Reproductive and Other Pelvic Viscera Flashcards
1
Q
What does the female external genitalia include?
A
- mons pubis
- labia majora
- labia minora
- clitoris
- bulbs of the vestibule
- greater and lesser vestibular glands
2
Q
What serves as a sensory and erectile tissue for sexual arousal and intercourse, directs the flow of urine, and prevents entry of foreign material into the UG tract?
A
the pudendum/vulva
3
Q
What is the rounded, fatty eminence anterior to the pubic symphysis, pubic tubercle, and superior pubic rami?
A
mons pubis
4
Q
What are prominent folds of skin that bound the pudendal cleft and indirectly provide protection for the urethral and vaginal orifices?
A
labia majora
5
Q
What are folds of fat-free, hairless skin that have a core of spongy connective tissue containing erectile tissue and many small blood vessels?
A
labia minora
6
Q
What is an erectile organ located where the labia minora meet anteriorly that consists of a root and a body, which are composed of two crura, two corpora cavernosa, and the glans?
A
clitoris
7
Q
What is the space surrounded by the labia minora, which contains the openings of the urethra, vagina, and ducts of the greater and lesser vestibular glands?
A
vestibule
8
Q
What are paired masses of elongated erectile tissue that lie along the sides of the vaginal orifice under cover of the bulbospongiosus muscles?
A
the bulbs of the vestibule
9
Q
What are located on each side of the vestibule, posterolateral to the vaginal orifice and secrete mucus into the vestibule during sexual arousal?
A
the greater vestibular glands
10
Q
What are smaller glands on each side of the vestibule that open into it between the urethral and the vaginal orifices that secrete mucus into the vestibule, which moistens the labia and vestibule?
A
the lesser vestibular glands
11
Q
Anterior, the labia minor form two laminae: the medial laminae unite as the (…), and the lateral laminae unite to form the (…)
A
- frenulum of the clitoris
- prepuce of the clitoris
12
Q
What is located adjacent to the urethra and secretes mucus into vestibule?
A
lesser vestibular glands
13
Q
What is the lesser vestibular glands homologous with in males?
A
prostate gland
14
Q
What is located posterior to the Bulbs of vestibule and secrete mucus in to the vestibule during sexual arousal?
A
greater vestibular glands (Bartholin’s glands)
15
Q
What are the greater vestibular glands homologous with in the males?
A
bulbourethral glands
16
Q
What functions as the birth canal, passageway for menstrual flow, and organ of copulatin?
A
the vagina
17
Q
What extends from the outer surface up to the posterior fornix?
A
the vagina
18
Q
What extends between the bladder and rectum from cervix to the exterior?
A
the vagina
19
Q
What runs parallel to the vagina anterior?
A
the urethra
20
Q
What does the external os open into?
A
internal os
21
Q
What is contained in the upper genital tract of the female?
A
- ovaries
- uterine/fallopian tubes
- uterus
22
Q
What are the different parts of the uterine/fallopian tubes?
A
- infundibulum (w/fimbriae)
- ampulla
- isthmus
- intramural
23
Q
What are the different parts of the uterus?
A
- fundus
- body/corpus
- isthmus
- cervix
24
Q
What are basically the “appendages” of the uterus?
A
adnexa
25
What pouch is found between the uterus and the bladder?
vesicouterine pouch
26
What pouch is found between the uterus and rectum?
rectouterine pouch
27
Where the uterus lies against the bladder (vesicouterine pouch), what can occur?
- spread of cancer
- infection
**things hide here**
28
What are the embryonic structures which begin as undifferentiated mesenchyme attaching to the caudal end of the gonads (testes in males/ovaries in females)?
gubernaculum
29
What is related to the descent of the ovary from its developmental position on the posterior abdominal wall?
gubernaculum
30
What are the ligaments related to the gubernaculum remnants?
- round ligament
- ovarian ligament
31
The round ligament of the uterus and ovarian ligament attach at the junction of (...) to (...)
1. uterine tube
2. uterus
32
What binds the uterus to the anterior body wall?
round ligament
33
What connects the ovary to the uterus?
ovarian ligament
34
What is a double layer of peritoneum that extends from the sides of the uterus to the lateral walls and floor of the pelvis?
the broad ligament of the uterus
35
What ligament assists in keeping the uterus relatively centered in the pelvis, but mostly contains the ovaries, uterine tubes, related structures, and vasculature?
the broad ligament of the uterus
36
What are the 3 parts of the broad ligament of the uterus?
- mesosalpinx
- mesovarium
- mesometrium
37
What part of the broad ligament of the uterus supports and serves as mesentery for the uterine tube?
mesosalpinx
38
What part of the broad ligament of the uterus suspends the ovaries?
mesovarium
39
What part of the broad ligament of the uterus plays a major part of the broad ligament, is below the mesosalpinx and mesovarium, and serves as a mesentery for the uterus?
mesometrium
40
What ligament contains ovarian arteries and veins?
suspensory ligament of the ovary
41
What ligament is part of the hypogastric sheath, carries uterine vessels towards cervix, and has the ureter passing inferior to these?
lateral (cardinal) cervical ligament
42
What extends from the cervix and lateral parts of the fornix of the vagina to the lateral walls of the pelvis?
Cardinal ligaments
43
What are the active elements that act as support systems for the uterus?
- pelvic diaphragm → especially pubococcygeus m
- minor support → UG diaphragm mm
- fibers of pubococcygeus muscles merge with adjacent pelvic viscera
44
What are the passive elements that act as a support system for the uterus?
**the anatomical position of the uterus**
- anteverted → cervix tilted forward relative to vagina (90 degrees)
- anteflexed → uterine body bent forward relative to cervix
- ligaments formed by thickened endopelvic fascia (uterosacral, transverse cervical, pubocervical)
45
What pelvic ligaments provide significant passive support to the uterus?
- uterosacral ligament
- transverse cervical (cardinal) ligament
- pubocervical ligament
46
What ligament holds the cervix back and upward and attached **uterus** to the **sacrum**?
uterosacral ligament
47
What ligament attaches **cervix** and lateral part of the fornix of the **vagina** to the lateral wall of the **pelvis**?
transverse cervical (cardinal) ligament
48
What ligament attaches the **cervix** to the posterior surface of the **pubic symphysis**?
pubocervical ligament
49
What pelvic ligaments do not provide significant passive support to the uterus?
- broad ligament
- ligament of ovary and round ligament
- suspensory ligament
50
What are the two pelvic fascias?
1. membranous pelvic fascia
2. endopelvic fascia
51
What are the two layers of the membranous pelvic fascia that are continuous where organs pierce the pelvic floor?
- parietal
- visceral (ensheathes pelvic organs)
52
What does the membranous pelvic fascia and what does it run from?
**tendinous arch of pelvic viscera**
- runs from **pubis** to **sacrum** adjacent to organs
53
What pelvic fascia consists of loose and condensed fascia and what do they make?
**endopelvic fascia**
- loose: retropubic and rectorectal spaces
- condensed: "pelvic ligaments"
54
What does the condensed endopelvic fascia form and what does it convey?
**hypogastric sheath**
- conveys neuromuscular structures from lateral wall of pelvis to organs
55
What (...) is a pear shaped organ that exhibits a body, (...) and neck (...)
1. uterus
2. fundus and isthmus
3. cervix
56
What are the different parts of the cervix?
- internal os (opening)
- cervical canal
- external os that opens into vagina
57
- The usual position of the uterus is in an (...) position and lies almost in the (...) plane
- The position of the uterus changes with the degree of (...)
1. anteflexed (anteverted) position
2. horizontal plant
3. fullness of the bladder and rectum
58
What are the three layers of the uterine wall from outermost to innemost?
1. perimetrium
2. myometrium
3. endometrium
59
- What layer of the uterine wall is the outermost serous layer (visceral peritoneum)?
- What layer of the uterine wall is the bulky middle layer consisting of interlacing layers of smooth muscle?
- What layer of the uterine wall forms the mucosal lining?
- perimetrium
- myometrium
- endometrium
60
- What uterine wall layer contracts rhythmically during childbirth?
- What uterine wall layer is made up of simple columnar epithelium on top of a thick lamina propria? (fertilized egg burrows and resides here during development)
- myometrium
- endometrium
61
What is the arterial supply to the uterus?
uterine arteries (from internal iliacs) → arcuate arteries (in myometrium) → radial arteries (in endometrium) → straight arteries (in stratum basalis) and spiral arteries (in stratum functionalis)
62
Which uterine arteries degenerate and regenerate and spams cause shedding of the functionalis layer during mestruation?
spinal arteries
63
What are the two chief layers of the endometrium (strata)?
- stratum functionalis (functional layer)
- stratum basalis (basal layer)
64
- What endometrial layer changes **in response to ovarian hormone** cycles and sheds during menstruation?
- What endometrial layer forms new stratum functionalis after menstruation and is **unresponsive to ovarian hormones**?
1. stratum functionalis
2. stratum basalis
65
What receives ovulated oocyte and is the usual site of fertilization and extends from area of ovary to superolateral region of the uterus?
uterine (fallopian) tubes
66
67
What are the different regions of the uterine tubes?
- isthmus
- ampulla
- infundibulum
- uterine part
68
- What region of the uterine tube is a constricted area where the tube joins the uterus?
- What region of the uterine tube is the distal end of the tube that curves around the ovary
- What region of the uterine tube is the distal expansion near the ovary?
- What region of the uterine tube is a short intramural segment that passes through the wall of the uterus that opens through the uterine ostium into the uterine cavity at the uterine horn?
- isthmus
- ampulla
- infundibulum
- uterine part
69
What part of the uterine tube contains ciliated fimbriae that created a current to move oocyte into the uterine tube?
infundibulum
70
Externally, the uterine tubes are:
- covered by peritoneum
- supported by a short mesentery called the mesosalpinx
71
What are the almost-shaped female gonads that are attached to the broad ligament by its mesovarium portion?
ovaries
72
The ovary is suspended between two attachments, what are they?
1. laterally to pelvic wall by suspensory ligament of the ovary
2. medially to uterus by ovarian ligament
73
What contains ovarian vessels, lymphatics, and autonomic nerve fibers?
suspensory ligament of the ovary
74
What is covered by its own epithelium and has no peritoneal covering?
ovaries
75
What is the blood supply for the ovaries?
- ovarian arteries
- ovarian branch of uterine arteries
76
Each ovary is surrounded by a (...), which is then covered by a (...) outer layer that is a continuation of the peritoneum
1. tunica albuginea
2. germinal cuboidal epithelium
77
What is in the rectouterine pouch in females?
- ligament of ovary
- round ligament
- uterosacral ligament
78
What is the vasculature of the uterus?
- **uterine arteries** (some supply from ovarian arteries)
- **uterine veins** (drains each side of uterus and vagina into internal iliac veins)
79
What is the vasculature of the ovaries and uterine tubes?
- ovarian arteries (from abdominal aorta)
- ascending branches of uterine arteries (from internal iliac artery)
80
The innervation of the inferior part of the vagina is (...) from the (....), a branch of the (...); however most of the vagina and entire uterus has (...) innervation
1. somatic
2. deep perineal n
3. pudendal n
4. visceral
**inferior part of the vagina has some voluntary control**
81
The nerves of the uterus and vagina derive from the (...), which travels with the uterine artery
uterovaginal nerve plexus
82
The uterus and vagina have what type of fibers innervating it?
- sympathetic (lumbar splanchnic nn and hypogastric-pelvic plexuses)
- parasympathetic (pelvic splanchnic nerves)
- visceral afferent (carries pain sensation; travel with parasympathetic fibers to sensor ganglia of S2-S4)
83
- The ovaries and uterine tubes are (...) to the pelvic pain line, so the visceral afferent pain fibers ascend with (...) of the (...) plexus and (...) nerves to cell body sin T11-L1 ganglia
- Visceral afferent reflex fibers follow (...) through the (...) and (...) plexuses and (...) nerves to 2S-S4 ganglia
1. superior
2. sympathetic fibers
3. ovarian plexus
4. lumbar splanchnic nerves
5. parasympathetic fibers
6. uterine
7. inferior hypogastric plexuses
8. pelvic splanchnic nerves
84
- Intraperitoneal visceral pain, via (...), to (...) and is (...) the pelvic pain line
- Subperitoneal visceral pain, via (...), to (...) and is (...) the pelvic pain line
- Somatic sensory of the pelvis and perineum goes to (...)
1. sympathetic fibers
2. T10-L2
3. above
1. parasympathetic fibers
2. S2-S4
3. below
1. S2-S4
85
What organs are above the pelvic pain line? below the pelvic pain line? have somatic pain?
**above pelvic pain line**
- ovaries, uterine tubes, uterine body and fundus
**below pelvic pain line**
- uterine cervix, superior/proximal vagina)
**somatic**
- inferior/distal vagina
- external genitalia
86
What acts as a cutaneous fibromuscular sac for the testes and associated structure; is situated postero-inferior to the penis, inferior to the pubic symphysis?
the scrotum
87
The scrotum is divided into two compartments, one for each testis, by a prolongation of (...), which forms the (...)
1. dartos fascia
2. septum of the scrotum
88
- What are the testis surrounded by (forms the capsule)?
- What do the testis produce?
- What do the testis contain and what do they go into?
1. tunica albuginea
2. testosterone and create spermatozoa
3. contains seminiferous tubules → straight tubules (Rete testis) → efferent ductules → epididymis
89
- What are the different parts of the epididymis?
- What is the function of the epididymis?
1. head, body, tail
2. storage and maturation of sperm
90
During descent of the testes into the scrotum, a pouch of abdominopelvic peritoneum called the (...) attaches to the anterior and lateral aspect of the testes (both visceral and parietal layers)
tunica vaginalis
91
Testes are encased within a thick capsule, the (...)
tunica albuginea
92
Testes are divided into lobules that contain (...)
seminiferous tubules
93
The seminiferous tubules are lines with germinal epithelium that gives rise to the spermatozoa which drain into the (...) and (...) of the epididymis
- rete testes (straight tubules)
- efferent ductules
94
Sperm mature and are stored in the (...), a long coiled tube about 6m in length if uncoiled
epididymis
95
What occurs in the seminiferous tubules?
spermatogenesis
96
The testis is divided into about (...) lobules, each containing (...) seminiferous tubules of the testes. The complete cycle of spermatogenesis takes about (...) days and (...) more days for sperm to mature and pass through epididymis
- 250 lobules
- 1 to 4 seminiferous tubules
- 74 days
- 12 more days
97
What are the different parts of the penis?
- root
- body
- glans
- prepuce (foreskin)
98
What part of the penis is composed of bulb (proximal corpus spongiosum) and two crura (proximal part of corpora cavernosa)?
the root
99
What part of the penis is covered by skin, dartos fascia, and deep (Buck's) fascia of penis, which envelops the corpora cavernosa and corpus spongiosum, which contains spongy urethra?
the body
100
What part of the penis is the expanded distal end of corpus spongiosum where the spongy urethra expands and opens externally?
the glans
101
What part of the penis is a thin, double layer of skin that extends over most of the glans penis; male circumcision removes this to expose glans?
the prepuce (foreskin)
102
The ductus (vas) deferens joins the ducts of the seminal vesicles to form the (...) which empty into the (...), the first part of the male urethra
- ejaculatory ducts
- prostatic urethra
103
What is a continuation of the duct of the epididymis?
the ductus (vas) deferens
104
What contribute fluid to the ejaculate and account for about 70% of the ejaculate volume?
seminal gland (vesicle)
105
What produces a viscous and alkaline fluid that nourishes the spermatozoa and protects them from the acidic environment of the female vagina?
seminal gland (vesicle)
106
What is made up of smooth muscle and does peristalsis to transport sperm?
ductus deferens
107
What does this describe:
- produces alkaline fluid (neutralize vaginal acidity)
- secretes prostaglandins (suppress female immune response)
- secretes fructose (energy)
seminal gland (vesicle)
108
What does this describe:
- surrounds prostatic urethra
- glandular part makes up 2/3 of prostate; other 1/3 is fibromuscular
- has dense, fibrous capsule that incorporates nerves and veins
prostate
109
What part of the prostate lies anterior to the urethra, is primarily muscular and represents the superior continuation of the urethral sphincter muscle?
isthmus of the prostate
110
What part of the prostate each is divided into 4 indistinct lobules in two concentric bands, defined by their relationship to the urethra and ejaculatory ducts?
right and left lobes of the prostate
111
What is the function of the prostate?
- secrete prostatic fluids (liquifies semen)
- receives ejaculatory duct into prostatic urethra
112
You should not do a digital prostate exam on individuals with what?
suspected prostatitis
113
What is found in the deep perineal space, within the external sphincter urethrae muscle and secretes pre-ejaculate (lubricate and neutralize male urethra)?
bulbourethral (Cowper's) glands
114
What is contained in corpus spongiosum and has urethral glands that protect the epithelium against acidic urine?
spongy urethra
115
What is the vasculature of the male reproductive organs?
- arteries are similar to females, except the uterine, vaginal, and ovarian branches are replaced by arteries to the ductus deferens, the prostatic artery, and testicular arteries
- veins drain into internal iliac veins
- venous plexuses are associated w/ bladder, rectum, vagina, uterus, and prostate and are referred to as the pelvis plexus of veins
116
The ductus deferens, seminal glands, ejaculatory ducts, and prostate are richly innervated by (...) fibers from the (...) nerves
1. sympathetic fibers
2. lumbar splanchnic nerves
117
The male reproductive organs are also innervated by (...) fibers from the (...) nerves (but not richly innervated by these)
1. parasympathetic fibers
2. pelvic splanchnic nerves
118
What provides somatic sensory to the penis and scrotum?
**penis**
- dorsal n of penis
**scrotum**
- posterior scrotal nn
- ilioinguinal and genitofemoral nn
119
What is the pelvic part of the alimentary tract and is continuous proximally with the sigmoid colon and distally with the anal canal?
the rectum
120
The rectosigmoid junction lies at the level of (...)
the S3 vertebra
121
The rectum ends antero-inferior to the tip of the (...), where the rectum turns postero-inferiorly and becomes the (...)
- coccyx
- anal canal
122
The dilated terminal part of the rectume, the (...), supports and retains fecal mass before it is expelled during defecation
ampulla of the rectum
123
The terminal part of the rectum bends sharply in a posterior direction, (...), as it perforates the pelvic diaphragm to become the anal canal
anorectal flexure
124
The roughly 80-degree anorectal flexure (angle) is an important mechanism for (...) and is maintained during the resting state by the tonus of the (...)muscle and by its active contraction during peristaltic contractions if defecation is not to occur?
- fecal continence
- puborectalis
125
Relaxation of the (...) during defecation results in straightening of the anorectal junction
puborectalis
126
Understand that there are tissue changes from inside the (...) to the outside
anus
127
What is the arterial supply to the rectum?
- superior rectal artery (from IMA; supplies proximal rectum)
- middle rectal arteries (from inferior vesical/uterine arteries; supplies middle and inferior rectum)
- inferior rectal arteries (from pudendal arteries; supplies anorectal junction and anal canal)
128
Blood from the rectum drains via what?
superior, middle, and inferior rectal veins
129
The sympathetic supply of the rectum is from what?
- lumbar splanchnic nerves
- hypogastric plexuses
- peri-arterial plexuses (on branches of IMA and superior rectal arteries)
130
The parasympathetic supply of the rectum is from what?
- pelvic splanchnic nerves
- inferior hypogastric plexuses
131
Because the rectum is inferior to pelvic pain line, all visceral afferent fibers follow (...)
parasympathetic fibers
132
The puborectalis muscle provides what to the rectum?
somatic control (motor)
133
What is the terminal part of the large intestine that extends from the superior aspect of the pelvic diaphragm to the anus?
the anal canal
134
What begins where the ampulla of the rectum abruptly narrows at the level of the U-shaped sling formed by the (...)
- anal canal
- puborectalis muscle
135
The anal canal ends at the anus, the external outlet of the (...)
It is surrounded by internal and external (...), descends posterio-inferiorly between the (...) and the perineal body
- alimentary tract
- anal sphincters
- anococcygeal ligament
136
What is normally collapsed except during passage of feces; both sphincters must (...) before defecation can occur
- anal canal
- relax
137
What type of cells are in the anus and what does this allow for?
- squamous cells
- allows for protection
138
What is a large voluntary sphincter that forms a broad band on each side of the inferior two thirds of the anal canal?
external anal sphincter
139
What is the external anal sphincter supplied mainly by?
S4 through the inferior anal (rectal) nerve
140
What is the involuntary sphincter surrounding the superior 2/3rds of the anal canal and is a thickening of the circular muscle layer?
internal anal sphincter
141
The contraction of the internal anal sphincter is stimulated and maintained by (...); it is inhibited, loses tonic contraction and is allowed to expand passively, by (...)
- sympathetic fibers from superior rectal and hypogastric plexuses
- parasympathetic fibers
142
The internal sphincter is tonically contracted most of the time to (...); however it relaxes temporarily in response to (...), requiring voluntary contraction of the (...) and the (...) if defecation or flatulence is not to occur
- prevent leakage of fluid or flatus
- distention of the rectal ampulla by feces or gas
- puborectalis
- external anal sphincter
143
The superior half of the mucous membrane of the anal canal is characterized by a series of longitudinal ridges called (...) that contain terminal branches of the (...)
- anal columns
- superior rectal artery and vein
144
The (...), indicated by the superior ends of the anal columns, is where the rectum joins the anal canal
anorectal junction
145
The inferior ends of the anal columns are joined by (...); superior to these are small recesses called (...)
- anal valves
- anal sinuses
146
What can be an issue in the anorectal junction?
hemorrhoids
147
- The nerve supply to anal canal superior to pectinate line is visceral innervation from the (...)
- The nerve supply of anal canal inferior to pectinate line is somatic from the (...), branches of the (...)
- inferior anal (rectal) nerves
- pudendal nerve
148
Which part of the anal canal is sensitive only to stretching?
Which part is sensitive to pain, touch, and temperature?
- superior part
- inferior part
149
What stimulates the contraction of the voluntary external anal sphincter?
somatic efferent fibers
150
The (...) drains in both directions of the anus from the level of the pectinate line
internal rectal venous plexus
151
Superior to pectinate line, the internal rectal venous plexus drains into (...) and (...)
- superior rectal vein
- portal system
152
Inferior to the pectinate line, the internal rectal venous plexus drains into the (...)
inferior rectal veins
153
The (...) mainly drain the muscularis externa of the rectal ampulla and form anastomoses with superior and inferior rectal veins
middle rectal veins (internal iliac veins)
154
- What supplies the anal canal superior to pectinate line?
- What supplies the inferior part of the anal canal as well as the surrounding muscles and peri-anal skin?
- What assists with blood supply to the anal canal by forming anastomoses with the superior and inferior rectal arteries?
- superior rectal arteries
- inferior rectal arteries
- middle rectal arteries
155
- Superior to the pectinate line, lymphatic vessels of the anus drain into what?
- Inferior to the pectinate line, lymphatic vessels of the anus drain into what?
- internal iliac lymph nodes (→ common iliac → lumbar lymph nodes)
- superficial inguinal lymph nodes
156
What serves as a reservoir for urine produced in the kidneys, lies within the pelvic cavity when empty, and extends superiorly into the abdominal cavity when full?
the urinary bladder
157
Between the pubic symphysis and urinary bladder is a potential space called the (...)
retropubic space
158
What is filled with fat and loose connective tissue to accommodate the expansion of the urinary bladder?
retropubic space
159
In males, the inferior limit of the retropubic space is defined by what?
puboprostatic ligament
160
What is a condensation of fascia that ties the prostate to the inner surface of the pubis?
puboprostatic ligament
161
In females, what is a condensation of fascia that ties the neck of the urinary bladder to the pubis across the retropubic space?
pubovesical ligament
162
When empty, the bladder is somewhat (...)
tetrahedral
163
What are the different parts of the bladder?
- apex of bladder
- fundus of bladder (base)
- body of bladder
- neck of bladder
164
What part of bladder points toward superior edge of pubic symphysis?
apex of bladder
165
What part of bladder is opposite of apex, formed by the somewhat convex posterior wall?
fundus of the bladder
166
What part of the bladder is the part between the apex and fundus?
the body of the bladder
167
What part of the bladder is where the fundus and inferolateral surfaces converge inferiorly?
neck of the bladder
168
In females, the fundus is closely related to the anterior wall of the (...); in males, it is related to the (...)
- vagina
- rectum
169
What is formed on each side by the pubic bones and the fascia covering the obturator internus and levator ani muscles and posteriorly by the rectum or vagina?
The bladder bed
170
The bladder is enveloped by loose connective tissue, the (...); only the superior surface is covered by (...)
1. vesical fascia
2. peritoneum
171
The walls of the bladder are composed of the (...)
detrusor muscle
172
Toward the neck of the male bladder, its muscle fibers form the involuntary (...)
internal urethral sphincter
173
In males, the muscle fibers in the neck of the bladder are continuous with the fibromuscular tissue of the (...), whereas in females, these fibers are continuous with muscle fibers in the wall of the (...)
- prostate
- urethra
174
Do females have an internal urethral sphincter?
no, only external
175
The (...) and the internal urethral orifice are at the angles of the (...)
- ureteric orifices
- trigone of the bladder
176
The (...) are encircled by loops of detrusor musculature that tighten when the bladder contracts to assist in preventing reflux of urine into the ureters
ureteric orifices
177
What is a slight elevation of the trigone in the internal urethral orifice?
the uvula of the bladder
178
The main arteries supplying the bladder are branches of the (...)
internal iliac arteries
179
What arteries supply the anterosuperior parts of the bladder?
superior vesical arteries
180
In males, the fundus and neck of the bladder are supplied by (...)
inferior vesical arteries
181
In females, the inferior vesical arteries are replaced by (...) which send small branches to the postero-inferior parts of the bladder
vaginal arteries
182
What also supply small branches to the bladder?
obturator and inferior gluteal arteries
183
In males, the vesical venous plexus is continuous with (...)
prostatic venous plexus -- envelops fundus of bladder, prostate, seminal glands, and ductus deferens and inferior ends of ureters
184
The prostatic venous plexus also receives blood from what?
deep dorsal vein of the penis
185
In females, the vesical venous plexus envelopes the pelvic part of what?
the urethra
186
In females, the neck of the bladder receives blood from what?
the dorsal vein of the clitoris and communicated with the vaginal/uterovaginal venous plexus
187
What is the lymphatic drainage of the bladder in both males and females?
- lymphatic vessels leave superior surface of bladder, pass to external iliac lymph nodes
- vessels from fundus pass to internal iliac lymph nodes
- some vessels from neck of bladder drain into sacral or common iliac lymph nodes
188
What is the innervation of the bladder?
- sympathetic fibers primarily through hypogastric plexuses and nerves
- parasympathetic fibers from pelvic splanchnic nerves and inferior hypogastric plexuses
189
What do parasympathetic fibers of the bladder act as?
they are motor to the detrusor muscle and inhibit internal sphincter or males (when visceral afferent fibers are stimulated by stretching, detrusor muscle contracts, internal sphincter relaces, urine flows into urethra)
190
Sensory fibers from the bladder are (...); reflex afferent and pain afferents from inferior part of bladder follow (...); superior surface of bladder (superior to pain line) follows (...)
- visceral
- parasympathetic fibers
- sympathetic fibers
191
The urethra in females contains two small (...) at its aperture
paraurethral mucous glands
192
What is the male urethra divided into?
- prostatic portion: traverses prostate gland
- membranous portion: traverses external urethral sphincter (skeletal muscle)
- spongy portion: traverses corpus spongiosum
193
Females have an (...) composed of skeletal muscle under (...) control innervated by somatic nerve fibers in the (...)
- external urethral sphincter
- voluntary control
- pudendal nerve
194
What urethral sphincters do males have?
internal and external sphincters
195
Which male urethral sphincter is a smooth-muscle involuntary sphincter at the neck of the bladder and innervated by sympathetic fibers from L1 to L2?
internal urethral sphincter
196
Which male urethral sphincter is a skeletal muscle voluntary sphincter surrounding the membranous urethra and innervated by the somatic nerve fibers in the pudendal nerve?
external urethral sphincter
197
What is the vasculature of the urethra in females?
- internal pudendal a
- vaginal aa
- veins follow arteries and have similar names
- lymph vessels pass to sacral and internal iliac lymph nodes
198
What is the innervation of the urethra in females?
- vesical plexus
- pudendal nerve
- visceral afferents mostly from pelvic splanchnic nerves, but the termination receives somatic afferents from pudendal n
199
What is the vasculature of the urethra in males?
**intramural part of urethra and prostatic urethra**
- inferior vesical a
- middle rectal aa
**intermediate and spongy parts of urethra**
- internal pudendal a
- veins accompany arteries with similar names
- lymphatic vessels drain mainly into internal iliac nodes, some pass to external iliac nodes; spongy urethra nodes pass to deep inguinal nodes
200
What is the innervation of the urethra in males?
- prostatic nerve plexus (sympathetic, parasympathetic, and visceral afferent fibers)
- inferior hypogastric plexus
