Anatomy Flashcards
(119 cards)
1
Q
What is contained within the pelvic cavity?
A
- ovaries
- uterine tubes
- uterus
- superior part of the vagina
2
Q
What separates the pelvic cavity and perineum?
A
- the pelvic floor
3
Q
What is contained within the perineum?
A
- inferior part of the vagina
- perineal muscles
- bartholin’s glands
- clitoris
- labia
4
Q
What is the female primary organ of reproduction?
A
- ovaries
5
Q
What is the peritoneum?
A
- floor of the peritoneal cavity
- roof of the pelvic cavity
6
Q
2 pouches formed by the peritoneum in females?
A
- recto-uterine
- vesico-uterine
7
Q
What are the 2 main ligaments associated with the uterus
A
- broad ligament
- round ligament
8
Q
Where is the round ligament found?
A
- proximal part is contained within the broad ligament
- passes through the pelvis
- through inguinal canal
- to the superficial fascial of the labia
9
Q
Where is the broad ligament found? and what is its role
A
- double layer of peritoneum over the uterine tube
- maintains uterus in the midline
10
Q
3 layers of the uterus?
A
- perimetrium
- myometrium
- endometrium
11
Q
How can the position of a normal uterus be explained anatomically?
A
- anteverted (relative to vagina)
- anteflexed (relative to cervix)
12
Q
What holds the uterus in place?
A
- strong ligaments
- endopelvic fascia
- muscles of the pelvic floor
13
Q
During a cervical screening cell samples from where are obtained?
A
- squamo-columnar
- transition zone
14
Q
Where does fertilisation normally occur?
A
- the ampulla of the uterine tubes
15
Q
What is a hysterosalpinogram?
A
- radiopaque dye to assess patency of the uterine tubes
16
Q
Where do the ovaries embryologically develop?
A
- posterior abdominal wall
17
Q
What aids the descent of the ovaries during embryological development?
A
- round ligament
18
Q
What is the function of the ovaries?
A
- secrete oesterogen (response to FSH)
- Secrete progesterone (response to LH)
19
Q
FSH role?
A
- oestrogen secretion from ovaries
- growth of ovarian follicles
20
Q
LH role?
A
- progesterone secretion from corpus callosum in ovaries
- ovulation
21
Q
The fornix of the vagina can be divided into what?
A
- anterior
- posterior
- 2xlateral
- pouches in vagina before cervix
22
Q
Where is the perineum located?
A
- between skin and pelvic diaphragm
23
Q
The perineum can be described as a diamond shape, what are the 2 divisions?
A
- urogenital triangle
- anal triangle
24
Q
What is the perineal body?
A
- composed of collagenous and elastic tissue
- important for pelvic floor strength
25
Where are Bartholin's glands located and their role?
- located in the perineum
| - secrete lubricating fluid
26
What is the main muscle that makes the pelvic floor?
- levator ani
| - composed of 3 smaller
27
Nerve supply to the levator ani?
- skeletal (voluntary)
- S3,4,5 (Sacral)
- S2,3,4 (Puedendal)
28
What is the name of the space deep to the breast tissue?
- retromammary space
29
4 quadrants of the female breast?
- upper outer
- upper inner
- Lower inner
- lower outer
30
Where does 75% of female breast lymph drain?
- axillary nodes -> subclavian node
31
Where might the inner quadrants of the female breast also have lymph drainage to?
- parasternal lymph nodes
32
Where might the lower inner quadrant of female breast also have lymph drainage to?
- abdominal lymph nodes
33
What level system is used in axillary clearance?
- in relation to pec minor
- level 1 = inferior and lateral to pec minor
- level 2 = deep to pec minor
- level 3 = superior and medial to pec minor
34
What is the blood supply to the female breast?
- internal thoracic (internal mammary) - branch of subclavian
- thoracic artery (branch of axillary)
- intercostal artery
35
What is the venous drainage of the female breast?
- follows arterial
- axillary vein
- internal thoracic vein
36
What are the 3 smaller muscles that make up the levator ani?
- puborectalis
- pubococcygeal
- ilococygeal
37
What is the pelvic floor?
- separates the pelvic cavity from perineum
38
3 major layers of the pelvic floor?
- pelvic diaphragm
- muscles of perineal pouches
- perineal membrane
39
What is the innermost layer of the pelvic floor
- pelvic diaphragm
40
what makes up the pelvic diaphragm?
- levator ani (puborectalis, pubococcygeus, iliococcygeus)
| - coccygeus
41
How is urinary continence maintained?
- external urethral sphincter
- compressor urethrae
- levator ani
42
How is faecal continence maintained?
- puborectalis
43
What lies immediately superior to the pelvic diaphragm?
- deep perineal pouch
44
What muscles are contained within the deep perineal pouch?
- external urethral sphincter
- compressor urethrae
- deep transverse perineal muscle (males)
- smooth muscle band (females)
45
What is the perineal membrane
- between deep and superficial perineal pouch
| - tough fascia
46
Where is the erectile tissue contained in the pelvic floor
- superficial perineal pouch
47
What is contained in the female superficial perineal pouch?
- clitoris and crura
- bulbs of vestibule
- bulbospongiosus
- ischiocavernosus
- greater vestibular gland (bartholins)
- superficial transverse perineal muscle
48
What is contained in the males superficial perineal pouch?
- bulb of penis
- crura
- bulbospongiosus
- ischiocavernosus
49
What is the perineal body
- point of muscle convergence
| - supports the pelvic floor
50
Name the layers of the pelvic floor deep to superficial?
- pelvic diaphragm
- deep perineal pouch
- perineal membrane
- superficial perineal pouch
- muscles of superficial perineal pouch
51
Urethrocele?
- herniation of the urethra
52
Cystocele?
- herniation of the bladder
53
Enterocele
- herniation of the rectouterine pouch
54
rectocele?
- herniation of rectum
55
The round ligament of the uterus is homologous to what in males?
- the vas deference
56
Name the main pelvic bones in the pelvic cavity?
- ilium
- pubis
- ischium
57
What passes through the obturator membrane?
- obturator neurovascular bundle
58
Majority of the arterial supply to the pelvic cavity is from branches of what artery?
- internal iliac artery
59
Gonadal artery is a branch of what?
- abdominal aorta
60
The superior rectal artery is a branch of what?
- inferior mesenteric
61
The internal iliac artery supplies most of the pelvic cavity. It can be further divided into what?
- anterior division
| - posterior division
62
The anterior division of the internal iliac artery mainly supplies what, compared to the posterior division
- anterior mainly supplies the visceral organs (ovary, bladder, uterus, rectum)
63
The posterior division of the internal iliac artery branches to what?
- gluteal arteries
64
The arterial supply to the perineum is mainly through what?
- internal pudendal artery
65
Describe the 2 important anastomosis of the female arterial pelvis supply?
- uterine and ovarian
| - uterine and vaginal
66
Where does the majority of pelvic blood venous drain?
- internal iliac vein
- Some via superior rectal -> hepatic portal
- some via lateral sacral -> internal vertebral venous plexus
67
The obturator nerve passes through the pelvic cavity but what___
- doesn't supply the pelvis
68
Majority of the nerve supply to the pelvis is from what nerve?
- sacral plexus (L4-S4)
69
Name the important divisions of the sacral plexus in regard to the pelvic cavity?
- sciatic (L4-S3)
- Pudendal (S2-4)
- Nerves to levator ani
- pelvic splanchnic (parasympathetic)
70
Parasympathetic nerve supply to the pelvis?
- pelvic splanchnic
71
Superior pelvic viscera has lymphatic drainage where?
- external iliac nodes -> common iliac -> aortic -> thoracic -> venous
72
Inferior pelvic viscera and the deep perineum has lymphatic drainage where?
- internal iliac nodes
73
Superficial perineum has lymphatic drainage where?
- superficial inguinal nodes
74
The ovaries and testes have lymphatic drainage where, and why is this?
- drain to the lumbar nodes
| - due to their embryological development
75
Functions of the bony pelvis?
- supports the upper body
- transference of weight
- attachment of muscles
- passage for childbirth
76
What is the bony pelvis composed of?
- 2 hip bones
- sacrum
- coccyx
77
What makes up the hip bones?
- ilium
- ischium
- pubis
78
What is the pelvic cavity?
- space continuous with abdominal cavity above
| - lies between pelvic inlet and pelvic floor
79
Where is the inguinal ligament?
- between the ASIS and pubic tubercle
80
Where are the ischial spines palpable?
- on vaginal palpation
| - at 4 and 8 o/clock
81
Name the 2 important ligaments of the bony pelvis and their role?
- sacrotuberous
- sacrospinous
- protection against weight transfer
- creates the greater and lesser sciatic foramen
82
Difference in male and female pelvis?
- AP and transverse diameter of female pelvis are larger than males
- the subpubic angle is wider in female
83
What is present on the foetus skull to help during childbirth?
- fontanelles
| - vertex is the area formed via the fontanelles
84
What is the station number?
- distance between the ischial spine and the foetus head
| - a negative number indicates no descent yet
85
Explain the turning of the foetus head during childbirth?
- pelvic inlet = foetal head transverse
- pelvic cavity = head rotated and flexed
- pelvic outlet = foetal head in occipitoanterior postion and in extension
86
Motor supply to pelvic organs?
- sympathetic or parasympathetic
87
Sensory supply to pelvic organs?
- visceral afferents
88
Motor supply to perineum?
- somatic motor
89
Sensory supply to perineum?
- somatic sensory
90
Motor supply to the pelvic floor?
- somatic motor
91
Sensory supply to the vagina?
- visceral afferents (pelvic)
| - somatic sensory (perineum)
92
Inferior hypogastric plexus is composed of what?
- sympathetic and parasympathetic fibres
93
Explain sensory supply to the superior aspects of the pelvic organs, touching peritoneum?
- visceral afferent
- run alongside sympathetic fibres
- t11-l2
- pain percieved suprapubic
94
Explain sensory supply to the inferior pelvic organs, not touching peritoneum?
- visceral afferents
- run along side parasympathetic
- s2, 3, 4
95
Which nerve supplies the perineum?
- pudendal
96
How is the level of L3/4 estimated?
- line drawn at the inter-crystal plane
97
Where is an epidural injected into to?
- epidural space
98
Name the layers a needle for a spinal anaesthetic passes?
- supraspinous ligament
- intraspinous ligament
- ligamentum flavum
- epidural space
- dura mater
- arachnoid mater
- subarachnoid space
99
Effect of a spinal anaesthetic?
- injected into CSF
- blockage of sympathetic fibres
- loss of sympathetic tone in lower limbs
- complication: hypotension
100
General sympathetic outflow levels?
- L1-T2
| - For pelvis T11-L2
101
Explain the route of the pudendal nerve?
- exits pelvis via greater sciatic foramen
- passes posterior to sacrospinous ligament
- re-enters pelvis via lesser sciatic foramen
- travels within pudendal canal
102
What is a episiotomy?
- planned incision to prevent tear at anal sphincter
- posterolateral
- sometimes (mediolateral)
103
How is the location for the pudendal nerve block found?
- vaginal palpation of ischial spines
| - medial to this bony landmark
104
What are the layers of the abdominal wall from superficial to deep?
- skin
- superficial fascia
- anterior rectus sheath
- rectus abdominis
- posterior rectus sheath
- external oblique
- internal oblique
- transversus abdominis
105
What direction do external oblique fibres run?
- run anterior inferior
| - hands in pocket
106
What forms the muscle aponeurosis on the anterior abdominal wall?
- the external oblique
- internal oblique
- transversus abdominis
107
Where do nerves and vessels lie in the abdominal wall?
- lie between internal oblique and transversus abdomens
108
What divides the rectus abdominis?
- tendinous intersections
109
Name of the midline fibrous line from the xiphoid process to pubic symphysis?
- linea alba
110
What lies immediately deep to the superficial fascia on the abdominal wall?
- rectus sheath
| - anterior (superior and inferiorly) and posterior (only found superiorly)
111
Where does the change in sheath formation occur and what is that change?
- occurs 1/3rd from the umbilicus and pubic crest
- superiorly there is an anterior and posterior rectus sheath
- inferiorly there is only an anterior rectus sheath
112
Nerve supply to the abdominal wall?
- subcostal
- iliohypogastric
- ilioinguinal
113
Blood supply to the anterior abdominal wall>>
- superior epigastric arteries
| - inferior epigastric arteries
114
Blood supply to the lateral abdominal wall?
- intercostal and subcostal arteries
115
Surface anatomy of pregnancy - what value changes with gestation?
- fundus-symphyseal height
116
Layers incised in a LSCS?
- Skin and fascia
- anterior rectus sheath
- rectus abdominis pulled apart
- fascia and peritoneum
- retract bladder
- uterine wall
- amniotic sac
117
What is the blood supply to the uterus?
- uterine arteries
| - branch of anterior division of internal iliac
118
Explain incisions in a laparoscopy?
- sub-umbilical
| - if a lateral port is required care to avoid inferior epigastric artery must be taken
119
Explain the route of the inferior epigastric artery?
- branch of external iliac artery
- emerges medial to deep inguinal ring
- passes superomedial direction
- forms superior border of inguinal triangle
