Urinary Tract and Pelvis

Question 1

How is the urethra oriented for catheterization?

Answer 1

Oriented anteriorly

Question 2

The true and false pelvis is separated by what?

Answer 2

The pelvic inlet

Question 3

If you damage S2 to S4 you will have trouble with what?

Answer 3

Trouble with urethral m and sphincters

Question 4

What nerve roots is the skeletal muscle in perineum and pelvic floor including urethral and anal sphincters controlled by?

Answer 4

S2 to S4

Question 5

Somatic motor and sensory innervation of the perineum is via what nerve and roots?

Answer 5

S2 to S4

Question 6

Where is a pudendal nerve block performed?

Answer 6

Medial to the ischial tuberosity

Question 7

What artery supplies the pelvis?

Answer 7

Internal iliac artery and branches

Anterior iliac artery (supplies bladder)
Posterior iliac artery (supplies posterior structures and anus)

Question 8

The deep pelvic structures drain into what? (bladder, rectum, pelvic genital organs and terminal part of the urethra)

Answer 8

Internal and external iliac chains

Question 9

The deep perineal structures drain into what? (urethra, external urethral sphincter, and the vagina in the female.)

Answer 9

Internal iliac chain

Question 10

The superficial perineal structures (penis, scrotum, clitoris and labia) drain into what?

Answer 10

Superficial inguinal nodes

Question 11

Other superficial perineal structures such as the glans penis, glans clitoris, labia minora and inferior end of the vagina drain into what two areas?

Answer 11

Deep inguinal nodes and external ililac chain

Question 12

The ovaries and related uterine structures and the testes drain into where?

Answer 12

Lateral and pre-aortic nodes

Question 13

The gluteal nodes drain into the

Answer 13

Internal iliac chain

Question 14

Drainage from the lower extremities is into where?

Answer 14

Superficial and deep inguinal nodes

Question 15

How are the deep parts of the perineum drained?

Answer 15

Internal pudendal-> internal iliac-> aortic nodes

Question 16

How are the superficial and external genitalia parts of the perineum drained?

Answer 16

Superficial inguinal nodes-> deep inguinal nodes-> external iliac nodes

Question 17

Ovaries and testes drain straight into which nodes?

Answer 17

Periaortic

Question 18

Why is a womans urethra more disposed to cystitis?

Answer 18

Because its shorter

Question 19

What are the boundaries of the perineum?

Answer 19

Well the urogenital triangle is located here and so is the anal triangle. Boundaries include:

• Pubic symphysis
• ischium
• sacrotuberous ligament

Question 20

What is the nerve supply to the perineum?

Answer 20

Pudendal nerve

Question 21

What is the arterial supply to the perineum?

Answer 21

internal pudendal artery

Question 22

The pelvic diaphragm consists of what two important strucutes?

Answer 22

levator ani and coccygeus

Question 23

What is the levator ani comprised of?

Answer 23

Pubococcygeus, puborectalis, iliococcygeus

Question 24

The levator ani and the urogenital diaphragm together do what?

Answer 24

Holt up the uterus, rectum and bladder

Question 25

What is the significance of the ischiorectal fossa?

Answer 25

AKA the deep perineal space (abscesses can form here because they have decrease vascular supply)

Question 26

The levator ani and the perineal membrane come together at the _________ ______

Answer 26

perineal body

Question 27

What is the clinical significance of the perineal body?

Answer 27

It is where the vagina and rectum meet and you don't want to cut this area in an episiotomy

Question 28

What systemic system is involved in external hemorrhoids?

Answer 28

Systemic venous system

Question 29

What systemic system do internal hemorrhoids to into?

Answer 29

Hepatic portal veins

Question 30

You can drain the bladder through the _________area

Answer 30

suprapubic

Question 31

In development, the bladder is connected to the _________

Answer 31

median umbilical ligament

Question 32

What female structure is analagous to the male vas deferens?

Answer 32

The round ligament

Question 33

What are the supporting structures of the uterus and what are the true supporting structures of the uterus?

Answer 33

Supporting structures: pelvic diaphragm, UG diaphragm and perineal body

Question 34

Are the round ligament, broad ligament or suspensatory ligaments supporting structures of the ovary?

Answer 34

No

Question 35

What are the MAJOR TRUE supporting structures of the uterus?

Answer 35

CUA | Cardinal, uterosacral, anterior pubocervical ligaments

Question 36

The pouch of douglas is part of what supporting structure of the uterus?

Answer 36

Uterosacral ligaments

Question 37

The uterine artery and vaginal arteries are in the __________ ________

Answer 37

broad ligament

Question 38

Significance of the uracus?

Answer 38

a canal that drains the urinary bladder of the fetus that joins and runs within the umbilical cord.

Question 39

Where is the vesicouterine pouch? where is the pouch of douglas?

Answer 39

Vesicouterine pouch is in front of the uterus Pouch of douglas or rectouterine pouch is behind the uterus in between the rectum

Question 40

What are the supporting structures of the ovary?

Answer 40

Major Suspensatory Ligament Mesovarium Suspensatory ligament of ovary Ligament of ovary

Question 41

What are the four parts of the male urethra?

Answer 41

1. Preprostatic part of urethra 2. Prostatic part of urethra 3. Membranous part of urethra 4. Spongy part of urethra

Question 42

This part of the urethra is surrounded by erectile tissue of the penis just below the deep perineal pouch and is thin, angled, and vulnerable to injury

Answer 42

spongy urethra

Question 43

The prostatic urethra is curved how?

Answer 43

Slightly anterior

Question 44

The external urethral sphincter is located where?

Answer 44

Deep perineal pouch

Question 45

Most prostate cancer is in the _________ zone

Answer 45

peripheral zone

Question 46

BPH is in the _________ zone

Answer 46

transitional zone (periurethral area)

Question 47

The sympathetic and visceral nerves of the spermatic cord descend through what?

Answer 47

Superficial inguinal canal and deep inguinal canal

Question 48

What n innervates the cremasteric muscle?

Answer 48

genitofemoral n

Question 49

Arterial supply of the penis? | IPDPD

Answer 49

Internal pudendal-> dorsal -> perineal->Deep A of penis

Question 50

Venous supply of the penis? | DPV IPI

Answer 50

Dorsal V-> prostatic plexus-> vesicle plexus -> internal pudendal -> internal iliac

Question 51

Where does the testicular artery come from?

Answer 51

Arises from the abdominal aorta to scrotum via inguinal canal

Question 52

Scrotum gets arterial supply from what?

Answer 52

Perineal AA

Question 53

How does the scrotum venous drainage go?

Answer 53

testicular veins, internal iliac and internal saphenous (TIISing out the blood)

Question 54

What artery is responsible for vasodilating for an erection?

Answer 54

Internal pudendal artery

Question 55

What nerves are responsible for the contraction of the internal urethral sphincter in men?

Answer 55

SNS fibers carried by sacral splanchnic nerves and the superior hypogastric plexus

Question 56

What nerves help stimulate an erection?

Answer 56

PSNS fibers from the pelvic splanchnic nerves to the inferior hypogastric plexus

Question 57

Somatic afferents (sensation) from the penis is via what two nerves?

Answer 57

Pudendal and perineal nerves

Question 58

What is the significance of the space of retzius aka retropubic space)?

Answer 58

The space of rezius is the area right above the pubic symphysis and this is an area in which you can insert a catheter. You don't want to go any higher or you will go through the peritoneum which is BAD

Question 59

Where would fluid from a torn urethra collect?

Answer 59

Anterior to the anterior abdominal wall. Not down the legs because the colle's fascia is continuous with the abdominal fascia but gets tacked down at the inguinal ligament and anterior to the anal triangle.