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
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
3
Q
sciatic notch
A
between posterior inferior iliac spine and the ischial spine
4
Q
sacrospinous ligament
A
changes the sciatic notch into an opening, the greater sciatic foramen
5
Q
difference between male and female for pelvic inlet
A
female: wide, oval or circular
male: narrow, heart-shaped
6
Q
difference between male and female for sacrum
A
female: short, straight
male: long, prominent
7
Q
difference between male and female for coccyx
A
female: straighter
male: curves ventrally
8
Q
difference between male and female for sciatic notch
A
female: wide
male: narrow
9
Q
difference between male and female for subpubic angle
A
female: broad, rounded (80-85 degrees)
male: deep, acute (50-60 degrees)
10
Q
pelvic wall muscles
A
piriformis and obturator internus
11
Q
pelvic floor consists of
A
pelvic diaphragm and urogenital diaphragm
12
Q
pelvic diaphragm
A
- levator ani and coccygeus muscles
* thin sheets of muscles that the urethra, vagina, and rectum pass through
13
Q
levator ani
A
made up of iliococcygeus, pubococcygeus, and puborectalis
14
Q
illiococcygeus and pubococcygeus contract when
A
abdominal pressure is raised to support the pelvic organs
15
Q
pubococcygeus helps
A
maintain urinary and fecal continence
16
Q
puborectalis function
A
relaxes and contracts the anorectal angle to control defacation and aids in voluntary control of micturition
17
Q
coccygeus
A
- deep to sacrospinous ligament
* pulls the coccyx forward after defacation
18
Q
uterus
A
pear-shaped and has 4 regions: fundus, body, isthmus, and cervix
19
Q
fundus of uterus
A
the upper area in which the uterine tube connect to the uterus
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
21
Q
isthmus of uterus
A
the lower, narrow, neck region
22
Q
cervix
A
extend from isthmus until it opens into the vagina
23
Q
anteverted or anteflexed uterus
A
- normal position of uterus
* oriented anteriorly toward the bladder
24
Q
retroverted or retroflexed uterus
A
- a normal anatomical variation of uterus position (1 in 4)
* oriented posteriorly toward the rectum
25
flexion of uterus
the angle between the uterine body and isthmus
26
version of uterus
the angle between the cervical canal and the vagina
27
broad ligament
* 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
28
mesometrium
the mesentery of the uterus; it is adjacent to uterus
29
mesovarium
mesentery of the ovary
30
mesosalpinx
mesentery of the uterine tube (also called salpinx)
31
what passes through the suspensory ligament of the ovary
ovarian vessels from the aorta to the ovary
32
ovarian ligament
attaches the inferomedial pole of the ovary to the uterus
33
round ligament of the uterus
is continuous with the ovarian ligament and travels from uterus laterally to enter the deep inguinal ring
34
vesicouterine pouch
recess between bladder and uterus
35
rectouterine pouch (of Douglas)
recess between the uterus and rectum
36
pubovesical ligaments
* formed by pelvic fascia deep to the peritoneum that thickens to help support pelvic organs
* from pubic bones to bladder
37
transverse cervical ligaments
* formed by pelvic fascia deep to the peritoneum that thickens to help support pelvic organs
* (cardinal ligaments) from uterus to lateral pelvic wall
38
uterosacral ligaments
* formed by pelvic fascia deep to the peritoneum that thickens to help support pelvic organs
* from uterus to sacrum
39
damage to pubovesical, transverse cervical, and uterosacral ligaments
* 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
what ligaments are involved in bladder prolapse
pubovesicle ligaments
41
what ligaments are involved in uterine prolapse
transverse cervical ligaments
42
testes
descend into the scrotum and are attaches to the seminal vesicle by the vas deferens
43
ejaculatory ducts are embedded into
the prostate
44
during ejaculation, semen passes
from the seminferous tubules in the testis -> the epididymis and vas deferens -> ejaculatory ducts -> urethra
45
epididymis is continuous with
the vas deferens
46
tunica vaginalis
* 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
descent of testis forms
inguinal canal and spermatic cord, which is covered in layers derived from the abdominal wall
48
external spermatic fascia
layer of spermatic cord derived from external oblique aponeurosis
49
cremasteric fascia/ muscle
layer of spermatic cord derived from the intenal oblique muscle
50
internal spermatic fascia
layer of spermtic cord derived from transversalis fascia
51
spermatic cord contains
ilioinguinal nerve, genital branch of genitofemoral nerve, testicular artery, pampiniform plexus, lymphatics, and vas deferens (and deferential vessels)
52
inguinal canal
* 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
deep inguinal ring
* in transversalis fascia
| * is the beginning of the inguinal canal
54
superficial inguinal ring
* opening in the aponeurosis of the external oblique musle
| * is the end of the inguinal canal
55
what is contained in the inguinal canal
in males: spermatic cord
| in females: round ligament of uterus
56
blood supply of reproductive system
from the internal iliac artery, a branch of the common iliac artery
57
internal iliac branches common to males and females
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
female exclusive branches off the internal iliac
uterine and vaginal arteries
59
male exclusive branches off the internal iliac
deferential artery (a branch of the umbilical artery to the vas deferens)
60
superficial and deep inguinal nodes
* receive lymph from the perineum and lower limb
| * drains to external iliac nodes, then common iliac, finally lateral aortic nodes
61
lymph from ovaries and testies
flow directly to the lateral aortic nodes because they are supplied from branches that come directly off the aorta
62
lymph from lateral aortic nodes drain to
cisterna chyli and then thoracic duct
63
Body of bladder
* main portion
| * collects urine
64
neck of bladder
* funnel shaped extension
| * connects bladder to the urethra
65
bladder lined with
transitional epithelium
66
detrusor muscle
* 3 poorly defined layers of smooth muscle in the bladder
| * the bulk of the bladder wall
67
internal urethral sphincter
* below the neck of the bladder
| * consists of smooth muscle cells extending from the detrusor muscle
68
external urethral sphincter
* at the level of the pelvic floor (below internal urethral sphincter)
* composed of voluntary striated muscle fibers
69
micturition reflex
* 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
micturition occurs in 2 phases
* filling phase and emptying (voiding) phase
| * both require coordinated interaction between bladder and nervous system
71
bladder filling is parasympathetic or sympathetic
sympathetic
| sympathetic=stores
72
bladder emptying is parasympathetic or sympathetic
parasympathetic
73
perineum
* diamond shaped area below pelvic floor
| * divided into 2 triangles by drawing a line between ischial tiberosities
74
anterior urogenital triangle
associated with openings of urinary and reproductive systems and functions to anchor the external genitalia
75
posterior anal triangle
contains the anus and the external anal sphincter
76
nerve and blood supply to perineum
pudendal nerve (S2-S4) and internal pudendal artery
77
deep perineal pouch
* 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
perineal membrane
tough fascia that provides attachment for external genitalia and helps support the pelvic organs
79
superficial perineal pouch
* part of urogenital triangle
* potential space between perineal membrane and perineal fascia
* contains external genitalia
80
perineal body
* connective tissue structure (central tendon) into which pelvic floor and perineal muscles attach
* in the midline of the perineum
81
erectile tissue of males
copora cavernosa and corpus spongiosum compose the penis
82
erectile tissue of females
* 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
bulbospongiosum
* covers proximal end of corpus spongiosum (bulb of penis) in males
* covers vestibular bulbs in female
84
Thin skeletal muscles that cover proximal ends or roots of erectile tissues
* bulbospongiosum, ischiocavernosum, and superficial transverse perineal muscles
* contract to move blood volume during orgasm
85
ischiocavernosum
* 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
superficial transverse perineal muscle
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
