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MSc Anatomy > Pelvis > Flashcards

Pelvis Flashcards

1
Q

What is the origin of the obturator internus muscle?

A

Anterolateral wall of the true pelvis (deep surface of obturator membrane and surrounding bone)

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2
Q

What is the insertion of obturator internus?

A

Medial surface of the greater trochanter of the femur

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3
Q

What is the function of the obturator internus muscle?

A

Lateral rotation of the extended hip joint

Abduction of the flexed hip

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4
Q

What is the innervation of the obturator internus muscle?

A

Nerve to obturator internus (L5, S1)

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5
Q

What is the origin of piriformis?

A

Anterior surface of sacrum between anterior sacral foramina

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6
Q

What is the insertion of piriformis?

A

Medial side of the superior border of the greater trochanter of the femur

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7
Q

What is the function of piriformis?

A

Lateral rotation of the extended hip

Abduction of the flexed hip

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8
Q

What is the innervation of piriformis?

A

Branches from L5, S1 and S2

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9
Q

Which muscles form the pelvic diaphragm?

A

Levator ani: iliococcygeus, pubococcygeus and puborectalis (from lateral to medial)
Coccygeus

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10
Q

What are the borders of the urogenital triangle?

A

Pubic symphysis, ischial tubersoties and perineal body

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11
Q

What are the borders of the anal triangle?

A

Perineal body, ischial tuberosities and coccyx

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12
Q

What is the function of the pelvic diaphragm?

A

Pelvic floor, supports the pelvic viscera, maintains an angle between the rectum and anal canal, reinforces the external anal sphincter, functions as a vaginal sphincter in women, pulls coccyx forward after defecation

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13
Q

What are the four parts of the male urethra?

A

Preprostatic, prostatic, membranous and spongy

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14
Q

Briefly describe the preprostatic urethra

A

It is about 1cm long, extends from the base of the bladder to the prostate and it is associated with the internal urethral sphincter which prevents retrograde movement of semen during ejaculation

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15
Q

Where do the ducts of the prostate empty in to?

A

The prostatic urethra - the lumen is marked by a longitudinal midline fold of mucosa (the urethral crest). The depression on each side of the crest is the prostatic sinus; the ducts of the prostate empty in to here.

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16
Q

What is the seminal colliculus?

A

An enlargement of the urethral crest midway along its length to form a somewhat circular elevation. The prostatic utricle opens on to the centre of the seminal colliculus

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17
Q

What might you find on each side of the prostatic utricle?

A

The opening of the ejaculatory duct

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18
Q

Briefly describe the membranous part of the urethra

A

It is narrow and passes through the deep perineal pouch. During its transit through this pouch, it is surrounded by skeletal muscle of the external urethral sphincter.

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19
Q

Briefly describe the spongy part of the male urethra

A

It is surrounded by erectile tissue (corpus spongiosum). It is enlarged at its base and at the end to form the navicular fossa. The two bulbourethral glands open in to the bulb of the spongy urethra. The external urethral orifice is the sagittal slit at the end of the penis.

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20
Q

Where is the trigone?

A

It is the smooth triangular area between the openings of the ureters and the urethra on the inside of the bladder. Stretch receptors are located here.

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21
Q

Where is the median umbilical ligament and what is it a remnant of?

A

From the apex of the bladder it continues superiorly up the anterior abdominal wall to the umbilicus. It is a remnant of the embryological urachus that contributes to the formation of the bladder.

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22
Q

What is the urachus?

A

A fibrous remnant of the allantois, a canal that drains the urinary bladder of the fetus that joins and runs in the umbilical cord

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23
Q

What is the interureteric crest?

A

The horizontal line that extends between the two urethral orifices inside the bladder

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24
Q

Where is the scrotal ligament found and what is it a remnant of?

A

Attaching the inferior pole of the testis to the scrotum and it is a remnant of the gubernaculum

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25
Q

What is the lymph drainage of the testes?

A

Lateral aortic or lumbar nodes and preaortic nodes. Due to descent of testes from abdomen carrying vessels and lymphatics.

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26
Q

What are the sides and anterior part of the testis covering by?

A

A closed sac of peritoneum - the tunica vaginalis

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27
Q

What structures are within the testis?

A

Seminiferous tubules and interstitial tissue

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28
Q

What encloses the seminiferous tubules and interstitial tissue?

A

A thick connective tissue capsule, the tunica albuginea

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29
Q

What do the seminiferous tubules connect to?

A

They become straight tubules and connect to a collecting chamber, the rete testis

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30
Q

Where is the rete testis located?

A

In a thick, vertically orientated linear wedge of connective tissue, the medistinum testis, projecting from the capsule into the posterior aspect of the gonad

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31
Q

What are the two distinct components of the epididymis?

A

The efferent ductules and the true epididymis

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32
Q

What do the efferent ductules form?

A

They form an enlarged coiled mass that sits on the posterior superior pole of the testis and forms the head of the epididymis

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33
Q

What is the true epididymis?

A

A single, long coiled duct into which the efferent ductules all drain, and which continues inferiorly along the posterolateral margin of the testis as the body of the epididymis and enlarges to form the tail of epididymis at the inferior pole of the testis

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34
Q

When does the ductus deferens become the ejaculatory duct?

A

When it is joined by the duct of the seminal vesicle

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35
Q

Where is the ampulla of the ductus deferens?

A

Between the ureter and ejaculatory duct, the ductus deferens expands to form the ampulla of the ductus deferens

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36
Q

Where are the seminal vesicles located?

A

It is immediately lateral to and follows the course of the ductus deferens at the base of the bladder

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37
Q

Where are the bulbourethral glands located?

A

There is one of each side, they are small, pea-shaped mucous glands situated within the deep perineal pouch. They are lateral to the membranous part of the urethra.

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38
Q

Where do the ducts of the bulbourethral glands open in to?

A

They open in to the bulb of the spongy urethra at the root of the penis

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39
Q

Where is the ovarian fossa?

A

It is a shallow depression in the lateral wall of the pelvis where the ovary lies. It has the following boundaries:
Superiorly by the external iliac artery and vein
Anteriorly and inferiorly by the broad ligament of the uterus
Posteriorly by the ureter, internal iliac artery and vein
Inferiorly by the obturator nerve, artery and vein

40
Q

What is a Graafian follicle?

A

Found in the ovary, it secretes hormones that influence stages of the menstrual cycle. Each contains a single oocyte.

41
Q

What is the corpus luteum?

A

Found in the ovary, it is a temporary endocrine structure that is involved in the production of progesterone, estradiol, inhibin A and oestrogen. It is the remains of the ovarian follicle that has released a mature ovum during a previous ovulation.

42
Q

What is the opening of the fallopian tube called?

A

The osteum

43
Q

What are the different parts of the uterine tube?

A

Infundibulum with margin rimmed with fimbriae. Medial to the infundibulum the tube expands to form the ampulla and then narrows to form the isthmus before joining the body of the uterus.

44
Q

Describe the different parts of the cervix

A

Internal and external os. External os is surrounded by the fornix. Anterior, posterior and two lateral fornices

45
Q

What is the anterior wall of the vagina related to?

A

The base of the bladder and the urethra. The urethra is embedded in, or fused to, the anterior vaginal wall.

46
Q

What attaches the cervix to the anterior pelvic wall?

A

The pubocervical ligament

47
Q

What attaches the cervix to the lateral pelvic walls?

A

The cardinal ligament (or transverse cervical)

48
Q

What attaches the cervix to the posterior pelvic wall?

A

The uterosacral ligament

49
Q

Which parts of the rectum are covered by peritoneum?

A

Peritoneum drapes over the anterior and lateral aspects of the upper third of the rectum, but only the anterior surface of the middle third is covered by peritoneum. The lower third is not covered at all.

50
Q

What is the vesico-uterine pouch?

A

In women, the uterus lies posterior to the bladder. A shallow pouch occurs between the two.

51
Q

What is the recto-uterine pouch?

A

Occurs posteriorly between the uterus and the rectum. It is deep and when supine, the lowest portion of the abdominopelvic cavity and is a site where infection and fluids typically collect.

52
Q

What are the three parts of the broad ligament?

A

Mesometrium - the largest part, extends from the lateral pelvic walls to the body of the uterus
Mesosalpinx - the most superior part, suspends the uterine tube in the pelvic cavity
Mesovarium - a posterior extension of the broad ligament that attaches to the ovary

53
Q

What are the ovarian vessels, nerves and lymphatics contained within on their course to the ovary?

A

The suspensory ligament of ovary

54
Q

What is attached to the inferior pole of the ovary?

A

The ligament of ovary which continues as the round ligament of uterus through the deep inguinal ring, through the inguinal canal to end in connective tissue related to the labium majus. Both ligament of ovary and round ligament of uterus are remnants of the gubernaculum.

55
Q

What is the rectovesical pouch?

A

Occurs between the bladder and rectum in men, formed from the draping of visceral peritoneum over the bladder and rectum.

56
Q

Briefly describe the course of the internal iliac artery

A

Originates approximately at the level of the intervertebral disc between L5 and S1. It courses inferiorly over the pelvic inlet, then divides in to anterior and posterior trunks at the level of the superior border of the greater sciatic foramen.

57
Q

What are the branches of the posterior trunk of the internal iliac artery?

A

Iliolumbar artery
Lateral sacral artery (usually two)
Superior gluteal artery (terminal continuation)

58
Q

What are the branches of the anterior trunk of the internal iliac artery?

A 
Superior vesical artery
Umbilical artery
Inferior vesical artery (men), Vaginal artery (women)
Middle rectal artery
Uterine artery
Obturator artery
Internal pudendal artery
Inferior gluteal artery
59
Q

What is the first branch of the anterior trunk of the internal iliac artery?

A

Umbilical artery, which gives rise to the superior vesical artery

60
Q

What does the superior vesical artery supply?

A

Superior aspect of the bladder and distal parts of the ureter. It men, it may give rise to a branch that supplies the ductus deferens.

61
Q

What does the inferior vesical artery supply?

A

Bladder, ureter, seminal vesicle and prostate

62
Q

What does the middle rectal artery supply and what does it anastamose with?

A

Supplies the rectum and anastamoses with the superior rectal artery (from the IMA) and the inferior rectal artery (from the internal pudendal artery)

63
Q

What does the obturator artery supply?

A

Leaves pelvic cavity via the obturator canal. Supplies the adductor region of the thigh.

64
Q

What does the internal pudendal artery supply?

A

Leaves the pelvic cavity through the greater sciatic foramen, inferior to the piriformis muscle. Passes laterally to the ischial spine and then through the lesser sciatic foramen to enter the perineum. It is the main artery of the perineum.

65
Q

What does the inferior gluteal artery supply?

A

It leaves the pelvic cavity through the greater sciatic foramen, inferior to the piriformis muscle. It is the large terminal branch of the anterior trunk of the internal iliac artery. It enters and contributes to the blood supply of the gluteal region and anastamoses with a network of vessels around the hip joint.

66
Q

What is the external anal sphincter innervated by?

A

Inferior rectal branches of the pudendal nerve and by branches directly from the anterior ramus of S4

67
Q

Where are the bulbs of vestibule located and what are they?

A

A pair of erectile tissues situated, one on each side, at the vaginal opening and are firmly attached to the perineal membrane. Small bands of erectile tissue connect the anterior ends of the bulbs to a single, small, pea-shaped erectile mass, the glans clitoris, which is positioned in the midline at the end of the body of the clitoris and anterior to the opening of the urethra

68
Q

What is the structural equivalent in men to the bulbs of vestibule, glans clitoris and interconnecting bands of tissue?

A

The corpus spongiosum

69
Q

What is the penile urethra enclosed within?

A

The corpus spongiosum

70
Q

Describe the clitoris

A

It is composed of two corpora cavernosa and the glans clitoris. The root of the clitoris consists of the two crura. The body of the clitoris is formed from the unattached parts of the corpora cavernosa. The glans is attached to the distal end of the body of the clitoris.

71
Q

Describe the structure of the penis

A

Composed mainly of two corpora cavernosa and the single corpus spongiosum, which contains the urethra. It has an attached part, the root, and a free part, the body of the penis.

72
Q

What does the root of the penis consist of?

A

Two crura, which are proximal parts of the corpora cavernosa attached to the pubic arch, and the bulb of the penis, which is the proximal part of the corpus spongiosum anchored to the perineal membrane

73
Q

What does the body of the penis consist of?

A

Formed from the tethering of the two proximal free parts of the corpora cavernosa and the related free part of the corpus spongiosum

74
Q

What are the greater vestibular glands?

A

Greater vestibular glands are seen in women, they are small, pea-shaped mucous glands that lie posterior to the bulbs of the vestibule on each side of the vaginal opening and are the female homologues of the bulbourethral glands in men

75
Q

Where are the isciocavernosus muscles located and what do they do?

A

They cover the crura of the penis and clitoris. They force blood from the crus in to the body of the erect penis and clitoris.

76
Q

Where are the bulbospongiosus muscles located?

A

Associated with the bulbs of the vestibule in women and with the attached part of the corpus spongiosum in men

77
Q

What is the function of the bulbospongiosus muscle?

A

Move blood from the attached parts of the clitoris and penis in to the glans.
In men, removal of residual urine from urethra after urination and pulsatile emission of semen during ejaculation

78
Q

What is the innervation of the isciocavernosus and bulbospongiosus muscles?

A

Pudendal nerve (S2-S4)

79
Q

Describe the superficial features of the female external genitalia

A

Either side of the midline are two thin folds of skin, the labia minora. The region enclosed between them, into which the urethra and vagina open is the vestibule. Anteriorly, the labia minora each bifurcate, forming a medial and lateral fold. The medial folds unite to form the frenulum of clitoris, that joins the glans clitoris. The lateral folds unite over the glans clitoris and the body of the clitoris to form the prepuce of clitoris (hood). Posterior to the vestibule, the labia minora unite to form the frenulum of labia minora (fourchette).

80
Q

What are the three major terminal branches of the pudendal nerve?

A

Inferior rectal nerve
Perineal nerve
Dorsal nerve of penis (or clitoris)

81
Q

What is the sensory supply of the penis and clitoris?

A

The dorsal nerve of penis/clitoris

82
Q

Which arteries supply the erectile tissues in men?

A

Artery of bulb of penis
Urethral artery
Deep artery of penis
Dorsal artery of the penis

83
Q

Which arteries supply the erectile tissues in women?

A

Arteries of the bulb of vestibule
Deep arteries of the clitoris
Dorsal arteries of the clitoris

84
Q

Describe the lymphatic drainage of the testes

A

Via channels that ascend in the spermatic cord, pass through the inguinal canal, and course up the posterior abdominal wall to connect directly with lateral aortic or lumbar nodes and pre-aortic nodes around the aorta. Disease from the testes tracks superiorly to nodes high in the posterior abdominal wall and not to inguinal or iliac nodes.

85
Q

What is the nerve supply of coccygeus?

A

Anterior rami of S3 and S4

86
Q

What is the innervation of levator ani?

A

Anterior ramus of S4 and inferior rectal branch of pudendal nerve (S2-S4)

87
Q

What are the contents of the spermatic cord?

A 
Cremasteric artery
Deferential artery
Testicular artery
Pampiniform plexus
Vas deferens
Genital branch of genitofemoral nerve
Sympathetic nerves
88
Q

What is the superficial inguinal ring?

A

Triangular opening, made from external oblique aponeurosis and it has two crura, lateral and a medial. Lateral is stronger because of gravity. The two crura are held together by intercrural fibres. Conjoint tendon is at the end of the medial crura.

89
Q

What are the layers of the scrotal sac from superficial to deep?

A

Tunica albuginea
Tunica vaginalis (visceral and parietal) (from peritoneum)
Internal spermatic fascia (transversalis fascia)
Cremasteric fascia (internal oblique)
External spermatic fascia (external oblique)
Dartos fascia (around both testes) (from Colles fascia)
Skin

90
Q

What are the septa of the testicle?

A

They are invaginations of the tunica albuginea

91
Q

What are the nerve roots of superior gluteal nerve?

A

L4, L5, S1

92
Q

What are the nerve roots of inferior gluteal nerve?

A

L5, S1, S2

93
Q

What are the nerve roots of the posterior femoral cutaneous?

A

S1, S2, S3

94
Q

What are the nerve roots of the pudendal nerve?

A

S2, S3, S4

95
Q

What are the nerve roots of the sciatic nerve?

A

L4, L5, S1, S2, S3 (common fibular ends at S2)

96
Q

What are the nerve roots of the nerve to quadratus femoris?

A

L4-S1 (also supplies inferior gemellius)

97
Q

What are the nerve roots of the nerve to obturator internus?

A

L5-S2 (also supplies superior gemellius)

MSc Anatomy (6 decks)

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