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CR4 > Rectum, bladder and female urethra > Flashcards

Rectum, bladder and female urethra Flashcards

1
Q

supravesical fossa

A

depression superior to the bladder

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2
Q

rectovesical pouch

A

depression between the rectum and bladder MALES

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3
Q

Uterovesical pouch

A

depression between the bladder and uterus FEMALES

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4
Q

Rectourterine pouch

A

depression between the rectum and uterus FEMALES

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5
Q

What are the inferiormost extents of the perineal cavity

A

Rectovesical pouch (males) and rectourterine pouch (females) - these are the sites where fluid, pus, and blood may collect

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6
Q

at what level do the common illiac arteries bifurcate

A

L5 and S1

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7
Q

what arteries come from the posterior division of internal iliac artery

A

Illiolumbar, Lateral Sacral, Superior gluteal

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8
Q

what artery passes between the lumbosacral trunk (L4/L5) and S1 to exit the pelvis via the greater sciatic foramen

A

superior gluteal

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9
Q

what arteries come from the anterior division of the internal iliac artery

A

Umbilical artery (superior vesical arteries, obliterated part - medial umbilical liagement) Obturator artery, Inferior vesical (MALES), Uterine artery (FEMALES- Vaginal branch and Uterine artery proper) Vaginal artery (FEMALES) Middle rectal, Internal pudendal, and inferior gluteal

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10
Q

the uterine artery passess _____ to the ureter near the lateral edge of the vagina

A

Superior to the ureter

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11
Q

what female structure is a homolog to the inferiro vesicular artery in males

A

vaginal artery

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12
Q

what artery passes between S2 and S3 to exit the pelvis vis the greater sciateic foramen inferior to the piriformis

A

inferior gluteal artery

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13
Q

Middle artery is a branch of

A

anterior division of the internal iliac artery

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14
Q

Superior rectal is a branch of

A

IMA

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15
Q

inferior rectal is a branch of

A

internal pudendal artery (from anterior division of internal iliac artery)

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16
Q

what artery supplies the external genetalia

A

internal pudendal artery

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17
Q

ovarian arteries are branch of what

A

abdominal aorta- give rise to ovarian and tubal branches that anastamose with ovarian and tubal branches of the uterine artery proper (from uterine artery from anterior division of the internal iliac)

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18
Q

Testicular arteries

A

off the abdominal aorta- run in spermatic cord to testes

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19
Q

unpaired artery off the posterior surface of the abominal aorta just superior to the bifurcation

A

median sacral artery

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20
Q

Terminal branc of IMA

A

Superior rectal artery

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21
Q

pelvic venous plexus drains mostly to

A

internal illiac veins

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22
Q

most of the pelvic lymph (except ovarian lymph) is drained to where

A

internal and external iliac lymph node and ultimately throacic duct

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23
Q

Ovarian lymph is drained where

A

directly draned to lateral aortic or lumbar nodes

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24
Q

Pelvic lumbar plexus

A

L1-L4 pass through but do not supply innervation to the true pelvis

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25
Q

Obturator nerve

A

L2-L4 exists through obturatory canal to supply medial thigh

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26
Q

Lumbosacral Plexus

A

L4-L5 joins the sacral plexus

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27
Q

Sacral Plexus

A

L4-S4 mainly supplies lower limb

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28
Q

what nerves make up the sacarl plexus

A

Sciatic ,Pudendal, Superior Gluteal, and Inferior gluteal

29
Q

Sciatic Nerve

A

L4-S3 (part of sacral plexis) exits though greater sciatic foramen INFERIOR to piriformis to supply posterior thigh, entire leg, and foot

30
Q

what nerve is the chief sensory nerve of the external genetalia

A

pudendal nerve (S2-S4)

31
Q

Pudendal nerve

A

S2-S4 (part of sacral plexus) exits pelvis via greater sciatic foramen inferior to piriformis and wraps around the ischial spine and sacrotuberous ligament and enters the perineum though the lesser sciatic foramen

32
Q

Superiror Gluteal nerve

A

exits via greater sciatic foramen superior to piriformis to supply gly med, min, and tensor fascia latal

33
Q

Inferior gluteal nerve

A

exits via greater sciatic foramen inferior to piriformis to supply glut max

34
Q

the rectum begins at what vertebral level

A

S3

35
Q

rectosigmoid juntion

A

teniae coli of the sigmoid become complete outer muscle covering so the outer longitudinal layer of the rectum is a complete sheath

36
Q

what part of the rectum has no peritoneal covering

A

rectal ampulla

37
Q

internal transverse rectal folds (rectal valves of Houston)

A

2 on the left (upper and lower) and one on the right (middle) - purpose is to help support the fecal matter as it accumulates in the rectum

38
Q

what muscle is imprtant for fecal continence

A

puborectalis

39
Q

anal canal

A

continuation of the rectum at the anorectal flexure and terminates as the anus (4 cm long)

40
Q

what muscle keeps the lateral walls in appsosition when not defactaing

A

levator ani and anal sphincters

41
Q

Anal columns

A

upper 1/2 of anal canal- separated by anal sinuses

42
Q

anal valves

A

connect the lower ends of the anal valves to form continuos ring known as the pectinate line

43
Q

what separtes skin and mucosa in the rectum

A

white line of hilton (interspincteric groove)

44
Q

internal anal sphincter

A

involuntary- surrounding the upper 2/3 of the anal canal. Contratcion stimulated and maintained by sympathetic fibers (tonically contracted most of the time)

45
Q

External Anal Sphincter

A

voluntary sphincter that surrounds the ENTIRE length of the anal canal

46
Q

what innervates the external anal sphincter

A

inferior rectal nerve (from pudendal nerve)

47
Q

External Anal Sphincter consists of

A

Subcutaneous part (encircles anus) Superficial part Deep part

48
Q

Subcutaneous part of the external anal sphincter

A

inferior to internal sphincter, encircles the anus and has no boney attachments

49
Q

intersphincteric groove

A

junction between the subcutaneous part of the external sphincter and the internal sphincter

50
Q

superficial part of the external anal sphincter

A

overlaps internal sphincter and is spindle shaped - attached to perineal body and coccyx

51
Q

deep part of the external anal sphincter

A

overlaps the internal sphincter and encircles the anal canal - fused to puborectalis

52
Q

what do the inferior recatal arteries supply

A

anal canal

53
Q

venous drainage of the rectum and anal canal

A

follow superior, middle, and inferior rectal veins

54
Q

portocaval venous anastamosis

A

Superior rectal vein drains to the portal venous system and middle and inferiro drain to the systemic system (caval system)

55
Q

Compare pain with internal vs external hemorrhoids

A

Internal are not painful (superior rectal veins) External hemorrhoids are quite painful (inferior rectal veins) . Above the pectinate line = visceral pain sensation below pectinate line = somatic sensory pain sensation)

56
Q

lymphatic drainage below the pectinate line

A

superficial inguinal lymph nodes

57
Q

lymphatic drainage above the pectinate line

A

internal iliac nodes

58
Q

lymphatic drainage of superior rectum

A

inferior mesenteric nodes

59
Q

thoracic pain line

A

at sternal angle

60
Q

pelvic pain line

A

corresponds to the lower limit of the peritoneum

61
Q

Pain lines and ANS

A

between the throacic and pelvic pain line is mainly sympatetic- pain follows sympathetics. Above throacic and below Pelvic pain line is parasympathetic

62
Q

Femal ureter spacial relationship

A

pass inferiror to the uterine artery

63
Q

Male ureter passes _____ to the ductus deferens and ____ to the seminal vesicles

A

Inferior to ductus deferens and superior to seminal vesicles

64
Q

ureters course ___ to the iliac vessels

A

anterior - then turn medially to enter the posterior bladder

65
Q

blood supply to the ureters

A

branches of common and interal iliac arteries

66
Q

location of empty vs distended bladder in the the adult

A

empty= below pubic symphasis distended= above the pelvic brim in the abdominal cavity

67
Q

what makes up the trigone of the bladder

A

two openinsg of the ureters and their interconnecting interuretic ridge and internal orifice of the urethra. Mucosa over trigone is smooth

68
Q

internal sphincter of the urethra

A

involuntary. Formed by muscular fibers of the bladder found at the neck

CR4 (7 decks)

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