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Anatomy - GSSE > Pelvis > Flashcards

Pelvis Flashcards

Question Bank

1
Q

Pelvic inlet boundaries

A

Bounded by pubic creast, pectineal line of pubis, arcuate line of ilium, ala of sacrum and posteriorly by sacral promontory

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2
Q

What muscles attach to the pubic crest?

A

Rectus abdominis External oblique aponeurosis

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3
Q

What attaches to the ilium

A

Rectus femoris Quadratus lumborum Lat dorsi

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4
Q

What transmits via the greater sciatic foramen

A

Above piriformis: superior gluteal nerve and vessels Below piriformis: inferior gluteal nerve and vessels, pudendal nerve and vessels, n to obturator internus, sciatic nerve

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5
Q

Structures passing through the lesser sciatic foramen

A

Medially: pudendal nerve, internal pudendal vessels Laterally: tendon of obturator internus, nerve to obturator internus

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6
Q

Borders of the lesser sciatic foramen

A

Lesser sciatic notch Sacrospinous lig Sacrotuberous lig

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7
Q

Ischial spine

A

Gives rise to coccygeus, superior gemellus m., attachment of sacrospinous ligament, n to obturator internus, pudendal n crosses behind

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8
Q

Borders of the inguinal canal

A

Internal oblique lateral part of anterior wall, fascia transversalis + conjoint tendon forms posterior wall, lacunar ligament is medial part of the floor

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9
Q

Where is the spermatic cord in relation to the lacunar ligament?

A

In erect position, spermatic cord is on its superoanterior surface

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10
Q

What is the conjoint tendon and where does it run?

A

Formed partly from aponeurotic fibres of the transversus muscle Attaches to superior pubic ramus, along pectineal line with a free inferolateral border

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11
Q

What area does the superficial inguinal lymph nodes drain?

A

Subcut tissues of the back below the waist, gluteal region and anal canal

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12
Q

Which branches of the lumbar plexus appear at the medial border of psoas major?

A

Obturator nerve Lumbosacral trunk

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13
Q

Which nerve supplies the skin over the root of the penis?

A

Ilioinguinal nerve

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14
Q

Define the lumbosacral trunk

A

Contributes to the sacral plexus, first appears medial to the psoas major, contributes fibres to the cutaneous nerve

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15
Q

What spinal levels contribute to the obturator nerve?

A

Anterior divisions of ventral rami of L2, L3 and L4

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16
Q

Where does the obturator nerve run?

A

Lies above the obturator vessles on lateral wall of pelvis, lateral to ureter thn pierces the medial border of the psoas

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17
Q

What does the obturator nerve supply?

A

Gracilis muscle, knee and hip joints. The posterior branch supplies the obturator externus muscle

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18
Q

What is an obturator hernia?

A

Rare hernia of the pelvic floor where pelvic or abdominal contents protrude through the obturator foramen. High mortality and morbidity. More common in multiparous elderly women who have lost a lot of weight

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19
Q

Where does the pain from an obturator hernia go?

A

Pain is referred to the medial thigh because the obturator nerve straddles the adductor brevis and supplies medial thigh sensation

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20
Q

Which nerve is the motor supply of the levator ani

A

Pudendal nerve on perineal surface and perineal branches of S3 + S4

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21
Q

Another name for nervi erigentes

A

Splanchnic nerves

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22
Q

What are the splanchnic nerves?

A

Arise from sacral spinal nerves S2, S3 and S4 to provide parasympathetic innervation to the hindgut

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23
Q

Define the urogenital diaphragm

A

Contains the external urethral spincter and deep transverse perineal muscles. Lies above the perineal membrane + contained by the deep perineal pouch

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24
Q

What is the least mobile part of the bladder and why?

A

The trigone, because it is fixed on top of the prostate by the urethra

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25
Q

What is the most common source of major bleeding during radical prostatectomy?

A

Dorsal vein complex of the penis

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26
Q

What lines the ductus deferens?

A

Stereo-ciliated columnar epithelium

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27
Q

Where do the ejaculatory ducts open?

A

Sides of the urethral crest

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28
Q

What is another name for mesonephric ducts

A

Wolffian ducts

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29
Q

What are Wolffian ducts

A

Paired embryonic tubules that drain the primitive kidney to the cloaca

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30
Q

What do the Wolffian ducts become in men

A

Rete testis, efferent ducts, epididymis, ductus deferens and seminal vesicles

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31
Q

Where does the prostate form from

A

Urogenital sinus

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32
Q

What do the Wolffian ducts become in women?

A

Epoophoron + skene’s glands (if remnant persists lateral to the vaginal wall - Gartner’s duct or cyst)

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33
Q

What artery supplies the corpus cavernosum

A

Deep artery to the penis

34
Q

What is the venous drainage of the corpus cavernosum

A

Prostatic venous plexus

35
Q

What encloses the corpus cavernosum

A

Tunica albuginea

36
Q

When do the testis descend

A

Descend to the deep inguinal ring by 7 months in the male foetus

37
Q

What LNs drain the testes

A

Para-aortic lymph nodes

38
Q

What is the arterial supply of the testis

A

Testicular artery however the artery of the vas which anastomosis with the testicular artery is very small - so limited supply if ligation of the testicular artery occurs

39
Q

What is the pathophys of varicocoele

A

It is a dilation of the pampiniform plexus (due to incompetence in the gonadal vein)

40
Q

Treatment of varicocoele

A

High ligation of gonadal vein

41
Q

Frequency & laterality of varicocoele

A

15% of young men. most frequently on the left side

42
Q

Why would you perform a renal USS in varicocoele?

A

Occasionally may result from obstruction of the renal vein by RCC (L>R)

43
Q

What is the effectiveness of vasectomy?

A

1 in 5000 risk of spontaneous recanalization of the vas

44
Q

What is the derivative of the internal and external spermatic fascia?

A

Internal: transversalis fascia External: external oblique

45
Q

What is the derivative of the cremaster muscle?

A

Internal oblique

46
Q

Contents of the spermatic cord

A

Ductus deferens Obliterated processus vaginalis Testicular artery Sympathetic fibres from T10 Genital branch of the genitofemoral nerve

47
Q

What innervates the anterior 1/3 of the scrotum

A

L1

48
Q

What contributes to the cutaneous nerve of the scrotum

A

Scrotal branches of the perineal nerve, ilioinguinal nerve

49
Q

Which sphincter provides urinary continence?

A

Spincter externus

50
Q

What pierces the perineal membrane in med?

A

Ducts of the bulbo-urethral glands

51
Q

Contents of the superficial perineal pouch

A

Ischio-cavernosus muscle, enclosed by superficial perineal fascia of Colles, contains vestibular glands, extends in front of symphysis pubis

52
Q

Contents of the deep perineal pouch in males

A

Bulbo-urethral glands Internal pudenal artery Membranous urethra sphincter urethrae muscle

53
Q

What is the broad ligament

A

A peritoneal fold which attaches the whole body of the uterus to the lateral wall of the pelvis

54
Q

What does the broad ligament contain?

A

Ureter, uterine artery, inferior hypogastric plexus

55
Q

What is the broad ligament

A

A peritoneal fold which attaches the whole body of the uterus to the lateral wall of the pelvis

56
Q

What does the broad ligament contain?

A

Ureter, uterine artery, inferior hypogastric plexus

57
Q

Lymph drainage of the ovary

A

Follows the ovarian artery to its origin at L2 (Para-aortic lymph nodes)

58
Q

Why can ovarian pain refer the medial thigh

A

Because the obturator nerve supplies the parietal peritoneum adjacent to the ovary

59
Q

Lymph drainage of the uterus

A

Some to superficial inguinal lymph nodes

60
Q

Blood supply of the uterus

A

Uterine artery, vaginal artery and ovarian artery. Receives branch from the inferior hypogastric plexus with sympathetic elements being vasoconstrictor

61
Q

Supply of the uterine artery

A

Anterior division of the internal iliac artery, crosses above the ureter in the broad ligament, supplies the vaginal vault and medial part of Fallopian tube

62
Q

What is the embryological origin of the Fallopian tube

A

Paramesonephric duct

63
Q

What part of the rectum is covered in peritoneum?

A

Upper 2/3rds of the anterior surface and upper 1/3 of the lateral surface

64
Q

Another name for bulbourethral glands?

A

Cowper’s glands

65
Q

What part of the rectum is covered in peritoneum?

A

Upper 2/3rds of the anterior surface and upper 1/3 of the lateral surface

66
Q

What separates the anterior wall of the rectum from the prostate and seminal veiscles

A

Fascia of Denonvilliers

67
Q

What folds does the rectum have

A

Permanent folds running transversely - mucous membrane and circular smooth muscle - but NO taeniae coli

68
Q

What suspends the rectum in the hollow of the sacrum?

A

Fascia of Waldeyer

69
Q

What separates the distended rectum from the sacrum and coccyx?

A

Ganglion impar, sacral part of the sympathetic trunk and piriformis

70
Q

What separates the anterior wall of the rectum from the prostate and seminal veiscles

A

Fascia of Denonvilliers

71
Q

What folds does the rectum have

A

Permanent folds running transversely - mucous membrane and circular smooth muscle - but NO taeniae coli

72
Q

What suspends the rectum in the hollow of the sacrum?

A

Fascia of Waldeyer

73
Q

What separates the distended rectum from the sacrum and coccyx?

A

Ganglion impar, sacral part of the sympathetic trunk and piriformis

74
Q

Another name for the ganglion impar

A

Walther’s ganglion

75
Q

What are possible consequences of APR and why

A

Failure of erection (parasympathetic)

Failure of ejaculation (sympathetic fibres T11-T12)

76
Q

What supplies the superior rectal artery?

A

The inferior mesenteric artery

77
Q

What is contained within the lateral ligament of the rectum?

A

Middle rectal artery

78
Q

Where do anal valves lie?

A

Above the smooth surfaced area of the anal canal, at the lower end of the anal colums. Not felt on PR exam

79
Q

What is the bony attachment of the internal sphincter?

A

It doesnt have one

80
Q

Where is the ischio-rectal fossa in relation to the urogenital diaphragm?

A

The ischio- rectal fossa extends anteriorly above the urogenital diaphragm BECAUSE the ischio-rectal fossa extends forwards below the levator ani muscles which are attached to the body of the pubic bone above the level of the urogenital diaphragm

Anatomy - GSSE (3 decks)

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