Repro Anatomy Flashcards
1
Q
name the labelled parts of the pelvis
A
2
Q
What is the true pelvis?
A
true pelvis is the area between the pelvic inlet, and the pelvic outlet
3
Q
what is the landmark which separates the true pelvis from the false pelvis?
A
The pelvic inlet separates the true and false pelvis
4
Q
Name the labelled parts of the pelvis
A
5
Q
What type of joint is the sacroiliac joint?
A
Synovial plane
6
Q
What type of joint is the pubic symphysis?
A
Secondary cartilaginous
7
Q
Describe how a male and female’s FALSE pelvis structure differs
A
Female false pelvis = shallow
male false pelvis = deep
8
Q
Describe how a male and female’s TRUE pelvis structure differs
A
Female true pelvis = wide and shallow
male false pelvis = narrow and deep
9
Q
Describe how a male and female’s pelvic inlet differs
A
Female pelvic inlet = oval and rounded
Male false pelvis = heart shaped
10
Q
Describe how a male and female’s pelvic outlet structure differs
A
Female pelvic outlet = comparatively large
Male pelvic outlet = comparatively small
11
Q
Describe the difference between the suprapubic angle of a male and female
A
Female = obtuse (greater than 90)
Male = acute (less than 90)
12
Q
Identify which pelvis is male and which is female
A
13
Q
What is the narrowest diameter of the pelvic INLET in females?
A
13cm
14
Q
What is the narrowest diameter of the pelvic OUTLET in females?
A
11cm
15
Q
Name the muscles of the pelvis labelled
A
16
Q
which muscle makes up the posterior wall of the pelvis?
A
Piriformis
17
Q
Which nerve plexus sits on piriformis?
A
The sacral plexus
18
Q
Which muscle does the sacral plexus sit on?
A
Piriformis
19
Q
Name the muscles
A
20
Q
Name the muscles
A
21
Q
What is the perineal body?
A
a fibromuscular node lying in the midline of the perineum.
22
Q
What is the function of the perineal body?
A
provides an anchor point for several of the muscles within the perineum
23
Q
What is the anococcygeal body?
A
A ligament which runs between the coccyx and the rectum
24
Q
Which muscles does the anococcygeal ligament/body run between?
A
It runs between the two walls of the levator ani muscle
25
What are the two muscles which make up the pelvic floor?
coccygeus and levator ani
26
What are two functions of the pelvic diaphragm?
Continence (urine and faeces)
Support for the abdominal viscera including the rectum
27
What nerves innervate the muscles of the pelvic floor? (Levator ani and coccygeus)
Pudendal nerves (S2, 3, 4) and anterior rami of S4
28
What are the roots of the pudendal nerve?
S2, 3, 4
29
What is a cystocele?
the bladder and vaginal wall fall into the vaginal canal.
30
What is a rectocele?
the front wall of the rectum sags and bulges into the vagina
31
Why are episiotomies performed?
To prevent a midline tear (a midline tear will damage the perineal body)
32
Name the labelled branches of the internal iliac artery
33
Which arteries supply the bladder, seminal gland and prostate?
Superior and inferior vesical (branch of anterior division of internal iliac artery)
34
Which artery supplies the uterus?
Uterine artery (branch of anterior division of internal iliac)
35
Which artery supplies the ovaries/testes?
Gonadal artery (ovarian or testicular) - branch of abdominal aorta
36
Which artery supplies the superior 2/3rds of the rectum?
Inferior Mesenteric Artery
37
Which artery supplies the inferior 1/3rd of the rectum?
the middle and inferior rectal arteries (branches of the internal iliac)
38
Which artery supplies the vagina and the base of the bladder?
The vaginal artery (branch of the uterine artery)
39
What is the main artery to the perineum?
The internal pudendal artery (brach of anterior division of internal iliac artery)
40
What organs are supplied by the superior and inferior vesicle arteries?
The bladder, seminal gland and prostate
41
Which organ is supplied by the uterine artery?
Uterus
42
Which organs are supplied by the gonadal arteries?
Ovaries (ovarian artery) and testes (testicular artery)
43
Which organ is supplied by the Inferior Mesenteric artery?
superior 2/3rds of the rectum
44
Which organ is supplied by the middle and inferior rectal artery?
The inferior 1/3rd of the rectum
45
Which parts of the rectum drain into the portal circulation?
the upper 1/3rds (via the superior rectal vein)
46
Which part of the rectum drains into the systemic circulation?
The lower 2/3rds via the the middle and inferior rectal veins
47
With which venous plexus does the prostatic venous plexus communicate with on its posterior side?
The internal vertebral venous plexus
48
Why is prostate cancer so often associated with spinal metastases?
Because the prostatic venous plexus communicates with the internal vertebral venous plexus
49
What is the nerve root of the ilioinguinal nerve?
L1
50
What does the ilioinguinal nerve supply?
Skin at the root of the penis in males
Labia in females
51
Where does the ilioinguinal nerve enter the inguinal canal?
At the superficial inguinal ring
52
What is the root value of the genitofemoral nerve
L1-2
53
What does the genital branch of the genitofemoral nerve supply?
Cremaster muscle and anterior scrotal skin
54
Which reflex can be used to assess for testicular torsion?
The cremaster reflex
55
Which nerve plexus gives of the pudendal nerve?
Sacral plexus
56
What does the pudendal nerve innervate?
Skin and muscles of the perineum
57
What is the root value of the pudendal nerve?
S2-4
58
What kind of nerve block is used in instrumental deliveries?
Pudendal nerve block
59
What bony landmarks are used when performing a pudendal nerve block?
The ischial spines
60
Where does the autonomic nerve supply to the pelvis originate from?
The hypogastric plexus
61
Where do sympathetic fibres supplying the pelvis originate from (remember autonomic supply comes from the hypogastric plexus so it must come from somewhere in there!)
Sympathetic = L1 and L2 via hypogastric nerve
62
Which male and female reproductive organs have sympathetic supply?
Male - vas deferent, seminal vesicles, prostate and epididymis
Females = Ovaries, uterus, Fallopian tubes and vagina
63
Where do parasympathetic nerve fibres which supply the pelvis originate from?
Pelvic splanchnic nerves (S2-4)
64
After rectal surgery, why are some men unable to ejaculate?
Damage to the parasympathetic pelvic splanchnic nerves
65
What is drained by the external iliac lymph nodes?
Urinary bladder
prostate
membranous urethra
Cervix
Upper part of vagina
66
What is drained by the internal iliac lymph nodes?
Gluteal region
Deep perineum
Pelvic viscera
67
What is drained by the sacral lymph nodes?
Posteroinferior pelvic viscera
sacrum
68
Which lymph nodes drain the urinary bladder, prostate, membranous urethra, cervix and upper part of vagina?
External iliac lymph nodes
69
Which lymph nodes drain the gluteal region, deep perineum and inferior pelvic viscera?
Internal iliac lymph nodes
70
Which lymph nodes drain the posterior inferior pelvic viscera and the sacrum?
Sacral lymph nodes
71
Which lymph nodes drain the ovaries?
ovaries are drained via:
1. the ovarian ligament (to lymph nodes in the obturator fossa and the internal iliac region)
2. the suspensory ligament (towards para-aortic and paracaval lymph nodes)
72
Which lymph nodes drain the uterus?
Primarily the obturator lymph nodes
73
Which lymph nodes drain the testes?
Para-aortic lymph nodes (Of the structures comprising the male external genitalia, the testes are the only ones that do not drain to the inguinal lymph nodes)
74
Name the bony landmarks that create the boundaries of the perineum
75
What is the name of the orange triangle?
The urogenital triangle
76
What is the name given to the green triangle?
The anal triangle
77
A thin sheet of fascia stretches between the right and left sides of the pubic arch, below the pubic symphysis. What is the name of this fascia?
the pubocervical fascia
78
What is the function of the external anal sphincter?
Voluntary control of defecation
79
What is the nerve supply of the external and internal anal sphincters?
Pudendal nerve S2-4
80
What is the function of the superficial transverse perineal muscle?
Stabilises the perineal body
81
What is the nerve supply of the superficial and deep perineal muscles?
Pudendal nerve (S2-4)
82
What is the function of the deep transverse perineal muscle?
Fixes the perineal body
Expels semen and the last drops of urine
83
What is the function and the nerve supply of the external urethral sphincter?
Compresses the urethra to maintain urinary continence
Supplied by pudendal nerve S2-4
84
What is the function of the bulbospongiosus muscle in the male?
helps to empty the penile urethra in urination and ejaculation
85
What is the function of bulbospongiosum in females?
clitoral erection, contractions of orgasm and closing of the vagina
86
What nerve supplies the bulbospngiosum muscle in males and females?
Pudendal nerve S2-4
87
What is the function of ischiocavernosum in males?
Compresses the penile crus which provides extra rigidity to the erect penis
88
What is the function of ischiocavernosus in the female?
Tenses the vagina during orgasm
89
What nerve supplies ischiocavernosus in males and females?
Pudendal nerve (S2-4)
90
Name the two layers of fascia which make up the pelvic diaphragm
Superior and inferior pelvic fascia
91
Which structures pierce the pelvic diaphragm?
Vagina, urethra, rectum
92
Label the following diagram
93
Name the three parts of the male urethra
Prostatic
Membranous
Spongy (longest
94
Which part of the male urethra is the widest?
Prostatic part
95
Which part of the male urethra is the narrowest part?
Membranous part
96
What is the end of the penis called?
Glans penis
97
Label the diagram below
98
What is the name given to the fascial layer which covers the corpus callous?
Tunica albuginea
99
What structure surrounds the penile urethra?
Corpus spongiosum
100
Sensory innervation of the penis is through which nerve?
The Doral penile nerve (branch of pudendal S2-4)
101
Where is the internal urethral sphincter located?
In the neck of the bladder
102
Is the internal urethral sphincter voluntary or involuntary?
Involuntary
103
What is the innervation of the internal urethral sphincter?
Sympathetic T11-L2
Parasympathetic S2-4
104
Where is the external urethral sphincter found in males?
In the membranous urethra just below the prostate
105
Where is the external urethral sphincter found in females?
Distally and inferiorly to the bladder neck between the vaginal orifice and clitoris
106
Is the external urethral sphincter voluntary or involuntary?
Voluntary
107
What is the innervation of the external urethral sphincter?
Deep branch of perineal nerve (of pudendal nerve) (S2-S4)
108
Label the internal and external urinary sphincters in the male
109
Label the internal and external urinary sphincters in the female
110
Which urinary sphincter is voluntary and which is involuntary?
Internal = involuntary
External = voluntary
111
Name the contents of the vulva (9)
1. labia majora
2. labia minora
3. clitoris
4. vulva vestibule
5. urethra
6. vaginal opening
7. Mons pubis (fat pad)
8. Bartholian’s glands
112
Name the nerve and artery that supply the vulva and all of the structures contained within it
Pudendal nerve and internal pudendal artery
113
What is contained within the vulval vestibule?
urethra and vagina (enclosed by the labia minora)
114
Which Male tissue is the clitoris equivalent to?
The corpus cavernosum
115
Name the sphincters in control of defecation
Internal and external anal sphincters
116
Which anal sphincter is voluntary?
External
117
Which anal sphincter is involuntary?
Internal
118
What is the function of the fat filled ischia-anal fossae?
Allow the anal canal to expand during defication
119
Label the diagram
120
Which vessels and nerves travel through the lesser sciatic foramen?
Pudendal artery, nerve and vein
121
What three structures constitute the birth canal?
Vagina, cervix & vulva
122
Label the structures
123
Label the structures
124
What are the three layers of the uterus?
Perimetrium (outer), myometrium & endometrium (inner)
125
When a caesarean delivery is done which part of the uterus is opened to deliver the baby?
Lower
126
Which angle is the angle of flexion and which is the angle of version
127
How is the normal position of the uterus described?
Anteverted and ante flexed
128
what is the normal angle of ante version?
129
What is the normal angle of anteflexion?
170
130
What is the name given to describe a uterus that flexes backwards instead of forwards over the bladder?
Retroverted uterus
131
How many vaginal fornices are there?
4 (anterior, posterior and 2x lateral)
132
What is the name given to the space which lies between the rectum and the uterus?
rectouterine pouch/pouch of Douglas
133
What is the name given to the space between the bladder and the uterus?
Vesicouterine pouch
134
Through which vaginal fornix you can access the rectouterine pouch?
The posterior fornix
135
What structures does the ovarian ligament connect
Ovarian ligament= connects ovary to uterus
136
What structures does the suspensory ligament of the ovary connect?
Suspensory ligament of the ovary = ovary to pelvic wall
137
What structures does the round ligament attach?
round ligament = sides of the uterus to the mons pubis
138
What structures does the broad ligament attach?
Uterus to lateral pelvic wall
139
Which ligament travels within the broad ligament?
The round ligament
140
Which ligament is sometimes referred to as the cardinal ligament?
The cervical ligament
141
Which structures does the cardinal ligament attach?
Lateral aspect of cervix and lateral vagina to the lateral pelvic walls
142
Name the parts of the uterine tube
143
In which part of the uterine tube does fertilisation occur?
In the ampulla
144
What is an ectopic pregnancy?
A pregnancy occurring outside of the uterus
145
What is a corneal ectopic?
A pregnancy in the uterine horn (where the Fallopian tube and the uterus meet)
146
Name the two ligaments which support the ovaries
ovarian ligament (1)
Suspensory ligament of the ovary (2)
147
What is the name of the artery that supplies the ovary?
Ovarian artery
148
do the ovarian arteries originate from?
L2 on the abdominal aorta
149
which ligament carries the ovarian arteries to the ovaries?
The suspensory ligament of the ovary
150
blood vessel does the ovarian artery anastomose with?
The uterine artery
151
Where do the right and left ovarian veins drain into?
RIKL
Right = IVC
Left = Left renal vein (kidney)
152
Where does the uterine artery branch from?
The internal iliac artery
153
Which structure passes under the uterine artery?
The ureter (water under the bridge)
154
Which lymph nodes drain the ovary?
Pre-aortic nodes
155
Which lymph nodes drain the uterine body?
Pre-aortic
156
Which lymph nodes drain the cervix and upper vagina?
Internal iliac and sacral lymph nodes
157
Which lymph nodes drain the lower vagina?
Superficial inguinal lymph nodes
158
What are the bony relations associated with the breast
2nd - 6th rib
lateral border of the sternum- midaxillary line
159
Which muscles lie deep to the breast?
Pectoralis major, pectorals minor and serrates anterior
160
Which arteries supply the breast?
Lateral thoracic artery (branch of axillary)
Medial mammary (branch of subclavian)
The veins have the same names
161
Name the 4 groups of lymph nodes which drain the breasts
1. Apical lymph nodes
2. central lymph nodes
3. Pectoral lymph nodes
4. Internal thoracic lymph nodes
162
Which group of lymph nodes drains the lateral quadrant of the breast?
axillary
163
Identify the tissue
breast (before pregnancy)
164
Identify the tissue
Breast (during pregnancy)
165
Identify the tissue
breast (lactating)
166
Identify the tissue
Uterus (proliferative stage)
167
Identify the tissue
Uterus (secretory phase)
168
Identify the structure
Fallopian tube
169
Which surface of the placenta is shown here?
Foetal surface
170
Which surface of the placenta is shown here?
Maternal surface
171
List 4 functions of the placenta
Gas exchange
Nutrient exchange
Immunity transmission (from mother to baby)
Produces HCG
172
At which stage of labour does the uterus separate from the uterine wall?
The third stage of labour
173
Identify the tissue
Umbilical cord
174
What do the letters in the image represent?
A= Artery
V= vein
W = Wharton's jelly
175
The umbilical artery carries oxygenated/deoxygenated blood
Deoxygenated blood (from foetus to mother)
176
The umbilical vein carries oxygenated/deoxygenated blood?
Oxygenated (from mother to foetus)
177
What structure (ligament) does the umbilical vein persist as in adult?
Round ligament of liver (also called ligamentum teres)
the round ligament forms the EDGE of the falciform ligament
178
Label the following diagram
179
What is the name of the canal that the testis passes through during development?
The inguinal canal
180
What is the name of the structure that pulls the testes down through the abdomen during growth and development?
The gubernaculum
181
From outside to inside, list the layers of skinned fascia surrounding the testes
Skin
Dartos muscle
external fascia
internal fascia
Tunica vaginalis (parietal layer)
Cavity of tunica vaginalis
Tunica vaginalis (visceral layer)
Tunica albuginea
testes
182
Name the inguinal rings
183
What is contained within the spermatic cord? (8)
1. Testicular artery (branch of aorta)
2. Cremasteric artery and vein (supplies cremasteric muscle and fascia)
3. Artery to the vas deferens (branch of the inferior vesicle artery, which arises from the internal iliac.)
4. Pampiniform plexus of testicular veins – drains venous blood from the testes into the testicular vein.
5. Genital branch of the genitofemoral nerve – supplies the cremaster muscle and autonomic nerves
6. Vas deferens
7. Processus vaginalis – projection of peritoneum that forms the pathway of descent for the testes during embryonic development. In the adult, it is fused shut.
8. Lymph vessels – these drain into the para-aortic nodes, located in the lumbar region.
184
What is the tough outer fibrous layer of the testis called?
Tunica albuginea
185
What is the arterial supply of the testes?
testicular artery
186
Where do the testicular arteries arise from?
Abdominal aorta at L2
187
Which structures do the testicular arteries cross?
Genitofemoral nerve and ureter
188
What is the term used for the 8-12 anastomosing veins associated with the testis?
Pampiniform plexus of the testes
189
What is the function of the pampiniform plexus?
Drains the testes and helps in temperature regulation
190
Explain the venous drainage of the left and right testes
RIKL
Right = IVC (via right pampiniform plexus)
Left = left renal vein (via the left pampiniform plexus)
191
What is a varicocele?
Large tortuous veins in the pampiniform plexus
192
What is the main cause of varicocele?
Defective valves in the scrotum
193
Which lymph nodes drain the prostate?
Internal iliac and sacral lymph nodes
194
Which lymph nodes drain the seminal vesicles?
Internal and external iliac nodes
195
Which lymph nodes drain the scrotum?
Superficial inguinal lymph nodes
196
Which lymph nodes drain the penis?
superficial inguinal
lateral sacral
hypogastric
197
What is the function of the epididymis?
Stores sperm
198
What is the function of the vas deferent?
takes sperm from the epididymis to the ejaculatory duct
199
What is produced by the seminal vesicles?
Alkaline component of semen
contains fructose (energy for sperm), prostaglandins (helps with sperm mobility), and proteins
200
What does the prostate produce?
Liquid component of semen
citric acid, proteolytic enzymes, clotting enzymes
201
Why does an enlarged prostate cause issues with urinary retention?
the prostate surrounds the prostatic urethra therefore if it enlarges it compresses the urethra
202
Why do patients with prostate cancer often present with spinal mets?
Because the prostatic venous plexus anastomoses with the internal venous vertebral plexus
203
What is the arrow pointing to?
The bulbourethral glands/ Cowper's glands
204
What secretions are produced by Cowper's glands?
Clear, colourless, mucoid secretions which are released prior to ejaculation
205
What is the function of the secretions from Cowper's glands?
Designed to neutralise the male urethra to protect sperm cells
lubricates the penis
helps neutralise the vagina (some of the cowper's gland secretions are also added to seminal fluid)
206
What is this?
Vas deferens
207
What is this?
Seminal vesicle
208
What is this?
Epididymis
209
What is this?
Testes
210
What is this?
Prostate
211
During which week of development do mammary crests form?
4th week
212
How many lobes make up a breast?
15-25
213
Breasts are highly modified sweat glands- true or false?
True
214
What is the name of the duct that drains the breast?
Lactiferous duct
215
What is the name of the ligament that anchors the breast to the dermis?
Suspensory ligament of Cooper
216
What is the nerve supply of the breast?
anterior and lateral cutaneous branches of the 4th-6th intercostal nerves
217
Which cells produce sperm?
Germ cells
218
What is the function of sertoli cells?
Produce inhibit and support sperm producing cells
219
Which structures produce:
A) Liquid component of semen
B) Mucoid component of semen
C) Alkaline component of semen
?
A) Liquid component = Prostate
B) Mucoid component = Cowper's glands
C) Alkaline component = seminal vesicles
220
What is the function of the rate testes?
Move sperm from testes to epididymis via ciliary action
221
What type of epithelium lines the seminal vesicle?
Pseudostratified columnar
222
What kind of epithelium lines the ductus deferens?
Pseudostratified columnar
223
Which structures come together to form the ejaculatory duct?
Vas deferens and seminal vesicle
224
Which two structures help to control the temperature of the testes?
Dartos muscle and cremaster muscle
225
How does the cremaster muscle help with thermoregulation?
darts expands or contracts to wrinkle the scrotal skin (changes surface area)
226
Explain how the cremaster muscle helps with thermoregulation of the testes
Contracts and brings the testes closer to the body for warmth and relaxs allowing the testes to drop away from the body when they need to cool
227
Which nerve innervates the cremaster muscle?
Genitofemoral (genital branch)
228
How many bulbs of corpus spongiosum are found in males and females?
One in males
Two in females
229
What do leading cells produce?
Testosterone
230
Where can leydig cells be found?
In the interstitum between semineferous tubules in the testes
231
In the female, there is a vesicuouterine pouch and a rectouterine pouch. what is the name of the pouch found in men?
Vesicorectal pouch
232
What is the round ligament the uterus a remnant of?
The ovarian gubernaculum
233
Which ligaments travel through the broad ligament
Round and ovarian
234
What kind of epithelium lines the prostate?
Simple cuboidal
235
Which muscle forms the posteriolateral wall of the pelvis?
Piriformis
236
Which muscle forms the anterior lateral wall of the pelvis?
Obturator interns
237
Name the structures
238
Name the structures
239
Name the structures
240
What is the embryological origin of the reproductive system?
The mesonephros (one of the 3 primitive kidneys)
241
How does the reproductive tract know if is male or female?
The Y chromosome codes for an SRY gene which causes the production of testis determining factor
242
What is the embryological origin of the vas deferens and the seminal vesicle?
mesonephric duct
243
What is the embryological origin of the Fallopian tube, uterus, cervix & upper vagina?
Paramesonephric duct
244
What is the prostate an outgrowth of?
The urethra
245
What is this?
Complete duplication of the uterus (caused by an abnormality in the paramesonephric duct during development)
246
What is this called?
Septate uterus (caused by a problem with the paramesonephric duct during development)
247
What is this called?
Bicornate uterus (caused by a problem with the paramesonephric duct during development)
248
What is this?
Arcuate uterus (caused by a problem with the paramesonephric duct during development)
