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SDR II > SDR Lab > Flashcards

SDR Lab Flashcards

0
Q

Piriformis innervation

A

L5, S1, S2

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1
Q

Piriformis inserts on the ___ and originates from the ___

A

greater trochanter anterior surface of the sacrum

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2
Q

Obturator internus originates and inserts

A

originates: obturator membrane inserts: greater trochanter

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3
Q

Obturator innervated by:

A

L5, S1

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4
Q

Levator ani origination and insertion

A

originates: pubic bone to iischial spine, creating a tendinous arch Inserts: perineal membrane and the anaococcygeal ligament

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5
Q

Levator ani innervation

A

S2-4; S4 and inferior rectal branch of the pudendal nerve

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6
Q

Coccygeus muscle origination and insertion

A

Originates on ischial spine and sacrospinous ligament Inserts: lateral margin of the coccyx and sacrum

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7
Q

Coccygeus muscle innervation

A

S3, S4

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8
Q

What lies in the ischial anal fossa

A

fat, pudendal nerve, internal pudendal vessels

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9
Q

Ischiocavernosus origin and insertion

A

Origin: ischial tuberosity and rami Insertion: crus of penis

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10
Q

Bulbosphongiosum origin and insertion

A

origin: perineal body and midline raphe insertion: pernieal membrane and corpus carvernosum

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11
Q

Superficial transverse perineal muscle origin and insertion

A

Origin: ischial tuberosity and ramus Insert: perineal body

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12
Q

Deep perineal pouch is between

A

UGD and perineal membrane

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13
Q

What is in the deep perineal pouch in males?

A
  1. membranous urethra 2. External urethral sphincter 3. Deep transverse perineal muscle 4. Bulbourethral glands 5. Internal pudendal vessels 6. Dorsal nerve of penis
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14
Q

Colle’s Fascia blends ___ attaches ___

A

blends campers and Scarpas attches to the perineal membrane and ischiopubic rami

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15
Q

Rectum begins at what point of the vertebra?

A

S3

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16
Q

Rectum vessels

A

Superior Middle Inferior rectal artery

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17
Q

Rectum lymph

A

pararectal internal iliac nodes

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18
Q

Nerves of rectum

A

Top 1/2 = autonomic afferent bottom 1/2 = inferior hypogastric plexuses

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19
Q

Median umbilical ligament is a remnant of

A

urachus

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20
Q

Where do the ureters cross things?

A
  1. ANTERIOR to bifurcation of common iliac 2. Ductus deferens
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21
Q

How does the bladder connect to the umbilicus?

A

median umbilical ligament (remnant of the urachus)

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22
Q

Bladder blood supply

A

Vesical arteries from the internal iliac

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23
Q

Bladder lymph

A

internal and external iliac nodes

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24
Q

Bladder nerves

A

inferior hypogastric plexuses

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25
Q

Urethra from bladder to prostate (and opening)

A

1cm, (internal urethral sphincter)

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26
Q

Urethra prostate length

A

3-4 cm

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27
Q

Where is the external urethral sphincter?

A

On the membranous urethra at the deep pouch

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28
Q

Where is the spongy urethra?

A

With the corpus spongiosum and connects the bulbourethral glands

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29
Q

Prostate arteries

A

inferior vesical middle rectal

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30
Q

Prostate veins

A

Prostatic venous plexus to internal iliac

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31
Q

Prostate nerves

A

Inferior hypogastric plexuses

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32
Q

What do the bulbourethral glands do?

A

Lubricats the urethra and contributes to the pre-ejaculatory emissions (duct passes thru the perineal membrane to open into the bulb of the spongy urethra)

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33
Q

Internal Iliac origination point

A

L5 and S1

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34
Q

Anterior Trunk branches

A

Inferior gluteal Middle Rectal Obturator Inferior vesical/vaginal Internal pudendal Umbilical Uterine Deferential

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35
Q

Inferior vesical artery feeds

A

bladder ureter seminal vesicles prostate

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36
Q

Obturator artery feeds

A

thru obturator cannal feeds adductor region not the obturator internus (that’s by internal pudendal)

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37
Q

lympathics from the internal and external iliac run

A

to common iliac to lateral aortic to thoracic duct

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38
Q

How does the ovary to the back of the broad ligament?

A

by the mesovarium

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39
Q

Ovary blood

A

ovarian artery from the abdominal aorta

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40
Q

Ovary lympoh

A

para-aortic nodes

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41
Q

Ovary nerves

A

aortic plexus

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42
Q

Fallopian tubes/uterine tubes blood supply?

A

ovarian and uterine arteries

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43
Q

uterus blood

A

uterine artery from internal iliac

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44
Q

nerve supply of uterus

A

inferior hypogastric plexus

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45
Q

lymph of uterus

A

para-aortic nodes internal and external iliac nodes superficial inguinal nodes

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46
Q

vagina arterial supply

A

vaginal and uterine arteries from the internal iliac

47
Q

vagina nerves

A

inferior hypogastric plexus

48
Q

vagina lymph

A

upper 1/3: internal and external iliac mid 1/3: internal iliac lower 1/3: superficial inguinal nodes

49
Q

What 5 things support the uterus?

A
  1. Pelvic diaphragm 2. perineal body 3. cardinal ligament 4. pubocervical ligament 5. sacrocervical ligament
50
Q

Where does the cardinal ligament attach?

A

cervix and upper vagina to the lateral pelvic wall

51
Q

Where does the pubocervical ligament attach?

A

cervix to the pubic bone

52
Q

Where does the sacrocervical ligament attach?

A

cervix and vagina to the lower end of the sacrum

53
Q

What does the mesoalphinx cover?

A

The fallopian/uterine tube

54
Q

What are the parts of the broad ligament?

A

Mesometrium Mesoalphinx Mesovarium

55
Q

Where is the uterine artery

A

courses medially and anteriorly in the base of the broad ligament to reach the cervix Crosses the ureter and passes superiorly to the lateral vaginal fornix Enlarges in pregnancy

56
Q

Superior gluteal from

A

from: L4-S1

57
Q

Superior gluteal to:

A

gluteus medius, gluteus minimus, tensor fascia latae

58
Q

Inferior gluteal from

A

L5-S2

59
Q

Inferior gluteal to

A

gluteus maximus

60
Q

Posterior femoral cutaenous nerve from

A

S1, S3

61
Q

Posterior femoral cutaenous nerve to

A

skin of the posterior aspect of the thigh

62
Q

Perforating cutaneous from

A

S2,S3

63
Q

Perforating cutaneous to

A

skin over gluteal fold

64
Q

Nerve to piriformis from

A

L5, S1, S2

65
Q

Nerves to levator ani, coccygeus, and external anal sphincter from

A

S4

66
Q

Coccygeal plexus from

A

S4 to coccyx

67
Q

Coccygeal plexus to

A

perianal skin

68
Q

adnexa

A

uterine tubes and ovaries

69
Q

Anteversion

A

whole uterus makes a right angle or angle greater than 90 compared to the vagina

70
Q

Anteflexion

A

fundus pears a forward angle relative to the servix

71
Q

Speculum exam:

A

speculum placed into the vaginal vault to assess the walls of the vagina and external surface of the cervix then take pap smaer for cervical aner

72
Q

Cystocele

A

bladder protrudes into the anterior aspects of the vagina

73
Q

Descensus fo the cervix and uterus

A

cervix and uterus “fall” thru the vagina = protrusion

74
Q

enterocele

A

peritonum protrusion between the rectum and vagina result of herniation of pouch of douglas due to weakening of rectovaginal septum and uterosacral ligament

75
Q

rectocele

A

rectum protrudes into posterior aspect of vagina

76
Q

urethrocele

A

urethra protrusion into vagina

77
Q

hysterosalpinogram

A

radiolgic study to evaluate the uterus and oviducts

78
Q

bicornuate uterus

A

mullerian duct anomaly in utero

79
Q

incompetent cervix

A

dialtion of the cervix during pregnancy

80
Q

sonoohistogram

A

ultrasound and inected water to evaluate abnormal bleeding, fibroids, or polyps

81
Q

Ectopic pregnancy can cause

A

hemorrage and maternal death

82
Q

ectopic pregnancy risk factors

A

pelvic infection (gonorrhea and chlamydia) surgical history previous ectopic pregnancy

83
Q

Ectopic pregnancy symptoms

A

amenorrhea minor vainal bleeding kpelvic pain + hCG exam

84
Q

Fix ectopic pregnancy by

A
  1. methotrexane If not: salpingECtomy (surgical itervention to remove it and the uterine tube) SalpingOStomy removes ectopic but leaves the tubes (though high risk for another ectopic pregnancy)
85
Q

Adenomyosis

A

occurence of bleeding associated with ectopic endometrial tissue within the myometrium

86
Q

Places to watch to not damage ureter

A

Uretovesicular junction Junction uterine artery and ureter Infundibulopelvic ligament

87
Q

Where does the dorsal aorta terminate?

A

L4

88
Q

Uterine artery divides into

A

tortuous ascending branch (in the broad ligament anastamoses with the ovarian) descending branch arcuate

89
Q

Post-partum hemorrhage

A

30# of deaths in pregnancy > 500cc vaginally >1000cc C section hematocrit drop by >10%

90
Q

Intervention for post-partum hemorrhage

A

IV hydration uterine massage drugs to contract uterus: Pitocin then bimanual uterine compressions to compress the uterus Then uterine artery ligation (O’Leary Suture) with the broad ligament or internal iliac artery ligation last: hysterectomy

91
Q

Uterine fibroids (leiomyomas)

A

benign tumors of smooth muscle can cause bleeding, pain, urinary frequency, sometimes abdominal enlargement

92
Q

4 places for stone from ureter

A
  1. Ureteropelvic junction (UPJ) 2. ureter corsses the external iliac artery 3. ureter crosses into the pelvis (pelvic brim) 4. Ureter unters the bladder (UVJ)
93
Q

Treatments of Ureteral Calculus

A

epectant management extracorporeal shock wave lithotripsy (ESWL) Ureteroscopy with laser lithrotripsy Ureteroscopy with basket extraction sten placement uretolithomy

94
Q

Expectant management

A

watch if pass if < 9mm

95
Q

Extracorporeal Shock Wve Lithotripsy (ESWL)

A

non invasive sound/shock waves to break the stones into dust good for higher in kidney/upper ureter

96
Q

Uteroscopy with laser lithotripsy

A

most common zap the stone into dust

97
Q

Uteroscopy with basket extraction

A

pull out stone with a basket small stones only otherwise ureter damage

98
Q

stent placemnt

A

dilate ureter and releave pain “double J”

99
Q

Ureterolithotomy

A

open surgery

100
Q

Teardrop bladder can be caused by

A

blood compression from both sides puboprostatic and pubourethral ligament torn

101
Q

suprapubic cystomy

A

catheter is inserted just above the pubic bone intot he bladder and urine is drained

102
Q

immediate or delayed repair of urethral injuries better?

A

delayed

103
Q

Intra vs Extra peritoneal ruptures

A

Intra: operate immediately in the peritoneal Etra: usually don’t require surgery but can drain fluid

104
Q

prostate cancer risk factors

A

family history diet (not proven) androgens ethnicity (AA) Age

105
Q

Transrectal ultrasound

A

insert an ultrasound probe up the rectum to help visualize the prostate

106
Q

Prostate cancer grading scale

A

Gleason Grading Higher score = more cancer Top 2 most common cell types, add #s Prostate cancer lowest core = 6

107
Q

Treatments for Prostate Cancer (8)

A

Watchful waiting Radical prostatectomy External beam radiation therapy (EBRT) Brachytherapy Cyberknife Cyrosurgery High intensitivy focused ultrasound Hormonal therapy

108
Q

Cyberknife

A

robotic radiation tool that zaps the tumor higher radiation doses

109
Q

cyrosurgery

A

freeze cencerous cell but can’t freeze around urethra 100% impotence

110
Q

Hormonal therapy

A

anti-androgen

111
Q

Radical Prostatectomy types

A

Perineal Retropubic Laparoscopic (8hrs) Laparoscopic w/Robotic Assistance (2hrs)

112
Q

Perineal:

A

old-fashioned (as is retropubic) incision right under the scrotum in the perineum

113
Q

Radical prostatectomy complications

A

incontenence (5%) impotence (25-100%) - nerves for erection very small but try nerve-sparing prostatectomy

114
Q

Urologic robic procedures include

A

radical prostatectomy simple prostaectomy for benign masses radical cystectomy partial nephrectomy UPJ obstruction bladder diverticulectomy

SDR II (42 decks)

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