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MRCS Anatomy > Pelvis > Flashcards

Pelvis Flashcards

1
Q

Perineum - borders anatomical

A 
Anterior - pubic symphysis
Posterior - tip of coccyx
lateral - inferior pubic rami/inferior ischial rami, sacrotuberous ligament
roof - pelvic floor
base - skin & fascia
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2
Q

Perineum - borders - surface

A

Anterior - mons pubis in females, base of penis
laterally - medial surface of the thigh
posteriorly - superior end of intergluteal cleft

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3
Q

Content - anal triangle

A

Posterior half of perineum
Anal aperture
External anal sphincter
two ischioanal fossa

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4
Q

Content - urogenital triangle

A

Anterior half of perineum
deep perineal pouch
perineal membrane - perforated by urethra, provides attachment to superficial external genitalia
Superficial perineal pouch
Deep perineal fascia
superficial perineal fascia - continuous to the abdominal wall
SKin

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5
Q

Content of deep perineal pouch

A

part of urethra
external urethral sphincter
bulbourethral glands
deep transverse perineal muscles

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6
Q

Content of Superficial perineal pouch

A 
erectal tissue 
ischiocavernosus
bulbocavernosus
superficial transverse perineal muscles 
Greater vestibular gland
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7
Q

What is the Perineal body

A

Central point of perineum

attachment to pelvic floor muscles

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8
Q

Hip/pelvic bone

A 
Ilium
Pubis
Ischium
sacrum
coccyx
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9
Q

Pelvic girdle

A

Sacroiliac joint
sacrococcygeal symphysis
pubic symphysis

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10
Q

Borders of Pelvic inlet

A

Posterior - sacral promontory
lateral - arcuate line on the inner surface of ileum, pectineal line on the superior ramus
anterior - pubic symphysis

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11
Q

Borders of Pelvic outlet

A

Posterior - tip of coccyx
lateral - ischial tuberosity & sacrotuberous ligament
anteiror - pubic arch/ischiopubic rami

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12
Q

Sacrum

A

Fused vertebrae
Pevic surface - transverse line & promontory, anterior sacral foramina
Dorsal surface - media sacral crest (fused SP), lateral sacral crest gives attachment to sacrotuberous ligament

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13
Q

Coccyx

A

Fused vertebrae
Caudal eminence
base has coccygeal cornu
attachment to levator ani

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14
Q

pelvic floor

A

Funnel shaped, attaches to the lesser pelvis and support abdominopelvic viscera
has 2 hiatus - urogenital and rectal
levator ani, coccygeus

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15
Q

Levator ani

A

3 paired muscles; S2-4
Pubococcygeus, Puborectalis, Iliococcygeus
Anterior - pubic body
Laterally - obturator internus/tendinous arch
Posterior - ischial spine

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16
Q

Puborectalis

A

U shaped sling
passed urogenital hiatus, around anal canal
Creates anorectal angle & anorectal junction
prevent defaecation

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17
Q

Pubococcygeus

A

Pubic to tendinous arch
travels around urogenital hiatus and attaches to coccyx and anococcygeal ligament
some loop around prostate/vagina, some terminate at perineal body

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18
Q

Iliococcygeus

A

ischial spine to tendinous arch

then attaches to coccyx and anococcygeal ligament

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19
Q

Coccygeus

A

Smaller posterior muscle

Ischial spine to sacrum/coccyx along sacrospinous ligaments

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20
Q

Ureter

A

25cm long, retroperitoneal
Starts at renal pelvis - uteropelvic junction
at SIJ, crosses pelvic brim & crosses CIA
Runs along the lateral wall and turn anteromedially at ischial spine
Enters ureter in oblique manner
Supplied by renal artery, CIA, vesical arteries

21
Q

Urinary bladder

A

anterior organ in pelvic cavity
Apex - connected to umbilicus via median umbilical ligament (remnant of urachus)
Body
Fundus - trigone (smooth wall location where ureters & urethra are found)
Neck

22
Q

Muscles of bladder

A

Detrusor muscles - smooth muscles
internal urethral sphincter - autonomic
external urethral sphincter - voluntary control

23
Q

Neurovascular supply of bladder

A 
Superior vesical artery - IIA
Inferior vesical artery 
Sympathetic - hypogastric nerve (T12-L2)
Parasympathetic - pelvic S2-S4
Voluntary control - pudendal nerve S2-S4
Bladder stretch reflex - primitive reflex, stretch in bladder wall in detected and detrusor muscle contract through parasympathetic nerve
24
Q

urethra

A

lined with stratified columnar epithelium
Male:
preprostatic - internal urethral orifice to prostate
prostatic - has ejaculatory duct & prostatic duct
membranous - through pelvic flour and deep perineal pouch, has external urethral sphincter
spongy - through bulb and corpus spongiosum & external urethral orifice
Female - 4cm long, opens between labia minora (vestibule)

25
Penis
Root - superficial perineal pouch Body Glans Muscles - bulbospongiosus, ischiocavernosus ligaments - suspensory and fundiform supplied by dorsal, deep and bulbourethral arteries (internal pudendal artery)
26
Erectile tissue
Corpora cavernosa x2 - root = crus Corpus spongiosum - urethra passes through, root = bulb Covered by deep fascia of penis and tunica albuginea
27
Testes
In scrotum suspended by spermatic cord contains seminiferous tubules for spermatogenesis has 2 coverings - tunica vaginalis (peritoneum) and tunica albuginea (fibrous capsule)
28
Describe sperm pathway
``` seminiferous tubules tubulus rectus rete testis efferent tubules epididymis vas deferens seminal vesicles add semen, passes through cowpers gland ejaculatory duct urethra ```
29
Scrotum layers
``` Skin Dartos - fascia/muscle external spermatic fascia cremasteric fascia internal spermatic fascia tunica vaginalis tunica albuginea ```
30
Spermatic cord - content
3 arteries - testicular, vas, cremateric 2 nerves - genitofemoral nerve, autonomic nerve 4 others - pampiliform plexus, lymphatics, vas deferens, processes vaginalis
31
Prostate gland
Anatomical lobes - anterior, posteiror, lateral, medial Histological zone - central, transitional and peripheral Covered by capsule suppied by prostatic artery (IIA) drained via protastic venous plexus (IIV but also connects to batson venous plexus/internal vertebral venous plexus)
32
Bulbourethral gland
Also known as Cowper's Located posterior to membranous urethra Secretes mucus for neutralising urethra Enclosed within the external urethral sphincter
33
Seminal vesicles
located between bladder fundus and rectum Joins vas deferens to form ejaculatory duct it has pseudostratified columnar epithelium From mesonephric duct supplied by internal pudendal/inferior vesicle and middle rectal arteries - IIA
34
Vulva
``` Mons pubis - anterior to vulva Labia majora - labioscrotal swellings Labia minora - urethral folds Vestibule - external vaginal orifice & urethra Bartholin's gland Clitoris ```
35
Neurovascular supply to vulva
Pudendal artery & veins Anterior - ilioinguinal & genitofemoral nerve Posteiror - pudendal nerve & posterior cutaneous nerve of thigh
36
Vagina
``` approx 9cm long Stratified squamous epithelium lining Elastic lamina propria Fibromuscular layer Adventitia supplied by uterine and vaginal artery uterovaginal plexus within broad ligament ```
37
Cervix
Lower portion of uterus ectocervix - stratified non keratinising squamous epithelium Endocervix - simple columnar epithelium supplied by uterine artery
38
Uterus
Fundus, body and cervix Fundus has 3 layers - peritoneum, myometrium, endometrium 5 ligaments
39
Endometrium
Deep stratum basalis - unchanged during menstruation | Superficial stratum functionalis - oestrogen & progesterone sensitive
40
5 ligaments of uterus
Broad ligament - peritoneum, acts as mesentery (mesometrium - proximal part of round ligament, mesovarium, mesosalpinx) Round ligament - gubernaculum, from uterine horn to labia majora through inguinal canal Ovarian ligament Cardinal ligament - base of broad ligament, from cervix to lateral pelvic wall, contains uterine artery Uterosacral ligament Pubocervical ligament
41
Fallopian tubes
Transport and transfer ovum inner mucosa - ciliated columnar epithelium & peg cells Fimbriae - Infundibulum - Ampulla - Isthmus Supplied by uterine and ovarian artery
42
Ovaries
Develop from mesonephric ridge attached to posterior surface of broad ligament - mesovarium Produce oocytes and sex hormones 3 surface - Surface (cuboidal epithelium), cortex, medulla 2 ligaments - suspensory ligaments (contains NV structures) and ovarian ligament
43
Internal iliac artery
bifurcates from CIA at L5/S1 | Divides into anterior and posterior trunk at superior border of greater sciatic foramen
44
Anterior trunk
Obturator - adductors, passes through obturator foramen Umbilical - gives off superior vesical Inferior vesical - bladder, prostate, seminal vesicles uterine - cardinal ligament, crosses uterer superiorly and 1cm laterally vaginal middle rectal - anastomoses with SRA & IRA Internal pudendal - exits via greater sciatic foramen and enters again via lesser sciatic foramen Inferior gluteal - leaves via greater sciatic foramen, inferior to piriformis, supplies gluteus maximus
45
Posterior trunk
Iliolumbar - posterior abdominal wall Lateral sacral Superior gluteal - greater sciatic foramen, superior to piriformis - gluteus minimus, medius
46
External iliac vein
Continuation of femoral vein receives inferior epigastric and deep circumflex iliac veins Joins IIV to become CIV
47
Internal iliac vein
``` Formed by Superior & inferior gluteal Internal pudendal - inferior rectal Obturator lateral sacral middle rectal - drains prostate vesical uterine and vaginal ```
48
Common iliac vein
Formed at L5 | iliolumbar and middle sacral joins as well

MRCS Anatomy (8 decks)

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