Things I cant remember Flashcards
what nerve innervates the levator ani muscle?
branches of the pudendal nerve or direct sacral nerves of S3/S4
what level does the common iliac split?
L5-S1
what does the inferior gluteal artery supply?
piriformis, pelvic diaphragm, glute max, sciatic n
what does the iliolumbar a supply?
psoas major, iliacus, quadratus lumborum, cauda equina
what do the lateral sacral veins do?
anastomose with internal vertebral plexus –> collateral pathway to reach the IVC
what is the paracolpium?
thickened fascia from the vagina to the tendinous arch of the levator ani
what are the parts of the bladder?
apex –> points towards pubic symphesis
fundus –> opposite the apex
body –> between apex and fundus
neck –> bottom where urethra starts
what is the posterior ridge of the urethra?
urethral crest
what is the prostatic utricle?
remnant of the paramesonephric system
where does urine gather in a superior bladder tear?
intraperitoneal space
where does urine gather in a posterior bladder tear?
extraperitoneal tissue
what are the 4 parts of the fallopian tube?
infindibulum, ampulla, isthmus, intrauterine
what female structures lie above the pelvic pain line? what does this mean they are innervated by?
body and fundus of uterus, T10-L2 sympathetics
what 3 ligaments are in female endopelvic fascia only?
cardinal ligament
uterosaral ligament
pubocervical ligament
what is contained in the cardinal ligament?
uterine a/v
what is contained in the uterosacral ligament?
middle rectal a.
what is contained in the pubocervical ligament?
superior vesicular a.
what level is a spinal block for delivery?
L3-L4
what level is a caudal epidural?
S5-Co
what is the landmark used for a pudendal nerve block injection?
ischial spine
what can you palpate with a digital vaginal exam?
cervix, ischial spines, sacral promontory
pulsations of the uternine artery
cysts
what forms the lateral border of the urogenital triangle?
sacrotuberous ligaments
what vasculature is contained in the deep perineal pouch?
deep dorsal veins of clit and penis
from superficial to deep, what are the contents of the superficial perineal pouch?
2 fascia and fat layers above this i forget bulbospongiosus/ischiocavernosus bucks fascia tunica albuginea corpus spongiosum and corpus cavernosum
what else is contained in the superficial perineal pouch?
superficial transverse perineal muscle
spongy urethra
pudendal n
internal pudendal a/v
how is the anterior scrotum supplied with blood?
femoral a. –> external pudendal –> branches to anterior scrotum, penis, labia, and clitoris
what nerve innervates the muscles of the superficial perineal pouch?
deep muscular branch of the perineal nerve (off pudendal)
What is contained in the vestibule of the vagina?
paraurethral glands
great vestibular glands
external urethral orifice
vaginal orifice
what makes up the bulb of the vestibule?
erectile tissue, bulbocavernosus muscle
what connects to the perineal body?
External anal sphincter Bulbospongiosus muscle Superficial transverse perineal muscle Anterior fibers of the levator ani Fibers from external urinary sphincter Deep transverse perineal muscle
what nerve plexus provides parasmpyhateic erecile stimulation to the lady parts?
uterovaginal nerve plexus
what does the mesonephric duct become in females?
eoophoron and gartners ducts
what comes from the urogenital sinus in females?
lower 2/3 of vagina,
greater vestibular glands,
urethral/paraurethral glands
membranous urethra
what comes from the genital tubercle in males?
glans penis, erectile tissue
what comes from the genital tubercle in females?
glans clitoris, erectile tissue
what is the female homolog to the male prostate?
paraurethral glands, urethral glands
what occurs in the epididymis
decapitation to prevent acromsomal activation
sperm learn to swim
what is the function of the vas deferens?
sperm trasport and storage in ampulla
provides fructose and citrate
what are the actions of estradiol in males?
bone maturation
growth
spermatogenesis
breast development
what breaks down the functional layer of the uterus during menses?
matrix metalloproteinases and prostaglandins and constriction of the spiral arteries
what are the functions of progesterone? 9
Stimulation of endometrial glandular secretions and spiral artery development.
Maintenance of pregnancy.
decrease myometrial excitability.
increases adhesiveness of endometrium
increase body temperature.
Inhibition of gonadotropins(LH, FSH).
Uterine smooth muscle relaxation (preventing contractions).
decrease estrogen receptor expression
Prevents endometrial hyperplasia
what are the functions of estrogen?
Development of genitalia and breast, female fat distribution.
Growth of follicle, endometrial proliferation, myometrial excitability.
Upregulation of estrogen, LH, and progesterone receptors; feedback inhibition of FSH and LH, then LH surge;
stimulation of prolactin secretion.
increases transport proteins, SHBG; HDL;
decreases LDL
What are the symptoms of endometriosis?
dysmenorrhea, menorrhagia, menometorrhagia, infertility
How does the LH surge form the stigma and eventually break down the ovarian wall?
proteolytic activity of the theca externa and tunica albuginea
how do granulosa cells communicate with each other/
gap junctions
what does LH surge do to the steriodogenic function of the granulosa cells?
inhibits aromatase so less estrogen
increases access to cholesterol for progesterone production
what is released from the granulosa/theca cells to help break down the follicle wall/tunica albuignea?
cytokines and hydrolytic enzymes
what happens when the sperm meets the plasma membrane?
something binds to izumo and sperm DNA condenses and a pronucleus forms arounds it
other than maintenance of the CL, what is the function of hCG
autocrine –> growth of trophoblasts and placenta
what is the funciton of syncytiotrophoblast?
secrete hCG, express adhesive proteins, break down ECM of uterus with metalloproteases and enzymes
what occurs during the attachment phase of implantation?
interaction between surface proteins on trophoblasts and endothelial cells starts decidualization
how do the endometrial cells change with decidualization?
more glycogen, structural changes
what does a type A spermatogonia look like?
oval euchromatic (lightly condensed) nucleus
what does a type B spermatogonia look like?
circular and darker
where are early spermatids found?
niches in cytoplasm of sertoli
where are late spermatids found?
in crypts of sertoli apical cytoplasm
what is the process of spermatogensis?
making of the acrosome, tail, shaping, and condensation of nucleus of a spermatid
where does most prostate cancer occur?
peripheral zone
what is located in the central zone of the prostate?
periurethral mucosal glands
what is in the transitional zone of the prostate?
periurethral submucosal glands
what is in the peripheral zone of the prostate?
tubuloalvolar branched glands
what type of epithelium is the prostate?
pseudo-stratified columnar epithelium m
what is the function of corpora almylacea
rich in glycoproteins and Ca deposits
what are the cell types in the epididymis?
simple or psudeostatified columnar ciliated
has principle and basal for repopulating
what is the epithelial cell type in the vas deferens
psudeostratified columnar ciliated
What directly surrounds erectile tissue?
tunica albuginea
what causes gestational diabetes?
maternal insuline resistance due to pregnancy hormones
progesterone, cortisol, GH, lactogen
what are risk factors of GDM? (6)
high BMI HTN previous large baby PCOS current diabetes being hispanic
what are risks for mother during/after GDM? (6)
stillbirth preeclampsia hydraminos macrosomia c section/birth trauma increased risk of developing DM in future
what risks are presented to the newborn because of GDM?
shoulder dystocia
neonatal hypoglycemia
hyperbilirubinemia
risk for being fat or having diabetes
