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Anatomy > Pelvis > Flashcards

Pelvis Flashcards

1
Q

When can the shape of your pelvis (i.e. android vs gynecoid) be clinically important?

A

If a biological female is planning to get pregnant, the shape of her pelvis will determine whether she should go with a natural birth or a C-section.

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2
Q

Define the boundaries of the true pelvis.

A 
Pubic symphysis
Superior rami of pubis
Sacrum
Coccyx
Body & superior ramus of ischium
Ileum below arcuate line
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3
Q

Name the contents of the obturator foramen.

A

Obturator nerve, artery & vein

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4
Q

Name the contents of the suprapiriform foramen.

A

Superior gluteal nerve, artery & vein

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5
Q

Name the contents of the infrapiriform foramen.

A

PIN PINS

Posterior cutaneous nerve of thigh
Inferior gluteal nerve, artery & vein
Nerve to quadratus femoris

Pudendal nerve
Internal pudendal artery & vein
Nerve to obturator internus
Sciatic nerve

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6
Q

Name the contents of the lesser sciatic foramen.

A

Obturator internus
Internal pudendal artery & vein
Pudendal nerve

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7
Q

From which germ layer is the enteric nervous system derived?

A

The ectoderm (specifically the neural crest).

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8
Q

What happens to spatial order & cell neighbours during collective cell migration?

A

Both are retained.

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9
Q

In which direction do cells migrate when colonising the gut?

A

Oral to anal.

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10
Q

What is optogenetics?

A

The use of light to control cells in living tissue.

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11
Q

Name the three components of the levator ani muscle.

A

Pubococcygeus
Puborectalis
Iliococcygeus

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12
Q

Why is puborectalis important in defecation?

A

The puborectal sling loops around the distal end of the GI tract. If it were to relax, the last part of the tract would be a straight line, and faecal contents would be pushing down on this point constantly. Instead, when contracted, the puborectal sling kinks the end of the tract, taking the pressure off the internal anal sphincter.

If the GI tract becomes full, the kink is stretched out and the puborectal sling will relax, allowing weight to push down on the anal sphincter, which will also relax, giving the sensation that you need to go to the bathroom. Thus, puborectalis prevents us from constantly feeling like we need to void our bowels.

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13
Q

What runs through the pudendal canal?

A

The pudendal neurovasculature.

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14
Q

What is the most commonly accepted rationale for the endopelvic fascia?

A

It supports the course of blood supply to the pelvic viscera.

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15
Q

From which direction do the major vessels enter the pelvic cavity?

A

Posteriorly & laterally.

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16
Q

At which structure does the endopelvic fascia originate?

A

The white tendinous line.

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17
Q

What could happen if the endopelvic fascia got too loose?

A

Structures like the uterus could prolapse anteriorly/posteriorly into neighbouring structures.

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18
Q

Define the boundaries of the ischioanal fossa.

A

Lateral: obturator internus
Medial: levator ani & part of external anal sphincter
Floor: deep perineal fascia
Posterior: sacrotuberous ligament & gluteus maximus

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19
Q

What is the broad ligament made up of?

A

Peritoneum hanging over the uterine tubes.

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20
Q

What is the function of the round ligament?

A

It attaches to the body of the uterus to anchor it and hold it in place.

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21
Q

What is the suspensory ligament made up of, and what is its function?

A

The suspensory ligament is a fold in the peritoneum that conveys the blood supply for the ovaries.

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22
Q

What is the function of the ovarian ligament?

A

It holds the ovary in place against the body of the uterus.

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23
Q

Where is the most common location for an ectopic pregnancy?

A

The rectouterine pouch.

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24
Q

What is the most anterior opening in the female pelvic floor?

A

The urethra.

25
Q

Which two structures does the prostate sit between?

A

The bulb of the penis and the urinary bladder.

26
Q

Which structure passes through the prostate?

A

The urethra.

27
Q

Ejaculate comes from which two structures?

A

The prostate & the seminal vesicle.

28
Q

Which structure separates the reproductive & urinary systems in the male?

A

The internal urethral sphincter.

29
Q

Distinguish between the internal & external urethral sphincters.

A

The internal urethral sphincter is composed of smooth muscle and is involuntary; the external urethral sphincter is composed of skeletal muscle and is under voluntary control.

30
Q

What is the function of the internal urethral sphincter in males?

A

It prevents reflux of the seminal fluids into the bladder during ejaculation. Dysfunction can cause infertility.

31
Q

Where does prostatic lymph drain to?

A

The internal iliac nodes.

32
Q

Describe how prostatic cancer can spread via lymph nodes.

A

Prostatic cancer can spread upward via the internal iliac, common iliac or lumbar nodes. It can also spread via lymphatics & venous channels up through the ventral sacral foramina into the vertebral column.

33
Q

From where does the prostate receive its innervation?

A

Two dorsal branches of the pudendal nerve.

34
Q

What is the difference between haustra in the GIT and haustra in the rectum?

A

In the GIT, the goal of the haustra is to create different micro-environments so things can be processed progressively and in slightly different ways. In the rectum, we are more concerned with storage and preparation for expulsion.

35
Q

Describe the changes at the anorectal junction that allow the formation of a seal.

A

The luminal surface changes to anal columns and veins in the hemorrhoidal plexus dilate & fill with blood, nestling into the spaces between the anal columns.

36
Q

Name the segments of the rectum, from the ampulla to the perianal skin.

A 
Rectal ampulla
Anorectal junction
Columnar zone
Dentate line
Anal pecten
Anocutaneous line
Cutaneous zone
Perianal skin
37
Q

Describe how the ischioanal fossa plays a role in defecation.

A

The muscles that close off the rectum are relaxed during defecation, so something else is needed to move faecal matter through the tube. When you are squeezing and actively trying to void your bowels, you are contracting levator ani, creating pressure in the ischioanal fat. This fat acts like fingers squeezing a toothpaste tube.

38
Q

What is the function of the corpus cavernosum in males?

A

The corpus cavernosum is a series of chambers that ill with blood to make the penis erect.

39
Q

What is the function of the corpus spongiosum in males?

A

The corpus spongiosum can fill with blood but mostly serves to contain & protect the urethra.

40
Q

Describe lymph drainage in the testes.

A

The skin of the scrotum drains to the ipsilateral superficial inguinal nodes. The testes drain to the ipsilateral para-aortic nodes.

41
Q

Name the layers of the testes.

A

Some Damn Englishman Called It (S) The Testes

Superficial fascia (Scarpa's/Dartos)
External spermatic cord
Cremasteric layer
Internal spermatic cord
Spermatic cord
Tunica vaginalis (parietal & visceral layers)
Tunica albuginea
42
Q

Why is the pampiniform plexus important for heat exchange?

A

The blood in the testicular artery is warm, body temperature blood. The pampiniform plexus encapsulates all of that and takes it away. The blood will be warmed up again as it gets pumped back to the heart, and the arterial blood will be cooler so that body temperature blood isn’t being pumped into the testes, making the cremaster muscle useless.

43
Q

What is varicocoele?

A

The dilation of the pampiniform plexus. It is more common on the left and is characterised by the “bag of worms” appearance. It may be indicative of systemic problems (e.g. renal problems and/or hypertension).

44
Q

What is hydrocoele?

A

Accumulation of fluid within the tunica vaginalis. It is usually caused by infection/trauma and is typically a local problem. A penlight examination will reveal a clear/translucent scrotum (apart from the testes).

45
Q

Describe the differences between varicocoele and hydrocoele.

A

Varicocoele:

  • characterised by “bag of worms” appearance
  • indicative of systemic problems
  • normal appearance of scrotum

Hydrocoele:

  • accumulation of fluid within tunica vaginalis
  • local problem
  • clear scrotum
46
Q

Define the boundaries of the urogenital triangle.

A

Pubic symphysis
Ischiopubic rami
Line between the two ischial tuberosities

47
Q

Define the boundaries of the anal triangle.

A

Coccyx
Sacrotuberous ligaments
Line between the two ischial tuberosities

48
Q

What is the function of Buck’s fascia?

A

It contains & protects the deep dorsal vein and dorsal arteries of the penis.

49
Q

Which artery runs in the suspensory ligament?

A

The ovarian artery.

50
Q

In which ligament does the ovarian artery run?

A

The suspensory ligament.

51
Q

Which artery runs in the cardinal ligament/endopelvic fascia?

A

The uterine artery.

52
Q

In which ligament does the uterine artery run?

A

The cardinal ligament.

53
Q

Why do the testes drain to the para-aortic nodes while the superficial tissues drain locally?

A

The testes originated in the abdomen and were dragged down.

54
Q

Why does prostate cancer often metastasise to the brain?

A

The lymphatic and venous drainage connects through the vertebral column.

55
Q

Describe the innervation of the pelvis.

A

The superior hypogastric plexus, derived from the inferior mesenteric plexus, is made up of sympathetic axons from the lower part of the sympathetic trunk. It comes over the pelvic brim, then splits into the two hypogastric nerves. As they descend, they accumulate parasympathetic axons from the pelvic splanchnic nerves (S2-S4).

These all converge into the inferior hypogastric plexus, running along the pelvic brim/internal iliac artery. This is the first time, in the pelvis, that we have all of the “cabling” that we need.

56
Q

Which nerve supplies sensory innervation to the anal pecten?

A

The pudendal nerve.

57
Q

Describe the role of the nervous system in defecation.

A

Under normal circumstances, a strong sympathetic impulse maintains the internal anal sphincter and prevents drainage of the hemorrhoidal plexus, keeping that seal closed.

Stretch receptors are triggered by an increased volume of stool. This decreases the sympathetic signal and increases the parasympathetic output, causing the internal anal sphincter to relax. The pudendal nerve is responsible for contracting the external anal sphincter until you are ready.

58
Q

Which nerve innervates the external anal sphincter?

A

The pudendal nerve.

Anatomy (8 decks)

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