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Anatomy > The Pelvis (2) > Flashcards

The Pelvis (2) Flashcards

1
Q

Describe the motion of the urinary bladder through development.

A

In infants, the bladder is almost entirely in the abdomen. It enters the pelvis at 6 years and descends fully at puberty.

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2
Q

Label this frontal section of the male urinary bladder.

A

1=fundus
2=vas deferens
3=interureteric crest
4=right ureteric orifice
5=trigone
6=neck
7=paravesical endopelvic fascia and vesical venous plexus
8=tendinous arch of levator ani
9=uvula of bladder
10=obturator internus
11=levator ani
12=capsule of prostate gland
13=prostate gland and prostatic urethra
14=seminal colliculus
15=Cowper’s gland
16=perineal membrane and urethral sphincter
17=(bulbous portion of spongy urethra)
18=corpus spongiosum and bulbospongiosus
19=deep perineal fascia
20=Colles’ fascia
21=crus of penis and ischiocavernosus
22=inferior pubic ramus
23=anterior recess of ischio-anal fossa
24=tendinous arch of pelvic fascia
25=internal urethral sphincter
26=parietal peritoneum

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3
Q

Label this diagram of the female urinary bladder.

A

1=round ligament of uterus
2=vagina
3=crus of clitoris and ischiocavernosus
4=urethra

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4
Q

Why is there an internal sphincter in the urinary bladder neck?

A

It prevents regurgitation into the bladder. (It is under autonomic and somatic control)

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5
Q

How do ureters enter the bladder, why?

A

They enter very obliquely in order to prevent reflux of urine.
The superolateral angles of the base posterior surface of the bladder receive the ureters.

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6
Q

State the position, attachments and relations of the neck of the bladder in males.

A

In males, it rests on the upper surface of the prostate. Anteriorly, it is attached to the puboprostatic ligament. Posteriorly, it relates to the beginning of the ejaculatory ducts.

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7
Q

State the attachments and relations of the neck of the bladder in females.

A

Anteriorly, it is attached to the pubovesical ligament. Posteriorly, it relates to the anterior wall of the vagina.

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8
Q

State the orientation of a normal, nulliparous uterus.

A

Antiverted and antiflexed

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9
Q

Label the diagram.

A

1=pubic symphysis
2=inferior pubic ligament
3=deep dorsal vein of penis
4=prostate
5=urethra
6=pubococcygeus
7=puboprostaticus
8=puboperinealis
9=pubo-analis
10=puborectalis
11=ilicoccygeus
12=coccygeus
13=anus
14=sacrum
15=coccyx
16=coccygeus
17=anococcygeal ligament
18=site of perineal body
19=ischial spine
20=ischial tuberosity
21=iliococcygeus
22=puborectalis
23=pubo-analis
24=puboperinealis
25=pubovaginalis
26=pubococcygeus
27=vagina
28=urethra
29=deep dorsal vein of clitoris

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10
Q

Where in the bladder bed is covered by peritoneum?

A

The superior surface in both sexes. The posterior surface in males only.

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11
Q

State the attachments and function of the median umbilical ligament.

A

It is a remnant of the urachus in the space of Retzius. It attaches to the apex of the bladder and the anterior abdominal wall. It is a fibrous remnant of the allantois, which drained the urinary bladder, traversing the umbilical cord, in intra-uterine life.

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12
Q

State the attachments of the lateral true ligament (of the bladder).

A

Lateral wall of bladder and tendinous arch of pelvic fascia

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13
Q

State the attachments of the puboprostatic ligament.

A

Body of pubis to prostatic fascia and neck of bladder

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14
Q

State the attachments of the pubovesical ligament.

A

Body of pubis to neck of bladder

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15
Q

What are the false ligaments of the bladder (positions)?

A

Superior, lateral and posterior (of little support)

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16
Q

What is the arterial supply of the urinary bladder?

A

Superior and inferior vesical arteries, from internal iliac artery. In females, uterine and vaginal arteries also supply blood.

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17
Q

Where does the internal iliac artery originate from?

A

Internal iliac, (left and right) common iliac, bifurcation of abdominal aorta

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18
Q

What is the venous drainage of the urinary bladder?

A

The vesical venous plexus at the space of Retzius drains into the internal iliac vein.

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19
Q

What is micturition?

A

Urination

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20
Q

How is the urinary bladder innervated?

A

By inferior hypogastric plexuses.
Parasympathetic: From S2,3,4 to detrusor and inhibitory to internal urethral sphincter, producing micturition.
Sympathetic: from L1,2
Ascending sensory fibers cause fullness (distension) and pain.

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21
Q

Where does lymph from the urinary bladder drain to?

A

Into internal and external iliac lymph nodes

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22
Q

Describe the position and composition of the detrusor muscle.

A

It lines the urinary bladder. It is smooth muscle composed of longitudinal and circular.

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23
Q

Which sphincter is voluntary, which is not?

A

The external sphincter is voluntary, the internal is autonomous. Skeletal/smooth

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24
Q

State the difference in urethral length in males and females.

A

Male urethras are much longer than females (20 cm vs. 4 cm)

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25
Where in females is the external urethral sphincter thicker?
Near the middle and anteriorly
26
How is the external urinary sphincter reinforced?
It is reinforced by fibers from the ischiopubic ramus and the perineal body.
27
How is the urethra innervated?
Upper portion: upper hypogastric plexus Lower portion: perineal branch of pudendal nerve (S2,3,4)
28
What is the arterial supply of the urethra in females?
Superiorly: inferior vesical and vaginal arteries Inferiorly: internal pudendal artery
29
What is cystoscopy?
Cystoscopy is the imaging process whereby a camera is inserted through the urethra and into the bladder.
30
Label this coronal section, viewed posteriorly.
1=epoophoron 2=fimbriae 3=vesicular appendage 4=ovarian mesothelium (surface epithelium) 5=ovarian ligament 6=body of uterus 6.5=isthmus 7=cervix 8=lateral vaginal fornix 9=vaginal orifice 10=labium minor 11=prepuce 12=clitoris 13=external urethral orifice 14=vestibule of vagina 15=protrusion of urethra 16=anterior wall of vagina 17=external os 18=cervical canal 19=ureter 20=internal os 21=endometrium 22=myometrium 23=perimetrium 24=ovary 25=ovarian vessels (in suspensory ligament of ovary) 26=abdominal ostium of uterine tube 27=infundibulum 28=ampulla 29=isthmus 30=uterine part 31=uterotubal junction 32=uterine horn (cornu) 33=fundus of uterus 34=uterine cavity 35=uterine ostium 36=round ligament 37=uterine tube
31
What are the layers of the uterus?
Perimetrium, myometrium, endometrium
32
What is prolapse?
Prolapse is when organs in the pelvis slip down from their normal position and bulge into the vagina.
33
State the attachments of the round ligament of the uterus.
Superolateral uterus, through inguinal canal to mons pubis and labium major
34
How can the round ligament cause pain during pregnancy/childbirth?
The round ligament may stretch, causing pain.
35
What are the upper ligaments of the uterus?
Round and broad
36
What are the middle ligaments of the uterus?
Transverse, pubovesical, uterosacral
37
Which ligament helps prevent prolapse?
Uterosacral ligament
38
Which ligament maintains the vaginal angle at 45 degrees?
Pubovesical ligament
39
State the epithelial type in the endocervix vs. the ectocervix area.
Columnar epithelia endocervically and stratified squamous epithelia ectocervically
40
What is the transformation zone on the ectocervix?
The transformation zone is the region on the ectocervix where the fragile columnar epithelial cells are replaced with more durable stratified epithelial cells. It is prone to dysplasia.
41
What is dysplasia?
Abnormal cell growth
42
Why can ovarian pain be referred to the thigh?
Due to the obturator nerve
43
Detail the layers and features of the mucosa.
Outer adventitia - nerve bundles and connective tissue Middle muscle layer - dense around vaginal opening Inner mucosa - squamous cell, containing rugae
44
What are the vaginal fornices? Name them.
Vaginal fornices are recesses around the cervix. There are anterior, posterior, and lateral parts
45
What is the vestibule of the vagina?
The vestibule of the vagina is the cleft between the labia minora.
46
In what shape is the transverse potential cavity of the vagina?
H-shape
47
State the arterial supply of the uterus.
Uterine artery, from the internal iliac artery
48
State the arterial supply of the vagina.
Vaginal, inferior vesical and internal pudendal arteries
49
State the venous drainage of the uterus and vagina.
Each organ has its own venous plexus which ultimately drains into the internal iliac veins.
50
State the branches of the internal iliac artery from anterior to posterior (anti-clockwise).
Anterior: umbilical (to superior vesical), obturator, inferior vesical/vaginal, middle rectal, internal pudendal and inferior gluteal arteries Posterior: superior gluteal, lateral sacrals and iliolumbar arteries
51
State the parasympathetic innervation of the uterus and vagina.
Pelvic splanchnic nerves (S2,3,4 anterior rami)
52
State the sympathetic innervation of the uterus and vagina.
T11,12 ganglia, via hypogastric plexus. Causes vasoconstriction to limit hormone secretion and is vital during labour.
53
What action of the vaginal muscle is somatic? What nerve dictates this?
The contraction of bulbospongiosus is somatic, innervated by pudendal (S2,3,4). In this contraction, the effects: narrowing of vaginal opening, compression of deep dorsal vein of clitoris, causing clitoral engorgement, support of pelvic floor (continence and prolapse prevention), occur.
54
What is the retro-inguinal space (of Bogros) occupied by?
Extraperitoneal fat
55
What is the thick collagenous connective tissue capsule that covers the testes?
The tunica albuginea
56
Localize the mediastinum (rete) testis. What is its distinguishing factor to the anterior testis?
The mediastinum testis is on its posterior aspect. It is thicker here compared to the anterior aspect.
57
What divides the testis into incomplete testicular lobules?
Septa that originates from the tunica albuginea
58
How many lobules are there in each testis?
Approximately 250
59
How many seminiferous tubules are there in each lobule?
1 to 4
60
Label the diagram.
1=spermatic cord 2=testicular artery 3=pampiniform plexus of testicular vein 4=head of epididymis 5=efferent ductules of testis 6= rete testis in mediastinum of testis 7=straight tubules 8=body of epididymis 9=duct of epididymis 10=ductus deferens 11=tail of epididymis 12=tunica albuginea 13=seminiferous tubules 14=septa of testis 15=visceral layer of tunica vaginalis 16=cavity of tunica vaginalis 17=parietal layer of tunica vaginalis
61
List in orders the ducts through which semen travels
Seminiferous tubules, Tubuli recti, Rete testis, Ductuli efferentes, Epididymis, Ductus (Vas) deferens, Ampulla of vas deferens, Ejaculatory duct, Urethra
62
What 2 ducts join to form the ejaculatory duct?
Ductus deferens and duct of seminal gland
63
What are the male reproductive glands?
Seminal vesicles, prostate and bulbourethral glands
64
Localize the bulbourethral glands.
There are multiple bulbourethral glands located along the length of the urethra.
65
Which gland neutralises left-over acid in the urethra?
Bulbourethral glands
66
How many seminal vesicles are there?
Same as the number of vas deferens, 2
67
Label the diagram.
1=bulbourethral gland and duct 2=perineal membrane 3=bulb of penis 4=root 5=body 6=glans 7=external urethral orifice 8=navicular fossa 9=corona 10=neck of glans 11=mucus-secreting urethral glands 12=spongy urethra 13=corpus spongiosum 14=corpus cavernosum 15=spongy urethra in bulb of penis 16=crus 17=intermediate urethra 18=orifice of prostatic utricle 19=prostatic urethra 20=prostate 21=intramural urethra 22=urinary bladder
68
What are bulbourethral glands alternatively known as?
Cowper's glands
69
How does the prostatic urethra differ to the other parts, in histology?
Prostatic: transitional epithelium Membranous and spongy: pseudostratified columnar epithelium
70
State the attachments of the suspensory ligament.
Erectile bodies and pubic symphysis
71
State the attachments of the fundiform ligament.
Pubic symphysis to tunica albuginea of corpus cavernosum. It is an inferior extension of Scarpa's fascia.
72
Where is skin attached to the penis?
Frenulum (posterior)
73
State the layering of fascia of the penis.
External fascia of Colles, deep fascia (Buck's), tunica albuginea
74
State the arterial supply of the penis.
Internal pudendal arteries from the anterior internal iliac. Dorsal arteries run along the glans. Helicine arteries supply the corpus cavernosum. Bulbourethral arteries supply the bulb and urethra.
75
State the venous drainage of the penis.
Deep dorsal vein of penis (to internal pudendal veins) and superficial dorsal vein (to superficial external pudendal vein)
76
What is the sensory innervation of the penis?
Glans: Dorsal nerve of penis from pudendal nerve Body: ilioinguinal nerve
77
State the parasympathetic innervation of the penis.
Pelvic splanchnic nerves (S2,3,4)
78
Which arteries are responsible for giving the penis its size during erection?
Helicine arteries
79
How does engorgement of the penis take place during erection?
The bulbospongiosus and ischiocavernosus are contracted to compress veins egressing the corpus cavernosum, impeding the return of venous blood.
80
What sort of nervous response is semen emission, what roots cause this?
Emission is a sympathetic response (L1,2)
81
What muscles contract 'uncontrollably' during ejaculation?
Internal urethral sphincter is closed (L1,2). Urethral muscle is contracted (parasympathetic - L2,3,4). Bulbospongiosus is contracted (pudendal nerves - S2,3,4)
82
What are the boundaries of the male urogenital triangle?
Anterior: pubic symphysis Anterolateral: ischiopubic rami Posterior: imaginary line joining ischial tuberosities The anal triangle is its reflection, with the opposite point being at Co5.
83
State the muscles of the levator ani, and their attachments.
Pubococcygeus – pubic bone to coccyx Puborectalis – pubic symphysis to sling around rectum Iliococcygeus – ischium to coccyx
84
State the attachments of coccygeus muscles.
Spine of the ischium to the coccyx and sacrum
85
What is a lithotomy?
A lithotomy is used to refer to the position or procedure relating to the removal of stones from the ducts of the pelvis.
86
State the arterial supply of the rectum.
Superior, middle and inferior rectal arteries.
87
What are the transverse folds of the rectal wall called?
Houston's valves
88
Differentiate between the superior and inferior epithelium of the anal canal.
Superior anal canal is lined with simple columnar epithelium. Inferior anal canal is lined with stratified squamous epithelium.
89
At what line does the rectum become the anus?
The pectinate line
90
Differentiate between the anal canal that exists on either side of the pectinate line.
The upper 2/3rds is the visceral canal, originating from the hindgut. It is quite insensitive, haemorrhoids here are not very painful. The lower 1/3rd is the parietal canal, originating from the proctodeum (ectoderm). It is highly sensitive, fissures and haemorrhoids are painful.
91
How does lymphatic drainage differentiate on either side of the pectinate line?
Superior lymphatic vessels drain to inferior mesenteric lymph nodes. Inferior lymphatic vessels drain to superficial inguinal lymph nodes.
92
Where does the pudendal canal (containing nerve, artery and vein) run along?
The pudendal canal runs alongside the medial ischiopubic ramus.
93
State the sex difference in the perineal membrane.
The perineal membrane is thinner in females.
94
What does the perineal membrane separate?
The superior and inferior perineal pouches
95
What ducts pierce the perineal membrane?
Urethra and bulbourethral gland ducts
96
What is the thickening of the anterior perineal membrane called?
Transverse perineal ligament
97
What is the vulva?
The vulva is the collective description of the external reproductive organ in females.
98
Where are the great vestibular (Bartholin's) glands located? What is their function?
They are located posteriorly and to either side of the vagina. They secrete mucus to lubricate the vagina.
99
What does the external iliac artery become?
The femoral artery, as it passes the pubic symphysis

Anatomy (10 decks)

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