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Anatomy > pelvis- internal genitalia > Flashcards

pelvis- internal genitalia Flashcards

1
Q

which testicle lies lower?

A

left

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2
Q

what do the visceral and parietal layers of the tunica vaginalis cover?

A

Visceral covers epididymis & testicle

Parietal lines internal spermatic fascia

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3
Q

what two structures is the epididymis continuous with?

A

Continuous with rete testis (via mediastinum) & ductus deferens

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4
Q

what is the firm muscular continuation of the epididymis?

A

ductus/vas defrens

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5
Q

what does the ductus defrens pass anteromedially to?

A

ureter, to merge with seminal vesicle

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6
Q

what path does the ductus defrens take come from the testes, through the inguinal canal and out of the deep ring? (where does it go from here?)

A

Crosses external iliac vessels to enter pelvis

Passes along lateral pelvic wall deep to peritoneum

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7
Q

where does the vas defrens get its blood supply from?

A

branches from superior vesicle artery (forms ductus defrens artery)
branches from inferior vesicle artery (more to lower- ejac duct area)

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8
Q

what covers the superior end of seminal vesicle?

A

by peritoneum of ureteric fold

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9
Q

where do the seminal glands/vesicles get there blood supply from?

A

Supplied by branches of inferior vesical arteries & middle rectal arteries

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10
Q

what is the path of the ejac ducts?

A

formed from vas defrens and seminal gland duct
Pass anteroinferior to enter prostate
Open into urethra via apertures on seminal colliculus

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11
Q

what type of fluid does the prostate secrete?

A

Contributes alkaline, milky fluid to semen

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12
Q

the superior base of the prostate contacts what? what about it’s inferior apex?

A

Superior base contacts bladder neck

Inferior apex contacts external urethral sphincter

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13
Q

what are the anterior and posterior surfaces of the prostate in contact with?

A

Anterior surface separated from pubic symphysis by retropubic (prevesical) space
Posterior surface contacts rectal ampulla

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14
Q

what portion of the prostate is palpable on exam?

A

inferior portion of posterior lobe

*BPH is most commonly here

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15
Q

what are the 5 different lobes of the prostate?

A
  • anterior/isthmus lobe
  • middle lobe
  • posterior lobe
  • right lateral lobe
  • left lateral lobe
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16
Q

what was the prostate historically divided into? what is the prostate currently divided into?

A

old- 5 “ lobes”

now- 4 “ zones”

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17
Q

which lobe has no glandular tissue (mostly muscular) AND has the prostatic commissure?

A

anterior lobe (isthmus)

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18
Q

what are the boundaries of the middle prostate lobe?

A

between urethra and ejac ducts

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19
Q

what is the posterior prostate lobe behind?

A

ejac duct

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20
Q

what separates the right and left lateral prostate lobes?

A

“furrow” - slight indentation

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21
Q

what are the 4 “zones” that prostate is now divided into? (kinda weeds)

A

anterior, intermediate, central (includes “posterior lobe”), peripheral (lateral lobes)

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22
Q

how many prostatic ducts are there? where do they open into?

A

20-30 prostatic ducts open into prostatic sinuses of urethra

Lateral to seminal colliculus

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23
Q

what artery supply the prostate?

A

Supplied by prostatic branches of inferior vesical artery

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24
Q

what is the purpose of the SNS and PSNS for the prostate/vas/seminal glands?

A

SNS: Stimulates peristalsis of vas, secretion by seminal glands/prostate
PSNS: function unclear

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25
Q

how does the innervation of the testes reflect posterior abd. origin?

A

PSNS: Vagal (CN10)
SNS: T10, T11

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26
Q

the ovary is truly intraperitoneal. its Suspended within the ________ portion of broad ligament
Not covered by _________

A 
mesovarium
peritoneum (mesothelium)
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27
Q

what are the lateral and medial attachments of the ovary?

A

lateral: attach to pelvic wall via SUSPENSORY LIGAMENT
medial: attach to uterus via OVARIAN LIGAMENT

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28
Q

what runs through the suspensory ligament?

A

ovarian neurovasculature

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29
Q

what runs through the ovarian ligament?

A

uterine branches (veins and artery)

30
Q

what ligament is a remnant of the fetal gubernaculum?

A

ovarian ligament

31
Q

what are the fallopian tubes located (where do they run?) and what are they suspended by?

A

Extend from uterine horns to ovaries

Suspended by mesosalpinx- portion that holds the tubes in place on superior edge of broad ligament

32
Q

fallopian tubes are analogous to what male structure (in terms of function)?

A

vas defrens

33
Q

what is the most superior structure in the broad ligament?

A

fallopian tubes

34
Q

describe the mesosaplinx, mesovarium and mesometrium: where area they located and how many layers in each?

A

superior mesosalpinx: double layer on either side of fallopian tube
posterior mesovarium: double layer around ovary
inferior mesometrium: double layer around the bottom- under fallopian tube, round ligament, ovary

35
Q

what is the infundibulum portion of the fallopian tube like?

A

Funneled distal end
Opens into peritoneal cavity via ostium
Numerous fimbria drape around ovary
Ovarian fimbria provide attachment

36
Q

what is the isthmus of the fallopian tube like? where is it?

A

Thick-walled

Enters uterine horn

37
Q

what is the uterine portion of the fallopian tube like?

A

Intramural segment

Opens into uterine cavity via ostium

38
Q

what are the arterial supply of the ovaries and fallopian tubes?

A

by abdominal & pelvic sources:
Ovarian arteries from abdominal aorta
Ascending branch of uterine artery from internal iliac

39
Q

where do the ovaries and fallopian tubes drain to (venous drainage) ?

A

Ovarian veins drain to IVC & left renal vein

40
Q

where is the uterus in relation to bladder and rectum?

A

Lies between (& superior to) bladder & rectum

41
Q

how are most uteruses sitting in the body? describe these terms

A

Anteverted (angled anteriorly relative to vagina)
Anteflexed (bent anteriorly relative to cervix)
–Typically transverse & mostly rests on bladder

42
Q

how many supports are there for the uterus, what plane are they in?

A 
2 coronal (really more like 3) 
2 transverse
43
Q

what are the two (really 3) uterine supports in the coronal plane?

A
  1. ovarian ligament & round ligament (lie between layers of broad ligament)
  2. broad ligament
44
Q

what is the broad ligmament?

A

Double layer of peritoneum
-Drapes over ovarian/round ligaments & uterine tube
-Covers ovarian vessels laterally
-Extends from sides of uterus to pelvic walls & floor
Mesometrium

45
Q

what are the two uterine supports in the transverse plane?

A

cardinal and uterosacral ligaments

46
Q

what forms the cardinal ligament and what does it attach and what does it contain?

A

Condensation of endopelvic fascia
Attach cervix to lateral pelvic wall
Contains uterine vessels

47
Q

what does the uterosacral ligaments attach?

A

Attach cervix to sacrum (coming off posterior uterus)

48
Q

ovarian and round support lateral uterus. ovarian on _____ side, round on _____ side

A

ovarian- anterior

round- posterior

49
Q

what is the superior portion of the birth canal?

A

cervix (lower 1/3 of uterus)

50
Q

how is the uterus broken down into body and cervix ?

A

body: superior 2/3
cervix: inferior 1/3

51
Q

which part of the uterus is “mobile” ?

A

body (upper 2/3)

52
Q

how is the uterus demarcated from the cervix?

where is the superior fundus” ?

A

Demarcated from cervix by isthmus constriction

Superior fundus above uterine ostia

53
Q

cervix: supravaginal vs vaginal portions

A

Supravaginal portion: between isthmus & vagina
Bears internal os

Vaginal portion: protrudes into vagina
Bears external os
Surrounded by vaginal fornix

54
Q

where does the uterine “cavity” extend from? what provide the entry point for uterine tubes into the cavity?

A 
Extends from fundus to external os
Superolateral horns (cornua) provide entry for uterine tubes
55
Q

where is the inferior fusiform cervical canal? (between what and what? )

A

Between internal & external os

56
Q

what are the 3 parts of the uterus wall?

A

perimetrium (outermost)
myometrium
endometrium (innermost)

57
Q

what is the perimetrium portion of the uterus wall?

A

Visceral peritoneum

58
Q

what is the myometrium?

A

Thick muscle coat

Hormonally responsive

59
Q

what is the endometrium? what is it responsive to?

A

Functional layer
Cyclical changes in response to ovarian hormones
Uterine (menstrual) cycle

60
Q

which two layers of uterus wall are hormonally responsive?

A

myometrium and endometrium

61
Q

where does the vagina extend from? (from where to where?)

A

Extends from mid cervix to vaginal orifice

Cleft between labia minora

62
Q

where are the lateral walls of the vagina collapsed? where are the anterior/posterior walls collapsed?

A

Lateral walls usually at orifice

Anterior/posterior walls in canal

63
Q

what are the 3 different portions of the vaginal fornices? which is right near the rectouterine pouch?

A

Anterior, lateral, posterior portions

Deep posterior fornix abuts rectouterine pouch

64
Q

what is the arterial supply of the vagina?

A 
vaginal branch of uterine (upper) 
internal pudendal (lower) arteries
65
Q

why is pelvic pain referred?

A

visceral afferents follow autonomics (SNS and PSNS)

66
Q

where do pelvic visceral afferents follow SNS? where do they enter the CNS?

A

in abdominal cavity
-Abdominopelvic splanchnic/lumbar splanchnic nerves
Sympathetic trunk
White rami communicantes

Enter CNS at inferior thoracic/upper lumbar levels
T6-L2

67
Q

where do pelvic visceral afferents follow PSNS? enter the CNS where?

A

Travel with parasympathetics distal to mid-sigmoid

Enter CNS at S2-S4

68
Q

what is the term for the “inferior/lower limit of the peritoneum”? what is the significance of this? where is it?

A

pelvic pain line: threshold/boundary determining the course of visceral pain sensation

  • runs just along the inferior peritoneum (top of bladder)
  • -> females: crosses just above cervix (lower 1/3 uterus)
69
Q

structures above or in contact with inferior peritoneum (pelvic pain line) convey visceral pain sensation via what nerves? what about those below inferior peritoneum (pelvic pain line)

A

above/in contact: pain via SNS lumbar splanchnic nerves

below: pain via PSNS pelvic splanchnic nerves

70
Q

which nerves have white rami communicantes?

A

sympathetics: T12-L2

so only for those visceral afferents above pelvic pain line

71
Q

where does the digestive tract “switch” in regards to innervation?

A

mid-sigmoid colon (pelvic pain line level)

72
Q

which have longer postsynaptic nerves, SNS or PSNS?

A

SNS

Anatomy (13 decks)

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