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Clinical Morphology > Week 6: Pelvis and Perineum > Flashcards

Week 6: Pelvis and Perineum Flashcards

1
Q

pelvic inlet

A
  • circular opening where the abdominal cavity is continuous with the pelvic cavity
  • sacral promontory protrudes into this opening
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2
Q

pelvic outlet

A

diamond shaped and bounded by the pubic symphysis, pubic arches, inferior pubic rami, ischial rami, sacrotuberous ligament, and the coccyx

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3
Q

sciatic notch

A

between posterior inferior iliac spine and the ischial spine

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4
Q

sacrospinous ligament

A

changes the sciatic notch into an opening, the greater sciatic foramen

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5
Q

difference between male and female for pelvic inlet

A

female: wide, oval or circular
male: narrow, heart-shaped

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6
Q

difference between male and female for sacrum

A

female: short, straight
male: long, prominent

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7
Q

difference between male and female for coccyx

A

female: straighter
male: curves ventrally

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8
Q

difference between male and female for sciatic notch

A

female: wide
male: narrow

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9
Q

difference between male and female for subpubic angle

A

female: broad, rounded (80-85 degrees)
male: deep, acute (50-60 degrees)

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10
Q

pelvic wall muscles

A

piriformis and obturator internus

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11
Q

pelvic floor consists of

A

pelvic diaphragm and urogenital diaphragm

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12
Q

pelvic diaphragm

A
  • levator ani and coccygeus muscles

* thin sheets of muscles that the urethra, vagina, and rectum pass through

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13
Q

levator ani

A

made up of iliococcygeus, pubococcygeus, and puborectalis

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14
Q

illiococcygeus and pubococcygeus contract when

A

abdominal pressure is raised to support the pelvic organs

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15
Q

pubococcygeus helps

A

maintain urinary and fecal continence

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16
Q

puborectalis function

A

relaxes and contracts the anorectal angle to control defacation and aids in voluntary control of micturition

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17
Q

coccygeus

A
  • deep to sacrospinous ligament

* pulls the coccyx forward after defacation

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18
Q

uterus

A

pear-shaped and has 4 regions: fundus, body, isthmus, and cervix

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19
Q

fundus of uterus

A

the upper area in which the uterine tube connect to the uterus

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20
Q

body of uterus

A

starts below the level of uterine tubes and continues downward until the uterine walls and cavity begin to narrow

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21
Q

isthmus of uterus

A

the lower, narrow, neck region

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22
Q

cervix

A

extend from isthmus until it opens into the vagina

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23
Q

anteverted or anteflexed uterus

A
  • normal position of uterus

* oriented anteriorly toward the bladder

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24
Q

retroverted or retroflexed uterus

A
  • a normal anatomical variation of uterus position (1 in 4)

* oriented posteriorly toward the rectum

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25
Q

flexion of uterus

A

the angle between the uterine body and isthmus

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26
Q

version of uterus

A

the angle between the cervical canal and the vagina

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27
Q

broad ligament

A
  • formed by the double layer peritoneum (mesentery) that drapes over the female reproductive tract
  • can be divided into parts depending on what structure it covers; vessels, nerves, and lymphatics travel via these messenteries
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28
Q

mesometrium

A

the mesentery of the uterus; it is adjacent to uterus

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29
Q

mesovarium

A

mesentery of the ovary

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30
Q

mesosalpinx

A

mesentery of the uterine tube (also called salpinx)

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31
Q

what passes through the suspensory ligament of the ovary

A

ovarian vessels from the aorta to the ovary

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32
Q

ovarian ligament

A

attaches the inferomedial pole of the ovary to the uterus

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33
Q

round ligament of the uterus

A

is continuous with the ovarian ligament and travels from uterus laterally to enter the deep inguinal ring

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34
Q

vesicouterine pouch

A

recess between bladder and uterus

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35
Q

rectouterine pouch (of Douglas)

A

recess between the uterus and rectum

36
Q

pubovesical ligaments

A
  • formed by pelvic fascia deep to the peritoneum that thickens to help support pelvic organs
  • from pubic bones to bladder
37
Q

transverse cervical ligaments

A
  • formed by pelvic fascia deep to the peritoneum that thickens to help support pelvic organs
  • (cardinal ligaments) from uterus to lateral pelvic wall
38
Q

uterosacral ligaments

A
  • formed by pelvic fascia deep to the peritoneum that thickens to help support pelvic organs
  • from uterus to sacrum
39
Q

damage to pubovesical, transverse cervical, and uterosacral ligaments

A
  • can be caused by multiparity, birth trauma, obesity, chronic cough, and heavy lifting
  • can result in stress incontinence, bladder prolapse, or varying degrees of uterine prolapse =
40
Q

what ligaments are involved in bladder prolapse

A

pubovesicle ligaments

41
Q

what ligaments are involved in uterine prolapse

A

transverse cervical ligaments

42
Q

testes

A

descend into the scrotum and are attaches to the seminal vesicle by the vas deferens

43
Q

ejaculatory ducts are embedded into

A

the prostate

44
Q

during ejaculation, semen passes

A

from the seminferous tubules in the testis -> the epididymis and vas deferens -> ejaculatory ducts -> urethra

45
Q

epididymis is continuous with

A

the vas deferens

46
Q

tunica vaginalis

A
  • in descent of testes into scrotum, tunica vaginalis attaches to the anterior and lateral aspect of the testes
  • it has a visceral and parietal layer
47
Q

descent of testis forms

A

inguinal canal and spermatic cord, which is covered in layers derived from the abdominal wall

48
Q

external spermatic fascia

A

layer of spermatic cord derived from external oblique aponeurosis

49
Q

cremasteric fascia/ muscle

A

layer of spermatic cord derived from the intenal oblique muscle

50
Q

internal spermatic fascia

A

layer of spermtic cord derived from transversalis fascia

51
Q

spermatic cord contains

A

ilioinguinal nerve, genital branch of genitofemoral nerve, testicular artery, pampiniform plexus, lymphatics, and vas deferens (and deferential vessels)

52
Q

inguinal canal

A
  • an oblique passageway through the abdominal wall
  • begins at the deep inguinal ring, passes obliquely toward the midline under the transverse abdominal and internal oblique muscles, and ends at the superficial inguinal ring
53
Q

deep inguinal ring

A
  • in transversalis fascia

* is the beginning of the inguinal canal

54
Q

superficial inguinal ring

A
  • opening in the aponeurosis of the external oblique musle

* is the end of the inguinal canal

55
Q

what is contained in the inguinal canal

A

in males: spermatic cord

in females: round ligament of uterus

56
Q

blood supply of reproductive system

A

from the internal iliac artery, a branch of the common iliac artery

57
Q

internal iliac branches common to males and females

A

iliolumbar, lateral sacral, superior gluteal, inferior gluteal, internal pudendal (gives off inferior rectal branch), umbilical - (superior) vesicle arteries to the bladder, obturator, middle rectal

58
Q

female exclusive branches off the internal iliac

A

uterine and vaginal arteries

59
Q

male exclusive branches off the internal iliac

A

deferential artery (a branch of the umbilical artery to the vas deferens)

60
Q

superficial and deep inguinal nodes

A
  • receive lymph from the perineum and lower limb

* drains to external iliac nodes, then common iliac, finally lateral aortic nodes

61
Q

lymph from ovaries and testies

A

flow directly to the lateral aortic nodes because they are supplied from branches that come directly off the aorta

62
Q

lymph from lateral aortic nodes drain to

A

cisterna chyli and then thoracic duct

63
Q

Body of bladder

A
  • main portion

* collects urine

64
Q

neck of bladder

A
  • funnel shaped extension

* connects bladder to the urethra

65
Q

bladder lined with

A

transitional epithelium

66
Q

detrusor muscle

A
  • 3 poorly defined layers of smooth muscle in the bladder

* the bulk of the bladder wall

67
Q

internal urethral sphincter

A
  • below the neck of the bladder

* consists of smooth muscle cells extending from the detrusor muscle

68
Q

external urethral sphincter

A
  • at the level of the pelvic floor (below internal urethral sphincter)
  • composed of voluntary striated muscle fibers
69
Q

micturition reflex

A
  • autonomic regulation of micturition by spinal cord reflex
  • involves impulses traveling from bladder to sacral spinal cord and vice versa
  • can be inhibited or facilitated by neurons located in cerebral cortex or brainstem
70
Q

micturition occurs in 2 phases

A
  • filling phase and emptying (voiding) phase

* both require coordinated interaction between bladder and nervous system

71
Q

bladder filling is parasympathetic or sympathetic

A

sympathetic

sympathetic=stores

72
Q

bladder emptying is parasympathetic or sympathetic

A

parasympathetic

73
Q

perineum

A
  • diamond shaped area below pelvic floor

* divided into 2 triangles by drawing a line between ischial tiberosities

74
Q

anterior urogenital triangle

A

associated with openings of urinary and reproductive systems and functions to anchor the external genitalia

75
Q

posterior anal triangle

A

contains the anus and the external anal sphincter

76
Q

nerve and blood supply to perineum

A

pudendal nerve (S2-S4) and internal pudendal artery

77
Q

deep perineal pouch

A
  • part of urogenital triangle
  • potential space between pelvic diaphragm and perineal membrane
  • contains part of urethra, external urethral sphincter, and deep transverse perineal muscle (also bulbourethral glands in males and part of the vagina, compressor urethrae, and sphincter urethrovaginalis in females)
78
Q

perineal membrane

A

tough fascia that provides attachment for external genitalia and helps support the pelvic organs

79
Q

superficial perineal pouch

A
  • part of urogenital triangle
  • potential space between perineal membrane and perineal fascia
  • contains external genitalia
80
Q

perineal body

A
  • connective tissue structure (central tendon) into which pelvic floor and perineal muscles attach
  • in the midline of the perineum
81
Q

erectile tissue of males

A

copora cavernosa and corpus spongiosum compose the penis

82
Q

erectile tissue of females

A
  • vestibular bulbs (bulb of the vestibule) - deep to labia majora and separated by vaginal opening
  • crura of clitoris - join to form the body and glans of clitoris
83
Q

bulbospongiosum

A
  • covers proximal end of corpus spongiosum (bulb of penis) in males
  • covers vestibular bulbs in female
84
Q

Thin skeletal muscles that cover proximal ends or roots of erectile tissues

A
  • bulbospongiosum, ischiocavernosum, and superficial transverse perineal muscles
  • contract to move blood volume during orgasm
85
Q

ischiocavernosum

A
  • covers proximal end of corpora cavernosa (crus of penis) in males
  • covers crus of the clitoris in female
  • lies along the pubic ramus on each side
86
Q

superficial transverse perineal muscle

A

runs transversely across the posterior border of the urogenital triangle from the ischial tuberosity to insert in the perineal body, along with the bulbospongiosum and external anal sphincter

Clinical Morphology (25 decks)

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