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Repro / GU > SM_220-221b: Anatomy of the Pelvis and Perineum I and II > Flashcards

SM_220-221b: Anatomy of the Pelvis and Perineum I and II Flashcards

1
Q
A
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2
Q

___ is the diamond-shaped pelvic outlet

A

Perineum is the diamond-shaped pelvic outlet

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3
Q

Perineum is subdivided into the ____ and ____

A

Perineum is subdivided into the anterior urogenital triangle and posterior anal triangle

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4
Q

Perineum has superior boundary of ____ and lateral boundary of ____

A

Perineum has superior boundary of pelvic diaphragm and lateral boundary of obturator internus muscle

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5
Q

Urogenital diaphragm is ____ closing off the urogenital triangle

A

Urogenital diaphragm is two fascial layers closing off the urogenital triangle

  • Superior fascia of urogenital diaphragm
  • Inferior fascia (perineal membrane)
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6
Q

____ is deep to urogenital diaphragm

A

Pelvic diaphragm is deep to urogenital diaphragm

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7
Q

Describe perineum landmarks in midsagittal segment

A

Perineum landmarks in midsagittal segment

  • Male: UG diaphragm is always in line with pubic symphysis and perineal body in front of the rectum
  • Female: UG diaphragm and perineal body are in line with pubc symphysis
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8
Q

Pubovesicular ligmanent in the female is analogous to ___ in the male

A

Pubovesicular ligmanent in the female is analogous to puboprostatic ligament in the male

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9
Q

Muscles in the UG diaphragm are ____ and ____

A

Muscles in the UG diaphragm are external urethral sphincter and deep transverse perineal muscle

  • Bulbourethral gland in male is also within UG diaphragm
  • Greater vestibular gland in female is superficial to UG diaphragm
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10
Q

Deep pouch is ____, while the superficial pouch is ____

A

Deep pouch is interior of the UG diaphragm, while the superficial pouch is the scrotum or labia majora (superficial body wall)

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11
Q

Superficial pouch of Colle’s fascia is tightly attached to the ____ and ____

A

Superficial pouch of Colle’s fascia is tightly attached to the back edge of the UG diaphragm and perineal body and fascia lata of the thigh

  • Blood or urine in the superficial pouch can only pass upward into the body wall between the superficial and deep layers
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12
Q

Superficial pouch contains ____

A

Superficial pouch contains everything superficial to the UG diaphragm

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13
Q

Diaphragms from deep to superficial are ____ and ____

A

Diaphragms from deep to superficial are pelvic diaphragm and UG diaphragm

  • Pelvic diaphragm: levator ani (pubococccygeus, iliococcygeus), ischiococcygeus
  • UG diaphragm: superficial fascia and inferior fascia (perineal membrane)
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14
Q

Describe contents of the superficial pouch of the UG diaphragm

A

Contents of the superficial pouch of the UG diaphragm

  • Bulb and crura of penis, clitoris, vestibular bulb, and greater vestibular gland
  • Bulbospongiosus, ischiocavernosus, and superficial transverse perineal muscles in both sexes
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15
Q

___ is enlarging the birth canal for an anticipated difficult birth

A

Episiotomy is enlarging the birth canal for an anticipated difficult birth

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16
Q

Midline episiotomy involves cutting ____

A

Midline episiotomy involves cutting the central tendon of the perineum (and wall of vagina)

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17
Q

Mediolateral episiotomy involves cutting the ____

A

Mediolateral episiotomy involves cutting the UG diaphragm, bulbospongiosus, and superficial transverse perineal muscles

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18
Q

____ is somatic innervation (S2-4) for perineum body wall

A

Pudendal nerve is somatic innervation (S2-4) for perineum body wall

  • Perineum body wall: UG diaphragm, genitalia, external anal sphincter, and skin of perineum
  • Branches: inferior rectal branch, perineal, and dorsal nerve of penis
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19
Q

___ enter the superior hypogastric plexus, while ___ leave the S2-4 ventral rami

A

Lumbar splanchnics enter the superior hypogastric plexus, while pelvic splanchnics leave the S2-4 ventral rami

  • Visceral sensory neurons are in all autonomic nerves and plexuses
20
Q

___ exit with ventral roots T1-L2

A

Sympathetics exit with ventral roots T1-L2

21
Q

___ travels from sacral plexus to external anal sphincter and perineum

A

Pudendal nerve (S-4) travels from sacral plexus to external anal sphincter and perineum

22
Q

Describe nerve functions

A

Nerve functions

  • Somatic (sacral ventral rami): body wall (skin of perineum, UG and pelvic diaphragms, external anal sphincter, external genital organs)
  • Sympathetic (lumbar splanchnics): arteries, internal sphincters, ureters, and ductus deferens
  • Parasympathetic (pelvic splanchnics): bladder (micturition), rectum (defecation, peristalsis), and erection of penis / clitoris
23
Q

Pudendal nerve block anesthetizes ____

A

Pudendal nerve block anesthetizes UG diaphragm and perineum

24
Q

Sacral epidural nerve block anesthetizes ____

A

Sacral epidural nerve block anesthetizes UG diaphragm, perineum, and cervix

25
Q

____ nerve block is the anesthesia of choice for childbirth

A

Lumbar epidural nerve block via catheter is the anesthesia of choice for childbirth

  • Uterus has lower thoracic and lumbar spinal segments
26
Q

Sacral epidural block anesthetizes ____

A

Sacral epidural block anesthetizes cervix and all of vagina

  • S2, 3, and 4 via pelvic splanchnic nerves
  • Somatic innervation between pudendal nerve
27
Q

Describe branches of the internal iliac artery

A

Internal iliac artery branches

28
Q

Describe exceptions to an internal iliac artery source of blood

A

Exceptions to an internal iliac artery source of blood

  • Upper rectum: inferior mesenteric
  • Gonads: aorta, inferior vena cava, left renal vein
  • Dorsal veins of penis / clitoris go under the pubic symphysis to the pelvic plexus rather than following the pudendal canal route
29
Q

Describe the male system

A

Male system

30
Q

Describe erectile tissues of the penis

A

Erectile tissues of the penis

  • Left and right crus
  • Bulb
  • Corpus cavernosum
  • Corpus spongiosum
  • Glans penis
31
Q

____ muscle envelops each crus, while the ____ muscle envelops the bulb and proximal corpus spongiosum

A

Ischiocarvernosus muscle envelops each crus, while the bulbospongiosus muscle envelops the bulb and proximal corpus spongiosum

32
Q

Each crus continues as the ____, and the bulb continues as the ____

A

Each crus continues as the corpus cavernosum dorsally, and the bulb continues as the corpus spongiosum ventrally

33
Q

Describe innvervation of the perineum and external genital organs

A

Innvervation of the perineum and external genital organs

  • Deep artery of penis to corpus cavernosus
  • Artery to bulb
  • Dorsal nerve / artery / vein to penis clitoris
  • Perineal nerve
34
Q

Describe prostate enlargement

A

Prostate enlargement

  • Outer zone tumors usually cancerous
  • Inner zone (median lobe) tumors usually benign and very common
  • Effects similar to kidney stones except the bladder is also involved (diverticula and trabeculation of the muscular wall)
35
Q

Describe prostate surgery and pelvic nerves

A

Prostate surgery and pelvic nerves

  • Removal of the prostate can be done through the urethra, above public bone, or through the perineal body
  • If via perineal body, parasympathetics from the pelvic plexus to the penis can be cut, resulting in impotence
36
Q

Describe female external genitalia

A

Female external genitalia

  • Labia majora: folds of superficial body wall
  • Labia minora: flank vestibule (space of the glans with the clitoris and openings of the vagina, urethra, and greater vestibular glands)
37
Q

____ surrounds the vestibular bulb and greater vestibular gland

A

Bulbospongiosus muscle surrounds the vestibular bulb and greater vestibular gland

38
Q

Vagina is primarily ____

A

Vagina is primarily retroperitoneal

  • Has no glands and few sensory nerves
39
Q

Cervix and fundus are ____, while most of the body is ____

A

Cervix and fundus are retroperitoneal, while most of the body is peritonealized (in a mesentery)

40
Q

___ is the angle between vagina and uterus

A

Anteversion is the angle between vagina and uterus

41
Q

___ is the angle between the cervix and the body of the uterus

A

Anteflexion is the angle between the cervix and the body of the uterus

42
Q

____ is retroversion where the uterus is tipped backward in line with the vagina

A

Tipped uterus is retroversion where the uterus is tipped backward in line with the vagina

43
Q

Describe ligaments of uterus

A

Ligaments of uterus

44
Q

Describe the broad ligament of the uterus

A

Broad ligament of the uterus

  • Mesosalpyinx: upper part of broad ligament
  • Mesovarium: posterior extension of broad ligament
  • Mesometrium: broad ligament
45
Q

Ovarian artery of the aorta reaches ovary through ____

A

Ovarian artery of the aorta reaches ovary through suspensory ligament of the ovary (lateral part of broad ligament)

  • Uterine artery from internal iliac

Repro / GU (46 decks)

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