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MBBS II ERS > ERS anat > Flashcards

ERS anat Flashcards

1
Q

List the organs located in the true pelvic cavity? What supports the organs?

A 
Urinary bladder 
Rectum 
Anal canal 
Female and male reproductive organs 
Nerves, vessels and lymphatics

Pelvic Diaphragm (PD)

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2
Q

List the main general nerve, blood supply of true pelvic cavity?

A 
Nerve = hypogastric plexus 
Blood = internal iliac a.
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3
Q

Peritoneal position, shape and mucosal folds of the rectum?

A

Retroperitoneal

Ampulla = widest and most distendible

3 transverse folds = Valve of Houston: 1 on right, 2 on left

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4
Q

Muscle the maintains continence in the rectum?

A

Rectal sling = Puborectalis muscle

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5
Q

Structures anterior and posterior to rectum?

A

Anterior = Rectovesical pouch (male)/ Rectouterine pouch (female)

Posterior = Sacrum, sacral nerves, LN

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6
Q

Blood supply + veins of rectum (3)

A

Superior rectal artery (Inf. mesenteric a.)&raquo_space; Inferior mesenteric vein

Middle rectal artery (internal iliac a.)&raquo_space; Internal iliac v.

Inferior rectal artery (Internal pudendal a.)&raquo_space; Internal iliac vein

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7
Q

Lymph and nerve supply of rectum?

A

Lymph: Preaortic, Pararectal, Inferior mesenteric LN

Nerve: Inferior hypogastric plexus

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8
Q

Examination techniques of rectum?

A

Digital rectal exam
Proctosigmoidoscopy
Colonoscopy

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9
Q

Spread of rectal cancer routes (3)

A 
Posterior = sacral plexus (pain!)
Anterior = direct invasion, bladder, prostate, uterus/ vagina 
Lymph = to liver
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10
Q

Anal canal: Compare mucosa lining, blood supply and vein of Upper and Lower anal canal?

A

Upper:

  • Columnar epi.
  • Superior rectal a (inf. mesenteric a.)
  • Superior rectal vein (inf. mesenteric v.)

Lower:

  • Stratified squamous epi.
  • Inferior rectal a.(pudendal a.)
  • Inferior rectal v.(internal iliac v)
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11
Q

Anal canal: Upper and Lower parts’ Nerve and LN?

A

Upper anal:

  • Hypogastric plexus (ANS)
  • Pararectal nodes

Lower half:

  • Inf. rectal nerve (pudendal nerve, somatic)
  • Superficial inguinal nodes
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12
Q

Internal and External anal sphincter nerve supply + MUSCLE name ?

A

Internal = SPHINCTER ANI = circular smooth muscle
= Inf. hypogastric plexus

External = SPHINCTER ANI EXTERNUS
= Perineal branch of S4 nerve + Inferior rectal nerve (pudendal n.)

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13
Q

Clinical outcome of torn Pelvic diaphragm in female? Outcome of torn Urogenital Diaphragm

A

PD = Prolapse of pelvic visecrea through perineum

UD = urinary incontinence

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14
Q

3 parts of male urethra?

A

Prostatic urethra: most dilatable, ejaculatory duct

Membranous urethra: within Urogential diaphragm, sphincter = UD

Spongy urethra: longest, ends at Fossa Navicularis

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15
Q

Part of male urethra most prone to damage? Which part has bulbourethral gland?

A

Membranous urethra: most prone to damage: fixed and narrow

Urogenial diaphragm contains bulbourethal/ greater vestibular gland

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16
Q

Location of prostate and tissue type? Lobes?

A

Below bladder, Above perineal membrane

Fibromuscular connective tissue

5 lobes: 2 lateral, 1 posterior, 1 median, 1 anterior

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17
Q

Lobes of prostate prone to malignancy?

A

Posterior lobe = Malignancy, prostatic carcinoma (BATSON PLEXUS TO SPINE)

Median lobe = BPH

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18
Q

Secretion of Prostate? Lobes in relation of ejaculatory duct?

A

Citric acid
Acid phosphatase

Ejac. duct = between psoteiror and median lobes

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19
Q

Blood supply and vein + Lymph + nerve of prostate?

A

Blood supply: Inferior vesical a. + Middle rectal a.
Vein: Prostatic plexus > Interional iliac vein

Lymph: Internal iliac LN
Nerve: Inferior hypogastic plexus

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20
Q

Area below Pelvic diaphragm? Artery and nerve supply?

A

Perineum
= House external genitalia
Divided into superficial and deep perineal space/ pouches

Internal pudenal artery
Pudendal nerve

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21
Q

List the muscles of the pelvic diaphragm.

A

From medial to lateral:

1) Levator ani muscles:
- Puborectalis (rectal sling)
- Pubococcygeus
- Iliococygeus
2) Coccygeus muscle

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22
Q

Clinical significance of Coccygeus muscle? Nerve supply and action?

A

Detroyed perineal body/ PD = prolapse of bladder, uterus/ vagina, rectum

Nerve = Sacral nerves (4,5) + pudendal nerve

Action = Support pelvic viscera + sphincter for anarectal junction and vagina

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23
Q

4 parts of uterus and natural position?*

A

Fundus, Cornu, Body, Cervix

Anteverted + Anteflexed

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24
Q

Primary and secondary support for uterus?

A

Primary = PD + UD

Secondary:
1) Broad ligament = peritoneum fold, gives rise to mesosalphinx + mesovarium for fallopian tube + ovaries

2) Pelvic Fasciae Condensation: 
Connective tissue from pelvic wall and floor: 
- Uterosacral lig. 
- Pubocrvical lig. 
- Transverse cervical lig.
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25
Q

Blood supply + vein + LN + nerve supply of uterus.

A

Blood supply = Uterine a. (internal iliac a.)

Vein = Uterine venous plexus > internal iliac v.

LN: External and internal iliac + Sacral LN

Nerve = Inf. hypogastric plexus

26
Q

Position of uterine artery and Ureter? Clinical significance?

A

Uterine artery = ABOVE ureter

Hysterectomy = accidental ligation of ureter

27
Q

4 parts of fallopian tube + support?

A

Isthmus, ampulla, infundibulum, fimbriae

Broad ligament enclosing the tube

28
Q

Blood supply for Fallopian tube?

A

Ovarian and uterine arteries

29
Q

Clinical significance of Fallopian tube?

A

Common site for ectopic pregnancy

Pelvic inflammatory disease

30
Q

3 supports for Ovaries + LN + nerve supply?

A 
Mesovarium from broad ligament 
Suspensory ligament (w/ vessels) 
Proper Ligament of Ovary (from uterine body)

LN = Paraaortic LN

Nerve = Aortic plexus

31
Q

Blood supply of ovaries.

A

Artery = Ovarian + Uterine arteries

Vein:

  • Left ovary = Left renal
  • Right ovary = IVC
32
Q

Explain the referred pain from ovary disease.

A

Ovary close to Obturator nerve

Referred pain to medial thigh and knee

33
Q

Name of 2 spaces in vagina + list supports.

A

2 spaces = Anterior + posterior Fornix

Upper = PD + Pelvic viscera 
Middle = UD 
Lower = Perineal body
34
Q

Blood supply + vein for vagina.

A 
Upper = Uterine + Internal iliac 
Middle = Middle rectal 
Lower = Internal pudendal arteries

Vaginal venous plexus > Internal iliac vein

35
Q

LN and nerve for Vagina.

A

LN:

  • Upper + middle = Internal and External iliac LN
  • Lower = Internal iliac LN + Superficial inguinal LN

Nerve:
Upper = Uterovaginal plexus (Inf. Hypogastric plexus)
Lower = Pudendal Nerve

36
Q

Nerve supply of vagina.

A 
Upper = uterovaginal plexus 
Lower = pudendal nerve
37
Q

Explain the spread of bacteria causing PID from the vagina.

A

Posterior fornix = close to uterine pouch

If superior wall is punctures during D&C procedure, bacteria spread through to pelvic cavity and peritoneum

38
Q

What divides the perineum into 2 triangles?

A

Line across Ischial tuberosity

Divide into Anal and Urogenital triangles

39
Q

Content of anal triangle?

A

Anal canal
Ischiorectal fossa
Anoccocygeal body/ ligament

40
Q

Location and clinical significance of ischiorectal fossa?

A

Lateral to anal canal

Adipose tissue with poor B/V supply = prone to infection + abscess

41
Q

Content of ischiorectal fossa?

A

Internal pudendal vessels
Pudendal nerve
External anal sphincter
External anal venous plexus

42
Q

Male urogenital triangle divisions?

A

Deep perineal pouch = Urogenital diaphragm (muscles)

Superficial perineal pouch = below UD = external genitalia

43
Q

Content of Deep perineal pouch in male urogenital triangle? Boundaries?

A

Superficial and inferior fascia of UD

Content: MBDISD
Membranous urethra 
Bulbourethral glands 
Internal pudendal vessels
Dorsal nerves of penis 
Deep transverse perineal muscle 
Sphincter urethrae
44
Q

2 layers of the superficial perineal pouch of male urogenital triangle?

A

Fatty layer: Dartos muscle (scrotum) from Campers fascia (abdomen)

Membranous layer: Colles’ fascia (scrotum) from Scarpa’s fascia (abdomen)

45
Q

Content of superficial perineal pouch of male urogenital triangle?

A

Bulbospongiosus + Ischiocavernosus muscles

Superficial transverse perineal muscle

Deep perineal branch of pudendal nerve + Internal pudendal vessels

46
Q

2 parts of the penis?

A
  • Root = Crura and bulb
  • Body

Crura (lateral)&raquo_space; 2 corpus cavernosum

Bulb (medial, attached to UD)&raquo_space; corpus spongiosum + glan penis

47
Q

Blood supply of penis?

A

Internal Pudendal artery: branches:

  • Deep artery = corpus cavernosum
  • Dorsal artery = corpus cavernosum, skin
  • Artery to bulb of penis = erectile tissue + bulbourethral gland)
  • Urethral artery = spongy urethra

(+Inferior rectal a. + Perineal a.)

48
Q

Vein drain of penis

A

Internal Pudendal vein > internal iliac vein

Deep dorsal vein&raquo_space; prostatic plexus

Superficial dorsal vein&raquo_space; Femoral vein

49
Q

Lymphatics of penis

A

Scrotum + superficial penis&raquo_space; superficial inguinal nodes

Deep penis&raquo_space; internal iliac nodes + deep inguinal LN

50
Q

Nerve supply of penis?

A

Pudendal nerve S2-S4

Branches:
Inferior rectal n. + Perineal n. + Dorsal nerve of penis

51
Q

List all parts of the female external genitalia

A

Libia majora + Minora

Mons pubis

Vesticular fossa

Clitoris ( crura = 2x corpus cavernosa + body = glans)

Vaginal orifice + hymen

52
Q

Content of the deep perineal pouch of female urogenital triangle?

A

Same as Male DPP:
Urethra, Sphincter urethrae, Internal pudendal vessels, Deep transverse perineal muscle

Different:
Paraurethral glands + greater vestibular glands
Dorsal nerve of clitoris

53
Q

Content of superficial perineal pouch in female urogenital triangle?

A

Bulbospongiosus + Ischiocavernosus
Superficial transverse perineal muscle

Clitoris
Greater vestibular gland
Bulb of vestible
Perineal nerve + internal pudenal vessels

54
Q

Muscles attached to perineal body in female?

A

External anal sphincter + superficial transverse perineal muscle + bulbospongiosum

55
Q

Blood supply of female superficial perineal pouch?

A

Internal Pudendal artery

Branches: 
Posterior labial 
Deep artery of clitoris 
Dorsal artery of clitoris 
Perinal a. 
Urethral a. 
Artery of Bulb of vestibule
56
Q

Vein drain of female SPP? LN drain?

A

Internal pudendal > internal iliac vein

Superficial inguinal LN

57
Q

Nerve supply of female SPP?

A

Pudendal nerve

Branches:
Inferior rectal, perineal, Dorsal nerve of clitoris

58
Q

4 causes of hemorrhoids?

A

Chronic constipation
Portal hypertension
Rectal tumour
Pregnancy

59
Q

Rupture of membranous urethra clinical sequaelae?

A

Urine leaks into SPP

Penile superficial fascia is continuous with abdomin fascia&raquo_space;> urine to anterior abdominal wall

60
Q

Tract ducts of breast?

A

15-20 lobes separated by fibrous septa/ suspensory ligament > lactiferous duct > ampulla > nipple

61
Q

Blood supply for breasts?

A 
Axillary artery 
\+ internal thoracic artery 
\+ Intercostal artery 
\+ Lateral thoracic a. 
\+ thoracoacromial a.
62
Q

LN drainage of breast?

A

Medial quadrant = Internal mammary chain/ Internal thoracic LN

Lateral quadrant = Anterior Axillary LN > Central LN > Apical LN > Subclavian trunk > thoracic duct/ Right lymphatic duct

MBBS II ERS (37 decks)

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