Pelvis and Perineum Flashcards

1
Q

Structure that divides the pelvis into false and true pelvis

A

Pelvic Brim

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2
Q

Structure passing through greater sciatic foramen

A

Sciatic nerve, pudendal nerve, gluteal nerves and vessels

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3
Q

Structure passing through lesser sciatic foramen

A

Pudendal nerve, internal pudendal vessels

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4
Q

Long, narrow, oval shaped pelvis

A

Anthropoid

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5
Q

Wide pekvis flattened at the brim with sacral promontory pushed forward

A

Platypelloid

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6
Q

Structures dividing sciatic notches to greater and lesser sciatic foramina

A

Sacrotuberous ligament

Sacrospinous ligament

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7
Q

Components of pelvic diaphragm

A

Levator ani and coccygeus

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8
Q

Components of levator ani

A

Levator prostatae or sphincter vaginae
Puborectalis
Pubococcygeus
Iliococcygeus

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9
Q

Small fibrous mass between tip of coccyx and anal canal, where pubococcygeus and iliococcygeus insert?

A

Anococcygeal body

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10
Q

Muscle which forms a sling around the junction of the rectum and anal canal

A

Puborectalis

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11
Q

Innervation of levator ani

A

Perineal branch of S4

Perineal branch of pudendal nerve

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12
Q

Forcible contraction of the sartorius muscle in athletes may damage which pelvic structure

A

ASIS

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13
Q

Forcible contraction of the rectus femoris muscle may damage which pelvic structure?

A

Anterior Inferior Iliac Spine

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14
Q

Forcible contraction of hamstring muscles may avulse this pelvic structure

A

Ischial tuberosity

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15
Q

Major source of bleeding in massive hemorrhage associated with pelvic fractures

A

Internal Iliac Veins and tributaries

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16
Q

TRUE OR FALSE. During defacation, the levator ani and puborectalis relax with the anal sphincters.

A

FALSE. Only puborectalis and sphincters relax. Levator ani continues to contract to support pelvic viscera

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17
Q

Contraction of the puborectalis helps maintain continence by pulling the anorectal junction to what direction

A

Upward and forward

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18
Q

The sacral plexus lies on the posterior pelvic wall in front of which muscle?

A

Piriformis

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19
Q

The lumbosacral trunk is formed from which spinal nerves

A

L4 L5

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20
Q

Where does the common iliac artery divide into internal and external iliac artery?

A

Pelvic inlet in front of sacroiliac joint

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21
Q

Branches of external iliac artery

A

Inferior Epigastric artery
Deep circumflex iliac artery
Femoral artery (under inguinal ligament)

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22
Q

Arteries which enter the pelvic cavity

A

Internal iliac artery
Superior rectal artery
Ovarian artery (NOT TESTICULAR kasi inguinal canal iyon)
Median Sacral Artery

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23
Q

Branches of the internal iliac artery

A
Anterior Division
Umbilical artery
Obturator artery
Inferior vesical artery
Middle rectal artery
Internal pudendal artery
Inferior gluteal artery
Uterine artery
Vaginal artery

Posterior
Iliolumbar artery
Lateral sacral artery
Superior gluteal artery

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24
Q

The superior vesical artery arises from which artery

A

Umbilical artery

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25
Q

The artery to the vas deferens arises from which artery

A

Inferior vesical artery

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26
Q

The uterine artery crosses the ureter. What is the relationship of the two?

A

Uterine artery crosses the ureter superiorly

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27
Q

The ovarian artery arises from what level of the abdominal aorta

A

L1

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28
Q

This divides the true pelvis into the main pelvic cavity and the perineum

A

Pelvic Diaphragm

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29
Q

The rectum begins in front of which vertebra?

A

S3

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30
Q

Which surfaces of the rectum are covered by peritoneum?

A

Anterior and lateral of first 1/3

Anterior middle third

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31
Q

Two or three semicircular permanent folds in the rectum

A

Transverse Folds/Valves of Houston

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32
Q

Blood supply of rectum?

A

Superior, Middle, and Inferior Rectal artery/vein

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33
Q

Lymph drainage of rectum?

A

Pararectal nodes – inferior mesenteric nodes

Lower rectum: Internal iliac nodes

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34
Q

Internal hemorrhoids are mainly from which set of rectal vessels?

A

Superior rectal artery/vein

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35
Q

TRUE OR FALSE: The urinary bladder, when empty lies entirely within the pelvic cavity?

A

FALSE: In adult, yes. In child, no

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36
Q

What connects the urinary bladder to the umbilicus?

A

Median umbilical Ligament

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37
Q

The median umbilical ligament is the remnant of which embryonic structure

A

Urachus

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38
Q

The ureters pierce the bladder on which surface?

A

Superolateral

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39
Q

Area of mucous membrane covering the internal surface of the base of the bladder, where mucous membrane is always smooth even on an empty bladder

A

Trigone

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40
Q

The three angles of the bladder trigone compose of?

A

Superior 2 - ureters

Inferior- internal urethral orifice

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41
Q

Muscular ridge which runs from the opening of one ureter to that of the other?

A

Interureteric ridge

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42
Q

Small elevation situated immediately behind the urethral orifice, produced by the underlying median lobe of the prostate

A

Uvula vesicae

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43
Q

Muscular coat of the bladder composed of smooth muscle, arranged as three layers of interlacing bundles known as

A

Detrusor Muscle

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44
Q

Blood supply of urinary bladder

A

Superior and inferior vesical artery

Vesical venous plexus

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45
Q

Lymph drainage of urinary bladder

A

Internal and external iliac nodes

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46
Q

Sympathetic nerves action on the muscles of the bladder?

A

Inhibitcontraction of detrusor

Stimulate closure of sphincter vesicae

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47
Q

Parasympathetic nerves action on the muscles of the bladder?

A

Stimulate contraction of the detrusor muscle of the bladder wall
Inhibit sphincter vesicae

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48
Q

Normal capacity of the adult bladder?

A

500 mL

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49
Q

The ampulla of the vas deferens and the duct of the seminal vesicle join to form what structure

A

Ejaculatory Duct

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50
Q

The seminal vesicles are located n which surface of the bladder?

A

Posterior

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51
Q

Blood supply of the seminal vesicles

A

Inferior vesical and middle rectal artery

Internal iliac veins

52
Q

The ejaculatory ducts join the urethra onwhich portion?

A

Prostatic part

53
Q

The prostate is separated from the symphisis pubis by the extraperitoneal fat in the retropubic space known as?

A

Cave of Retzius

54
Q

What structure separates the anterior surface of the rectal ampulla from the prostate?

A

Rectovesical septum (Fascia of Denonvilliers)

55
Q

Prostate lobe devoid of glandular tissue

A

Anterior Lobe

56
Q

Wedge of prostate gland situated between the urethra and ejaculatory ducts

A

Median/Middle Lobe

57
Q

Prostate lobe situated behind the urethra and below the ejaculatory ducts

A

Posterior Lobe

58
Q

Lobes of the prostate separated by a shallow vertical groove on the posterior surface of the prostate

A

Left and Right Lateral Lobes

59
Q

Blood supply of the prostate

A

Inferior vesical and middle rectal artery

Prostatic venous plexus

60
Q

Lymph drainage of the prostate

A

Internal iliac nodes

61
Q

Widest and most dilatable portion of the urethra

A

Prostatic Urethra

62
Q

Lowest part of the abdominopelvic cavity when patient is in erect position

A

Rectovesical pouch

63
Q

The mesovarium attaches the ovary to whnat structure

A

Broad ligament

64
Q

Part of broad ligament extending between the attachment of the mesovarium and the lateral wall of the pelvis is called

A

Suspensory ligament of the ovary

65
Q

Ligament which connects lateral margin ofuterusto ovary

A

Round ligament of ovary

66
Q

THe round ligament of the ovary represents the remains of which embryonic structure

A

Gubernaculum

67
Q

Thin fibrous capsule surrounding ovary

A

Tunica Albuginea

68
Q

Modified area of peritoneum covering the tunica albuginea

A

Germinal epithelium

69
Q

The ovarian fossa is bound by which vessels

A

External iliac vessels above, internal iliac vessels behind

70
Q

Blood supply of ovary

A

Ovarian artery/Vein

71
Q

Lymph drainage of ovary

A

Para-aortic nodes

72
Q

FUnnel shaped lateral end of fallopian tube

A

Infundibulum

73
Q

Widest and narrowest part of fallopian tube

A

Widest - ampulla

Narrowest - Isthmus

74
Q

Blood supply of fallopian tube

A

Uterine artery/vein and ovarian artery/vein

75
Q

Lymph drainage of fallopian tube

A

Internal Iliac and para-aortic nodes

76
Q

Normal position of uterus

A

Anteverted and anteflexed

77
Q

Blood supply of uterus

A

Uterine artery and ovarian artery

Uterine vein

78
Q

Lymph drainage of uterus

A

Fundus Para-aortic nodes
Body and cervix - internal and external iliac nodes
few: Superficial ingunal nodes

79
Q

What structure connects the levator ani and the cervix

A

Pelvic fascia

80
Q

Subperitoneal condensations of pelvic fascia which play an important part in supporting uterus

A

Cardinal Ligament (Transverse cervical)
PubocervicalLigament
Sacrocervical Ligament

81
Q

TRUE OR FALSE: Upper half of vagina lies above pelvic floor and lower half lies within the perineum

A

TRUE

82
Q

Vaginal lumen surrounding the cervix

A

Fornix

83
Q

Blood supply of the vagina

A

Vaginal artery

Vaginal branch of uterine artery

84
Q

Lymph drainage of vagina

A

Upper 3rd - external and internal iliac nodes
Middle 3rd - Internal iliac nodes
Lower 3rd - superficial inguinal nodes

85
Q

Lowest portion of abdominopelvic peritoneal cavity in females

A

Rectouterine pouch (Pouch of Douglas)

86
Q

THe epoophoron and paroophoron are vestigial structures in the broad ligament which are remnants of which embryonic structure?

A

Mesonephros

87
Q

Borders of the perineum

A

Anterior - symphysis pubis
Posterior - Coccyx
Laterally - ischial tuberosities

88
Q

Innervation of skin around the anus

A

Inferior rectal nerve(hemorrhoidal nerve)

89
Q

Lymph drainage of skin around anal canal

A

Medial group of superficial inguinal nodes

90
Q

The diamond shaped perineum is divided into two “triangles” which are

A

Urogenital triangle and anal triangle

91
Q

Structure lateral and posterior to the anal canal

A

Lateral - ischiorectal fossae

Posterior - anococcygeal body

92
Q

Vertical folds in the mucous membrane of theanal canal

A

Anal columns (of Morgagni)

93
Q

The anal columns are joined together at their lower ends by small semilunar folds called

A

Anal valves

94
Q

Differentiate upper half and lower half of anal canal in terms of embryology, histology, blood supply, innervation, and lymphatic drainage

A

Embryo: Upper - from hindgut entoderm, Lower - ectoderm of proctodeum

Histo: Upper - Columnar epithelium, with anal columns. Lower - stratified squamous epithelium, no anal columns

Blood supply: Upper - superior rectal artery/vein and portal vein. Lower - inferior rectal artery/vein

Nerve - upper: stretch sensitive only (like rectum) Lower: pain,touch, temperature, stretch

95
Q

Level where upper half and lower half of anal canal meet?

A

Pectinate line

96
Q

Part of the external anal sphincter attached to bone

A

Superficial part

The subcutaneous and deep part have no bony attachments

97
Q

The anorectal ring isfound at the junction between the rectum and anal canal and is formed by which muscles

A

Deep part of external sphincter
Internal sphincter
puborectalis

98
Q

Contents of ischiorectal fossa

A
Dense fat
Pudendal canal (on the lateral wall) which contains internal pudendal vessels and pudendal nerve
99
Q

Branches of the pudendal nerve

A

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

100
Q

Branches of the internal pudendal artery

A

Inferior rectal artery
Branch to the penis
Branch to the labia and clitoris

101
Q

The perineal vessels and nerves enter the perineum through what structure

A

Lesser sciatic foramen.

They leave pelvis through greater sciatic foramen

102
Q

Piles are another term for which structure?

A

Internal hemorrhoids

103
Q

The tributaries of the superior rectal vein lie on which position of the anal column, when patient is viewed from the lithotomy position

A

3 - 7 - 11 o clock

104
Q

Fascia enclosing the erectile tissue of the penis

A

Buck’s fascia

105
Q

The glans penis is continuous with which erectile tissue?

A

Corpus spongiosum

106
Q

Blood supply of penis

A

Deep artery of the penis from internal pudendal artery

Internal pudendal vein

107
Q

Lymph drainage of the penis

A

Skin - medial group of superficial inguinal nodes

Deep structures - internal iliac nodes

108
Q

Layers of the scrotum

A
Skin
Dartos Muscle
Colles Fascia
External spermatic fascia
Cremasteric vascia
Internal spermatic fascia
Tunica vaginalis
109
Q

Blood supply of scrotum

A

External pudendal branch of femoral artery/vein

Scrotal branch of internal pudendal artery/vein

110
Q

Lymph drainage of scrotum

A

Medial group of superficial inguinal nodes

111
Q

Lymph drainage of testis and epididymis

A

Para-aortic lymph nodes

112
Q

This muscle compresses the penile part of the urethra and deep dorsal vein of the penis, assisting in emptying urine or semen, and maintaining erection

A

Bulbospongiosus

113
Q

This muscle compresses the crus penis and assists in erection

A

Ischiocavernosus

114
Q

Shortest and least dilatable part of the urethra

A

Membranous part

115
Q

Small glands beneath the sphincter urethrae

A

Bulbourethral grand

116
Q

Erection of the penis is stimulated by sympathetic or parasympathetic nerves?

A

Parasympathetic

117
Q

Ejaculation is stimulated by sympathetic or parasympathetic nerves

A

Parasympathetic

118
Q

Narrowest part of the male urethra

A

External meatus

119
Q

The part of the urethra that lies within the glans penis that is dilated is called?

A

Fossa terminalis (navicular fossa)

120
Q

Constriction of the orifice of the prepuce caused by repeated inflammation

A

Phimosis

121
Q

Glands in the female corresponding to the male prostate

A

Paraurethral gland

122
Q

Structures supporting the upper third of vagina

A

Levator ani, transverse cervical, pubocervical, and sacrocervical ligament

123
Q

Structures supporting the middle third of vagina

A

Urogenital diaphragm

124
Q

Structures supporting the lower third of vagina

A

Perineal body

125
Q

Blood supply of vulva

A

External and internal pudendal artery/vein

126
Q

Lymph drainage of vulva

A

Medial group of superficial inguinal nodes