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Pelvis, Perineum, + Lower Limb > 11/15 Pelvic Viscera > Flashcards

11/15 Pelvic Viscera Flashcards

1
Q

What does the pelvic viscera include?

A

Distal parts of the urinary system
Distal parts of the gastrointestinal tract
Reproductive system

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2
Q

What are the urinary system pelvic viscera?

A

Ureters, bladder, urethra

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3
Q

What do the ureters connect?

A

The kidneys to the urinary bladder

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4
Q

Are the ureters intraperitoneal or retroperitoneal?

A

Retroperitoneal in abdomen

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5
Q

Where are the ureters oriented in comparison to other structures (arteries, pelvis)?

A

At the bifurcation of the common iliac artery, pass over the pelvic brim, entering the lesser pelvis

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6
Q

After the ureters enter the lesser pelvis, how do they run?

A

along lateral wall, between the parietal pelvic peritoneum and internal iliac arteries

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7
Q

How do the ureters pass through the urinary bladder? What is contained in the ureters distally?

A

Pass obliquely through the urinary bladder
Connection is “flap valve”- one way valve

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8
Q

How does the pressure of the bladder affect the tissues?

A

The internal pressure from the filling of the bladder causes the intramural passage to collapse

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9
Q

How do the contractions of bladder musculature help?

A

act like a sphincter preventing the reflux of urine into the ureters when the bladder contracts

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10
Q

How does urine pass down the ureters?

A

via peristaltic contractions

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11
Q

How does the path of the female ureters differ from the males?

A

Female: Ureter passes medial to the origin of the uterine artery. At the ischial spine the ureter passes inferior to the uterine artery
Male: Ductus deferens passes between the ureter and peritoneum

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12
Q

What makes up the arterial supply of the ureters?

A

Ureteric branches are highly variable (common iliac a., internal iliac a., ovarian a.)
Ureteric branches form an anastomosis along the ureter
Uterine a./ inferior vesical a, supply terminal parts of the ureter

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13
Q

What is the venous supply of the ureters in comparison to the arterial supply?

A

Venous drainage parallels the arterial supply, draining to corresponding venous names

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14
Q

What is the urinary bladder and what is it like/made of?

A

Reservoir for urine
Hollow structure with muscular walls (detrusor muscle) and distensible.

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15
Q

What do the apex, fundus, body, and neck of the urinary bladder correspond with?

A

Apex-points toward superior edge of pubic symphysis.
Fundus- convex posterior wall
Body-area between the apex and the fundus
Neck- where fundus and inferolateral surfaces meet

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16
Q

What is the trigone of the urinary bladder?

A

area bounded by the ureteric orifices and internal urethral orifice

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17
Q

Where is the empty urinary bladder found in adults and infants/children?

A

Adults: lesser pelvis
Infants/Children: almost entirely in the abdomen, even when empty

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18
Q

What is the relationship between the urinary bladder and peritoneum? Where does the urinary bladder rest?

A

Inferior to the peritoneum, rests on pubic symphysis and prostate or vagina

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19
Q

What anchors the neck of the bladder?

A

lateral ligaments of the bladder and the tendinous arch of the pelvic fascia

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20
Q

What are the anterior urinary bladder supports in the male and female?

A

Male: Puboprostatic ligament
Female: Pubovesical ligament

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21
Q

What makes up the arterial supply of the urinary bladder?

A

Superior vesical a. - Anterosuperior part of bladder
Male: Inferior vesical a. - Fundus and neck of bladder
Female: Vaginal a. - Postero-inferior bladder
Obturator and inferior gluteal a.

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22
Q

What makes up the venous drainage of the urinary bladder?

A

Form a complicated plexus on its inferolateral surface and pass backwards in the lateral ligaments of the bladder to end in the internal iliac veins

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23
Q

Is this male or female? What are the structures?

A

Male
A: obturator artery
B: superior vesical arteries
C: inferior gluteal artery
D: inferior vesical artery* (male structure)

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24
Q

Is this male or female? What are the structures?

A

Female
A: obturator artery
B: superior vesical arteries
C: inferior gluteal artery
D: vaginal artery* (female structure)

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25
Q

What are the functions of the proximal male urethra?

A

Provides an exit for urine and semen

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26
Q

What are the divisions for the proximal male urethra?

A

Intramural- pre-prostatic
Prostatic
Membranous
Spongy

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27
Q

What are the sphincters for the proximal male urethra?

A

Internal urethral sphincter
External urethral sphincter

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28
Q

What are the divisions (left) and sphincters (right) of the proximal male urethra?

A

A: intramural
B: prostatic
C: membranous
D: spongy

E: internal urethral sphincter
F: external urethral sphincter

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29
Q

What is the female urethra like in comparison to the male?

A

Shorter (1/5 of the length)

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30
Q

What is the musculature of the female urethra?

A

musculature surrounding the internal urethral orifice of the female bladder has incomplete fibers that form an internal urethra sphincter (not able to see grossly)

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31
Q

Where is the external urethra sphincter in the female?

A

In the vestibule of the vagina

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32
Q

What is the rectum to the digestive tract?

A

Rectum is the pelvic portion of the digestive tract

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33
Q

Where does the rectum end?

A

Ends antero-inferior to the tip of coccyx

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34
Q

What artery supplies the anterosuperior part of the bladder?

A

Superior vesical artery

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35
Q

What artery supplies the fundus and neck of bladder in the male?

A

Inferior vesical artery

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36
Q

What supplies the postero-inferior bladder in the female?

A

Vaginal artery

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37
Q

What does the anorectal flexure do as part of the rectum? What muscle?

A

mechanism for fecal continence, maintained by tonus of puborectalis muscle

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38
Q

What does the ampulla of the rectum do?

A

Receives and holds fecal mass until expulsion
Ampulla needs to relax to accommodate the initial and subsequent arrival of fecal material.

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39
Q

What is the arterial supply of the rectum?

A

Superior rectal artery, middle rectal artery, inferior rectal artery

40
Q

What is the arterial supply of the proximal rectum?

A

Superior rectal artery

41
Q

What is the arterial supply of the middle and inferior rectum?

A

Middle rectal artery

42
Q

What is the arterial supply of the anorectal junction?

A

Inferior rectal artery

43
Q

What does the male pelvic viscera consist of?

A

Testes*
Epididymis*
Ductus deferens
Seminal glands
Ejaculatory ducts
Prostate
Bulbo-urethral glands

44
Q

Where does the ductus deferens begin, where does it travel, and where does it end?

A

Begins at the epididymis
Passes through the inguinal canal, enters the pelvis.
Ends by joining the duct of the seminal gland to form the ejaculatory duct.

45
Q

Where are the seminal glands? In comparison to prostate?

A

Between the bladder and rectum.
Oblique and superior to prostate gland

46
Q

What do the seminal glands do?

A

Secrete alkaline fluid with fructose and coagulating agent that mixes with sperm

47
Q

Largest accessory gland of the male reproductive system

A

Prostate

48
Q

What is the size of the prostate and what does it surround?

A

Size of a walnut
surrounds the prostatic urethra.

49
Q

Where is the prostate?

A

Just inferior to the neck of the bladder, a posterior surface that is related to the ampulla of the rectum, and inferolateral related to levator ani.

50
Q

What are the bulbourethral glands shaped like?

A

Two pea-size glands

51
Q

Where are the bulbourethral glands embedded?

A

Embedded within the external urethral
sphincter

52
Q

Where are the bulbourethral glands open?

A

Open in the proximal part of spongy urethra

53
Q

What do the bulbourethral glands have?

A

Mucus-like secretions

54
Q

Benign hypertrophy of the prostate is common after?

A

Middle age

55
Q

Hypertrophy of the prostate englargement projects into?

A

The urinary bladder

56
Q

What are some issues associated with an enlarged prostate?

A

Weak or slow urinary stream
Feeling of incomplete bladder emptying
Difficulty starting urination
Urgency to urinate
Increased frequency at night

57
Q

How is hypertrophy of the prostate diagnosed?

A

Digital rectal examination

58
Q

How can you fix hypertrophy of the prostate?

A

TURP, transurethral resection of prostate

59
Q

What are the female pelvic viscera?

A

Ovaries, uterine tubes, uterus (round ligament of uterus), vagina (fornices)

60
Q

What is the size and shape of the ovaries?

A

About the size and shape of an almond.

61
Q

What do the ovaries contain?

A

Site of oocyte development

62
Q

What are the ovaries suspended by?

A

Mesovarium

63
Q

What do neurovascular structures pass to and from the ovary via?

A

The suspensory ligament of the ovary

64
Q

What tethers the ovary to the uterus?

A

The ligament of the ovary

65
Q

Where do the uterine tubes lie?

A

In the mesosalpinx

66
Q

Where do the uterine tubes extend posterolaterally to and arch anterosuperiorly to?

A

extend posterolaterally to the lateral pelvic walls and arch anterosuperior to the ovaries

67
Q

What are the 4 divisible parts of the uterine tubes?

A

Infundibulum, ampulla, isthmus, uterine part (intramural)

68
Q

What is the pathway of an ovulated oocyte?

A

Expelled from the ovary
Free floats in the peritoneal cavity
Captured by fimbriae of uterine tube
Cilia propel oocyte to infundibulum, then ampulla of uterine tube

69
Q

If sperm are present, where does fertilization typically occur?

A

In the ampulla

70
Q

What is the uterus like? Walls, shape, density

A

Thick-walled, pear-shaped, hollow muscular organ

71
Q

What does the uterus do during childbirth?

A

Provides power for expulsion

72
Q

What are the two divisible main parts of the uterus?

A

Body of the uterus, cervix

73
Q

What does the body of the uterus encompass, what separates from cervix?

A

forms the superior 2/3 and includes the fundus.
Isthmus of the uterus separates the body from the cervix

74
Q

What is the cervix shaped like and what does it encompass?

A

cylindrical, narrow inferior 1/3 of the uterus

75
Q

What is the normal position of the uterus?

A

Anteverted and antiflexed

76
Q

What does the anteverted position of the uterus mean?

A

Tipped anterosuperiorly relative to vaginal axis

77
Q

What does the antiflexed position of the uterus mean?

A

Flexed anteriorly relative to cervix

78
Q

What is used to determine size and disposition of the uterus?

A

Bimanual palpation

79
Q

What is the vagina and what does it encompass?

A

Distensible musculomembranous tube
Extends from the vaginal part of cervix to vaginal orifice

80
Q

What are the functions of the vagina?

A

Canal for menstrual fluid
Inferior part of birth canal
Receives the penis and ejaculate during sexual intercourse

81
Q

What is the broad ligament of the uterus and where is it?

A

Double layer of peritoneum that extends from the sides of the uterus to the lateral walls of the pelvis

82
Q

What are the parts of the broad ligament of the uterus?

A

Mesovarium, mesosalpinx, mesometrium

83
Q

What are the ligaments of the female pelvic viscera?

A

Broad ligament, ligament of the ovary, round ligament of the uterus, suspensory ligament of the ovary, cardinal ligament, uterosacral ligaments

84
Q

What does the ligament of the ovary attach?

A

Attaches ovary to the uterus

85
Q

What does the round ligament of the uterus attach?

A

Attaches antero-inferiorly to uterotubal junction

86
Q

What does the suspensory ligament of the ovary carry?

A

neurovascular structures

87
Q

What does the cardinal ligament attach?

A

From lateral parts of fornix to lateral walls of pelvis
Uterine artery travels in this

88
Q

What does the uterosacral ligaments attach?

A

From side of cervix to sacrum

89
Q

What does the ovarian artery originate from?

A

The aorta

90
Q

What do the uterine and vaginal arteries arise from?

A

Internal iliac artery

91
Q

How do the arteries to the female viscera travel?

A

Run between layers of the broad ligament

92
Q

What is the etiology of cystocele, urethrocele, and urinary incontinence?

A

Damage to the pelvic floor during childbirth
Laceration of perineal muscles
Lesions of nerves supplying them
Rupture of fascial support of the vagina

93
Q

What happens to the bladder during cystocele, urethrocele, and urinary incontinence?

A

Bladder collapses onto the anterior vaginal wall

94
Q

What is cystocele?

A

Herniation of urinary bladder

95
Q

What is urethrocele?

A

Alterations in the placement, direction, or angle of the urethra

Pelvis, Perineum, + Lower Limb (12 decks)

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