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Human Anatomy Exam #3 > Pelvis & Perineum > Flashcards

Pelvis & Perineum Flashcards

1
Q

What is the only type of innervation found in the pelvic diaphragm?

A

Somatic ONLY (no visceral)

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2
Q

What does SI joint stand for and what type of joint is this (2)?

A

Sacroiliac joint (SI) is a synovial joint anteriorly and a syndesmosis joint posteriorly

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3
Q

What are the five joints of the pelvic joint and what are their functions? (hint: 2 grouped together and other 3 grouped together)

A
  • Iliolumbar joint (stabilize joint)
  • Anterior SI joint (stabilize joint)
  • Posterior SI joint (stabilize joint)
  • Sacrospinous (prevent flexion)
  • Sacrotuberous (prevent flexion)
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4
Q

What three subunits make up the levator ani muscle?

A
  • Pubococcygeus
  • Iliococcygeus
  • Puborectalis
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5
Q

What is the urogenital hiatus (where is it located)? What structures pass through it?

A

Urogenital hiatus is an opening in the levator ani muscles that allows for the passage of the urethra in males and females, as well as the vagina in females

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6
Q

During defecation, what is the role of each of the levator ani muscles?

A
  • Pubococcygeus and Iliococcygeus contract to resist increased abdominal pressure when the abdominal muscles contract
  • Puborectalis relaxes to straight then anorectal junction
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7
Q

What are the three branches of the posterior division of the Internal Iliac a.?

A
  • Iliolumbar a.
  • Lateral sacral a.
  • Superior rectal a.
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8
Q

What are the eight branches of the anterior division of the Internal Iliac a.?

A
  • Umbilical a.
  • Obturator a.
  • Middle rectal a.
  • Internal pudendal a.
  • Inferior gluteal a.
  • Superior vesical a.
  • Uterine a./Inferior vesical a.
  • Vaginal branches/prostatic branches
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9
Q

What are the two arteries/branches found in the anterior division of the Internal Iliac a. that are analogous in females versus males?

A
  • Uterine a. and Inferior vesical a.

- Vaginal branches and prostatic branches

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10
Q

What levels of the vertebral column provide somatic innervation to the pelvic diaphragm?

A
  • Lumbosacral trunk (L4-5 anterior rami)

- Sacral plexus (S1-4 anterior rami)

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11
Q

What are the ten branches from the sacral plexus that pass through the pelvis?

A
  • Sciatic n.
  • Superior gluteal n.
  • Inferior gluteal n.
  • Pudendal n.
  • Posterior femoral cutaneous n.
  • Nerve of piriformis
  • Nerve of obturator internus
  • Nerve of quadrates femoris
  • Nerve of levator ani
  • Nerve of coccygeus
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12
Q

What is the one nerve that branches from the lumbar plexus and passes through the pelvis?

A

Obturator n.

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13
Q

What plexus provides innervation to the pelvis? What are the sympathetic (visceral motor) innervations and the parasympathetic (visceral motor) innervations?

A

Superior hypogastric plexus

  • Sympathetics: lower lumbar splanchnic nn. and upper sacral splanchnic nn.
  • Parasympathetics: Pelvis splanchnic nn. (S2-4)
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14
Q

Where do the hypogastric nerves originate from and what plexus do they form? What type of ganglions are found in this plexus?

A

Hypogastric nerves come from the Superior hypogastric plexus and converge to form the Inferior hypogastric plexus

  • Postganglionic sympathetics (synapse in plexus)
  • Preganglionic parasympathetics (wait and synapse at target organs)
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15
Q

What is the one pouch found in the peritoneum of males?

A

Rectovesical pouch (between rectum and bladder)

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16
Q

What are the two pouches found in the peritoneum of females? Which is more anterior?

A
  • Vesicouterine pouch (between bladder and uterus) - more anterior of the two
  • Rectouterine pouch (between rectum and uterus)
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17
Q

Where is the pelvic pain line located? What are the rules for visceral pain and non-pain sensation above/below the PPL?

A

Pelvic pain line (PPL): inferior extent of peritoneum across the midpoint of the sigmoid colon

Above PPL

  • Non pain: parasympathetics in reverse
  • Pain: sympathetics in reverse

Below PPL:

  • Non pain: parasympathetics in reverse
  • Pain: parasympathetics in reverse
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18
Q

What type of muscle makes up the internal urethral sphincter? What type of muscle makes up the external urethral sphincter?

A
  • Internal urethral sphincter: smooth muscle

- External urethral sphincter: striated muscle

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19
Q

Describe the actions of the sympathetic and parasympathetic innervations in the bladder.

A
  • Sympathetics: allows for filling, contracts internal sphincter during ejaculation (filling gives chance for other organs to be active)
  • Parasympathetics: contract detrusor muscle and inhibit internal sphincter (finally have time to urinate)
20
Q

What is the flow of urine starting from the kidneys?

A

Kidneys > Ureters > Bladder > Urethra

21
Q

What is the clinical significance of the posterior vaginal fornix of the vagina?

A

The posterior vaginal fornix is the site for culdocentesis, which is sampling peritoneal fluid from the peritoneal cavity’s rectouterine pouch

22
Q

What three vessels are intentionally ligated during a hysterectomy? What must be protected when ligating one of these specific a. (and which artery is this)?

A

During a hysterectomy, the cervix and uterus are removed and the ovarian a., uterine a. and vaginal a. are all ligated
- Must be sure to protect the ureter when ligating the uterine a.

23
Q

What two plexuses provide autonomic innervation to the female internal genitalia? Where do these plexuses originate from?

A

Ovarian plexus and Uterovaginal plexus from the Inferior hypogastric plexus

24
Q

What are the four primary components of semen and what three structures secretes each component?

A
  • Sperm via ductus deferens
  • Thick alkaline high-fructose fluid and coagulating agent from seminal vesicle
  • Milky fluid from prostate
25
Q

Where is the prostate located, and what is its function?

A

Prostate surrounds the prostatic urethra, just inferior to the bladder
- Secretes milky fluid that is the final component of semen

26
Q

Which prostate lobe is the most common site for BPH? What are the other two lobes?

A

Central Zone: common site for BPH

- Also the Peripheral Zone and Anterior Muscular Zone

27
Q

What three arterial vessels are found in the male internal genitalia? What structures does each provide blood to (3, 2, 2)?

A
  • Testicular a.: testes, ureters, epididymis
  • Superior vesical a.: bladder, ductus deferens
  • Inferior vesical a.: seminal vesicles, prostate
28
Q

What venous plexus of the male internal genitalia is a potential site for cancer metastases and why?

A

The prostatic venous plexus has posterior communication with the vertebral venous plexus, creating a potential pathway for metastasis of cancer cells

29
Q

What are the three arteries of the rectum and from where do they originate?

A
  • Superior rectal a. (from IMA)
  • Middle rectal a. (from Internal Iliac a.)
  • Inferior rectal a. (from Internal Pudendal a.)
30
Q

What are the three veins of the rectum and from where do they drain into?

A
  • Superior rectal v. (drains into IMV)
  • Middle rectal v. (drains into IVC)
  • Inferior rectal v. (drains into IVC)
31
Q

What is the name of the plexus that provides autonomic innervation to the rectum? Where does this plexus originate from?

A

Rectal pelvic plexus from the Inferior hypogastric plexus

32
Q

What two muscles make up the roof and walls of the perineum?

A
  • Roof: Pelvic diaphragm

- Walls: Obturator internus

33
Q

What is the primary arterial supply to all structures of the perineum? How does this artery pass from the pelvis to the perineum?

A

Internal Pudendal a. exits the Greater Sciatic foramen, past the Piriformis, and enters the perineum through the Lesser Sciatic foramen

34
Q

What nerve travels with the Internal Pudendal a. and from which vertebral levels does it originate?

A

Pudendal n. (S2-4) runs with the Internal Pudendal a.

35
Q

What are the Ischioanal Fossae and what role can they play clinically?

A

The Ischioanal Fossae are fat-filled spaces that support the anal canal in the anal triangle
- They communicate with the urogenital triangle and can be a potential route for the spread of infection

36
Q

What is the pectinate line of the anal canal?

A

The pectinate line is developmentally, the hindgut-proctodeum junction

37
Q

What is each part of the pectinate line (above or below) a derivative of, and what is its innervation? What is the vessel/lymphatic supply of each?

A

Above the pectinate line:

  • Derivative of endoderm
  • Visceral innervation
  • Portal blood supply and internal iliac nodes (like hindgut)

Below the pectinate line:

  • Derivative of ectoderm
  • Somatic innervation
  • Caval blood supply and inguinal nodes
38
Q

What three structures maintain fecal incontinence? What is considered “incontinent”?

A

If any two of the three below is compromised, patient has fecal incontinence:

  • Internal anal sphincter
  • External anal sphincter
  • Puborectalis
39
Q

What are the two types of erectile tissue in the penis?

A
  • Corpus cavernosum (x2)

- Corpus spongiosum

40
Q

What is the phallus in females and males? What are the two components and what type of erectile tissue are they composed of?

A

Phallus is the penis or clitoris

  • Crus of phallus: corpus cavernosum
  • Bulb of penis/vestibule: corpus spongiosum
41
Q

What are the two muscles of the urogenital triangle and with what erectile tissue is each associated with? What n. are they innervated by?

A
  • Ischiocavernosum: corpus cavernosum
  • Bulbospongiosum: corpus spongiosum

Both innervated by the Pudendal n.

42
Q

What are the three types of urethral sphincters?

A
  • External urethra sphincter
  • Compressor urethrae
  • Urethrovaginal sphincter
43
Q

What is the path of most of the veins in the urogenital triangle? What are the two exceptions and what does each drain into?

A

Most veins follow the arteries and drain back into the Internal Pudendal v.

Exceptions:

  • SF Dorsal v.: drains to External Pudendal v.
  • Deep Dorsal v.: drains to pelvic/prostatic venous plexus
44
Q

What are the two layers of the perineal fascia and what are they each a continuation of?

A
  • Fatty layer: continuation of Camper’s fascia

- Membranous layer: continuation of Scarpa’s fascia

45
Q

What two spaces does the perineal membrane divide the perineum into? Where is each located?

A
  • SF perineal pouch: between perineal membrane and membranous layer of SF perineal fascia
  • Deep perineal pouch: between perineal membrane and inferior fascia of pelvic diaphragm
46
Q

What ligaments are the uterine vessels and ovarian vessels found?

A
  • Ovarian vessels: found in suspensory ligament

- Uterine vessels: found in inferior portion of broad ligament

Human Anatomy Exam #3 (7 decks)

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