Structure and Compartmentation - Pelvis and Perineum II Flashcards

1
Q

contents of pelvis

A

urinary tract elements
GI tract elements
reproductive organs

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2
Q

urinary tract elements pelvis

A

most anterior structure
pelvic portion of ureter
urinary bladder

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3
Q

GI tract elements in pelvis

A

most posterior structures

rectum and anus

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4
Q

repro organs in pelvis

A

between UT and GI elements

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5
Q

male repro organs in pelvis

A

pelvic portion of vas deferens
seminal vesicles
prostate gland

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6
Q

female repro organs in pelvis

A

vagina
uterus
uterine tube
ovaries

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7
Q

endopelvic fascia

A

membranous lining and loose CT

covers and surrounds pelvic contents
fills space between peritoneum and muscles

between peritoneum and muscles

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8
Q

peritoneum

A

does not contact floor

  • draped over superior aspect of pelvic structures
  • distinctive folds and pouches form
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9
Q

rectovesical pouch

A

in male

between rectum and bladder

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10
Q

rectouterine pouch

A

between rectum and uterus

in female

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11
Q

vesicouterine pouch

A

in female

between superior aspect of urinary bladder and uterus

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12
Q

most common site of fertilization

A

uterine tube

fimbrae that don’t catch eggs - may go to peritoneal cavity

sperm, bacteria, etc.
-go to rectouterine pouch

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13
Q

broad ligament

A

from paramesonephric ducts

formed during formation of uterus and vagina

laterally across pelvis, folded over uterus

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14
Q

perineum

A

area between coccyx and pubis

used to refer central tendon of female

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15
Q

boundaries of perineum

A

anterior - pubis
lateral - ischiopubic rami, ischial tuberosities
posterior - coccyx and caudal sacrum
posterolateral - sacrotuberous ligament
superior - pelvic diaphragm
inferior - skin posteriorly, fascia anteriorly

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16
Q

UG diaphragm

A

stretches anteriorly between two ischiopubic rami creating urogenital and anal regions

voluntary muscles than span UG triangle

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17
Q

divisions of perineum

A

anal triangle

urogenital triangle

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18
Q

boundaries of anal triangle

A

anterior - UG diaphragm
posterior - boundaries of perineum
lateral - ischiopubic rami and obturator internus below arcus tendinus
superior - roof of anal triangle formed by inferior aspect of pelvic diaphragm
inferior - skin and superficial fascia of perineum

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19
Q

perineal membrane

A

inferior to UG diaphragm muscles

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20
Q

muscles of UG diaphragm

A

sphincter urethrae m.
comoressor urethrae
deep transvers perineal m.

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21
Q

sphincter urethrae m.

A

surrounds membranous urethrae

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22
Q

compressor urethrae

A

extends laterally from sphincter

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23
Q

deep transverse perineal m.

A

posterior to sphincter urethrae muscle

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24
Q

femal sphincter urethrae

A

aka urethrovaginalis

-surrounds vagina as well as urethra

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25
Q

deep dorsal vein to penis or clitoris

A

runs anterior to UG diaphragm

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26
Q

superficial perineal space

A

below UG diaphragm

erectile bodies, muscles, vessels, nerves

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27
Q

deep perineal space

A

within UG diaphragm

muscles of UG diaphragm, vessels, nerves

28
Q

superior fascia of UG diaphragm

A

transversalis fascia

29
Q

inferior fascia of UG diaphragm

A

perineal membrane - colles fascia

30
Q

moving external to internal through perineum

A
skin
superficial fascia - campers and colles
superior perineal space and contents
perineal membrane
deep perineal space and contents
superior fascia of UG diaphragm
ischioanal fossa
pelvic diaphragm (levator ani m.)
extraperitoneal CT
peritoneum
peritoneal space in pelvis
31
Q

ischioanal fossa

A

filled with adipose tissue

32
Q

boundaries of ischioanal fossa

A

superior - pelvic diaphragm
inferior - skin of perineum
posterior - R and L ischioanal fossa communicate
anterior - components of external anal sphincter and UG diaphragm fuse

anterior recesses - anteriorly between levator ani and urogenital diaphragm

33
Q

vas deferens

A

cross anterior to ureter

34
Q

pelvic ureter

A

crosses iliac vessels anteriorly

35
Q

uterine artery in female

A

crosses ureter anteriorly/superiorly

don’t want to ligate ureter

36
Q

ureter in bladder

A

for about 2cm
opens at urethral orifices
no valves
pressure on bladder closes intramural ureters
-during urination and distension of bladder

37
Q

detrusor muscle

A

PS autonomics

to bladder

38
Q

vascular supply to pelvic ureter

A

common iliac a
internal iliac a
male - inferior vesical a
female - uterine or inferior vesical a

venous drainage follows arteries

39
Q

surfaces of bladder

A

superior
2x inferolateral
inferoposterior

ureter - where superior and inferolateral borders join

goes down to neck

base - meeting of two inferolateral surfaces

40
Q

apex of bladder

A

junction of inferolateral and superior surfaces

-urachus - origin of median umbilical ligament

41
Q

superior lateral angles of bladder

A

where ureters enter bladder

42
Q

neck of bladder

A

internal urethra openings

junction of inferolateral surface and inferoposterior surface

43
Q

trigone

A

2 ureteric orifices and urethral orifice

44
Q

trigonal muscle

A

sympathetic innervation
smooth m.

prevent retrograde urine flow

45
Q

bladder blood supply

A

superior vesical a

  • from umbilical a
  • major supply

middle vesical a.

  • from superior vesical a.
  • variable from superior vesical or deferential a.

inferior vesical a.

  • from anterior division of internal iliac a.
  • in males (vaginal a in females)
46
Q

vesical

A

term for bladder

47
Q

venous drainage of urinary bladder

A

does not correspond to arteries

drains deep plexus around base and neck
prostatic plexus of male
vesico-vaginal of female

drains with deep dorsal v of penis to internal iliac v

48
Q

male urethra

A
4 parts:
intramural
prostatic
membranou (through UG diaphragm)
penile (aka spongy)
49
Q

penile urethra dilations?

A
in bulb (bulbar portion)
in glans (fossa navicularis)
50
Q

external orifice of urethra

A

opening through glans

least extensible portion of urethra

51
Q

2 glands into penile urethra

A

bulbourethra (cowpers) - into bulbar portion)

urethral glands of littre

  • proximal 2/3 spongy body
  • numerous small glands
52
Q

female uretha

A

shorter

2 parts
superior portion
-surrounded by urethral glands
-paraurethral glands correspond to prostate in male

membranous - pierces urogenital diaphragm

53
Q

rectum

A

terminal 6-8” of large bowel

3rd sacral vertebrae
-rectosigmoid junction

54
Q

rectosigmoid junction

A

SV3

55
Q

rectum vs. sigmoid

A

lacks mesocolon - rectum is retroperitoneal
-sigmoid is peritonealized

tenia coli spread out
forms longitudinal muscle
surrounds entire rectum

56
Q

2 portions of rectum

A

rectum proper

anal canal

57
Q

palpable in male from rectum

A
posterior surface of bladder
seminal vesicles
distal vas deferens
prostate
sacrum, coccyx, ischial spines
58
Q

peritoneum on rectum

A

only ventral rectum

59
Q

palpable in female from rectum

A

rectouterine pouch

cervix, vagina, sacrum, coccyx, ischial spines

60
Q

anal verge

A

stratified squamous non-keratinized to keratinized

61
Q

features of rectum

A
transverse rectal fold - 3x
rectal column
anal valves
pectinate line
-formed by anal valves and base of rectal columns
62
Q

vasculature of rectum

A

superior rectal a.

  • single branch from IMA
  • divides near rectosigmoid junction - R/L branches

middle rectal a.
-from internal iliac (anteiror division)

inferior rectal a. - anal canal
-from internal pudendal arteries

63
Q

vascualar drainage at pectinate line

A

above - middle and superior rectal vv

below - inferior rectal vv

64
Q

lymph drainage at pectinate line

A

above - pelvic nodes

below - inguinal nodes

65
Q

innervation at pectinate line

A

above - autonomic

below - somatic

66
Q

epithelium at pectinate line

A

above - GI tract mucosa

below - skin