Repro Anatomy Flashcards
name the labelled parts of the pelvis
What is the true pelvis?
true pelvis is the area between the pelvic inlet, and the pelvic outlet
what is the landmark which separates the true pelvis from the false pelvis?
The pelvic inlet separates the true and false pelvis
Name the labelled parts of the pelvis
What type of joint is the sacroiliac joint?
Synovial plane
What type of joint is the pubic symphysis?
Secondary cartilaginous
Describe how a male and female’s FALSE pelvis structure differs
Female false pelvis = shallow
male false pelvis = deep
Describe how a male and female’s TRUE pelvis structure differs
Female true pelvis = wide and shallow
male false pelvis = narrow and deep
Describe how a male and female’s pelvic inlet differs
Female pelvic inlet = oval and rounded
Male false pelvis = heart shaped
Describe how a male and female’s pelvic outlet structure differs
Female pelvic outlet = comparatively large
Male pelvic outlet = comparatively small
Describe the difference between the suprapubic angle of a male and female
Female = obtuse (greater than 90)
Male = acute (less than 90)
Identify which pelvis is male and which is female
What is the narrowest diameter of the pelvic INLET in females?
13cm
What is the narrowest diameter of the pelvic OUTLET in females?
11cm
Name the muscles of the pelvis labelled
which muscle makes up the posterior wall of the pelvis?
Piriformis
Which nerve plexus sits on piriformis?
The sacral plexus
Which muscle does the sacral plexus sit on?
Piriformis
Name the muscles
Name the muscles
What is the perineal body?
a fibromuscular node lying in the midline of the perineum.
What is the function of the perineal body?
provides an anchor point for several of the muscles within the perineum
What is the anococcygeal body?
A ligament which runs between the coccyx and the rectum
Which muscles does the anococcygeal ligament/body run between?
It runs between the two walls of the levator ani muscle
What are the two muscles which make up the pelvic floor?
coccygeus and levator ani
What are two functions of the pelvic diaphragm?
Continence (urine and faeces)
Support for the abdominal viscera including the rectum
What nerves innervate the muscles of the pelvic floor? (Levator ani and coccygeus)
Pudendal nerves (S2, 3, 4) and anterior rami of S4
What are the roots of the pudendal nerve?
S2, 3, 4
What is a cystocele?
the bladder and vaginal wall fall into the vaginal canal.
What is a rectocele?
the front wall of the rectum sags and bulges into the vagina
Why are episiotomies performed?
To prevent a midline tear (a midline tear will damage the perineal body)
Name the labelled branches of the internal iliac artery
Which arteries supply the bladder, seminal gland and prostate?
Superior and inferior vesical (branch of anterior division of internal iliac artery)
Which artery supplies the uterus?
Uterine artery (branch of anterior division of internal iliac)
Which artery supplies the ovaries/testes?
Gonadal artery (ovarian or testicular) - branch of abdominal aorta
Which artery supplies the superior 2/3rds of the rectum?
Inferior Mesenteric Artery
Which artery supplies the inferior 1/3rd of the rectum?
the middle and inferior rectal arteries (branches of the internal iliac)
Which artery supplies the vagina and the base of the bladder?
The vaginal artery (branch of the uterine artery)
What is the main artery to the perineum?
The internal pudendal artery (brach of anterior division of internal iliac artery)
What organs are supplied by the superior and inferior vesicle arteries?
The bladder, seminal gland and prostate
Which organ is supplied by the uterine artery?
Uterus
Which organs are supplied by the gonadal arteries?
Ovaries (ovarian artery) and testes (testicular artery)
Which organ is supplied by the Inferior Mesenteric artery?
superior 2/3rds of the rectum
Which organ is supplied by the middle and inferior rectal artery?
The inferior 1/3rd of the rectum
Which parts of the rectum drain into the portal circulation?
the upper 1/3rds (via the superior rectal vein)
Which part of the rectum drains into the systemic circulation?
The lower 2/3rds via the the middle and inferior rectal veins
With which venous plexus does the prostatic venous plexus communicate with on its posterior side?
The internal vertebral venous plexus
Why is prostate cancer so often associated with spinal metastases?
Because the prostatic venous plexus communicates with the internal vertebral venous plexus
What is the nerve root of the ilioinguinal nerve?
L1
What does the ilioinguinal nerve supply?
Skin at the root of the penis in males
Labia in females
Where does the ilioinguinal nerve enter the inguinal canal?
At the superficial inguinal ring
What is the root value of the genitofemoral nerve
L1-2
What does the genital branch of the genitofemoral nerve supply?
Cremaster muscle and anterior scrotal skin
Which reflex can be used to assess for testicular torsion?
The cremaster reflex
Which nerve plexus gives of the pudendal nerve?
Sacral plexus
What does the pudendal nerve innervate?
Skin and muscles of the perineum
What is the root value of the pudendal nerve?
S2-4
What kind of nerve block is used in instrumental deliveries?
Pudendal nerve block
What bony landmarks are used when performing a pudendal nerve block?
The ischial spines
Where does the autonomic nerve supply to the pelvis originate from?
The hypogastric plexus
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
Which male and female reproductive organs have sympathetic supply?
Male - vas deferent, seminal vesicles, prostate and epididymis
Females = Ovaries, uterus, Fallopian tubes and vagina
Where do parasympathetic nerve fibres which supply the pelvis originate from?
Pelvic splanchnic nerves (S2-4)
After rectal surgery, why are some men unable to ejaculate?
Damage to the parasympathetic pelvic splanchnic nerves
What is drained by the external iliac lymph nodes?
Urinary bladder
prostate
membranous urethra
Cervix
Upper part of vagina
What is drained by the internal iliac lymph nodes?
Gluteal region
Deep perineum
Pelvic viscera
What is drained by the sacral lymph nodes?
Posteroinferior pelvic viscera
sacrum
Which lymph nodes drain the urinary bladder, prostate, membranous urethra, cervix and upper part of vagina?
External iliac lymph nodes
Which lymph nodes drain the gluteal region, deep perineum and inferior pelvic viscera?
Internal iliac lymph nodes
Which lymph nodes drain the posterior inferior pelvic viscera and the sacrum?
Sacral lymph nodes
Which lymph nodes drain the ovaries?
ovaries are drained via:
- the ovarian ligament (to lymph nodes in the obturator fossa and the internal iliac region)
- the suspensory ligament (towards para-aortic and paracaval lymph nodes)
Which lymph nodes drain the uterus?
Primarily the obturator lymph nodes
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)
Name the bony landmarks that create the boundaries of the perineum
What is the name of the orange triangle?
The urogenital triangle
What is the name given to the green triangle?
The anal triangle
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
What is the function of the external anal sphincter?
Voluntary control of defecation
What is the nerve supply of the external and internal anal sphincters?
Pudendal nerve S2-4
What is the function of the superficial transverse perineal muscle?
Stabilises the perineal body
What is the nerve supply of the superficial and deep perineal muscles?
Pudendal nerve (S2-4)
What is the function of the deep transverse perineal muscle?
Fixes the perineal body
Expels semen and the last drops of urine
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
What is the function of the bulbospongiosus muscle in the male?
helps to empty the penile urethra in urination and ejaculation
What is the function of bulbospongiosum in females?
clitoral erection, contractions of orgasm and closing of the vagina
What nerve supplies the bulbospngiosum muscle in males and females?
Pudendal nerve S2-4
What is the function of ischiocavernosum in males?
Compresses the penile crus which provides extra rigidity to the erect penis
What is the function of ischiocavernosus in the female?
Tenses the vagina during orgasm
What nerve supplies ischiocavernosus in males and females?
Pudendal nerve (S2-4)
Name the two layers of fascia which make up the pelvic diaphragm
Superior and inferior pelvic fascia
Which structures pierce the pelvic diaphragm?
Vagina, urethra, rectum
Label the following diagram
Name the three parts of the male urethra
Prostatic
Membranous
Spongy (longest
Which part of the male urethra is the widest?
Prostatic part
Which part of the male urethra is the narrowest part?
Membranous part
What is the end of the penis called?
Glans penis
Label the diagram below
What is the name given to the fascial layer which covers the corpus callous?
Tunica albuginea
What structure surrounds the penile urethra?
Corpus spongiosum