Pelvis & Reproductive Organs Flashcards
what structure is important to identify during pelvic surgery?
ureters; they have multiple blood supplies, but sometimes it isn’t enough if one of these is ligated during surgery
what is the major cause of obstruction of the ureters?
ureteric calculi
where are the three most likely sites of ureteric calculi?
- renal pelvis
- where the ureters cross external iliac vessels
- passage into bladder
how are ureteric calculi removed?
lithoscopy or endoscopy; found with CT
what is a cystocele?
hernia of bladder onto the anterior vaginal wall
what causes a cystocele?
- damage to pelvic floor during childbirth
- laceration of perineal muscles (or nerves)
- rupture of paracolpium
where does the bladder extend when it fills?
superior to pubic symphysis into loose areolar tissue between parietal perintoneum & anterior abdominal wall
if the bladder ruptures superiorly, where can urine escape into?
peritoneal cavity
if the bladder ruptures inferiorly, where can urine escape into?
perineum
how can you view the interior bladder and its three orifices?
cystoscope
why is the rectovesical septum clinically important?
in males, during a rectum resection, the prostate and urethra can be separated from the rectum because of this fascial septum that extends superiorly from the perineal body
what’s the most common method of male sterilization?
deferentectomy or vasectomy
why is a vasectomy successful?
ligation of vas deferens in superior scrotum so sperm aren’t expelled and they die in epididymis
abscesses in seminal glands can rupture it’s contents into?
peritoneal cavity
almost every male who lives long enough experiences?
benign hypertrophy of the prostate
which lobule of the prostate enlarges to constrict the urethra?
middle lobule
BHP can clinically cause?
- nocturia
- dysuria
- urgency
how can prostatic cancer metastastize?
- lymphatic: internal iliac/sacral nodes
- venous: internal vertebral venous plexus to vertebrae and brain
obstruction of the prostate is relieved by?
- transurethral resection of prostate
- radical prostatectomy
why is it important to preserve nerves and vessels through prostate during TURP and radical prostatectomy?
to increase possibility that the patient will retain sexual functions after surgery & to restore normal urinary control
infections of the vagina, uterus, and tubes can result in?
peritonitis (communicates through abdominal ostia of tubes)
what is salpingitis?
- inflammation of a uterine tube
- major cause of blockage of tube –> infertility
how can you check for patency of the uterine tubes?
- hysterosalpingography
- gas bubbles in pararectal fossae = patent tubes
what is a surgical method of birth control for a female?
surgical ligation of uterine tubes
where is an incision for an abdominal tubal ligation?
suprapubic (pfannenstiel)
where is the incision for a laparoscopic tubal ligation?
small incision near umbilicus
what is pyosalpinx?
collection of pus in a uterine tube
what can pyosalpinx cause?
ectopic tubal pregnancy
where is the common site of an ectopic pregnancy?
ampullae of tubes
a ruptured tubal pregnancy and resulting peritonitis can be misdiagnosed as?
appendicitis
Gartner duct cysts are the result from?
accumulation of fluid in a persistant duct of epoophoron
incomplete fusion of embryonic paramesonephric ducts causes?
congenital anomalies of the uterus
what causes uterine prolapse?
- increased intra-abdominal pressure
- disrupted perineal body
- atrophic pelvic floor ligaments/muscles
where can cervical cancer spread? why?
to the bladder because no peritoneum intervenes between anterior cervix and base of the bladder
what is the lymphogenous spread of cervical cancer?
external/internal iliac nodes or to sacral nodes
how can cervical cancer be spread through the blood?
through iliac veins or internal vertebral venous plexus
what is a hysterectomy?
surgical removal of the uterus
what kind of fistulas can result from difficult labor?
vesicovaginal, urethrovaginal, or rectovaginal
what is culdocentesis?
drainage of a pelvic abscess in the recto-uterine pouch through an incision in the posterior part of the vaginal fornix
what is endometriosis?
presence of functioning endometrial tissue outside of uterus
what’s important about a caudal epidural block during childbirth?
it anesthetizes subperitoneal structures and the somatic areas innervated by the pudendal nerve; pain fibers from uterine body are superior to pelvic pain line (unaffected by anesthetic, so uterine contractions are felt by mother to know when to push)
why is a spinal block via lumbar puncture not a top choice for anesthesia during childbirth?
mother can’t feel uterine contractions & it usually causes a “spinal headache”
