Yip (Blue Boxes, etc) Flashcards
Injury to the pelvic floor (like in childbirth) would injure what muscles? Weakening of these muscles may result in what problem?
Injured = perineum, levator ani, and pelvic fascia
Injury my alter the position of the neck of the bladder and urethra, causing URINARY STRESS INCONTINENCE, whose symptoms are dribbling of urine when intraabdominal pressure is raised during coughing and lifting
During childbirth which muscle would be TORN? Why is this muscle important?
TORN = pubococcygeus
This muscle is important because it supports and encircles the urethra, vagina and anal canal.
What device allows you to see the interior of a bladder and it’s three orifices?
Cytoscope
What is the pathway that the cytoscope travels?
In the urethra through the prostate into the urinary bladder (NOT the rectum)
Benign hypertrophy of the prostate (BHP) does what and causes what?
An enlarged prostate projects into the urinary bladder and ipedes urination by distoring the prostating urethra.
In benign hypertrophy of the prostate, which lobe enlarges the most and what does it obstruct?
The middle lobule usually enlarges the most and obstructs the internal urethral orifice.
Where does prostate cancer usually occur? In advanced stages, where do the cancer cells spread to?
Prostate cancer usually occurs In the posterolateral region. In advanced stages, prostate cancers spread to the iliac and sacral lymph nodes, and later to distant nodes and bone.
How could a prostatectomy affect the prostate plexus?
The prostatic plexus is close to the prostatic sheath, which gives passage to the parasympathetic fibers, that give rise to the cavernous nerves that convey the fibers that cause penile erection. In prostatectomy, impotency might be a consequence.
In which direction is the vagina likely to be distended during childbirth?
Anteroposteriorly.
Why is lateral distension of the vagina limited?
The ishial spines, which project posteromedially, and the sacrospinous ligaments limit distension laterally
During a manual pelvic examination, what structures can you palpate? Where can you palpate from?
The cervix, ischial spines, and sacral promontory can be palpated from the vaginal and/or rectum.
What is culdocentesis?
Culdocentesis is an endoscopic instrument that is inserted through an incision made in the posterior part of the vaginal fornix into the peritoneal cavity to drain a pelvic abscess in the retco-uterine pouch.
From what site can you aspirate fluid from the perineal cavity?
From the posterior part of the vaginal fornix into to recto uterine pouch.
Where is a hysterectomy (excision of the uterus) performed?
Through the lower anterior abdominal wall or through the vagina.
During a hysterectomy, which artery is tied off? What else is in danger of being inadvertantly clamped?
Because the uterine artery crosses anterior to the ureter near the lateral fornix of the vagina, the ureter is at danger of being tied off during a hysterectomy
At what point does the artery and tureter cross?
2 cm superior to the ischial spine near the lateral fornix of the vagina.
During a Pap smear, where do you place the spatula?
On the external os of the uterus to scrape material from the vaginal surface of the cervix, followed by insertion of a cytobrush into a cervical canal.
What are the effects of a lumbar and spinal epidural blocks? What does it affect?
The epidural anesthesize somatic and visceral afferent fibers below the waist, affecting uterine, birth canal, perineum and lower libs.
What are the effects of a caudal epidural block? Where is it administered?
A caudal epidural block is administered in the sacral canal affecting nerves S2-S4. This affects the visceral pain fibers from the uterine cervix and upper vagina, and somatic pain fibers of the pudendal nerve. Therefore the birth canal is anesthesized but the lower limbs are NOT affected. The uterine contracts are still perceived via the visceral pain fibers that ascend to the lwoer thoracic and upper lumbar spinal levels.
