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Flashcards in Anatomy Deck (64):
1

What is meant by the perineum?

A shallow space that lies between the levator ani and the perineal skin

2

What structures pass through the levator ani muscle in the male?

Rectum
Urethra

3

What structures pass through the levator ani muscle in the female?

Urethra
Vagina
Rectum

4

What are the nerve roots of the pudendal nerve?

S2, S3 and S4

5

What types of nerve fibres doe the pudendal nerve contain?

Somatic motor - to levator ani and perineal muscles
Somatic sensory - from the perineum
Symphathetic (as in all spinal nerves)

6

Describe the route taken by sperm from production to fertilisation

1. Seminiferous tubules
2. Rete testes
3. Epididymis
4. Vas deferens (travels in spermatic cord)
5. Ejaculatory duct
6. Prostatic urethra
7. Membranous urethra
8. Spongy urethra
9. External urethral meautus of penis

Then....
1. Vagina
2. Cervix
3. Uterine Tube

7

How is fluid from the pouch of Douglas drained?

Via a needle placed through the posterior fornix of the vagina

8

Name the structure formed by a double layer of peritoneum, extending between the uterus and the lateral pelvic walls and floor

Broad ligament

9

What is a cystocele?

Hernial protrusion of the bladder into the vaginal wall

10

What is a rectocele?

Hernial protrusion of the rectum into the vaginal wall

11

What nerve supplies the levator ani muscle?

Nerve to levator ani
This comes from the S3, 4 and 5 sacral plexus

12

What is the name give to the bunch of collagenous and elastic tissue into which the perineal muscles attach?

Perineal body

13

What ligaments are responsible for holding up the breast?

Suspensory ligaments

14

Where would you find the retromammary space?

Between the fascia and the breast

15

What muscles lie deep to the breast?

Pectoralis major
Serratus anterior

16

From what ribs do the bed of the breast extend?

Ribs 2 - 6

17

Where does most lymph from the breast drain?

Ipsilateral axillary lymph node and then to the supraclavicular nodes

18

Where might lymph from the lower inner breast quadrant drain?

Abdominal lymph nodes

19

Where does lymph from the upper limb drain?

Axillary lymph nodes

20

What is meant by level 1 axillary lymph nodes?

Inferior and lateral to pectoralis minor

21

What is meant by level 2 axillary lymph nodes?

Deep to pectoralis minor

22

What is meant by level 3 axillary lymph nodes?

Superior and medial to pectoralis minor

23

Which two arteries of the pelvis/perineum do not arise from the internal iliac artery?

Gonadal artery
Superior rectal artery

24

What three branches come off the posterior trunk of the internal iliac artery?

Iliolumbar
Lateral sacral
Superior gluteal

25

What does the internal iliac artery initially split into?

An anterior and posterior trunk

26

What does the superior gluteal artery supply?

Gluteus minimus

27

What branches come off the anterior branch of the the internal iliac artery

Umbilical (gives rise to the superior vesical)
Obturator
Inferior vesical (in women this is called the vaginal artery)
Middle rectal
Internal pudendal
Inferior gluteal
Uterine artery

28

Within what structure does the uterine artery run?

Broad ligament

29

Describe the course of the internal pudendal artery in the pelvis?

Arises from internal iliac artery
Exits through the greater sciatic foramen
Descends and then enters the perineal region via the lesser sciatic foramen

30

What happens to the umbilical artery?

After giving rise to the superior vesical artery the umbilical artery ends and becomes the median umbilical ligament.

31

Which 2 arteries does the uterine artery have an anastomosis with?

Ovarian
Vaginal

32

What is the main drainage vein for the pelvis?

Internal iliac vein

33

Where does the blood that goes into the superior rectal vein go?

hepatic portal system

34

What are the three possible veins that blood from the pelvis will drain into?

Mainly to internal iliac
Superior rectal (and then into hepatic portal system
Lateral sacral veins then into the internal vertebral venous plexus

35

Where do the ovarian arteries arise from?

The abdominal aorta just below the renal arteries

36

Where does the left ovarian vein drain into?

The left renal vein

37

Where does the right ovarian vein drain into?

Vena Cava

38

What structure does the ovarian artery travel in?

The suspensory ligament of the ovary

39

Where exactly does the uterine artery arise from?

the anterior division of the internal iliac artery

40

Within what structure does the uterine artery lie?

Base of the broad ligament

41

Does the uterine artery go under or over the ureter?

Over "Water under the bridge"

42

Which artery usually supplies the body of the uterus?

Uterine artery

43

Which artery tends to supply the fundus of the uterus?

Ovarian artery

44

Where do the ovarian arteries arise from?

Branch of the abdominal aorta (last paired branch) leave at L2 level

45

Which vaginal fornix is closely related to the pouch of Douglas?

Posterior

46

What is the name given to the part of the broad ligament that acts as a mesentery for the fallopian tube?

Mesosalpinx

47

Which part of the bladder is covered by peritoneum?

Superior aspect

48

Where is the site of lymph drainage for the rectum?

Sacral and Internal Iliac nodes

49

Where is the site of lymph drainage for the anal canal?

Internal iliac above the pectinate line
Below the pectinate line is perineum so drainage in to superficial inguinal

50

Where is the site of lymph drainage for the prostate gland?

Internal iliac

51

Where is the site of lymph drainage for the proximal urethra?

Internal iliac

52

Where is the site of lymph drainage for the penile urethra, clitoris and penis?

Superficial inguinal

53

Where is the site of lymph drainage for the uterine fundus, uterine tube and upper uterine body?

Para aortic

54

Where is the site of lymph drainage for the lower uterus, cervix and proximal vagina?

Internal and External Iliac
Sacral

55

Where is the site of lymph drainage for the distal vagina and vulva?

superficial inguinal

56

Which fornix of the vaginal is closely related to the ureter?

Lateral

57

What structures support eh cervix and upper vagina?

Uterosacral ligament
Transverse Cervical
Pubocervical

58

Which ligaments help to support the uterus is anteversion and anteflexion?

Broad ligament
Round ligament

59

What are the proximal and distal attachments of coccygeus?

Proximal: Ischial spine
Distal: Inferior end of sacrum and coccyx

60

What are the proximal and distal attachments of puborectalis?

Proximal: Body of pubis
Distal: Perineal body

61

What are the proximal and distal attachments of pubococygeus?

Proximal: Pubic bone, tendinous arch of obturator fascia
Distal: Vagina, perineal body, rectum and coccyx

62

What are the proximal and distal attachments of iliococcygeus?

Proximal: Ischial spine
Distal: Perineal body, coccyx

63

Which part of the levator ani is important in maintaing faecal continence?

Puborectalis

64

What is nerve supply to the lavator ani (and the nerve roots) ?

Nerve to levator ani (S4)
Pudendal nerve (S2, 3 and 4)