Pelvis and Perineum 1.4

Question 1

When is the posterior lobe of the prostate enlarged? (M)

Answer 1

by adenocarcinoma

Question 2

How can you palpate the posterior lobe of the prostate? (M)

Answer 2

digitally in a rectal examination

Question 3

What is the order of metastases for prostate cancer in bone? (M)

Answer 3

1. Pelvis
2. Sacrum
3. Spine
4. Femur

Question 4

What supports the uterus? (W)

Answer 4

1. Subperitoneal ligaments e.g. cardinal and uteroscral ligaments
2. pubovesicle ligaments supporting the urinary bladder may also offer some support
3. pelvic diaphragm
4. broad ligament

Question 5

What makes up the pelvic diaphragm (W)?

Answer 5

levator ani and coccygeus muscles

Question 6

What do the uterine vessels run within? (W)

Answer 6

superior margin of the cardinal ligament, passing over the ureters

Question 7

What is uterine prolapse? (W)

Answer 7

1. involves the loss of support by cardinal and uterosacral ligaments and the pelvic diaphragm (levator ani portion)
2. When these important support structures are weakened, the broad ligament alone is not sufficient to support the uterus or prevent its prolapse.

Question 8

What happens in uterine prolapse? (W)

Answer 8

1. uterus may descend slightly (common in parous women)

2. or may reach the vaginal orifice or beyond (complete prolapse)

Question 9

What is the perineum (W)?

Answer 9

region between the proximal portions of the thigh

Question 10

What is the extent of this diamond shaped area? (W)

Answer 10

1. Anteriorly: from the mons pubis

2. Laterally: medial surfaces of the thighs (ischial tuberosities) 3. Posteriorly: coccyx

Question 11

What does the horizontal line joining the 2 ischial tuberosities divides the diamondshaped perineum into? (W)

Answer 11

1. anterior urogenital triangle 2. posterior anal triangle

Question 12

What is the perineal body? (W)

Answer 12

a fibromuscular mass

Question 13

What does the perineal body mark? (W)

Answer 13

point of convergence of the

• bulbospongiosus muscle
• external anal sphincter
• transverse perineal muscles

Question 14

What support does the perineal body supply? (W)

Answer 14

support to the perineum and pelvic viscera

Question 15

What happens if the perineal body is torn? (W)

Answer 15

(e.g., during childbirth) and is not properly repaired, its support function is compromised and vaginal prolapse may result

Question 16

What is the extent of the male peritoneum (M)?

Answer 16

1. passes from the anterior abdominal wall
2. over the superior surface of the urinary bladder
3. inferiorly on the posterior surface of the bladder
4. passes over the superior ends of the seminal vesicles 5. posteriorly lines the rectovesical pouch

Question 17

What is the rectovesical pouch? (M)

Answer 17

space between the rectum and urinary bladder

Question 18

When does the peritoneum reflect (M)?

Answer 18

onto the superior part of the rectum

Question 19

What does the peritoneum become posteriorly and superiorly (M)?

Answer 19

sigmoid mesocolon

Question 20

Where do the testicular vessels and lymphatic lie and course? (M)

Answer 20

1. lie in a retroperitoneal position
2. course to and from the deep inguinal ring
3. At the ring the retroperitoneal pathway of the ductus deferens as it courses toward the seminal vesicle

Question 21

What is the retroperitineal course of the ureters as they pass to the urinary bladder? (M)

Answer 21

1. course beneath the testicular vessels but over the iliac vessels
2. then pass deep to the ductus deferens as they approach the bladder

Question 22

When can extravasation of urine into adjacent retroperitenal and intrapeirotneal spaces happen? (M)

Answer 22

damaged in surgery in abdominopelvic cavity

Question 23

What does the male perineum include? (M)?

Answer 23

1. anal canal
2. the membranous and spongy parts of the urethra
3. the root of the penis
4. the scrotum

Question 24

What does the root or attached part of penis consist of? (M)

Answer 24

1. 2 crura and a bulb
2. which lies centrally
3. the ischiocavernosus and bulbospongiosus muscles which cover those erectile bodies

Question 25

What is the cura attached to? (M)

Answer 25

internal surface of the ischial ramus

Question 26

What does the urethra do after descending from the bladder and passing through the prostate? (M)

Answer 26

1. enters the proximal portion of the bulb of the penis

2. It passes through the corpus spongiosum as the spongy urethra

Question 27

What muscle is visible in the anal triangle (M)?

Answer 27

levator ani muscle, a portion of the pelvic diaphragm

Question 28

What does circumcision involve?

Answer 28

removal of the prepuce or foreskin of the penis, leaving the glans exposed

Question 29

What are the testes?

Answer 29

paired gonads that are about the size of a chestnut

Question 30

What is each testes encased in?

Answer 30

a thick capsule called the tunica albuginea (white tunic)

Question 31

What are lobules of seminiferous tubules lined with?

Answer 31

the germinal epithelium that gives rise to spermatozoa

Question 32

Where does the spermatozoa drain?

Answer 32

1. into the rete testes (straight tubules)
2. via the efferent ductules into the epididymis
3. where maturation continues until they are ready to be secreted

Question 33

What does the ductus (vas) deferens do?

Answer 33

1. conveys the sperm to the seminal vesicles
2. where they join the seminal vesicle ducts
3. to form the ejaculatory ducts
4. which empty into the prostatic urethra

Question 34

What are testicular tumours?

Answer 34

heterogenous neoplasms

Question 35

Are testicular tumours malignants?

Answer 35

95% of which arise from germ cells and almost all of which are malignant

Question 36

When are testicular tumours common?

Answer 36

This type of cancer is most common in males from the age of puberty until the mid or late 30s