Review Questions

Question 1

Most easily damaged pelvic floor muscle in normal childbirth?

Answer 1

Puborectalis

Question 2

Is a CT arteriogram the same as an arteriogram?

Answer 2

No they sure as hell ain’t

Question 3

How are parasympathetic nerve fibres related to detrusor muscle and internal urethral sphincter?

Answer 3

Motor to the detrusor muscle and inhibitory to the internal urethral sphincter

Question 4

What is another name for the pudendal canal?

Answer 4

Alcock’s canal

Question 5

What structures enter the pudendal canal?

Answer 5

Pudendal nerve
Internal pudendal vessels
Nerve to the obturator internus

Question 6

What is the somatic innervation of the vulva?

Answer 6

Ilioinguinal
Genitofemoral
Pudendal
Posterior cutaneous nerve to the thigh

Question 7

Ejaculation is a combination of which of the following:

parasympathetic, sympathetic, somatic

Answer 7

All of them

Question 8

What is the lymphatic drainage of the vulva?

Answer 8

Superficial inguinal
Deep inguinal
Internal iliac

Question 9

What nerve stimulation results in increased production of vaginal secretions?

Answer 9

Parasympathetic

Question 10

What nerve stimulation results in erection of clitoris?

Answer 10

Parasympathetic

Question 11

What nerve stimulation results in engorgement of bulb of vestibule?

Answer 11

Parasympathetic

Question 12

What are the erectile tissues for females?

Answer 12

Clitoris and bulb of the vestibule. Not to be mistaken for ischiocavernosus or bubospongiosus

Question 13

What is the lymphatic drainage of the uterus?

Answer 13

Internal iliac
External iliac
Sacral lymph nodes
Superficial inguinal

Question 14

The medial umbilical ligament is the remnant of what embryological structure?

Answer 14

Umbilical artery

Question 15

For the rectum: what is the arterial supply for above the pectinate line?

Answer 15

Inferior mesenteric artery

Question 16

For the rectum: what is the arterial supply for below the pectinate line?

Answer 16

Inferior rectal artery

Question 17

Innervation of the external anal sphincter?

Answer 17

Pudendal nerve

Question 18

Where does the internal rectal venous plexus lie?

Answer 18

Deep to the mucosa of the rectum

Question 19

Lymphatic drainage of the rectum?

Answer 19

Para-rectal
Inferior mesenteric
Internal iliac
Sacral*

Question 20

What is a caudal epidural block?

Answer 20

Nerve block at S2-S4, including visceral and somatic fibre block

Question 21

What is a pudendal nerve block?

Answer 21

Nerve block for the perineum

Question 22

What is the position of ureter in relation to uterine artery at the lateral wall of the uterus?

Answer 22

Posterior to the uterine artery. Lies underneath it “water under the bridge”

Question 23

What is the nerve supply of uterus?

Answer 23

Uterovaginal nerve plexus, which derives from the inferior hypogastric plexus. It contain autonomic and visceral sensory fibres.

Question 24

What muscle maintains the anorectal flexure?

Answer 24

Puborectalis

Question 25

Which main lumbar plexus nerve forms the side all of the true pelvis?

Answer 25

Obturator internus

Question 26

What makes up the ejaculatory duct?

Answer 26

Duct of the vas deferens and duct of the seminal vesicle

Question 27

What does the corpora amylacea comprise of?

Answer 27

Thickened prostatic secretions

Question 28

What is the characteristic histological appearance of the seminal vesicle?

Answer 28

Honeycombed appearance. Histological features include lipofuscin granules and a muscular wall

Question 29

What do the seminal vesicles secrete?

Answer 29

Fructose, Vitamin C, prostaglandins, fibrinogen

Question 30

What does the prostate secrete?

Answer 30

Citric acid and proteolytic enzymes

Question 31

The gubernaculum gives rise to what structures?

Answer 31

Ovarian ligament

Round ligament of uterus

Question 32

What are the anatomical borders of perineum?

Answer 32

Anterior: pubic symphysis
Lateral: inferior ischioramus of pubis and sacrospinous ligaments
Posterior: tail of coccyx

Question 33

If you have damage to the membranous urethra, where does the fluid drain into?

Answer 33

Superficial perineal pouch

Question 34

What injury most likely causes damage to the membranous urethra?

Answer 34

Straddle e.g. riding a bike

Question 35

What is the structure between the superficial transverse perineal muscle and the ischiocavernosus?

Answer 35

Perineal membrane

Question 36

When performing an episiotomy, which bony structure do you palpate?

Answer 36

Ischial spine

Sacrospinous ligament

Question 37

Contents of superficial perineal pouch?

Answer 37

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

Question 38

Contents of the deep perineal pouch?

Answer 38

Both: deep transverse perineal muscle, external urethral sphincter
Female: Utherovaginal sphincter
Male: Bulbourethral gland , compressor muscle

Question 39

Duct of greater vestibular gland opens into?

Answer 39

Lateral walls of vaginal orifice

Question 40

Pudendal nerve significance to the perineum?

Answer 40

Motor to the perineal and sensory to the erectile tissues

Question 41

Origins of the inferior hypogastric nerve plexus?

Answer 41

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