Pelvis and Perineum (Exam 3 part 1) Flashcards
what is the function of the pelvic diaphragm? what interrupts it?
serves as the floor of the pelvic cavity, interrupted by urogential hiatus
what is the pelvic diaphragm comprised of?
levator ani and coccygeus muscles
the __________ forms a sling around the anus at the anorectal junction. Function?
puborectalis, keeps waste in
what forms the lateral pelvic wall?
obuerator internus, and obturator membrane
what forms the posterior pelvic wall
piriformis, sacral plexus
what does the endopelvic fascia consist of?
parietal and visceral fascia layers
what does the parietal endopelvic fascia cover?
surface of sacrum, coccyx, pelvic wall and floor muscles
what does the visceral endopelvic fascia suspend? function?
viscera of the pelvis, support
what does the uterosacral ligament connect?
uterus and sacrum
what does the cardinal ligament connect?
cervix to fascia of the piriformis
where is the retrovesicle pouch located?
space between bladder and rectum, males
where is the vesico-uterine pouch located?
females, space between bladder and uterus
where is the rectouterine pouch located?
space between rectum and uterus, females
why do females not have a rectovesicle pouch?
because the uterus is in between the bladder and rectum
what are the peritoneal recesses?
rectovesical pouch, vesicouterine pouch, rectouterine pouch
what are the various subperitoneal recesses
retropubic space, retrorectal space, rectovesical septum, rectovaginal septum
where is the retropubic space located?
space between pubic symphysis and bladder
where is the retrorectal space located?
space between rectum and sacrum
where is the rectovesical septum located?
septum between bladder and rectum in males
where is the rectovaginal septum located?
septum between rectum and vagina in females
what supplies the pelvic and perineal structures?
internal iliac arteries
generally, what do the anterior divisions of the internal iliac arteries supply?
viscera of the pelvis
generally, what do the posterior divisions of the internal iliac arteries supply?
muscles, gluteal and pelvic wall structures
generally what is the venous drainage of the pelvis and perineum?
series of venous plexuses surrounding the pelvis viscera which drain into the internal iliac veins
describe the venous drainage of the gonads?
right gonads drained by gonadal veins into the inferior vena cava directly
left gonads drained into the left renal vein, then into the inferior vena cava
describe the somatic innervation of the pelvis and perineum
pudendal nerve, nerves to the levator ani and coccygeus
What is the pudendal nerve? what kind of innervation?
anterior rami of S2-4, voluntary motor for external anal and urethral sphincters, sensory of genitalia
what are the nerves to the levator ani and coccygeus? what kind of innervation?
anterior rami of S3-4, motor for pelvic diaphragm
what is the sacral plexus comprised of?
anterior rami of S1-4, and contributions from lumbar spinal nerves via the lumbosacral trunk
what pelvic structures are somatically innervated? plexus?
skeletal muscle and skin of the pelvic diaphragm, pelvic wall, and perineum
sacral plexus
what pelvic structures are autonomically innervated?
smooth muscle of the pelvic viscera and perineal vasculature
what forms the inferior hypogastric plexus
preganglionic sympathetic and parasympathetic fibers
sympathetic ___________ fibers from _______ splanchnic nerves form the _______ ____________ plexus and continue as right and left ___________ nerves to synapse with ________ fibers associated with ganglia within the __________ __________ plexus
preganglionic, lumbar, superior hypogastric, hypogastric, postganglionic, inferior hypogastric
postganglionic sympathetic fibers travel along __________ to pelvic and perineal viscera
arteries
what is the result of parasympathetic autonomic innervation of pelvic and perineal structures
opens sphincters, bladder emptying, erection, sexual excitation, and mediate sensation from pelvic viscera
what will innervate the levator ani muscles
nerve to levator ani and coccygeus
what will produce ejacuation
lumbar splanchnic nerves from superior hypogastric plexus form left and right hypogastric nerves then synapse in inferior hypogastric plexus
what does the pelvis viscera include
portions of the digestive, urinary, and reproductive systems that are contained within the lesser pelvis
where does the transition from the sigmoid colon to the rectum occur?
rectosigmoidal junction
the rectum lacks ______ ____________ and _______ ________ but possesses three ________ _________ folds
teniae coli, omental appendices, transverse rectal
how is continence of the rectum maintained?
constant contraction of the puborectalis muscles surrounding the anorectal flexure
where does the rectum become the anal canal
terminal part bends sharply posterior at the anorectal flexure
what supplies the rectum? drains it?
the superior, middle, and inferior rectal arteries
superior, middle, inferior rectal veins into the HPS and caval system
what are ureters? function?
mostly retroperitoneal muscular tubes connecting kidneys and urinary bladder, peristaltic contraction transports urine
how do the ureters pierce the lateral aspect of the bladder wall?
in an oblique inferomedial angle
what is the function of the ureters piercing the bladder at an oblique inferomedial angle
creates a one way valve filling of bladder collapses the passage through the wall preventing back flow of urine
what is the autonomic innervation of the ureters?
via renal, aortic, superior and inferior hypogastric plexuses
what are the 4 parts of the bladder?
apex, fundus, body, neck
what forms the trigone?
ureters and internal urethral orifices
what muscle forms the bladder wall?
detrusor muscle
what ligament supports the bladder?
median umbilical ligament
what supplied the bladder? drains it?? (blood!!)
superior and inferior vesical arteries of the internal iliac arteries
drained by superior and inferior vesical veins into the internal iliac veins
