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anatomy year 3 > Reproduction 3 - Pelvis and Perineum 1 > Flashcards

Reproduction 3 - Pelvis and Perineum 1 Flashcards

1
Q

What are some of the organ systems within the pelvis and perineum?

A
  • The Terminal Portion of the GI tract
  • The Urinary System
  • Male and Female Reproductive Systems
  • The Nerve Supply to the Above Organs from the Sacral Plexus
  • Elements of the Musculoskeletal System related to the Bony Pelvis, SI Joints, muscles and ligaments
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2
Q

What is A?

A

Ale of sacrum

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3
Q

What is B?

A

Pubic tubercle

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4
Q

What is C?

A

Pecten pubis

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5
Q

What is D?

A

Pubis symphysis

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6
Q

What is E?

A

Pubic crest

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7
Q

What is F?

A

Arcuate line of ileum

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8
Q

What is G?

A

Sacral promontory

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9
Q

What is the inferior opening of pelvis called?

A

The pelvic outlet is the inferior opening of the pelvis and is formed by bony features and ligaments

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10
Q

What is A?

A

Sacro-tuberous ligaments

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11
Q

What is B?

A

Tip of coccyx

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12
Q

What is C?

A

Inferior Rami of Pubis

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13
Q

What is D?

A

Inferior margin of pubic symphysis

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14
Q

What parts of the pelvis are termed true and false pelvis?

A
  • True Pelvis
    • ​Pelvic viscera such as urinary bladder, reproductive organs such as the uterus and ovaries
  • False Pelvis
    • ​Some abdominal viscera such as sigmoid and some loops of ileum
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15
Q

What types of joints are:

  • sacroiliac joint
  • pubic symphysis
A
  • Sacroiliac joint
    • Synovial joint
  • Pubic Symphysis
    • Secondary cartilaginous joint
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16
Q

Which of A and B is male and female pelvis?

A

A - male pelvis

B - female pelvis

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17
Q

What are the differences in the following parts of bony pelvis in male and females:

  • greater pelvis (pelvis major)
  • lesser pelvis (pelvis minor)
  • pelvic inlet
  • pelvic outlet
  • subpubic angle
  • obturator foramen
  • acetabulum
A
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18
Q

With regards to the female pelvis and normal vaginal delivery

What is the narrowest diameter of the pelvic inlet?

What is the narrowest diameter of the pelvic outlet?

A
  • Pelvic inlet
    • 13cm
  • Pelvic outlet
    • 11cm
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19
Q

What are the walls of the pelvic cavity?

A

Antero-inferior wall

Two lateral walls

Posterior wall

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20
Q

What is the anterior-inferior wall of the pelvis formed from?

A

The anterior-inferior wall is formed by the bodies and rami of the pubic bones and the pubic symphysis.

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21
Q

What is A?

A

Obturatory internus

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22
Q

What is B?

A

Piriformis

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23
Q

What is C?

A

Coccygeus

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24
Q

Which muscle is present in the posterior wall of the pelvis?

A

Coccygeus

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25
Q

What is A?

A

Sacral plexus

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26
Q

Which nerve network lies on the muscle forming the posterior wall of the pelvis?

A

Sacral plexus

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27
Q

What is A?

A

Levator ani pubococcygeus

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28
Q

What is B?

A

Levator ani iliococcygeus

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29
Q

What is C?

A

Levator ani puborectalis

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30
Q

What is D?

A

Anoccygeal body

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31
Q

What is E?

A

Perineal body

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32
Q

What is the perineal body?

A

(also known as central tendon of perineum) a pyramidal fibromuscular mass in the middle line of the perineum and the junction between the urogenital triangle and the anal triangle, found in both males and females

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33
Q

What is perineal body also called?

A

Central tendon of perineum

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34
Q

What is anoccocygeal body?

A

(also known as anococcygeal ligament) is a fibrous median raphe in the floor of the pelvis, which extends between the coccyx and the margin of the anus

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35
Q

What is anococcygeal body also called?

A

Anococcygeal ligament

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36
Q

What are the 2 muscles that makes up the majority of pelvis floor?

A
  • Coccygeus muscle
  • Levator ani muscle (3 paired seperate muscles)
    • Levator ani pubococcygeus
    • Levator ani iliococcygeus
    • Levator ani puborectalis
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37
Q

What are the 3 paired muscles that forms the levator ani?

A
  • Levator ani pubococcygeus
  • Levator ani iliococcygeus
  • Levator ani puborectalis
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38
Q

What are 3 functions of the pelvic diaphragm/floor?

A
  1. Supports pelvis viscera
  2. Resists increases in intra-abdominal pressure
  3. Aids in micturation
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39
Q

What is the innervation of the pelvic diaphragm/ floor?

A

S2, S3, S4

40
Q

What is a cystocele?

A

Also known as prolapsed bladder, occurs when ligaments that hold the bladder in place and muscles stretches or weakens allowing the bladder to sag into the vagine, usually caused by levator ani pubococcygeus

41
Q

What is cystocele also called?

A

Prolapsed bladder

42
Q

What muscle usually causes cystocele?

A

Levator ani pubococcygeus

43
Q

What is rectocele?

A

Herniation of the front wall of rectum into the back wall of the vagina, cause by the tissue between the two (rectovaginal septum) becoming thin and weak over time

44
Q

What is rectocele caused by?

A

cause by the tissue between the two (rectovaginal septum) becoming thin and weak over time

45
Q

Why can injury to the pelvic floor during childbirth be damaging?

A

Can lead to urinary stress incontinence

46
Q

Why may an episiotomy minimise long-term pelvic floor damage during childbirth?

A

Enlarges opening for baby to pass through, reducing the risk of a tear

47
Q

Why is a mediolateral episiotomy preferable to a midline episiotomy for assisting childbirth?

A

idline has greater risk of deep perineal tears than mediolateral

48
Q

List the main pelvis viscera organs in male and females that are part of urinary system?

A
  • Male
    • Ureter
    • Urinary bladder
    • Urethra
  • Female
    • Ureter
    • Urinary bladder
    • Urethra
49
Q

List the main pelvic viscera in males and females that are part of reproductive system?

A
  • Male
    • Seminal glands
    • Ductus deferens
    • Prostate gland
  • Female
    • Ovary
    • Uterine tube
    • Uterus
50
Q

List the main pelvic viscera in males and females part of the alimentary system?

A
  • Males
    • Rectum
  • Females
    • Rectum
51
Q

What structures can be palpated when performing a digital rectal examination (DRI) in males?

A
  • Males
    • Prostate and seminal glands
    • Pelvic surface of the sacrum and coccyx
    • Ischial spines and tuberosities
    • Enlarged iliac nodes
    • Pathological thickening of ureters
    • Swellings in ischio-anal fossae
52
Q

What structures can be palpated when performing a digital rectal examination (DRI) in females?

A
  • Females
    • Cervix
    • Pelvic surface of sacrum and coccyx
    • Ischial spines and tuberosities
    • Enlarged iliac lymph nodes
    • Pathological thickening of ureter
    • Swellings in ischio-anal fossae
53
Q

Branches of what supplies blood to most of the pelvic orans, perineum and gluteal region?

A

Branches of the right and left internal iliac artery

54
Q

Branches of right and left inguinal iliac artery supplies most pelvic viscera, what are exceptions?

A
  • Testis
  • Ovary
  • Upper part of rectum
55
Q

What is A?

A

Lateral sacral artery

56
Q

What is B?

A

Superior gluteal artery

57
Q

What is C?

A

Inferior gluteal artery

58
Q

What is D?

A

Internal pudendal artery

59
Q

What is E?

A

Middle rectal artery

60
Q

What is F?

A

Superior vesical artery

61
Q

What is G?

A

Uterine artery

62
Q

What is H?

A

Obturator artery

63
Q

What is I?

A

Common iliac artery

64
Q

What is J?

A

Iliolumbar artery

65
Q

For superior and inferior vesical arteries:

  • distribution
  • origin
A
  • Distribution
    • Bladder
    • Seminal gland
    • Prostate in males
  • Origin
    • Internal iliac artery
66
Q

For uterine artery:

  • distribution
  • origin
A
  • Distribution
    • Pelvic part of ureter
    • Uterus
    • Ligament of uterus
    • Uterine tube
    • Vagina
  • Origin
    • Anterior division of internal iliac artery
67
Q

For gonadal (testicular/ovarian) artery:

  • distribution
  • origin
A
  • Distribution
    • Testis and ovaries
  • Origin
    • Abdominal aorta
68
Q

For middle rectal artery:

  • distribution
  • origin
A
  • Distribution
    • seminal gland, prostate, rectum
  • Origin
    • Anterior division of internal iliac artery
69
Q

For vaginal artery:

  • distribution
  • origin
A
  • Distribution
    • Vagina and branches to inferior part of urinary bladder
  • Origin
    • Uterine artery
70
Q

For internal pudendal:

  • distribution
  • origin
A
  • Distribution
    • Main artery to perineum
  • Origin
    • Anterior division of internal iliac artery
71
Q

For obturator artery:

  • distribution
  • origin
A
  • Distribution
    • Pelvic muscles, nutrient artery to ileum and head of femur
  • Origin
    • Internal iliac
72
Q

How are the pelvic veins complex?

A

The venous drainage of the pelvic structures is complex and involves interplay between the portal and systemic circulations. This has clinical significance especially in some pathologies e.g. liver cirrhosis, pelvic cancers

73
Q

What are examples of venous plexuses formed in relation to pelvic organs?

A

There are many venous plexuses formed in relation to pelvic organs (for example: rectal, prostatic) – some of these have clinical significance (e.g. prostatic venous plexus)

74
Q

Which part(s) of the rectum drain(s) into the portal circulation?

A

Superior rectal vein

75
Q

Which part(s) of the rectum drain(s) into the systemic circulation?

A

Middle and inferior rectal veins

76
Q

What is the significance of understanding the venous drainage of the rectum?

A

Allows administration of some medications normally given by mouth to be given rectally, bypassing first pass metabolism

77
Q

Why might haemorrhoids be associated with cirrhosis of the liver?

78
Q

With which venous plexus does the prostatic venous plexus communicate with on its posterior side?

A

Internal vertebral venous plexus

79
Q

With which venous plexus does the prostatic venous plexus communicate with on its posterior side? Internal vertebral venous plexus

Why is this important – think of how prostate cancer spreads…?

80
Q

For ilioinguinal nerve:

  • origin
  • where does it enter inguinal canal
  • innervates
A
  • Origin
    • L1
  • Enters inguinal canal at superficial inguinal ring
  • Innervates
    • Skin at root of penis in male and labia in females
81
Q

For pudendal nerve:

  • origin
  • course
  • innervates
A
  • Origin
    • Sacral plexus (S2-S4)
  • Course
    • Course of pudendal artery
  • Innervation
    • Skin and muscles of perineum
82
Q

For genitofemoral nerve:

  • origin
  • where enters inguinal canal
  • innervation
A
  • Origin
    • L1-L2
  • Enters inguinal canal at deep inguinal ring
  • Innervation
    • Scrotal skin and cremaster
83
Q

What are the somatic nerves of the reproductive tract?

A
  • Ilioinguinal nerve
  • Genitofemoral nerve
  • Pudendal nerve
84
Q

What bony landmarks are used when performing a pudendal nerve block during labour?

A

Ischial spines

85
Q

Where does the autonomic nerve supply to the pelvis originate?

A

From the pelvis plexus (or inferior hypogastric)

86
Q

For the sympathetic fibres of the pelvis:

  • origin
  • course
  • innervates
A
  • Origin
    • L1 and L2 via the hypogastric nerve and terminal aspect of sympathetic trunk
  • Course
    • Follow arterial supply to targets
  • Innervates
    • Sympathetic innervation to all internal pelvic organs
    • In males - vas deferns, seminal vesicles, prostate and epididymis
    • In females - ovaries, uterus, fallopian tubes and vagina
87
Q

For parasympathetic fibres of pelvis:

  • origin
  • innervation
A
  • Origin
    • Pelvic spanchnic nerves (S2-S4)
  • Innervates
    • Parasympathetic innervation to all internal pelvic organs
    • Erectile tissue in both males and females
88
Q

Are the following splanchnic nerves sympathetic or parasympathetic:

  • greater splanchnic of thorax
  • lesser splanchnic of thorax
  • least splanchnic of thorax
  • pelvic splanchnic nerves
A
  • Greater splanchnic of thorax
    • Sympathetic
  • Lesser splanchnic of thorax
    • Sympathetic
  • Least splanchnic of thorax
    • Sympathetic
  • Pelvic splanchnic nerves
    • Parasympathetic
89
Q

After rectal surgery, why are some men unable to ejaculate?

A

Damage to sympathetic nerves

90
Q

Is the sympathetic or parasympathetic system responsible for:

  • ejaculation
  • erection
A
  • Ejaculation
    • Sympathetic
  • Erection
    • Parasympathetic
91
Q

What are the 4 primary lymph nodes present in the pelvic region?

A

External iliac lymph nodes

Internal iliac lymph nodes

Sacral lymph nodes

Common iliac lymph nodes

92
Q

What areas do the external iliac lymph nodes drain?

A
  • infraumbilical abdominal wall
  • adductor region of the thigh
  • glans penis/clitoris
  • membranous urethra
  • prostate
  • fundus of bladder
  • uterine cervix and upper vagina
93
Q

What areas do the internal iliac lymph nodes drain?

A
  • Gluteal region
  • Deep perineum
  • and inferior pelvic viscera
94
Q

What areas do the sacral lymph nodes drain?

A
  • From posterio-inferior pelvic viscera (rectum and posterior wall of pelvis)
95
Q

What areas do the common iliac lymph nodes drain?

A
  • Drainage from the 3 main groups
    • External, internal and sacral lymph nodes

anatomy year 3 (18 decks)

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