SUGER 3 - Lower limb nerves and muscles, lower urinary tract and pelvic floor Flashcards
What are the names for the male and female pelvis?
M: android pelvis
F: gynaecoid pelvis
Features of the gynaecoid pelvis
- wider
- broader
- lighter
The pubic inlet is oval shaped in..
females
What shape is the pubic inlet in males?
heart shaped
Features of the android pelvis
- longer sacrum
- more narrow sub-pubic arch
What adaptations makes the female pelvis more suited to childbirth?
- wider, broader, lighter pelvis
- less prominent ischial spines
- oval shaped pubic inlet
- wider subpubic arch
- shorter coccyx
3 parts of the pubis
- superior rami
- inferior rami
- pubic tubercle
Parts of the ischium (sit bones)
- superior ischial ramus
- body of ischium
- inferior ischial ramus
Parts of the ilium
- iliac crest
- wind of ilium (illac fossa)
- ASIS
- acetabulum
Psoas major and iliacus are both..
flexors of the hip
What is the trigone?
smooth area of mucosa on inner aspect of base of bladder
The ridge of muscle between the ureteric orfices is the…
inter-ureteric bar
How do the ureters pass into the bladder wall? What feature does this give the ureters and what does it allow?
- ureters pass obliquely
- gives ureters a valve-like mechanism
- prevents urine reflux when bladder contracts
Where may kidney stones arrest in the ureter? Name the sites
- stones stuck in places where ureter narrows
- pelvo-ureteric junction
- over the iliac vessels
- entering the bladder
Blood supply of the bladder
internal iliac arteries
Does the ureter run under of over the uterine artery?
runs under (water under the bridge)
Overview of micturition
- parasymp nerves stimlate detrusor muscle to contract
- sympathetic nerves inhibit external and internal spincters - sphincters relax
- detrusor contraction > bladder contraction
- spincter relaxation > urine out
Spinal reflex for micturiton is between which nerve roots? Is this automatic or not?
S2-S4 - AUTOMATIC REFLEX - found in pre-potty trained children
What happens to your ability to wee upon spinal cord transection?
- wee yourself as higher centres are unable to inhibit the spinal reflex
Control of the internal and external urethral sphincter
INTERNAL: involuntary
EXTERNAL: voluntary
What action does the pedunal nerve have in weeing? What are its nerve roots and fibre type?
- S2-S4
- somatic
- allows you to hold wee in
- contracts external urethral sphincter when we hold wee in
What action does the pelvic nerve have in weeing? What are its nerve roots and fibre type? (AFFERENT)
- paraympathetic
- detect bladder stretch
- AFFERENT FIBRES TO S2-S4
- involved in automatic spinal reflex
What action does the pelvic nerve have in weeing? What are its nerve roots and fibre type? (EFFERENT)
- paraympathetic
- EFFERENT FIBRES FROM S2-S4
- causes contraction of detrusor muscle
- cause sphincter relaxation
BLADDER = VOID/EMPTIED
What action does the hypogastric nerve have in weeing? What are its nerve roots and fibre type?
- T10-L2
- sympathetic - stops your wee
- causes relaxation detrusor
- causes contraction of internal sphincter
