Review Questions Flashcards
Most easily damaged pelvic floor muscle in normal childbirth?
Puborectalis
Is a CT arteriogram the same as an arteriogram?
No they sure as hell ain’t
How are parasympathetic nerve fibres related to detrusor muscle and internal urethral sphincter?
Motor to the detrusor muscle and inhibitory to the internal urethral sphincter
What is another name for the pudendal canal?
Alcock’s canal
What structures enter the pudendal canal?
Pudendal nerve
Internal pudendal vessels
Nerve to the obturator internus
What is the somatic innervation of the vulva?
Ilioinguinal
Genitofemoral
Pudendal
Posterior cutaneous nerve to the thigh
Ejaculation is a combination of which of the following:
parasympathetic, sympathetic, somatic
All of them
What is the lymphatic drainage of the vulva?
Superficial inguinal
Deep inguinal
Internal iliac
What nerve stimulation results in increased production of vaginal secretions?
Parasympathetic
What nerve stimulation results in erection of clitoris?
Parasympathetic
What nerve stimulation results in engorgement of bulb of vestibule?
Parasympathetic
What are the erectile tissues for females?
Clitoris and bulb of the vestibule. Not to be mistaken for ischiocavernosus or bubospongiosus
What is the lymphatic drainage of the uterus?
Internal iliac
External iliac
Sacral lymph nodes
Superficial inguinal
The medial umbilical ligament is the remnant of what embryological structure?
Umbilical artery
For the rectum: what is the arterial supply for above the pectinate line?
Inferior mesenteric artery
For the rectum: what is the arterial supply for below the pectinate line?
Inferior rectal artery
Innervation of the external anal sphincter?
Pudendal nerve
Where does the internal rectal venous plexus lie?
Deep to the mucosa of the rectum
Lymphatic drainage of the rectum?
Para-rectal
Inferior mesenteric
Internal iliac
Sacral*
What is a caudal epidural block?
Nerve block at S2-S4, including visceral and somatic fibre block
What is a pudendal nerve block?
Nerve block for the perineum
What is the position of ureter in relation to uterine artery at the lateral wall of the uterus?
Posterior to the uterine artery. Lies underneath it “water under the bridge”
What is the nerve supply of uterus?
Uterovaginal nerve plexus, which derives from the inferior hypogastric plexus. It contain autonomic and visceral sensory fibres.
What muscle maintains the anorectal flexure?
Puborectalis
Which main lumbar plexus nerve forms the side all of the true pelvis?
Obturator internus
What makes up the ejaculatory duct?
Duct of the vas deferens and duct of the seminal vesicle
What does the corpora amylacea comprise of?
Thickened prostatic secretions
What is the characteristic histological appearance of the seminal vesicle?
Honeycombed appearance. Histological features include lipofuscin granules and a muscular wall
What do the seminal vesicles secrete?
Fructose, Vitamin C, prostaglandins, fibrinogen
What does the prostate secrete?
Citric acid and proteolytic enzymes
The gubernaculum gives rise to what structures?
Ovarian ligament
Round ligament of uterus
What are the anatomical borders of perineum?
Anterior: pubic symphysis
Lateral: inferior ischioramus of pubis and sacrospinous ligaments
Posterior: tail of coccyx
If you have damage to the membranous urethra, where does the fluid drain into?
Superficial perineal pouch
What injury most likely causes damage to the membranous urethra?
Straddle e.g. riding a bike
What is the structure between the superficial transverse perineal muscle and the ischiocavernosus?
Perineal membrane
When performing an episiotomy, which bony structure do you palpate?
Ischial spine
Sacrospinous ligament
Contents of superficial perineal pouch?
Both: Ischiocavernosus, Bulbospongiosus, superficial transverse perineal muscle, Perineal body, external anal sphincter, anus
Female: clitoris, opening of vagina, opening of urethra
Male: corpus spongiosum, corpus cavernosa, urethra
Contents of the deep perineal pouch?
Both: deep transverse perineal muscle, external urethral sphincter
Female: Utherovaginal sphincter
Male: Bulbourethral gland , compressor muscle
Duct of greater vestibular gland opens into?
Lateral walls of vaginal orifice
Pudendal nerve significance to the perineum?
Motor to the perineal and sensory to the erectile tissues
Origins of the inferior hypogastric nerve plexus?
Lumbar splanchnic -> aortic plexus -> superior hypogastric nerve -> splits into 2 hypogastric nerves -> joined by pelvic splanchnic -> the nerve is then known as inferior hypogastric plexus which supplies both para and sympathetic innervation to perineum
