LEC34: Pelvis, Perineum, and Female Reproductive Anatomy Flashcards

1
Q

openings in male pelvic diaphragm

A

urethral hiatus, anorectal hiatus

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2
Q

openings in female pelvic diaphragm

A

urethra, vagina, rectum

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3
Q

muscles of pelvic diaphragm

A

puborectalis, pubococcygeus, iliococcygeus, coccygeus (ischiococcygeus)

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4
Q

extremity muscles

A

muscles that move the lower extremity, but origins are outside pelvic diaphragm

obturator internus, piriformis

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5
Q

levator anai

A

muscles that elevate the anus; cover pelvic opening

puborectalis, pubococcygeus, iliococcygeus

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6
Q

clinical significance of women having wider gap between levator anai muscles

A

after birth, area becomes loose, more likely to have organs prolapse through this area

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7
Q

kegel

A

exercises women can do to tighten pelvic floor muscles

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8
Q

what does pelvic diaphragm support

A

organs: rectum, bladder, uterus

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9
Q

where is external anal sphincter

A

below pelvic diaphragm

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10
Q

muscles of anal sphincter

A

1) levator ani portion of pelvic diaphragm (SKELETAL)
2) external anal sphincter (SKELETAL)
3) internal anal sphincter (SMOOTH)

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11
Q

what innervates anal sphincter area

A

inferior rectal nerve, branch of pudendal n.

S2, 3, 4

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12
Q

what is the shape of the anal canal / why does this matter

A

banana shape- flexure from sigmoid colon > rectum

anything inserted into canal must be flexible, not too big for that area (i.e. re: abuse)

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13
Q

2 triangles inferior to pelvic bones

A

anal triangle of perineum, urogenital triangle of perineum

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14
Q

boundaries of anal triangle of perineum

A

point of coccyx, front of pubis, ischeal tuberosities (on side)

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15
Q

what structure is wider in females

A

urogenital triangle of perineum - can widen during childbirth

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16
Q

perineum meaning

A

“area around the newborn”

same name for men and women

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17
Q

what surrounds anal triangle

A

ischiorectal fossa, pocket filled with fat - can compress when vagina or anus expands, and is expendable

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18
Q

urogenital diaphragm (UGD)

A

aka deep perineal pouch

forms a shelf superficial to the pelvic diaphragm, has 2 layers of fascia

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19
Q

layers of fascia around UGD

A

superior and inferior (perineal) fascia layers

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20
Q

what does UGD’s fascia membrane contain

A

contains muscles of urogenital diaphragm in a pouch called deep perineal pouch

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21
Q

what is within deep perineal pouch

A

deep transverse perineal muscle
sphincter urethrae m (males)
sphincter urethrea m + spincter urethrovaginalis (females)

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22
Q

structures within male urogenital diaphragm/deep pouch

A

urethral sphincter, bulbourethral gland, deep transverse perineal muscle

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23
Q

what does bulbourethral gland contribute to

A

fluid of the ejaculate

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24
Q

shape of female bladder

A

flat top, except when very expanded, because uterus sits directly on top

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25
Q

urethra length in women vs. men

A

short in women, long in men

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26
Q

is cistitis more common in women or men

A

women because their urethra is so short, can get bacteria up tube very easily

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27
Q

cell type of bladder, importance

A

transitional epithelium

allows for massive distortion of shape of whole organ

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28
Q

why does bladder sometimes appear to be an abdominal organ, and is it?

A

transitional epithelium of bladder means bladder can change shape, go over pelvic brim, appear to go into abdominal area, although in reality it’s in peritoneum so isn’t an abdominal organ

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29
Q

can you work out your bladder muscles

A

no!

can train yourself to not react when full, but not skeletal, so not excercisable

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30
Q

can you work out pelvic floor muscles?

A

yes!

are skeletal muscles, so can work them out

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31
Q

sections of male urethra

A

1) preprostatic part
2) prostatic part- through the prostate
3) membranous part- through peritoneal membrane
4) spongy part- through penis

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32
Q

where do prostate fluids drain

A

prostatic sinuses, where prostatic utricle, opening of ejaculatory ducts are

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33
Q

sympathetic innervation of pelvic area

A

superior hypogastric plexus

comes from above

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34
Q

parasympathetic innervation of pelvic area

A

pelvics
go into inferior hypogastric plexus
> smooth muscle of pelvis, i.e. bladder, to propel things down the ureter

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35
Q

what controls erectile tissue

A

blood flow

controlled by autonomics of pelvic splanchnic nerves

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36
Q

prostatic plexus

A

cluster of nerves from inferior hypogastric plexus nerves; run on both sides of diaphragm, cluster around prostate
makes surgery difficult

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37
Q

glans

A

where fluid exits seminal vesicle

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38
Q

common ducts for urination and ejaculation

A

ejaculatory duct, prostatic urethra, membranous urethra, spongy (penile) urethra

39
Q

erectile tissue made of

A

corpus cavernosum, corpus spongiosum

40
Q

which erectile tissue is where urethra runs

A

corpus spongiosum

41
Q

why isn’t the clitoris a male penis

A

the urethra doesn’t pass through it

its erectile tissues do not enclose the urethra

42
Q

what structures do sperm pass through

A

testis, epididymis, prostate, passage through diaphragms, corpus spongiosum, glans

43
Q

what surrounds corpus cavernosum

A

tough fibrous coat

ensures tissue is extremely stiff when erect, penetration occurs

44
Q

why is it important corpus spongiosum is spongy

A

stays soft, even when erect, so can expand and allow ejaculate w/ sperm to travel through

45
Q

os penis

A

most mammals have penis made of bone; humans likely don’t because ability to become erect means good cardiovascular strength; evolutionarily helpful for mate-finding

46
Q

female erectile tissue function

A

stiffens the vaginal orifice

47
Q

female erectile bodies/locations

A

1) corpus cavernosum (body, glans, crus of clitoris)

2) corpus spongiosum (bulb of vestibule)

48
Q

greater vestibular glands function

A

lubricate vagina

49
Q

what stiffens vaginal orifice? bulb of vestibule function

A

bulb of vestibule

50
Q

clitoris body and glans homologous to

A

dorsal paired penis bodies

51
Q

bulbs of vestibule homologous to

A

bulb of penis, ventral body, glans

52
Q

where are erectile tissues located

A

superficial to UGD, in superficial pouch/perineal space

53
Q

what covers erectile tissues

A

skeletal muscles

54
Q

what covers crus of clitoris

A

ischiocavernous muscles

55
Q

what covers spongy tissue, bulb of penis?

A

bulbospongiosus musle

56
Q

skeletal muscles of superficial pouch

A

bulbospongiosus, ischiocavernosus, superficial transverse perineal

57
Q

what does superficial pouch contain?

A

scrotal contents, erectile tissues, skeletal muscle covers, an outer layer of fascia

58
Q

superficial pouch location re: UGD

A

below

59
Q

is urethra inside the clitoris?

A

no! separate. women do not pee out of their vagina.

60
Q

homologue to testis

A

ovaries

61
Q

homologue to gubenaculum

A

round ligament

62
Q

homologue to prostate

A

skene’s glands

63
Q

homologue to prostatic utricle

A

uterus

64
Q

homologue to bulbourethral glands

A

greater vestibular glands

65
Q

skene’s glands

A

aka female prostate
located between urethra and vagina
has ducts, glands; make fluid, “female ejaculation,” serves antimicrobial purpose to prevent intercourse-induced cystitis

66
Q

what is g-spot, why controversial

A

region of anterior vaginal wall

proposed to have increased sensitivity, but no anatomical data exists to support this

67
Q

homologue to body of penis

A

shaft of clitoris

68
Q

homologue to skin around scrotum

A

labium majus

69
Q

homologue to raphe of penis

A

urethral opening

70
Q

innervation of female external genitalia

A

perineal branch of pudendal nerve, inferior rectal nerve (around anus)

71
Q

blood supply to external female genitalia

A

perineal branches of internal pudendal artery, inferior rectal artery (around anus)

72
Q

bladder innervation

A

smooth m., so GVE fibers from lumbar splanchnics (sympathetic) and pelvic splanchnics (parasympathetic)

73
Q

pelvic, UGD diaphragms, superficial pouch innervation

A

skeletal m., so GSE fibers from pudendal & other sacral spinal nerves (S2-4)

74
Q

ovary innervation

A

GVA fibers; travel along ovarian artery to T10

75
Q

uterus, vagina innervation

A

GVE fibers from lumbar splanchnics (sympathetics), pelvic splanchnics (parasympathetics); GVA back travel along same path

76
Q

lymphatic drainage from ovaries goes where?

A

aortic lymph nodes

77
Q

where do ovarian (gonadal) arteries branch from?

A

directly from abdominal aorta

78
Q

which arteries are crucial to pregnancy?

A

abdominal aorta branch:ovarian a.,
internal iliac branches: uterine a., vaginal a., internal pudendal a.
all anastomose, support pregnancy

79
Q

size of uterus over lifetime

A

grows from birth > puberty > adult > menopause, regresses to size of before changes happened during puberty

80
Q

uterus position re: bladder?

A

uterus is in an anteverted position over bladder

81
Q

what facilitates vaginal walls’ stretch?

A

abundance of fat in anterior recess of ischiorectal fossa

82
Q

cardinal ligaments function, location

A

aka lateral cervical ligament/suspensory ligament
at base of broad ligament of the uterus
contains uterine artery, vein
attaches cervix to lateral pelvic wall by attachment to obturator fascia of obturator internus m.

83
Q

ligaments that support uterus, ovaries

A

round ligament (ligamentum teres), proper ovarian ligament, uterosacral fold, suspensory ligament of ovary (contains ovarian vessels)

84
Q

layers of broad ligament of uterus

A

covers uterus

1) mesometrium- around body of uterus
2) mesoalpinx- around tube
3) mesovarium- comes out toward us, where ovary is suspended

85
Q

what surrounds cervix

A

fornix; have 2 fornices (anterior, posterior)

back alley abortion with straight tool can penetrate posterior fornix, go into peritoneum

86
Q

what is cervical opening called

A

os

87
Q

what/where is opening of uterine tube?

A

os of uterine tube

in middle of fimbriae

88
Q

how do you ensure a woman can be fertilized, tubes aren’t closed?

A

introduce dye into uterus, it emerges from ostia of uterine tubes and enters peritoneum

89
Q

what happens during ovulation that causes pain?

A

parietal peritoneum tears > pain

90
Q

why can uterus expand for pregnancy?

A

transitional epithelium, smooth muscle

91
Q

where does a pregnant woman feel late appendicitis pain?

A

anywhere that her appendix has been pushed

92
Q

why do pregnant women need to pee so much and become constipated?

A

bladder becomes compressed, above public arch; rectum compressed also

93
Q

why so much pain during childbirth?

A

so many different nerve fibers in this area carry pain from all different surrounding structures
epidural anesthesia mitigates pain