Anatomy

Question 1

In what spermatic vein is varicocele more common?

Answer 1

Left as it drains into the left renal vein at a 90deg angle

Question 2

What drains into the para-aortic lymph nodes?

Answer 2

Ovaries/testes/ fundus of uterus

Question 3

What drains into the external iliac nodes?

Answer 3

• Body of uterus
• Cervix
• Superior part of bladder

Question 4

What drains to the internal iliac nodes?

Answer 4

• Prostate
• Cervix
• Corpus cavernosum
• Proximal vagina

Question 5

What drains to the superficial inguinal nodes?

Answer 5

• Distal vagina
• Vulva
• Scrotum
• Distal anus

Question 6

Where does lymph from the clitoris and glans of the penis drain to?

Answer 6

Deep inguinal lymph nodes

Question 7

What is the venous plexus in the scrotum called?

Answer 7

Pampiniform plexus

Question 8

What does the infundibulopelvic (suspensory) ligament attach?

Answer 8

Ovaries to lateral pelvic wall

Question 9

What structures run with the infundibulopelvic (suspensory) ligament?

Answer 9

Ovarian vessels

Question 10

Ligation of the ovarian and uterine vessels during oopherectomy presents a risk to what structure?

Answer 10

Ureter

Question 11

What does the cardinal (transverse cervical) ligament connect?

Answer 11

Cervix to the side wall of the pelvis

Question 12

What structures are contained in the cardinal ligament?

Answer 12

Uterine vessels

Question 13

What does the round ligament connect?

Answer 13

Uterine horn to labia majora

Question 14

What is the round ligament a derivative of?

Answer 14

Gubernaculum

Question 15

What does the round ligament travel through?

Answer 15

Round inguinal canal

Question 16

What does the round ligament of the uterus travel above?

Answer 16

Artery of Sampson

Question 17

What does the Broad ligament connect?

Answer 17

• Uterus
• Fallopian tubes
• Ovaries
  All to pelvic side wall

Question 18

What ligament is contained inside the round ligament?

Answer 18

Round ligaments of the uterus

Question 19

What is the broad ligament made of?

Answer 19

Fold of peritoneum that comprises the mesosalpinx, mesometrium and mesovarium

Question 20

What does the ovarian ligament connect?

Answer 20

Medial pole of ovary to uterine horn

Question 21

What is the ovarian ligament a derivative of?

Answer 21

Gubernaculum

Question 22

What is adnexal torsion?

Answer 22

• Twisting of ovary and fallopian tube around infundibulopelvic ligament and ovarian ligament thus causing compression of ovarian vessels
• Associated with ovarian mass
• Presents w. acute pelvic pain, adnexal mass, N/V

Question 23

What are the different types of pelvic organ prolapse?

Answer 23

• Ant compartment prolapse - bladder (cystocele)
• Post compartment prolapse - rectum (rectocele) or SI (enterocele)
• Apical compartment prolapse - uterus, cervix, or vaginal vault

Question 24

What is pelvic organ prolapse?

Answer 24

Herniation of pelvic organs to or beyond the vaginal walls (ant, post) or apex

Question 25

What is pelvic organ prolapse associated with?

Answer 25

- Multiparity - Age - Obesity

Question 26

What are the symptoms of pelvic organ prolapse?

Answer 26

- Pelvic pressure - Tissue protrusion from vagina - Urinary frequency - Constipation - Sexual dysfunction

Question 27

What is a pelvic organ prolapse involving all 3 compartments called?

Answer 27

Uterine procidentia

Question 28

What are the nerves involved in expulsion of semen?

Answer 28

- Pelvic splanchnic nerves (S2-S4) (para) - Hypogastric nerve (T11-L2) (symp) - Pudendal nerve (somatic)

Question 29

How does sildenafil cause erections?

Answer 29

Blocks the degradative action of cGMP-specific phosphodiesterase type 5 (PDE5) on cyclic GMP - Increased cGMP

Question 30

What is the histology of the transformation zone?

Answer 30

Squamocolomnar junction - Ectocervix is stratified squamous - Endocervix is simple columnar

Question 31

What is the epithelium of the ovary characterised by?

Answer 31

Simple cuboidal epithelium (germinal epithelium covering surface of ovary)

Question 32

What can renal trauma present with?

Answer 32

- Bruising - Flank pain - Hematuria

Question 33

What can renal truama be due to?

Answer 33

Direct blows or lower rib fractures

Question 34

What are the symptoms/signs of bladder rupture?

Answer 34

- Hematuria - Suprapubic pain - Difficulty voiding - Increased BUN and creatinine (due to peritoneal absorption of urine)

Question 35

Where is the most common site for bladder wall rupture?

Answer 35

Superior bladder wall (dome) injury

Question 36

Where other than the dome is a common site of bladder injury? and what can it be caused by?

Answer 36

Anterior wall or neck injury | - Due to pelvic fracture -> perforation of bony spicules

Question 37

Where does urine accumulate in an anterior bladder injury?

Answer 37

Extraperitoneal urine accumulation | - Retropubic space

Question 38

What are the symptoms/signs of urethral injury?

Answer 38

- Blood at urethral meatus - Hematuria - Difficulty voiding

Question 39

What kind of injury may cause an anterior urethral injury?

Answer 39

Perineal saddle injury

Question 40

What can happen as a result of bulbar spongy urethra is disruptes as a result of ant urethral injury?

Answer 40

Scrotal hematoma

Question 41

Where may urine collect as a result of tearing Bucks fascia?

Answer 41

Perineal space

Question 42

What may cause posterior urethral injury?

Answer 42

Pelvic fracture

Question 43

Where can urine collect as a result of posterior urethral injury? and what is this due to?

Answer 43

- May cause disruption at bulbomembranous junction (weakest part) - > Urine leakage into retropubic space and high-riding prostate

Question 44

What lines the penis and testes?

Answer 44

Internal to external - Tunica albuginea (found in penis and testes) - Deep (Buck's) fascia (only penis) - Superficial (dartos) fascia (only penis)

Question 45

What do Sertoli cells produce?

Answer 45

- Inhibin B (inhibits FSH) - Androgen-binding protein (maintains local levels of T) - MIF - Converts T to E via aromatase

Question 46

What do tight junctions between adjacent Sertoli cells function as?

Answer 46

Blood-testis barrier - preventing gametes from immune attack

Question 47

What can cause a temperature rise in sertoli cells and what are the effects of this?

Answer 47

- Decreased sperm production - Decreased inhibin B - Increased temperature seen in varicocele and cryptorchidism

Question 48

What do the sertoli cells line?

Answer 48

The seminiferous tubules

Question 49

Where are Leydig cells found?

Answer 49

Adjacent to sertoli cells in the interstitium