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Clinical Morphology > Pelvis > Flashcards

Pelvis Flashcards

1
Q

Components of bony pelvis

A

right and left pelvic bones, fusion of ilium, ischium, pubis, sacrum, coccyx

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2
Q

midline of pelvic inlet

A

sacral promontory

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3
Q

boundaries of pelvic outlet

A

pubis, ischial rami, sacrotuberous ligament, coccyx

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4
Q

pelvic inlet in females

A

wider, more circular

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5
Q

pelvic inlet in males

A

narrow, heart-shaped

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6
Q

sacrum in females

A

short, straight

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7
Q

sacrum in males

A

long, prominent

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8
Q

coccyx in females

A

straighter

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9
Q

coccyx in males

A

curves ventrally

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10
Q

sciatic notch in females

A

wide

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11
Q

sciatic notch in males

A

narrow

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12
Q

subpubic angle in females

A

broad, rounded, 80-85 degrees

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13
Q

subpubic angle in males

A

deep, acute, 50-60 degrees

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14
Q

pelvic wall muscles

A

piriformis, obturator internus

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15
Q

components of pelvic floor

A

pelvic diaphragm, urogenital diaphragm

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16
Q

purpose of pelvic diaphragm

A

thin sheets of muscle through which the urethra, vagina, and rectum pass

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17
Q

muscles of pelvic diaphragm

A

levator ani, coccygeus

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18
Q

components of levator ani

A

iliococcygeus, pubococcygeus

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19
Q

purpose of levator ani

A

contract when abdominal pressure rises to support pelvic organs

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20
Q

purpose of pubococcygeus

A

maintain urinary and fecal continence

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21
Q

medial fibers of pubococcygeus

A

puborectalis

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22
Q

action of puborectalis

A

forms a sling around the rectum to relax and contract the anorectal angle to control defecation, aids in voluntary control of micturition

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23
Q

which muscles are injured during childbirth

A

pubococcygeus and puborectalis

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24
Q

muscle injury during childbirth can result in

A

urinary and fecal incontinence

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25
Q

coccygeus location

A

deep to the sacrospinous ligament

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26
Q

coccygeus action

A

pulls the coccyx forward after defecation

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27
Q

4 regions of uterus

A

fundus, body, isthmus, cervix

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28
Q

area in which the uterine tubes connect to the uterus

A

fundus

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29
Q

normal position of uterus

A

anteverted/anteflexed

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30
Q

flexion

A

angle between uterine body and isthmus

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31
Q

version

A

angle between cervical canal and vagina

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32
Q

normal anatomical variation in position of uterus

A

retroverted/retroflexed

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33
Q

parts of broad ligament

A

mesovarium, mesosalpinx, mesometrium

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34
Q

ovarian vessels travel through this to reach ovary from abdominal aorta

A

suspensory ligament of ovary

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35
Q

vesicouterine pouch location

A

between bladder and uterus

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36
Q

rectouterine pouch of douglas location

A

between uterus and rectum

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37
Q

most inferior part of peritoneal cavity when supine

A

rectouterine pouch of douglas

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38
Q

male equivalent of rectouterine pouch

A

rectovesical pouch

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39
Q

retropubic space

A

subperitoneal space between the bladder filled with fatty areolar tissue

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40
Q

pubovesical ligaments travel from

A

travel from pubic bones to bladder

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41
Q

transverse cervical ligaments aka

A

cardinal ligaments

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42
Q

transverse cervical ligaments travel from

A

uterus to lateral pelvic wall

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43
Q

uterosacral ligaments travel from

A

uterus to sacrum

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44
Q

what causes bladder prolapse

A

damage to pubovesical ligaments

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45
Q

what causes uterine prolapse

A

damage to transverse cervical ligaments

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46
Q

what causes damage to the fascial ligaments

A

chronic cough, heavy lifting, multiparity, birth trauma, obesity

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47
Q

components of male reproductive tract

A

prostate, seminal vesicles, vas deferens, testes

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48
Q

which elements of male reproductive tract are subperitoneal

A

prostate, seminal vesicle

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49
Q

which elements of male reproductive tract are closely associated with the urethra

A

prostate, seminal vesicle

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50
Q

the testes are attached to the seminal vesicle via the

A

vas deferens

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51
Q

course of the vas deferens

A

ascends from the scrotum in the spermatic cord, passes through the inguinal canal, and joins the ejaculatory ducts of the seminal vesicles

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52
Q

ejaculatory ducts location

A

embedded in the prostate

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53
Q

external spermatic fascia is derived from

A

external oblique aponeurosis

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54
Q

cremasteric fascia and muscle are derived from

A

internal oblique muscle

55
Q

internal spermatic fascia is derived from

A

transversalis fascia

56
Q

tunica vaginalis

A

pouch of peritoneum surrounding the testis with a visceral and parietal layer

57
Q

descent of testis forms the

A

inguinal canal and spermatic cord

58
Q

contents of spermatic cord

A

ilioinguinal nerve, genitofemoral nerve, testicular artery, pampiniform plexus, lymphatics, vas deferens

59
Q

deep inguinal ring is an opening in the

A

transversalis fascia

60
Q

superficial inguinal ring is an opening in the

A

aponeurosis of external oblique

61
Q

the urethra runs through the (male)

A

corpus spongiosum

62
Q

muscle that provides propulsive force during ejaculation

A

bulbospongiosus

63
Q

branches of internal iliac artery common to males and females

A

iliolumbar, lateral sacral, superior gluteal, inferior gluteal, internal pudendal (inferior rectal branch), umbilical, obturator, middle rectal

64
Q

female branches of internal iliac artery

A

uterine, vaginal

65
Q

male branches of internal iliac artery

A

vas deferens branch off umbilical artery

66
Q

ovarian artery is a branch of

67
Q

ovarian artery anastomoses with the

A

uterine artery

68
Q

major blood supply to perineum and external genitalia

A

internal pudendal artery

69
Q

branches of internal pudendal artery

A

inferior rectal, perineal, posterior labial/scrotal, artery of the bulb, dorsal/deep arteries of the clitoris/penis

70
Q

uterine artery crosses ___ to distal ureters

71
Q

ductus deferens crosses ____ to ureters

72
Q

lymphatic drainage from areas supplied by internal iliac artery

A

internal iliac nodes to common iliac nodes to lateral aortic (lumbar) nodes

73
Q

lymphatic drainage from perineum and lower limb

A

superficial and deep inguinal nodes to external iliac nodes to common iliac nodes to lateral aortic nodes

74
Q

lymphatic drainage from areas supplied directly by aorta

A

lateral aortic nodes to cisterna chylli to thoracic duct

75
Q

innervation of skin and skeletal muscles of pelvis

A

ventral rami of lumbosacral (L2-L4) and coccygeal spinal nerves to lumbosacral and coccygeal plexuses

76
Q

parasympathetic innervation of smooth muscle and glands of pelvic viscera

A

pelvic splanchnics (S2-S4)

77
Q

sympathetic innervation of smooth muscle and glands of pelvic viscera

A

thoracic, lumbar, and sacral splanchnics (T10-T12, L1-L2)

78
Q

afferent fibers of lower vagina and perineum

A

travel via the pudendal nerves to S2-S4

79
Q

preganglionic sympathetic neurons for pelvic viscera and smooth muscle

A

T10-T12 (lesser and least splanchnics), L1-L2 (lumbar splanchnics)

80
Q

postganglionic sympathetic neurons for pelvic viscera and smooth muscle

A

hypogastric plexus via the pelvic ganglia

81
Q

Afferent fibers of intraperitoneal pelvic viscera travel (eg uterine contractions)

A

with lesser/least splanchnics and lumbar splanchnics

82
Q

preganglionic parasympathetic neurons for pelvic viscera and smooth muscle

A

pelvic splanchnics

83
Q

afferent fibers of subperitoneal pelvic viscera travel (eg cervical dilation)

A

with S2-S4 pelvic splanchnics

84
Q

bulk of bladder wall is made up of

A

detrusor muscle

85
Q

internal urethral sphincter consists of

A

smooth muscle cells extending from detrusor muscle

86
Q

external urethral sphincter consists of

A

voluntary striated muscle fibers

87
Q

external urethral sphincter location

A

level of pelvic floor

88
Q

the _________nervous system predominates during bladder filling phase

A

sympathetic

89
Q

preganglionic sympathetic nerves for micturition origin

90
Q

preganglionic sympathetic nerves for micturition

A

lumbar and sacral splanchnics

91
Q

where do preganglionic and postganglionic sympathetic nerves for micturition synapse

A

inferior hypogastric plexus

92
Q

postganglionic sympathetic nerves for micturition

A

hypogastric nerves

93
Q

action of hypogastric nerves

A

contraction of internal urethral sphincter and relaxation of detrusor muscle

94
Q

what regulates the micturition reflex

A

sensory stretch fibers in bladder wall and parasympathetic fibers located in pelvic splanchnics

95
Q

location of micturition reflex

A

sacral spinal cord

96
Q

first sensation for urge to void bladder occurs at what amount of urine

97
Q

sensation of bladder fullness occurs at what amount of urine

A

400-500 ml

98
Q

how is sensory information about bladder fullness conveyed

A

via visceral afferent fibers associated with pelvic splanchnic nerves (parasympathetic)

99
Q

inhibition of micturition reflex

A

efferent impulses from the brain inhibit the preganglionic parasympathetic neurons in sacral spinal cord and continue to contract the external sphincter via the pudendal nerve

100
Q

2 triangles of the perineum

A

urogenital triangle, anal triangle

101
Q

pudendal nerve origin

102
Q

pudendal nerve and artery supply

103
Q

divisions of urogenital triangle

A

deep perineal pouch, superficial perineal pouch

104
Q

what are the perineal pouches separated by

A

perineal membrane

105
Q

what is the deep perineal pouch

A

a potential space between the pelvic diaphragm and the perineal membrane

106
Q

what does the deep perineal pouch contain in males

A

part of urethra, external urethral sphincter, deep transverse perineal muscle, bulbourethral glands

107
Q

what does the deep perineal pouch contain in females

A

part of urethra, external urethral sphincter, deep transverse perineal muscle, part of vagina, compressor urethrae, sphincter urethrovaginalis

108
Q

perineal membrane function

A

provides support for external genitalia and pelvic organs

109
Q

what is the superficial perineal pouch

A

a potential space between the perineal membrane and the perineal fascia

110
Q

what does the superficial perineal pouch contain

A

the external genitalia

111
Q

what is the perineal body

A

a central tendon into which pelvic floor and perineal muscles attach

112
Q

perineal body location

A

midline of perineum

113
Q

male sets of erectile tissue composing the penis

A

corpora cavernosa and corpus spongiosum

114
Q

female sets of erectile tissue

A

vestibular bulbs, crura of clitoris

115
Q

thin skeletal muscles that cover the roots of the external genitalia

A

bulbospongiosum, ischiocavernosum, superficial transverse perineal muscles

116
Q

bulbospongiosum in males

A

covers proximal corpus spongiosum (bulb of penis)

117
Q

bulbospongiosum in females

A

covers vestibular bulbs

118
Q

ischiocavernosum in males

A

covers proximal ends of corpora cavernosa (crus of penis)

119
Q

ischiocavernosum in females

A

covers crus of clitoris

120
Q

superficial transfer perineal muscles course

A

run transversely across posterior border of urogenital triangle from ischial tuberosity to insert into perineal body

121
Q

what muscles insert onto perineal body

A

bulbospongiosum, external anal sphincter, superficial transverse perineal

122
Q

male sympathetic action in ejaculation

A

contraction of smooth muscle of epidydimal ducts, vas deferens, seminal vesicles, prostate

123
Q

pudendal nerve origin

A

ventral rami of S2-S4

124
Q

pudendal nerve action

A

sensory and motor to perineum

125
Q

pudendal nerve course

A

exits greater sciatic foramen, passes over sacrospinous ligament, enters lesser sciatic foramen under sacrotuberous ligament to enter pudendal canal

126
Q

pudendal canal aka

A

Alcock’s canal

127
Q

nerve block in vaginal deliveries

128
Q

method of giving pudendal nerve block

A

transvaginally or transperineally

129
Q

location of pudendal nerve block

A

1 cm anterior and medial to ischial spine

130
Q

pathway for contraction of detrusor muscle

A

visceral afferents running with pelvic splanchnics stimulate preganglionic parasympathetic neurons in sacral spinal cord

131
Q

pathway for conscious desire to urinate

A

visceral afferents running with pelvic splanchnic nerves stimulate ascending pathways to brain

132
Q

pathway for conscious urination

A

descending pathways from brain inhibit sympathetic output via hypogastric plexus to allow for relaxation of internal urethral sphincter and stimulate parasympathetics to contract detrusor muscle

133
Q

pathway for voluntary relaxation of external urethral sphincter

A

descending signals from brain inhibit pudendal nerve activity

Clinical Morphology (18 decks)

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