Pelvis: Bladder, Rectum, and Anal Canal Flashcards
1
Q
Ureters in the male pelvis
A
- Descends on lateral wall of pelvis
- Passes inferior to ductus deferens posterior to bladder in males
2
Q
Ureters in the female pelvis
A
- Descends on lateral wall of pelvis
- Passes inferior to uterine vessels in females
3
Q
Ureters in the female pelvis can be damaged
A
- During hysterectomy
- Passes inferior to uterine vessels in females
4
Q
Bladder
A
- Only superior surface is covered in peritoneum
5
Q
Bladder location
A
- Lesser (True) pelvis
- Greater pelvis when distended
- Greater pelvis/abdomen in infants and children
6
Q
Anatomical relationships of pevlis
A
- Posterior to pubic bone (males and females)
- Retropubic space (space of Retzius)
7
Q
Bladder relationships in males
A
- Prostate is inferior
- Seminal vesicle, ductus deferens, and rectum are posterior
8
Q
Bladder relationships in females
A
- Uterus and anterior vaginal wall are posterior
9
Q
Bladder wall
A
- Mostly detrusor muscle (autonomic innervation)
- Parasympathetics: contraction
10
Q
Bladder orifices
A
- 2 Ureteric
- Internal urethral
11
Q
Bladder contains
A
- Bladder wall
- Orifices
- Trigone
- Uvula of the bladder (males)
12
Q
Parts of the bladder
A
- Apex
- Fundus
- Body
- Neck
13
Q
Male urethra
A
- Conveys urine and semen
14
Q
Parts of the male urethra
A
- Intramural
- Prostatic
- Membranous
- Spongy
15
Q
Neck of the male bladder contains
A
- Internal urethral sphincter
16
Q
Internal urethral sphincter (IUS) is innervated by
A
- Autonomics (Parasympathetics cause relaxation)
17
Q
IUS (neck of male bladder) prevents
A
- Retrograde flow of semen
18
Q
Prostatic part of male bladder
A
- Passes through prostate
- Seminal colliculus
- Prostatic sinuses
19
Q
Seminal colliculus (prostatic part of male bladder)
A
- Openings for ejaculatory ducts - Prostatic utricle
20
Q
Prostatic sinuses (prostatic part of male bladder)
A
- Openings for prostatic ducts
21
Q
Membranous part of male urethra
A
- External urethral sphincter surround it
- Voluntarily controlled (pudendal nerve)
22
Q
Spongy part of male urethra
A
- Travels through corpus spongiosum
- Openings for bulbourethral ducts and urethral glands
23
Q
Femle urethra
A
- Short, anterior to vagina
- External orifice opens in vestibule of vagina
- External urethral sphincter more elaborate
24
Q
Rectum location
A
- Begins at S3
- Follows sacral curve
25
Rectum does not contain
- Omental appendices
| - Teniae coli
26
3 lateral flexures of rectum
- Correspond with internal transverse rectal folds
27
Upper 1/3 of rectum
- Covered with peritoneum anterior and lateral surfaces
28
Middle 1/3 of rectum
- Covered with peritoneum on anterior surface only
29
Ampulla of the rectum
- Dilated end of rectum
| - Accumulates fecal mass prior to defecation
30
Anorectal flexure
- Important for fecal continence
| - Puborectalis
31
Parts of the rectum
- Ampulla
| - Anorectal junction
32
Anal junction
- Contains anorectal flexure
33
Anal canal spans from
- Puborectalis sling to anus
34
Anal columns
- Longitudinal ridges mucosal folds
| - Contain branches of superior rectal artery and tributaries of superior rectal vein
35
Anal valves
- Junction of columns at inferior end
36
Anal sinuses
- Pouches above valves
| - Contain openings for mucous glands
37
Pectinate line (Dentate line)
- Junction between embryonic hindgut and skin
| - Visceral vs. Somatic: histology, innervation, lymph, blood supply
38
Anal canal contains
- Anal columns
- Anal valves
- Anal sinuses
39
Internal anal sphincter located
- Between external anal sphincter and anal canal
| - Extends further superiorly
40
Internal anal sphincter muscle
- Involuntary
- Smooth muscle
- Continuous with muscle of rectum
41
Internal anal sphincter innervation
- Autonomic nervous system
- Parasympathetic (relax)
- Sympathetic (contract)
42
Internal anal sphincter has constant tone, but relaxes with
- Distension of rectal ampulla
43
External anal sphincter
- Extends further inferiorly than the internal
44
External anal sphincter muscle
- Voluntary
| - Skeletal muscle
45
External anal sphincter innervation
- S4 via inferior rectal nerve
| - Also nerve to levator ani
46
Rectum/anal canal arterial supply
- Superior rectal (inferior mesenteric)
- Middle rectal (internal iliac)
- Inferior rectal (internal pudendal)
47
Rectum/anal canal venous drainage
- Superior rectal vein (IMV, portal system)
- Middle rectal vein (internal iliac v, caval system)
- Inferior rectal vein (internal pudendal v, caval system
48
Internal venous plexus and External venous plexus
- Sacculated veins form anal cushions
| - Helps with closure of anal canal
49
Hemorrhoids
- Dilation of internal/external venous plexus
50
Internal hemorrhoids
- Dilation and prolapse of internal rectal venous plexus
- Painless bleeding
- Internal venous plexus can drain superiorly or inferiorly
51
Internal hemorrhoids are painless bleeding because of
- Autonomic innervation
52
Internal venous plexus can drain superiorly or inferiorly due to
- Portal-systemic anastomoses
53
External hemorrhoids
- External rectal plexus, subcutaneous around the anus
| - Can be painful, especially if thrombosed
54
External hemorrhoids are painful because of
- Somatic sensory innervation
55
Hemorrhoid cause
- Increased intra-abdominal pressure,
| - Impaired venous return
56
Blood flow above pectinate line
- Columnar epithelium
- Superior rectal artery
- Superior rectal vein (IMV > portal system)
57
Lymph drainage above pectinate line
- Lymph drainage to internal iliac nodes
58
Innervation above pectinate line
- Visceral innervation from the inferior hypogastric plexus (autonomics)
59
Skin above pectinate line
- Columnar epithelium
60
Skin below pectinate line
- Stratified squamous
61
Bloow flow below pectinate line
- Inferior rectal artery
| - Inferior rectal vein (caval system)
62
Lymph drainage below pectinate line
- Lymph drainage to superficial inguinal nodes
63
Innervation below pectinate line
- Somatic innervation from inferior rectal nerves
| - Sensitive to touch, temperature
