterial supply to bladder
Inferior/Superior vescical arteries
(branches of internal iliac)
Venous supply of bladder
vescicoprostatic or vescicouterine plexus
(drains into internal iliac vein)
Parts of male urethra
Pre prostatic
Prostatic
Membranous
Spongy
Pre-prostatic urethra features
Contains internal sphincter, which may contract and prevent retrograde ejaculation
Prostatic urethra features
Wider than pre-prostatic
Urethral crest: midline fold of mucosa
Seminal colliculus: enlarged section of urethral crest, used to determine prostate position during TURP
Membranous urethra features
Narrowest part of urethra
External urethral sphincter
Spongy urethra features
Surrounded by corpus spongiosum
Navicular fossa: the end dilation
Bulbourethral glands insert here
Mucosa of urethra
Transitional near bladder
Squamous near external meatus
Testicular anatomy
Seminefrous tibules->straight tubules-> rete testis -> efferent tubules-> head/body/tail of epididymus- vas deferens
Tunica albuginea
Tunica vaginalis
Peri-rectal fascia
Waldeyer’s fascia: posterior
Denoviller’s: anterior
Branches of posterior trunk of internal iliac artery
iliolumbar
Lateral sacral
Superior gluteal
Branches of anterior trunk of internal iliac
Umbilical
Superior vesical
Inferior vesical
Middle rectal
Obturator
Internal pudendal
Inferior gluteal
Roof of perineum
levator ani
Borders of perineum
Ishial spine
coccyx
pubic symphysis
Which part of perineum does the perineal membrane cover
Urogenital triangle
Function of perineal membrane
Attachment for external genitalia
Anatomy of penis
Corpora cavernosa: attached to urogenital triangle by crura (legs)
Corpus spongiosum: surrounds urethra, and anchors to perineal membrane. Forms bulb of penis, body of penis and glans
Ligaments of penis
Suspensory ligament: attached to pubic symphysis
Fundiform ligament: attached to linea alba
Arterial supply to penis
Internal pudendal artery
Muscles of superfical perineal pouch
Ischicavernous
Bulbospongiosus
Superficial transverse perineal
Innervation of superficial perineal muscles
pudendal nerve
Function of ischicavernosus
Move blood from crura into body of erect penis
Function of bulbospongiosus
removal of residual urine from urethra after urination
Pulsatile emission of semen during ejaculation
Function of superficial transverse perineal
Stabilises perineal body
Superficial fascia of the urogenital triangle attachments
Posteriorly to perineal membrane: doesnt extend into anal triangle
Anteriorly ischiopubic rami: does not extend into thigh
This stops spread of infection into thigh or anal triangle, but allows movement into peritoneum out of perineum
Pudendal canal content
Pudendal nerve
Internal pudendal artery
Veins
What forms the pudendal canal
Fascia of obturator internus
Branches of pudendal nerve
Inferior rectal
Perineal
Dorsal nerve
Inferior rectal innervates
External anal sphincter
Levator ani
Perineal nerve innervates
S: posterior scrotal skin
M: urogenital triangle muscles
Dorsal nerve of penis innervates
Sensory to penis
Lymph drainage of perineum
Deep parts: internal iliac
Superficial parts: superior inguinal
Glans of penis: deep inguinal/ external iliac
Testis: para-arotic
Spaces anterior and posterior to prostate
Anterior: cave of retzius
Posterior: dennovilliers
Difference between male and female pelvis
Female:
- wider, shallower,
- larger superior and inferior apertures,
- ischial tuberosities are farther apart
- sacrum less curved
- obturator foramen oval (vs round in M)
Bucks vs Dartos fascia of penis
