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RAD414 pt 2 > reproductive tracts plenary > Flashcards

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

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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

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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

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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)
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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
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6
Q

The pelvic ligaments are so strong that the pelvis will fracture before the ligaments will break.

A
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7
Q

what is the pelvic girdle

A

The ring formed by the pelvic bones and ligaments, particularly the sacroiliac ligament and pubic symphysis

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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.

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9
Q

what causes pelvic girdle pain during pregnancy

A

unborn baby also puts a lot of uneven pressure on the girdle

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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
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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
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12
Q

what does the peritoneal membrane attach to?

A

external genitals

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13
Q

what do you call the space between the perineal membrane and the perineal floor muscles

A

deep peritoneal pouch

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14
Q

what is found between the peritoneal membrane and the skin

A

superficial peritoneal pouch

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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)

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16
Q

what is a lithotomy position

A
  • supine frog legged position patients do on bed as we examine their reproductive areas
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17
Q

where is sperm produced

A

testies

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18
Q

where does sperm mature

A

epididymis

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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)
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20
Q

what is found within the spermatic cord

A
  • ductus deferens
  • lymphatic vessels
  • testicular artery and vein
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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
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22
Q

what part of the male reproductive system sits at the back of the bladder

A

seminal vesicle

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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
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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

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25
Q

what does the ejaculatory duct join with in the prostate

A

it joins with the urethra coming from the bladder

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26
Q

what is the function of the prostate

A
  • ## add proteolytic enzymes to ejaculate (break down protein)
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27
Q

why is proteolytic enzymes added into ejaculate by the prostate

A
  • prevent the ejaculate from clotting until it is outside the penis
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28
Q

what 4 areas can the prostate be split into

A

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)
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29
Q

which zone of the prostate is most likely for cancer to originate and what makes it easier to find

A
  • peripheral zone
  • being at the bottom makes it easier to palpate
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30
Q

where is the external urethral sphincter found

A
  • beneath the prostate
  • in the perineal pouch
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31
Q

where is the bulbourethral gland found

A

in the external urethral sphincter

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32
Q

what is the purpose of the bulbourethral gland

A
  • joins with the urethra and provides lubication for sperm motility
  • pre-ejaculate
  • alkaline fluid
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33
Q

why is it necessary for the release of alkaline fluid by the bulbourethral gland

A

as u urinate, the urethra becomes acidic and you dont want the acid to kill the sperm

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34
Q

what part does the ejaculate or urine etc come out of

A

external urethral meatus

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35
Q

where do the testis develop / originate

A

abdomen

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36
Q

how does the testis descend from the abdomen into the scrotum (skin)

A
  • gubernaculum (‘string’ attached to the testis) (ligament cord)
  • pulls down on testis through inguinal canal along with its vasculature and into the scrotum
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37
Q

state the layers of the scrotum following the acronym
Some damn Englishman Called It The Testis

A

scrotum is formed from the layers of the abdomen

  • scrotum
  • dartos (fascia/muscle)
  • external spermatic fascia
  • cremaster
  • internal spermatic fascia
  • tunica vaginalis
  • testis
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38
Q

what is the function of the cremaster

A
  • muscle which can pull the testis back up closer to the body to regulate temperature/keep internal temperature warmer
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39
Q

what are the 2 different types of tissue that attache from the peritoneum onto the penis

A
  • corpus spongiosum (bulb of penis) (underside of penis)
  • 2 sets of corpus cavernous ( crus of penis) (upper lateral)
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40
Q

during erection, why does the corpus spongiosum fill with less blood

A
  • so it does not press against the urethra and prevent the ejaculate from leaving
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41
Q

what are the muscles lying on top of the corpus cavernous and corpus spongiosum (dont need to know)

A
  • over the spongiosum= bulbospongiosus muscle
  • over the cavernous= ischiocavernosus muscle
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42
Q

what is the purpose of bulbospongiosum and ischiocavernosus muscle

A
  • support erection, ejaculation and urination
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43
Q

what do you call the external part of the end of the penis

A

glans penis
- has a corona (crown)

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44
Q

there are a lot of nerve endings in the glans penis (dont need to know)

A
45
Q

what connects the glans penis to the foreskin / body of penis (DNTK)

A

frenulum

46
Q

what is the line thats found from the scrotum up through the middle of the penis (DNTK)

A

raphe of penis

47
Q

what vasculature is found in the corpus cavernous and why

A
  • deep artery
  • to provide blood (for erection)
48
Q

from a cross section view of the penis, which side is ventral and which side is dorsal

A

top part = dorsal (as when erect faces the back)

bottom part = ventral (as when erect faces the front) (ventral = tummy)

49
Q

what is the space between the rectum and bladder known as, what causes this

A
  • rectovesical (males)/ retrouterine (females) pouch (also known as pouch of Douglas)
  • formed by the peritoneal membrane
50
Q

why is the rectovesical pouch clinically relevant

A
  • if theres fluid in the abdomen e.g burst appendix, it can build up in the pouch
51
Q

what is the most anterior component in the female abdomen

A
  • pubic symphisis
52
Q

where is the external urethral sphincter found in females

A

in the deep perineal pouch
- beneath the bladder

53
Q

what is the purpose of the vaginal wall to have rugae (bumpy edges)

A
  • allows to expand
  • increased surface area for microbiome
54
Q

why is having microbiome important for the vagine

A

important for maintaining internal environment of vagine

55
Q

what component is found connecting the uterus and vagine

A

cervix

56
Q

what do you call the lateral spaces on either side of the cervix

A

fornix

57
Q

what are the 3 layers of the uterus

A
  • endometrium (layer that sheds)
  • myometrium (majority muscle/bulk of uterus)
  • perimetirum (part of peritoneum)
58
Q

describe the features of the perimetirum

A
  • serous layer
  • secretes fluid that’ll lubricate the uterus
59
Q

the uterus is anteverted, what does this mean and how is it different to retroverted

A
  • anteverted = leaning forward (over top of bladder)
  • retroverted = leaning back towards the rectum
60
Q

why is the uterus in older women more retroverted

A
  • ligaments that hold the uterus in place are more weaker
61
Q

the uterus is ante flexed what does this mean and compare it to retroflexed

A

ante flexed = flexing forwards
retroflexed = flexing backwards

62
Q

the Fallopian tubes extend from the uterus to the ovaries, what structure connects the Fallopian tubes to the ovaries

A

fimbriae

63
Q

what is the function of fimbriae

A
  • envelop eruption site
  • encourage movement of oocyte into uterine tube where till travel down into the uterus
64
Q

what do you call the space between the rectum and uterus

A

rectouterine pouch

65
Q

what are the 6 ligaments of the uterus

A
  • broad ligament
  • round ligament
  • cardinal
  • ovarian
  • uterosacral
  • suspensory ligament of ovary
66
Q

what does the broad ligament do

A

acts as mesentery for uterus / keeps it in place

67
Q

what does the round ligament do

A

connects uterus to labia majora via inguinal canal to maintain its anteverted position

68
Q

what does the cardinal ligament do

A

attaches cervix to pelvis

69
Q

what does the ovarian ligament do

A

joins ovaries to uterus

70
Q

what does the uterosacral ligament do

A

joins uterus to sacrum

71
Q

what does the suspensory ligament do

A

attaches ovaries to pelvic wall and contains ovarian vein, artery and lymph

72
Q

which uterine ligament causes pain during precnancy

A

round ligament as it passed through the inguinal canal

73
Q

what does the crus of the clitoris attach to

A

glans of clitoris

74
Q

bulb of vestibule and crus of clitoris make up the tissues of the external component of the vagine

A
75
Q

what gland is located on the posterior part of the bulb of vestibule

A

greater vestibular (bartholin) gland

76
Q

what is the purpose of the greater vestibular (bartholin) gland

A

secrete lubricating fluid onto vagina

77
Q

what are the different cell types found between the uterus and vagina

A

uterus = columns cells
vagina = squamous cells

78
Q

what is known as the transformation zone on a histology of the vagina/uterus

A

area where the cells are multipotent and deciding if they want to become columnar cells of uterus or squamous cells of vagina

79
Q

in which area are you most likely to get HPV virus / cervical cancer and why

A
  • in the transformation zone due to the multi potency of the cells
80
Q

which artery supplies the reproductive organs in men

A

anterior division of the interior iliac artery

81
Q

what organs do the inferior vesicle artery and vein supply in men

A
  • prostate
  • ductus defernes
  • semicle vesicle
  • bladder
82
Q

what organs do the uterine and vaginal artery supply

A
  • uterus and ovaries
83
Q

the internal pudenal artery/vein is posterior to the uterine and vaginal artery, explain how the pudenal artery is structured

A
  • 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
Q

what body part does the internal pudenal artery/vein supply

A

external genitalia

85
Q

which nerve is found next to the internal pudenal artery/vein and hence follows the same structure

A

pudenal nerve

86
Q

what is the purpose of the pudenal nerve

A
  • ## sensation to external genitalia
87
Q

where does the testicular artery and vein originate from

A

the abdominal aorta and inferior vena cava
- left testicular vein drains into the left renal vein

88
Q

what do you call the vascular network on the testis

A

pampiform plexus

89
Q

pampiform plexus goes through the inguinal canal joining to the testicular vein (men)

A
90
Q

what does the vascular network travel through in women as the pampiform plexus does in the inguinal canal in men

A

through the suspensory ligament of the ovary

91
Q

what lymph nodes drain the ovaries and testis

A

lumbar/aortic nodes

92
Q

what lymph nodes drain the superficial genitalia

A

superficial inguinal lymph nodes

93
Q

what lymph nodes drain the glans penis and clitoris

A

deep inguinal lymph node

94
Q

what lymph nodes drain the more internal structures of the pelvis

A

internal and external iliac lymph nodes

95
Q

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.

A
96
Q

the ischium posteriorly, the ilium superiorly, and the pubis anteriorly

A

triradiate cartilage only seen in younger skeleton

97
Q

name the 6 ligaments in the pelvis

A
  • anterior and posterior sacroiliac ligament
  • inguinal ligament
  • sacrotuberous liagment
  • sacrospinous ligament
  • coccyx ligament
98
Q

what do you call the membrane that covers the obtuator foramen

A

perineal membrane

99
Q

the pelvic floor is a funnel-shaped group of what 2 muscles supporting the pelvic and abdominal viscera

A
  • levator ani
  • coccygeus
100
Q

what is a hiatus in the pelvic floor

A

two gaps in the muscle sheet

101
Q

what are the 2 hiatus in the pelvic floor and what passes through them

A
  • 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
Q

Name the attachment site of the bulbospongiosus muscle in males

A

perineal membrane

103
Q

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

A
104
Q

which nerve is connected to the vagina

A

inferior hypogastric nerve

105
Q

which landmark is used to prescribe anaesthetic to the pudenal nerve

A

ischial spine

106
Q

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

A
107
Q

remember that the names of the lymph nodes always follow the names of the corresponding artery

A
108
Q
A

RAD414 pt 2 (33 decks)

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