Reproductive Organs and the Pelvic Floor Flashcards
Pelvic floor function
trampoline supporting organs of pelvis
crucial to continence (bladder and bowel control) and sexual function
3 groups of pelvic diaphragm muscles
- Pelvic diaphgram
- The urogenital diaphgram
- The sphincters and erectile muscles of the urogenital tract
What is the levator ani group
most significant muscle of the pelvic diaphragm. tonically contracted continuously to support weight of abdominopelvic viscera. contracts actively in response to coughing, sneezing, forced expiration, and vomiting. relaxation of these muscles allow for urination and defecation.
comprised of 3 individual muscles:
* Puborectalis
* Pubococcygeus
* Iliococcygeus
- What is a common consequence of vaginal baby delivery?
- What are the common muscles injured?
- What are the symptoms observed by these patients
- pelvic floor injury
- puborectalis and pubococcygeus
- incontinence and sexual dysfunction
- 2 fold increase in risk for pelvic floor dysfunction compared to c section; measured 20 years after birth
Uterus
* function
* weight
* different portions
- contains the developing fetus
- 50-200g in a non-pregnant female; expands tremendously, and weighs ~1kg at birth
- The fundus (top part) is
connected to the ovaries via the Fallopian tubes - The cervix (neck) is connected to the vagina
The expansion of the uterus during pregnancy can compress adjacent organs and create complications during pregnancy. What are some of the complications?
- Shortness of breath
- Heartburn
- Reduced stomach capacity
- Impaired intestinal
transit and constipation
What is the function of the broad ligament of the uterus. What is it made of?
Extends from the sides of the uterus to the lateral wall and floor of the pelvis, holding the uterus in position
sheet like fold of peritoneum
What is the function and location of the round ligament of the uterus. What is it made of?
When a person has round ligament pain, what is usually the cause?
Extends from the lateral aspects (horns, cornu) of the uterus to the labium majorum
true ligament
round ligament pain: weight of uterus tugs on ligaments
if the uterine ligaments and pelvic floor muscles are damaged, what can occur
uterine is unsupported and can prolapse
uterine tubes
* function
* parts
transport the fertilized ovum from the ovaries to the body of the uterus.
from closest to uterus to furthest: Intramural, isthmus, ampulla, infundibulum
Ectopic pregnancy
* what is it
* what can it be mistaken for and why
tubal pregnancy resulting in embryo death; egg implants into fallopian tube
dangerous for mother, tube can burst
Appendix lies very close to the right ovary and right uterine tube – tubal pregnancy can be misdiagnosed as appendicitis.
vagina function
Facilitates childbirth, menstruation, sexual intercourse, and sexual pleasure
Clinical importance of the cervix
- Dilates during labour to admit the passage of the baby into the birth canal
- Is checked routinely for changes indicative of cervical cancer via Pap smear
*separates uterus and vagina
Describe the apperance of a normal cervix and a cervix with HPV infection/cervical cancer
- Smooth, glistening muscosal surface
- Cervical os (cervical opening) is small and round: in nulliparous woman (never gave birth)
cervical os can be wider, there can be damage to the cervix
vulva
and its components
all of the external female genitalia
mons pubis
prepuce
clitoris
labia minora
labia majora
external urethral orfice
vaginal orfice
bartholin glands
fourchette
what are erectile bodies
tissue containing vascular
spaces/sinuses that can become engorged with blood (in tumescence).
What are the 4 types of female genital mutilation
- clitoridectomy
- excision (clitoris + more)
- infibulation (sewing vagina shut)
- other
primary erectile bodies of the penis are called what? what is their function and location
corpora cavernosa
(singular, corpus cavernosum)
spaces that can become engorged with blood. provide most of the engorgement (when compared to corpus spongiosum)
lies dorsally (when you are at a urinal looking down, you’re looking at the dorsal side of the penis)
corpus spongiosum
* where
* what passes through it
* continuous with what
lies ventrally in penis
urethra passes through the corpus spongiosum
The corpos spongiosum is continuous with the glans; both have less tunical covering relative to the corpus cavernosum
Where is the levator ani muscle in men
base of the penis
Penis transverse view
What is it wrapped in?
most ventral: corpus spongiosum
lateral and posterior (dorsal) to corpus spongiosum: corpora cavernosa
wrapped in buck’s fascia
Which surface of the penis is dorsal vs ventral?
dorsal: what you see when you’re at a urinal looking down.
ventral:
penis divisions
root (2 crura and 1 bulb)
body (from root to glans)
glans
corpus cavernosa
corpus spongiosum
What covers the penile glans
prepuce (foreskin)
What are the perceived/potential benefits and risks with circumcision
Perceived/potential benefits: reduced risk of urinary tract infection, penile cancer, and sexually transmitted infection (including HIV)
- Risks: infection, permanent disfiguration,
impaired sexual pleasure or function
urethra
* path of travel
* 4 parts
- extends from the internal urethral orifice of the bladder to the external urethral orifice of the glans
proximal to distal:
* Preprostatic (intramural) urethra: Surrounded by the internal urethral sphincter
* Prostatic urethra
* Membranous urethra: Surrounded by the external urethral sphincter
* Spongy (penile) urethra
What is the importance of the prosthatic urethra (what does it contain, what can affect it?)
- Contains the urethral crest, where prostatic ducts open bilaterally
- Contains the seminal colliculus, where the ejaculatory ducts open bilaterally (ejaculatory duct: formed by the merger of the seminal vesicle duct with the vas deferens)
- Affected by benign prostatic hyperplasia, a non-cancerous increase in prostate size (age related)
What are some symptoms of benign prostatic hyperplasia
- Waking up in the night to
urinate - Urinary hesitancy
- Intermittent urine flow
Along the spongy urethra, what glands and openings can you find?
- Bulbourethral glands (Cowper’s glands)
eject lubricating fluid into the urethra - Two openings increase the size of the
urethra, the ampulla (proximally) and the
navicular fossa (distally, in the glans)
Describe the path of sperm
Sertoli cells in the seminiferous tubules —> rete testes – (separated by the tunica vaginalis)–> epididymis (head: storage; body: maturation; tail: exit) —> vas deferens
travel behind the bladder
merges with the seminal gland to form the ejaculatory duct –> seminal collicus –> prostatic urethra –> prostatic fluid from the prostate joins here –> membranous urethra –> spongy urethra
at the most proximal portion of the spongy urethra there are secretions from the bulbourethral glands (cowper’s glands) (within external urethral sphincter)
seminal gland secretions: thick allkaline fluid rich in fructose and coagulation agents
prostatic fluid: thin, milky, 20% of semen by volume
bulbourethral gland secretions: mucus like
What is the surgical form of birth control for women and men called?
women: tubal ligation
Ova that are released simply degenerate and are absorbed.
men: vas deferns ligation (vasectomy)
Discuss the anatomical borders of the pelvic cavity
antero-inferior: weight bears the urinary bladder; bodies and rami of pubic bones and pubic symphysis
lateral pelvic walls: bony left and right hip bones + obturator membrane and obturator internus muscle
posterior wall: formed by piriformis
What is the importance of the piriformis
sacral plexus is deep to/ embedded in the piriformis
What lines the bladder walls and what is its function
detrusor muscle. relaxes to allow bladder to store urine. contracts to cause bladder to void its contents
Describe the innervation of the bladder
* where do the fibres stem from
* function
- sympathetic fibres stem from the caudal thoracic and upper lumbar spinal cord level to pelvic plexus
- parasympathetic fibres arise from sacral spinal cords. innervate detrusor muscles
- increased urine content causes bladder stretch –> stimulates parasympathetic fibres –> internal urethral sphincter relaxes
testosterone function
what synthesizes testosterone?
sex drive
fertility
development of bone and muscle mass
leydig cells
where specifically in the testes is sperm synthesized
seminiferous tubules. sertoli cells line the epithelium of these tubules and hormonally facilitate the production of sperm by stimulating spermatogenic cells
ovaries
* function
development of oocytes
endocrine function (produce estrogen, progesterone, even testosterone)
layers of the uterus
outer to inner
perimetrium
myometrium
endometrium: where the fertilized egg will implant if conception is successful
