reproductive tracts plenary Flashcards
1
Q
what do you call the cartilage that fused up until late teenage years in the pelvis between the ischium, ileum and pubic, found in the acetabulum/forming the acetabulum
A
triradiate cartilage
2
Q
how can the triradiate cartilage affect what you see on a pelvis scan
A
you can mistake an unfused triradiate cartilage in a teen for example as a fracture
3
Q
describe how you’d tell the difference between man and woman in a pelvic xray
A
pelvic angle of male is more V shaped, females is more U shaped
Males = narrow shape
female = wider shape
wings of iliac is more flared in women and less flared in males
wider birthing canal hence perturding sacrum in females
4
Q
what are the 4 different female pelvic shapes and how can u differentiate them
A
- gynecoid (round/circular birthing canal)
- platypelloid (rugby ball shape birthing canal)
- android ( heart shaped canal_
- anthropoid ( egg shape canal)
5
Q
due to the shape of the pelvis, what does this indicate about fractures is can have
A
due to the shape of the pelvis, if there is one fracture, there is likely to be another
- breaks in at least 2 places
6
Q
The pelvic ligaments are so strong that the pelvis will fracture before the ligaments will break.
A
7
Q
what is the pelvic girdle
A
The ring formed by the pelvic bones and ligaments, particularly the sacroiliac ligament and pubic symphysis
8
Q
due to pregnancy, what changes do the ligament of the pelvis girdle undergo and how
A
the ligaments of the pelvic girdle become more elastic due to increased levels of hormones in preparation for the birth.
9
Q
what causes pelvic girdle pain during pregnancy
A
unborn baby also puts a lot of uneven pressure on the girdle
10
Q
the perineum is the a posterior/under diamond shape between the ischial tuberrosities, what 2 sections can we divide the peritoneum into
A
- imaginary line draw through the peritoneum at the level of the ischial tuberosity
- the anterior triangle is the urogenital
- the posterior triangle is the anal
11
Q
what is the name of the membrane in the peritoneum and what area does this cover
A
- peritoneal membrane
- it ONLY covers the urogenital triangle
12
Q
what does the peritoneal membrane attach to?
A
external genitals
13
Q
what do you call the space between the perineal membrane and the perineal floor muscles
A
deep peritoneal pouch
14
Q
what is found between the peritoneal membrane and the skin
A
superficial peritoneal pouch
15
Q
what is the perineal body?
A
- fibromuscular mass that provides an attachment site for many peritoneal muscles
(when snipped in child birth, can cause weak pelvic floor muscles)
16
Q
what is a lithotomy position
A
- supine frog legged position patients do on bed as we examine their reproductive areas
17
Q
where is sperm produced
A
testies
18
Q
where does sperm mature
A
epididymis
19
Q
what muscular tube connects to the epididymis and why does it need to be muscular
A
- ductus deferens
- it is muscular to undergo peristalsis (squeeze sperm to move up in the tube)
20
Q
what is found within the spermatic cord
A
- ductus deferens
- lymphatic vessels
- testicular artery and vein
21
Q
which canal does the ductus deferens pass through to get to the posterior section of the bladder where the seminal visible is
A
- inguinal canal
22
Q
what part of the male reproductive system sits at the back of the bladder
A
seminal vesicle
23
Q
what is the function of the seminal vesicle
A
- provides majority volume of the ejaculate
- fructose for energy
- prosto glands which suppress the immune system of females
- clotting factors so the ejaulate clots in the vagine
24
Q
what duct is formed as a result of the joining between the seminal vesicle and ductus deference and where does this happen
A
ejaculatory duct
- occurs within the prostate
25
what does the ejaculatory duct join with in the prostate
it joins with the urethra coming from the bladder
26
what is the function of the prostate
- add proteolytic enzymes to ejaculate (break down protein)
-
27
why is proteolytic enzymes added into ejaculate by the prostate
- prevent the ejaculate from clotting until it is outside the penis
28
what 4 areas can the prostate be split into
looking at it from a sagittal view
- central zone ( upper side left/ posterior )
- transitional zone (upper middle)
- anterior zone (upper side right)
- peripheral zone (across entire bottom)
29
which zone of the prostate is most likely for cancer to originate and what makes it easier to find
- peripheral zone
- being at the bottom makes it easier to palpate
30
where is the external urethral sphincter found
- beneath the prostate
- in the perineal pouch
31
where is the bulbourethral gland found
in the external urethral sphincter
32
what is the purpose of the bulbourethral gland
- joins with the urethra and provides lubication for sperm motility
- pre-ejaculate
- alkaline fluid
33
why is it necessary for the release of alkaline fluid by the bulbourethral gland
as u urinate, the urethra becomes acidic and you dont want the acid to kill the sperm
34
what part does the ejaculate or urine etc come out of
external urethral meatus
35
where do the testis develop / originate
abdomen
36
how does the testis descend from the abdomen into the scrotum (skin)
- gubernaculum ('string' attached to the testis) (ligament cord)
- pulls down on testis through inguinal canal along with its vasculature and into the scrotum
37
state the layers of the scrotum following the acronym
Some damn Englishman Called It The Testis
scrotum is formed from the layers of the abdomen
- scrotum
- dartos (fascia/muscle)
- external spermatic fascia
- cremaster
- internal spermatic fascia
- tunica vaginalis
- testis
38
what is the function of the cremaster
- muscle which can pull the testis back up closer to the body to regulate temperature/keep internal temperature warmer
39
what are the 2 different types of tissue that attache from the peritoneum onto the penis
- corpus spongiosum (bulb of penis) (underside of penis)
- 2 sets of corpus cavernous ( crus of penis) (upper lateral)
40
during erection, why does the corpus spongiosum fill with less blood
- so it does not press against the urethra and prevent the ejaculate from leaving
41
what are the muscles lying on top of the corpus cavernous and corpus spongiosum (dont need to know)
- over the spongiosum= bulbospongiosus muscle
- over the cavernous= ischiocavernosus muscle
42
what is the purpose of bulbospongiosum and ischiocavernosus muscle
- support erection, ejaculation and urination
43
what do you call the external part of the end of the penis
glans penis
- has a corona (crown)
44
there are a lot of nerve endings in the glans penis (dont need to know)
45
what connects the glans penis to the foreskin / body of penis (DNTK)
frenulum
46
what is the line thats found from the scrotum up through the middle of the penis (DNTK)
raphe of penis
47
what vasculature is found in the corpus cavernous and why
- deep artery
- to provide blood (for erection)
48
from a cross section view of the penis, which side is ventral and which side is dorsal
top part = dorsal (as when erect faces the back)
bottom part = ventral (as when erect faces the front) (ventral = tummy)
49
what is the space between the rectum and bladder known as, what causes this
- rectovesical (males)/ retrouterine (females) pouch (also known as pouch of Douglas)
- formed by the peritoneal membrane
50
why is the rectovesical pouch clinically relevant
- if theres fluid in the abdomen e.g burst appendix, it can build up in the pouch
51
what is the most anterior component in the female abdomen
- pubic symphisis
52
where is the external urethral sphincter found in females
in the deep perineal pouch
- beneath the bladder
53
what is the purpose of the vaginal wall to have rugae (bumpy edges)
- allows to expand
- increased surface area for microbiome
54
why is having microbiome important for the vagine
important for maintaining internal environment of vagine
55
what component is found connecting the uterus and vagine
cervix
56
what do you call the lateral spaces on either side of the cervix
fornix
57
what are the 3 layers of the uterus
- endometrium (layer that sheds)
- myometrium (majority muscle/bulk of uterus)
- perimetirum (part of peritoneum)
58
describe the features of the perimetirum
- serous layer
- secretes fluid that'll lubricate the uterus
59
the uterus is anteverted, what does this mean and how is it different to retroverted
- anteverted = leaning forward (over top of bladder)
- retroverted = leaning back towards the rectum
60
why is the uterus in older women more retroverted
- ligaments that hold the uterus in place are more weaker
61
the uterus is ante flexed what does this mean and compare it to retroflexed
ante flexed = flexing forwards
retroflexed = flexing backwards
62
the Fallopian tubes extend from the uterus to the ovaries, what structure connects the Fallopian tubes to the ovaries
fimbriae
63
what is the function of fimbriae
- envelop eruption site
- encourage movement of oocyte into uterine tube where till travel down into the uterus
64
what do you call the space between the rectum and uterus
rectouterine pouch
65
what are the 6 ligaments of the uterus
- broad ligament
- round ligament
- cardinal
- ovarian
- uterosacral
- suspensory ligament of ovary
66
what does the broad ligament do
acts as mesentery for uterus / keeps it in place
67
what does the round ligament do
connects uterus to labia majora via inguinal canal to maintain its anteverted position
68
what does the cardinal ligament do
attaches cervix to pelvis
69
what does the ovarian ligament do
joins ovaries to uterus
70
what does the uterosacral ligament do
joins uterus to sacrum
71
what does the suspensory ligament do
attaches ovaries to pelvic wall and contains ovarian vein, artery and lymph
72
which uterine ligament causes pain during precnancy
round ligament as it passed through the inguinal canal
73
what does the crus of the clitoris attach to
glans of clitoris
74
bulb of vestibule and crus of clitoris make up the tissues of the external component of the vagine
75
what gland is located on the posterior part of the bulb of vestibule
greater vestibular (bartholin) gland
76
what is the purpose of the greater vestibular (bartholin) gland
secrete lubricating fluid onto vagina
77
what are the different cell types found between the uterus and vagina
uterus = columns cells
vagina = squamous cells
78
what is known as the transformation zone on a histology of the vagina/uterus
area where the cells are multipotent and deciding if they want to become columnar cells of uterus or squamous cells of vagina
79
in which area are you most likely to get HPV virus / cervical cancer and why
- in the transformation zone due to the multi potency of the cells
80
which artery supplies the reproductive organs in men
anterior division of the interior iliac artery
81
what organs do the inferior vesicle artery and vein supply in men
- prostate
- ductus defernes
- semicle vesicle
- bladder
82
what organs do the uterine and vaginal artery supply
- uterus and ovaries
83
the internal pudenal artery/vein is posterior to the uterine and vaginal artery, explain how the pudenal artery is structured
- exits the pelvis via the greater sciatic notch (passing above pelvic muscles)
- enters again via the less sciatic notch into the deep perineal pouch
84
what body part does the internal pudenal artery/vein supply
external genitalia
85
which nerve is found next to the internal pudenal artery/vein and hence follows the same structure
pudenal nerve
86
what is the purpose of the pudenal nerve
- sensation to external genitalia
-
87
where does the testicular artery and vein originate from
the abdominal aorta and inferior vena cava
- left testicular vein drains into the left renal vein
88
what do you call the vascular network on the testis
pampiform plexus
89
pampiform plexus goes through the inguinal canal joining to the testicular vein (men)
90
what does the vascular network travel through in women as the pampiform plexus does in the inguinal canal in men
through the suspensory ligament of the ovary
91
what lymph nodes drain the ovaries and testis
lumbar/aortic nodes
92
what lymph nodes drain the superficial genitalia
superficial inguinal lymph nodes
93
what lymph nodes drain the glans penis and clitoris
deep inguinal lymph node
94
what lymph nodes drain the more internal structures of the pelvis
internal and external iliac lymph nodes
95
The posterior superior iliac spine (PSIS) is located at S2, and can be the site of 'sacral dimples', where the skin is attached more tightly to the bone.
96
the ischium posteriorly, the ilium superiorly, and the pubis anteriorly
triradiate cartilage only seen in younger skeleton
97
name the 6 ligaments in the pelvis
- anterior and posterior sacroiliac ligament
- inguinal ligament
- sacrotuberous liagment
- sacrospinous ligament
- coccyx ligament
98
what do you call the membrane that covers the obtuator foramen
perineal membrane
99
the pelvic floor is a funnel-shaped group of what 2 muscles supporting the pelvic and abdominal viscera
- levator ani
- coccygeus
100
what is a hiatus in the pelvic floor
two gaps in the muscle sheet
101
what are the 2 hiatus in the pelvic floor and what passes through them
- anterior hiatus is called the [Urogenital] hiatus, through which the [Urethra] and the [Vagina] pass.
- posterior hiatus is called the [Rectal] hiatus, located posterior, through which the anal canal pass.
102
Name the attachment site of the bulbospongiosus muscle in males
perineal membrane
103
In births that are developing more quickly than the vagina can relax, or when the baby is larger, an episiotomy can be performed to direct any tearing tear away from the [Perineal body].
Prior to performing an episiotomy, the [Pudendal nerve] needs to be anaesthetised. This relieves pain in the perineum however not in the [Vagina] as the this is innervated by the [Inferior hypogastric plexus].
The [Ischial spine] nerve is used as a landmark to deliver the anaesthetic to the [Pudendal nerve] nerve
104
which nerve is connected to the vagina
inferior hypogastric nerve
105
which landmark is used to prescribe anaesthetic to the pudenal nerve
ischial spine
106
the hiatus in the pelvic floor needs to be filled to ensure the pelvic viscera down fall through the hole. So the perineal pouch sits directly inferior to it
107
remember that the names of the lymph nodes always follow the names of the corresponding artery
108
