29- Pelvic Viscera #1 & #2

Question 1

These muscular tubes are retroperitoneal organs. They are approximately 10” long and enter the pelvis minor by passing over the pelvic brim just anterior to the internal iliac vessels.

Answer 1

Ureters

Question 2

In the male, the _______ _______ crosses the ureters. While in the female, the _______ _______ crosses over the ureter.

Answer 2

Ductus Deferens

Uterine A.

Question 3

The ureters enter the wall of the ________ at its posterosuperior angle. In the male, this angle is immediately above the seminal vesicles and inferior to the ductus deferens.

Answer 3

Bladder

Question 4

The intramural portion of the ureters, in the wall of the urinary bladder, forms a one-way flap _______ tat prevents retrograde flow of urine.

Answer 4

Valve

Question 5

________ in the urethras moves urine from the kidneys to the bladder.

Answer 5

Peristalsis

Question 6

The ureters are abundantly supplied with neurons that detect pain. These pain fibers reach the spinal ganglia and spinal cord levels ________. Pain from the ureters is referred ipsilaterally to the _______ _______ _______ and _______.

Answer 6

T10-L2
Lower Abdominal Quadrant
Groin

Question 7

This sac is very distensible, containing three layers of smooth muscle in its walls. Its size, shape, position, and relationships vary with the amount of urine it contains.

Answer 7

Urinary Bladder

Question 8

The mucosa of the urinary bladder is very loosely attached, except at the neck of the bladder in an area known as the ________.

Answer 8

Trigone

Question 9

The sac of the urinary bladder is located in the anteroinferior part of the pelvis minor, below the peritoneum, resting on the pelvic diaphragm. As it fills, it ascends into the abdomen elevating its peritoneal covering with it. How could we obtain a urine sample because of this?

Answer 9

It’s possible to get a urine sample from a filled bladder by inserting a hypodermic needle just above the pubic symphysis in the midline (without entering abdominal cavity).

Question 10

In the male, the superior surface of the urinary bladder is covered by peritoneum and the base is posterior. The base is separated from the rectum by what?

Answer 10

Vas Deferens

Seminal Vesicles

Question 11

This is a peritoneal recess in males that partly separates the bladder from the rectum.

Answer 11

Rectovesical Pouch

Question 12

In males, the apex of the bladder is anterior while the neck is where it junctions with the _______ and rests upon the _______ _______.

Answer 12

Urethra

Prostate Gland

Question 13

In males, within the neck of the bladder there is an _______ _______ _______ composed of smooth muscle that guards the opening of the urethra called the _______ _______ _______. This prevents the retrograde flow of semen into the bladder during ejaculation.

Answer 13

Internal Urethral Sphincter
Internal Urethral Orifice

***Female bladder does NOT contain sphincter!

Question 14

In females, what lies posterior and superior to the bladder?

Answer 14

Superior = Body and Fundus of Uterus

Posterior = Vagina and Uterine Cervix

Question 15

In females, a peritoneal pouch called the ________ ________ is located between the superior surface of the bladder and the uterus.

Answer 15

Vesicouterine Pouch

Question 16

In females, the neck of the bladder is held in position by what ligaments?

Answer 16

Pubovesical Ligaments

Question 17

In males, the neck of the bladder is held in position by what ligaments?

Answer 17

Puboprostatic Ligaments

Question 18

The lateral surfaces of the bladder are surrounded by the vesical fascia, which contains the…

Answer 18

Vesical Venous Plexus

Question 19

In males, what is included in the trigone area of the bladder?

Answer 19

Internal Urethral Orifice

Two Ureteric Orifices

Question 20

What are the four parts of the male urethra?

Answer 20

1) Intramural portion in bladder wall
2) Prostatic urethra
3) Membranous urethra
4) Spongy (penile) urethra

Question 21

The male urethra has four parts and totals 6-8 inches in length. This part is common to both males and females and passes through the bladder wall.

Answer 21

Intramural Portion

Question 22

In males, the intramural portion contains what?

Answer 22

Internal Urethral Sphincter

Question 23

The second part of the male urethra is approximately 1 inch long and passes through the _______ _______.

Answer 23

Prostate Gland

***Called the Prostatic Urethra

Question 24

The Prostatic Urethra is the widest and most dilatable portion of the entire urethra. On the posterior wall is a longitudinal ridge called the _______ _______. On each side of this ridge is a groove called the _______ ______.

Answer 24

Urethral Crest

Prostatic Sinus

Question 25

What opens into the Prostatic Sinus?

Answer 25

Prostatic Glands

Question 26

The Prostatic Urethra is the widest and most dilatable portion of the entire urethra. On the posterior wall is a longitudinal ridge called the Urethral Crest. On the summit of the crest is a depression called the _______ _______, which is an analog of the uterus and vagina in females. On the edge of the mouth of this are openings of two ________ ________.

Answer 26

Prostatic Utricle | Ejaculatory Ducts

Question 27

The third part of the male urethra, Membranous Urethra, is 1 cm long and passes through the _______ _______ ______. Contained within this is the ________ _______ _______, a voluntary muscle that surrounds the Membranous Urethra and relaxes only during urination and ejaculation.

Answer 27

``` Muscular Urogenital (UG) Diaphragm External Urethral Sphincter ```

Question 28

The fourth part of the male urethra, Spongy (Penile) Urethra, passes through the bulb, body, and glans of the ________ ________. It then terminates at the ________ ________ ________.

Answer 28

Corpus Spongiosum | External Urethral Orifice

Question 29

The female urethra is approx. 1.5 inches in length and passes anteroinferiorly from the Internal Urethral Orifice (of the bladder) posterior to the pubic symphysis to the External Urethral Orifice. The External Urethral Orifice is located in the ________ of the Vagina, just anterior to the _______ _______.

Answer 29

Vestibule | Vaginal Orifice

Question 30

In females, there are bilateral _______ _______ located on either side of the urethra. These are homologs to the Prostate Gland in males. Their ducts open near the External Urethral Orifice.

Answer 30

Paraurethral Glands

Question 31

In females, the urethra is compressed by the External Urethral Sphincter, a voluntary muscle. This sphincter is located in the...

Answer 31

Urogenital Diaphragm ***Similar to males

Question 32

This is a thick-walled muscular tube that is the continuation of the epididymis.

Answer 32

Vas (Ductus) Deferens

Question 33

Describe the path that the Vas Deferens travel.

Answer 33

Ascends in Spermatic Cord then passes through the Inguinal Canal and stays in contact with Parietal Peritoneum as it approaches urinary bladder. It then crosses the Ureter to lie superior to the Seminal Vesicle.

Question 34

The medial portion of the Vas Deferens expands to form the ________ and ends by joining the duct of the ________ ________ to form the Ejaculatory Duct.

Answer 34

Ampulla | Seminal Vesicle

Question 35

These are glands made of coiled tubes approx. 6 inches long. They are located on the posterior surface of the bladder, between the Vas Deferens and Prostate Gland.

Answer 35

Seminal Vesicles

Question 36

The Seminal Vesicles are accessory sex glands that do not actually store sperm cells. They produce seminal fluid (pH > 7.0) which contains _________ and constitutes the majority of the semen.

Answer 36

Fructose

Question 37

These are formed by the union of the Vas Deferens and the duct of the Seminal Vesicle near the neck of the bladder.

Answer 37

Ejaculatory Ducts

Question 38

The Ejaculatory Ducts pass anteroinferiorly through the Prostate Gland to open on the _______ _______ in the Prostatic Urethra.

Answer 38

Seminal Colliculus

Question 39

This surrounds the Prostatic Urethra and is the largest accessory sex gland in the male. Normally the size of a walnut.

Answer 39

Prostate Gland

Question 40

The Prostate Gland is described as being _________. 2/3s is ________ tissue and 1/3 is _________ tissue.

Answer 40

Fibromuscular Glandular (Fibrous) Muscular

Question 41

For the Prostate Gland, the ________ lobe is fibrous, while the _______ and _______ lobes contain muscular tissue.

Answer 41

Anterior Right Left

Question 42

The prostatic secretion is a milky, ________ fluid (pH > 7.0) which comprises about 20% of semen. This helps to neutralize the acidic fluid produced by the female reproductive tract (vagina).

Answer 42

Alkaline

Question 43

________, a carbohydrate contained within prostatic fluid, provides an important source of energy to the sperm cells on their journey to hopefully fertilize an ovum.

Answer 43

Fructose

Question 44

The Prostate Gland is surrounded by a dense fascial sheath called the ________ ________ ________.

Answer 44

Visceral Pelvic Fascia

Question 45

Anterior to the Prostate Gland is the _______ _______ filled with fat, while posteriorly is the ampulla of the ________.

Answer 45

Retropubic Space | Rectum

Question 46

What lies laterally to the Prostate Gland?

Answer 46

Prostatic Venous Plexus

Question 47

Many older men experience an enlargement of the posterior middle portion of the prostate, which narrows the prostatic urethra. This is called...

Answer 47

Benign Prostatic Hyperplasia (BPH)

Question 48

How can we palpate for the prostate?

Answer 48

By digital rectal examination

Question 49

T/F. Approx. 50% of all cancer in the male population of the United States originate in the prostate gland. Metastatic cells from a malignant tumor of the prostate gland may spread via lymphatics or enter the prostatic venous plexus and travel to the spine, liver or lungs.

Answer 49

True

Question 50

These are a pair of pea-sized accessory sex glands located in the Urogenital Diaphragm just lateral to the Membranous Urethra.

Answer 50

Bulbourethral Glands

Question 51

The ducts of the Bulbourethral Glands pass through the perineal membrane to penetrate the bulb of the penis and open into the proximal part of the ________ _______. They produce a ________ secretion that is released just prior to ejaculation, for the purpose of lubricating the urethra.

Answer 51

Spongy Urethra | Mucous

Question 52

This organ is continuous with the Sigmoid Colon and is approx. 5" long. This portion of the GI tract begins at S3 and flows the concave curvature of the sacrum and coccyx.

Answer 52

Rectum

Question 53

The Rectum turns posteroinferiorly (80˚ flexure) to become continuous with the _______ ______, the terminal segment of the GI tract.

Answer 53

Anal Canal

Question 54

The upper 1/3 of the rectum is covered by ________, while the middle 1/3 is covered only on its anterior surface.

Answer 54

Peritoneum

Question 55

The _______ _______ (spaces on either side) permit the rectum to expand when it becomes distended with feces.

Answer 55

Pararectal Fossae

Question 56

There are three lateral flexures, called _______, _______, and ________. These flexures are formed in relation to three internal foldings.

Answer 56

Superior Intermediate Inferior

Question 57

The distal portion of the rectum is dilated forming its...

Answer 57

Ampulla

Question 58

This is a highly elastic, muscular tube in females that is 3-4" long. It descends anteroinferiorly from the uterine cervix to open into the vestibule of the vagina between the labia minor.

Answer 58

Vagina

Question 59

Superiorly, the vagina surrounds the cervix forming a vaginal recess that has what subdivisions?

Answer 59

Anterior Fornix Posterior Fornix 2 Lateral Fornices

Question 60

This is the deepest subdivision of the vagina and is related to the peritoneum forming the Rectouterine Pouch (pouch of Douglas).

Answer 60

Posterior Fornix

Question 61

What lies anterior and posterior to the vagina?

Answer 61

Anterior = Bladder and Urethra Posterior = Rectouterine Pouch, Rectum, and Anal Canal

Question 62

What is on either side of the vagina?

Answer 62

Levator Ani | Broad Ligaments of Uterus

Question 63

This is a pear-shaped, muscular organ that lies in the pelvis minor. Its body rests on top of the bladder, while its cervix is located between the bladder and rectum.

Answer 63

Uterus

Question 64

The ________ is the rounded upper portion of the uterus above the entrance of the uterine tubes.

Answer 64

Fundus

Question 65

The ________ of the uterus lies between the fundus and cervix.

Answer 65

Body

Question 66

The ________ and _______ comprise 2/3's of the uterus, while the ________ comprises the remaining 1/3.

Answer 66

Fundus Body Cervix

Question 67

The internal opening into the cervix is the _______ ______, and the opening in the cervix next to the vagina is the _______ _______. Between these openings is the _______ _______.

Answer 67

Internal Os External Os Cervical Canal

Question 68

What surrounds the External Os of the uterus?

Answer 68

Vaginal Fornix

Question 69

What are the 3 layers of the Uterus?

Answer 69

Endometrium Myometrium Perimetrium

Question 70

This layer of the Uterus is an outer serous coat of peritoneum.

Answer 70

Perimetrium

Question 71

This layer of the Uterus is the middle coat of smooth muscle.

Answer 71

Myometrium

Question 72

This layer of the Uterus is the inner mucous coat (its thickness varies with the various stages of the menstrual cycle).

Answer 72

Endometrium

Question 73

The anteroinferior (vesical) surface of the Uterus is related to the ________, while the posterosuperior surface is related to the ________. The right and left borders are associated with the _______ _______ of the Uterus.

Answer 73

Bladder Intestines Broad Ligaments

Question 74

The _______ _______ of the uterus extends from the side of the uterus to the deep inguinal ring, where it traverses the inguinal canal. It terminates in the subcutaneous CT of the labia majorum, after passing through the superficial inguinal ring.

Answer 74

Round Ligament

Question 75

This ligament extends from the cervix and lateral vaginal fornices to the lateral walls of the pelvis minor.

Answer 75

Transverse Cervical (Lateral Cervical) Ligaments

Question 76

This ligament passes from the sides of the cervix toward the sacrum. They lie between the peritoneum and the levator ani.

Answer 76

Uterosacral Ligament

Question 77

The _______ _______ extend from the sides of the Uterus to the lateral walls and floor of the Pelvis. They consist of two layers of peritoneum draped over the Uterine Tubes.

Answer 77

Broad Ligaments

Question 78

Contained within the double-layer of peritoneum making up the Broad Ligaments, are the...

Answer 78

Ligaments of the Ovary | Round Ligaments of the Uterus

Question 79

What are the parts of the Broad Ligaments?

Answer 79

Mesometrium Mesosalpinx Mesovarium

Question 80

The part of the Broad Ligament is attached to the Uterus.

Answer 80

Mesometrium

Question 81

This part of the Broad Ligament is associated with the Uterine Tubes.

Answer 81

Mesosalpinx

Question 82

This part of the Broad Ligament is associated with the ovary.

Answer 82

Mesovarium

Question 83

The Uterine (Fallopian) Tubes or Oviducts are muscular tubes 4-5" long and consist of what parts?

Answer 83

Infundibulum Ampulla Isthmus Uterine Part

Question 84

This part of the Fallopian Tubes is the funnel-shaped end that opens at the abdominal ostium.

Answer 84

Infundibulum

Question 85

This part of the Fallopian Tubes is the widest and longest.

Answer 85

Ampulla

Question 86

This part of the Fallopian Tubes is the short and thick-walled portion that joins the uterus.

Answer 86

Isthmus

Question 87

This part of the Fallopian Tubes is the intramural portion which opens at the uterine ostium.

Answer 87

Uterine Part

Question 88

These are the female, almond-shaped gonads located near the lateral wall of the pelvis minor in a recess called the ovarian fossa.

Answer 88

Ovaries

Question 89

Each ovary is located on the posterior side of the Broad Ligament. The ________ attaches the anterior border of the ovary to the posterior surface of the Broad Ligament.

Answer 89

Mesovarium

Question 90

This ligament attaches the medial portion of the ovary to the lateral angle of the uterus.

Answer 90

Ligament of the Ovary (Ovarian Ligament)

Question 91

This ligament is a thickening of CT that contains the ovarian vessels and nerves. It passes from the lateral wall of the pelvic cavity to the ovary.

Answer 91

Suspensory Ligament

Question 92

During child birth, structures below the _______ _______ _______ include the distal rectum, anal canal, uterine cervix, vagina, and bladder. These structures are anesthetized using epidural anesthesia.

Answer 92

Pelvic Pain Line

Question 93

Conduction of pain in organs above the Pelvic Pain Line follow ________ fibers retrograde, while pain in organs below the line follow ________ fibers retrograde.

Answer 93

Sympathetic | Parasympathetic

Question 94

There are several types of anesthesia used for childbirth. The _______ _______ is a popular choice for participatory childbirth. It is administered into the epidural space at the _______ vertebral level. The anesthetic agent bathes the spinal nerve roots, including pain fibers from the cervix, vagina, and Pudendal N. Pain from uterine body is still felt so the mother is aware of contractions.

Answer 94

Epidural Block | L3-L4

Question 95

Another anesthesia option is the _______ _______ _______, which provides anesthesia over the S2-S4 dermatomes (the majority of the perineum) and the inferior 1/4 of the vagina. It does not block pain from the superior birth canal, so the mother still feels contractions.

Answer 95

Pudendal Nerve Block