Repro - pelvic anatomy + perneum Flashcards

1
Q

What features make up the superior pelvic aperture?

A

Pelvic inlet

Pelvic brim

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2
Q

What constitutes the true pelvis?

A

Lesser pelvis - the “bowl”

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3
Q

What constitutes the false pelvis?

A

The wings of the pelvis (greater pelvis)

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4
Q

How does the pelvic inlet differ in men/women?

A

Male - heart shaped

Female - oval + rounded

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5
Q

What are the subpubic angles of the different sexes?

A

Female - greater than 90 degrees

Male - less than 90 degrees

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6
Q

How do the greater/lesser pelvises differ in the sexes?

A

Female - greater pelvis is shallow
Lesser pelvis wide + shallow

Males greater pelvis is deep
Lesser pelvis is narrow and deep

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7
Q

What is the shape of the obturator foramen in the sexes?

A

Male - round

Female - oval

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8
Q

Which muscle occupies the lateral pelvic wall?

A

Obturator internus

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9
Q

Which muscle is present in the posterior wall of the pelvis?

A

Piriforis

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10
Q

What are the pernieal/anococcygeal bodies?

A

Two fibrous joinings of muscles in midline

Found either side of the anus

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11
Q

What muscles form the pelvic floor?

A

Coccygeus

Levator ani

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12
Q

What are two functions of the pelvic floor

A

Continence

Supports load of viscera

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13
Q

What is the innervation of the pelvic floor?

A

Pudenal nerve

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14
Q

What is a cystoceole?

A

Where bladder buldges into vagina “prolapsed bladder”

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15
Q

What is a rectocoele?

A

Wall of rectum bulding into vagina

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16
Q

Why is the perineal body often damaged in childbirth?

A

Weakest point, so first to tear

Problem because mainly avascular so slow to heal

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17
Q

How does an epiotomy minimise long term damage?

A

Stops tearing in central midline, and redirects into the mediolateral plain if needed,
This is more muscular and vascular so heals better

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18
Q

What structures can you feel in men/women in a rectal exam?

A

Female - rectouterine pouch (pouch of douglas)

Male - prostate

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19
Q

What ateries of the pelvis arise from the internal iliac artery?

A
Superior/inferior vesical arteries
Uterine arteries
Middle + inferior iliac arteries
Vaginal artery (along with branch from uterine artery)
Internal pudenal artery
Obturator artery
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20
Q

Where do the vesical arteries arise from?

A

Internal iliac

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21
Q

Where does the uterine artery arise from?

A

Internal iliac artery

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22
Q

Where do the gondal arteries arise from?

A

Aorta

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23
Q

Where do the superior recotal arteries arise from?

A

Inferior mesenteric artery

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24
Q

Where do the inferior/middle rectal arteries arise from?

A

internal iliac

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25
Q

Where do the vaginal arteries arise from?

A

Uterine artery

Internal iliac

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26
Q

Where does the pudenal artery arise from?

A

Internal iliac artery

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27
Q

Where do the obturator arteries arise from?

A

Internal iliac artery

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28
Q

What do the vesical arteries supply?

A

Bladder
Seminal gland
Prostate in amles
Ureter

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29
Q

What do the uterine arteries supply?

A

Uterus

Ureter

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30
Q

What do the gonadal arteries supply?

A

Testis/ovaries

Branches leading to - ureter, uteric tube (fallopian)

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31
Q

What do the rectal arteries supply?

A

Rectum

Middle/inferior - anal canal

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32
Q

What do the vaginal arteries supply?

A

Vagina

Base of bladder

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33
Q

What does the internal pudenal supply?

A

Pernieum + external genitalia

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34
Q

What does the obturator artery supply?

A

Adducts of medial thigh

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35
Q

What veins drain the pelvic region?

A
Internal iliac
Superior rectal
Median sacral
Gonadal
Internal vertebral venous plexus
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36
Q

What parts of the rectum drain into the portal circulation?

A

Superior

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37
Q

What parts of the systemic circulation?

A

Middle/inferior

38
Q

What is the significance of the rectum draining into the portal circulation?

A

Haemorrhoids + portacava anastomosis

39
Q

With which venous plexus does the prostatic venous plexus communicate on its posterior side?

A

Vesical plexus

40
Q

Where does the ilioinguinal nerve originate from?

A

L1

41
Q

Where does the ilioinguinal nerve supply? How does it get there?

A

Root of penis/labia (male/female)

Enters through inguinal canal

42
Q

How does the ilioninguinal nerve enter the inguinal canal?

A

Through the superficial inguinal ring

43
Q

How does the genitofemoral nerve enter the inguinal canal?

A

Deep inguinal ring

44
Q

What is the origin of the genitofemoral nerve?

A

L1/2

45
Q

What does the genitofemoral nerve supply in males?

A

Cremaster muscle

Scrotal skin

46
Q

What is the function o the cremaster muscle?

A

Part of the cremaster reflex

Pulls testis into scrotum

47
Q

From what segemental levels does the pudenal nerve originate?

A

S2-4

48
Q

What does the pudenal nerve innervate?

A

Innervates skin + muscles of perneum

49
Q

What bony landmark does the pudenal nerve cross (palpable transvaginally)?

A

Ischial spine

50
Q

What nerve is blocked in childbirth for pain relief (especially in instrumental birth)?

A

Pudenal nerve

51
Q

What sympathetic fibres form the hypogastric plexus?

A

L1/2

52
Q

What does the hypogastric plexus supply?

A
Sympathetic
Vas deferens
Seminal vesicles
Prostate
Epididymis
Parasympathetic
Errectile tissues (both male and female ) S2-4
53
Q

What nerve plexus supplies the female genital tract?

A

Pelvic + ovarian plexuses + Pelvic splanchnic nerves

S2-4

54
Q

Why are some men unable to ejaculate after rectal surger?

A

Hypogastric plexus nerves damaged

55
Q

What are the lymph nodes that drain teh pelvis area?

A

External + internal iliac nodes
Sacral lymph nodes
Common iliac lymph nodes

56
Q

What do the external iliac lymph nodes drain?

A
Belwo umbilicus
Adductor region of thigh
Fundus of bladder
Male - penis/prostate
Female - Clitorus/cervix/upper vagina
57
Q

What do the internal iliac lymph nodes drain?

A

Gluteal region
Deep perineum
Inferior pelvic viscera

58
Q

What do the sacral lymph nodes drain?

A

Rectum

Posterior wall of pelvis

59
Q

What do the common iliac lymph nodes drain?

A

Drains external, internal iliac nodes + sacral lymph nodes

60
Q

Where is the perineum located?

A

Inferior to pelvic diaphragm

Most inferior part of the trunk

61
Q

What is found in the perneum?

A

Both - perineal muscles
Anal canal
External genitalia (EG)

Male EG consists of urethra, scrotum + penis

62
Q

What are the two perineal triangles?

A

Urogenital

Anal

63
Q

Which triangle is inferior to the pubic symphsys?

A

Urogenital triangle

64
Q

Which triangle is anteroingerior to the cocyx?

A

Anal triagnle

65
Q

What is the perineal membrane?

A

A thin sheet of fascia strecthing from right/left sides of pubic arch
Below pubic symphysis

66
Q

What is the innervation of the external anal sphincter?

A

Pudenal nerve

67
Q

What is the action of the external anal sphincter?

A

Continence

68
Q

What is the innervation of the bulbospongiosus?

A

Pudenal nerve (muscular branch)

69
Q

What is the action of the bulbospongiosuis

A

Empties male urethra

70
Q

What is the innervation of the isciocavernosus?

A

Muscular branch of pudenal nerve

71
Q

What is the action of the isciocavernosus?

A

Retards venous drainage + maintains errection of penis/clitorus

72
Q

What is the innervation of the superficial transverse perineal muscle?

A

Muscular branch of pudenal nerve

73
Q

What is the action of the superficial transverse pernieal muscle?

A

Strengthens midline tendon of perneum

74
Q

What is the innervation of the deep transverse perineal muscle?

A

Pudenal nerve muscular branch

75
Q

What is the action of the deep transverse perineal muscle?

A

Supports pelvic organs

76
Q

What is the innervation of the external urethral sphincter?

A

Pudenal nerve muscular branch

77
Q

What is the action of the external urethral sphincter?

A

Compresses urethra to maintian urinary contience

78
Q

What muscles converge towards the perineal body?

A

Levator ani
Transverse perineal muscles (duperficial + deep)
Bulbospongiousus
External anal/urethral sphincters

79
Q

What are the superficial/seep perineal pouches?

A

Potential spaces transversed by the urehtra

Limited by fascia

80
Q

What is the significance of the perineal pouches?

A

Can become infiltrated by urine following a traumatic event or surgical injury

81
Q

Where is the external urethral sphincter found?

A

Deep perineal space

82
Q

Where is the internal urethral sphincter found?

A

Subperitoneal sphincter

83
Q

Which spincters is voluntary, which involunatry?

A

External - volunatry

Internal - involuntary

84
Q

Where is the superficial pouch found?

A

Anteroinferior to urogenital membrane

It surrounds external geniltalia

85
Q

Where is teh deep perineal pouch found?

A

Surrounding the deep transverse perineal muscle

86
Q

What are the three parts of the male urethra?

A

Prostatic
Spongey (penile)
Membranous
(some state preprostatic as a fourth)

87
Q

What is the widest part of the male urethra?

A

Prostatic urethra

88
Q

What is the narrowest part of the male urethra?

A

Membranous, as surrounded by sphincter

89
Q

What is the function of the ischioanal canal?

A

Allowing anal cnaal to expand during defaecation

90
Q

What does the ischioanal canal contain?

A

Mostly fat

Nuerovascular bundle containing pudenal nerve + internal pudenal artery/nerve

91
Q

Why is the ischioabanal fossa often a site of abscess formation?

A

Due to its relation to the anal canal

92
Q

What does the inernal pudenal artery suply?

A

Perineal muscles

Sensory - perineum + genitalia