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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
What is the most common source of major bleeding during radical prostatectomy?
Dorsal vein complex of the penis
26
What lines the ductus deferens?
Stereo-ciliated columnar epithelium
27
Where do the ejaculatory ducts open?
Sides of the urethral crest
28
What is another name for mesonephric ducts
Wolffian ducts
29
What are Wolffian ducts
Paired embryonic tubules that drain the primitive kidney to the cloaca
30
What do the Wolffian ducts become in men
Rete testis, efferent ducts, epididymis, ductus deferens and seminal vesicles
31
Where does the prostate form from
Urogenital sinus
32
What do the Wolffian ducts become in women?
Epoophoron + skene's glands (if remnant persists lateral to the vaginal wall - Gartner's duct or cyst)
33
What artery supplies the corpus cavernosum
Deep artery to the penis
34
What is the venous drainage of the corpus cavernosum
Prostatic venous plexus
35
What encloses the corpus cavernosum
Tunica albuginea
36
When do the testis descend
Descend to the deep inguinal ring by 7 months in the male foetus
37
What LNs drain the testes
Para-aortic lymph nodes
38
What is the arterial supply of the testis
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
What is the pathophys of varicocoele
It is a dilation of the pampiniform plexus (due to incompetence in the gonadal vein)
40
Treatment of varicocoele
High ligation of gonadal vein
41
Frequency & laterality of varicocoele
15% of young men. most frequently on the left side
42
Why would you perform a renal USS in varicocoele?
Occasionally may result from obstruction of the renal vein by RCC (L\>R)
43
What is the effectiveness of vasectomy?
1 in 5000 risk of spontaneous recanalization of the vas
44
What is the derivative of the internal and external spermatic fascia?
Internal: transversalis fascia External: external oblique
45
What is the derivative of the cremaster muscle?
Internal oblique
46
Contents of the spermatic cord
Ductus deferens Obliterated processus vaginalis Testicular artery Sympathetic fibres from T10 Genital branch of the genitofemoral nerve
47
What innervates the anterior 1/3 of the scrotum
L1
48
What contributes to the cutaneous nerve of the scrotum
Scrotal branches of the perineal nerve, ilioinguinal nerve
49
Which sphincter provides urinary continence?
Spincter externus
50
What pierces the perineal membrane in med?
Ducts of the bulbo-urethral glands
51
Contents of the superficial perineal pouch
Ischio-cavernosus muscle, enclosed by superficial perineal fascia of Colles, contains vestibular glands, extends in front of symphysis pubis
52
Contents of the deep perineal pouch in males
Bulbo-urethral glands Internal pudenal artery Membranous urethra sphincter urethrae muscle
53
What is the broad ligament
A peritoneal fold which attaches the whole body of the uterus to the lateral wall of the pelvis
54
What does the broad ligament contain?
Ureter, uterine artery, inferior hypogastric plexus
55
What is the broad ligament
A peritoneal fold which attaches the whole body of the uterus to the lateral wall of the pelvis
56
What does the broad ligament contain?
Ureter, uterine artery, inferior hypogastric plexus
57
Lymph drainage of the ovary
Follows the ovarian artery to its origin at L2 (Para-aortic lymph nodes)
58
Why can ovarian pain refer the medial thigh
Because the obturator nerve supplies the parietal peritoneum adjacent to the ovary
59
Lymph drainage of the uterus
Some to superficial inguinal lymph nodes
60
Blood supply of the uterus
Uterine artery, vaginal artery and ovarian artery. Receives branch from the inferior hypogastric plexus with sympathetic elements being vasoconstrictor
61
Supply of the uterine artery
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
What is the embryological origin of the Fallopian tube
Paramesonephric duct
63
What part of the rectum is covered in peritoneum?
Upper 2/3rds of the anterior surface and upper 1/3 of the lateral surface
64
Another name for bulbourethral glands?
Cowper's glands
65
What part of the rectum is covered in peritoneum?
Upper 2/3rds of the anterior surface and upper 1/3 of the lateral surface
66
What separates the anterior wall of the rectum from the prostate and seminal veiscles
Fascia of Denonvilliers
67
What folds does the rectum have
Permanent folds running transversely - mucous membrane and circular smooth muscle - but NO taeniae coli
68
What suspends the rectum in the hollow of the sacrum?
Fascia of Waldeyer
69
What separates the distended rectum from the sacrum and coccyx?
Ganglion impar, sacral part of the sympathetic trunk and piriformis
70
What separates the anterior wall of the rectum from the prostate and seminal veiscles
Fascia of Denonvilliers
71
What folds does the rectum have
Permanent folds running transversely - mucous membrane and circular smooth muscle - but NO taeniae coli
72
What suspends the rectum in the hollow of the sacrum?
Fascia of Waldeyer
73
What separates the distended rectum from the sacrum and coccyx?
Ganglion impar, sacral part of the sympathetic trunk and piriformis
74
Another name for the ganglion impar
Walther's ganglion
75
What are possible consequences of APR and why
Failure of erection (parasympathetic) Failure of ejaculation (sympathetic fibres T11-T12)
76
What supplies the superior rectal artery?
The inferior mesenteric artery
77
What is contained within the lateral ligament of the rectum?
Middle rectal artery
78
Where do anal valves lie?
Above the smooth surfaced area of the anal canal, at the lower end of the anal colums. Not felt on PR exam
79
What is the bony attachment of the internal sphincter?
It doesnt have one
80
Where is the ischio-rectal fossa in relation to the urogenital diaphragm?
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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