Repro 6

Question 1

What is the pelvic brim?

What is the pelvic inlet?

Answer 1

Inlet - junction between greater and lesser pelvis.

Brim - the bony edges of the pelvic inlet

Question 2

What are the boundaries of the pelvic inlet?

Answer 2

Posterior - sacral promontory
Anterior - pubic symphsis
Lateral - arcuate line on the inner surface of the ilium and the pectineal line on the superior ramus.

Question 3

What type of pelvis do men and women have?

Answer 3

Men - android

Women - gynecoid.

Question 4

Compare and contrast the adaptations the female pelvis has, when compared to males.

Answer 4

• a greater sub-pubic angled arch, more than 80-90 degrees
• shorter sacrum, more curved with a less pronounced sacral promontory
• oval shape inlet compared to the android heart shape inlet.
• wider and broader structure but yet it is lighter than android.

Question 5

How does the size of the pelvic outlet increase?

Answer 5

Progesterone secretion causes the sacrospinous and the sacrotuberous ligaments to become a little lax, which causes the outlet to open up a bit more.

Question 6

What are the urogenital hiatus and the rectal hiatus

Answer 6

UGH - allows the passage of the urethra, and vagina in females
RH - allows the passage of the anal canal

Question 7

What are the functions of the pelvic floor muscles?

Answer 7

• Support the abdominal and pelvic viscera
• resistance to increase in intra-abdominal pressure and intra- pelvic pressure during exertion such as lifting heavy objects or sneezing
• sphincter action - some of the fibres allow for urethral and rectal continence, by acting as sphincters. Relaxation allows defacation and micturition.

Question 8

What are the 3 components of the pelvic floor?

Answer 8

• levator ani muscles
• coccygeus muscle
• fascial coverings of the muscles.

Question 9

With respects to the pelvis, which pelvis do the pelvic viscera lie in?
What’s the name of the other one?

Answer 9

They lie in the true (lesser) pelvis.

The ‘other’ pelvis is the false (greater) pelvis. This supports the lower abdominal viscera.

Question 10

Describe the shape of the puborectalis muscle and the course it takes

Answer 10

U shaped muscle, can be thought of as a sling
Extends from the bodies of the pubic bones, passing the urogenital hiatus and around the anal canal.
- contracts tonically which gives the control of defacation.

Question 11

Describe the path of the pubococcygeus muscle in males and females

Answer 11

Some of its fibres pass around the prostate in men and the vagina in the female.

Question 12

Which component of the pelvic floor muscles lie anteriorly and which lie posteriorly ?

Answer 12

The levator ani muscles lie anteriorly

The coccygeus lies posteriorly.

Question 13

What are the nerve innervations of the levator ani and the coccygeus?

Answer 13

Levator ani
- pudendal nerve S2-S4

Coccygeus
- anterior rami of S4 and S5

Question 14

What embryonic structure does the scrotum develop from, and what is the contents?

Answer 14

Develops from the labioscrotal folds.

Contents

• testes
• epididymis
• first section of spermatic cord

Question 15

What is the scrotal raphe?

Answer 15

The fusion of the genital folds

Question 16

What is the function of the dartos muscle? Where is it located?

Answer 16

Located just below the skin.

This wrinkles the scrotum skin - decreasing surface area - hence decreasing heat loss, when needed.

Question 17

How is the parenchyma of each testicle divided into lobules?

Answer 17

The inner fibrous capsule called the Tunica Albuginea penetrates into the parenchyma, dividing it.

Question 18

Describe the arterial supply of the testicles, their journey to the testicles and any coverings they may have.

Answer 18

• paired arteries called the Testicular arteries.
  
  • direct branches off the abdominal aorta.
• they pass through the abdomen, through the inguinal canal and into the scrotum.
• they travel in the spermatic cord, which is the covering the question related to.

Question 19

Describe the venous drainage of the testicles.

Answer 19

The pampiniform plexus, which is a network of veins that wrap around the testicular arteries, drain into the testicular veins.
The left testicular vein drains into the left renal, while the right testicular vein drains into the IVC.

Question 20

Explain the following pathologies

• hydrocoele
• varicocoele
• haematocoele
• spermatocoele.

Answer 20

Hydrocoele - serous fluid in the tunica vaginalis
Haematocoele - blood in the tunica vaginalis
Varicocoele - varicosities of the pampiniform plexus
Spermatocoele - aka epididymal cyst
- collection of fluid in the epididymis.

Question 21

What is the basis for differentiation between haematocoele and hydrocoele?

Answer 21

Trans illumination.
When a light is passed through the area, if the problem is hydrocoele then the light passes through as its serous fluid.
However if the light doesn’t pass through, then it’s blood.

Question 22

What is the risk in testicular torsion?

Answer 22

Necrosis of the testicles.

Question 23

What is the course of the spermatic cord?

Answer 23

It originates from the deep inguinal ring and enters the inguinal canal and then the scrotum. It attaches to the posterior border of the testes, where the contents open up into the testicles, supplying it with the various structures.

Question 24

What is the cremasteric reflex?

Answer 24

Stroking the superior and medial part of the thigh produces a contraction of the cremaster muscle.
This immediately elevates the testicle on the side that has been stroked.

Question 25

Describe the lymphatic drainage of the testicles and scrotum

Answer 25

Very important to know the difference.
Just as the ovaries do in females, the testicles in men drain to the para aortic nodes

The scrotum drains to the superficial inguinal nodes.

Question 26

In the penis, what does the ischiocavernosus do?

Answer 26

It compresses the veins, allowing the maintenance of an erection.

Question 27

Name the levator ani muscles

Answer 27

Pubococcygeus, puborectalis and iliococcygeus.