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Anatomy Flashcards

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1
Q

What is meant by the perineum?

A

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

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2
Q

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

A

Rectum

Urethra

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3
Q

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

A

Urethra
Vagina
Rectum

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4
Q

What are the nerve roots of the pudendal nerve?

A

S2, S3 and S4

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5
Q

What types of nerve fibres doe the pudendal nerve contain?

A

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

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6
Q

Describe the route taken by sperm from production to fertilisation

A
  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
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7
Q

How is fluid from the pouch of Douglas drained?

A

Via a needle placed through the posterior fornix of the vagina

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8
Q

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

A

Broad ligament

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9
Q

What is a cystocele?

A

Hernial protrusion of the bladder into the vaginal wall

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10
Q

What is a rectocele?

A

Hernial protrusion of the rectum into the vaginal wall

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11
Q

What nerve supplies the levator ani muscle?

A

Nerve to levator ani

This comes from the S3, 4 and 5 sacral plexus

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12
Q

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

A

Perineal body

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13
Q

What ligaments are responsible for holding up the breast?

A

Suspensory ligaments

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14
Q

Where would you find the retromammary space?

A

Between the fascia and the breast

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15
Q

What muscles lie deep to the breast?

A

Pectoralis major

Serratus anterior

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16
Q

From what ribs do the bed of the breast extend?

A

Ribs 2 - 6

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17
Q

Where does most lymph from the breast drain?

A

Ipsilateral axillary lymph node and then to the supraclavicular nodes

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18
Q

Where might lymph from the lower inner breast quadrant drain?

A

Abdominal lymph nodes

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19
Q

Where does lymph from the upper limb drain?

A

Axillary lymph nodes

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20
Q

What is meant by level 1 axillary lymph nodes?

A

Inferior and lateral to pectoralis minor

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21
Q

What is meant by level 2 axillary lymph nodes?

A

Deep to pectoralis minor

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22
Q

What is meant by level 3 axillary lymph nodes?

A

Superior and medial to pectoralis minor

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23
Q

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

A

Gonadal artery

Superior rectal artery

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24
Q

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

A

Iliolumbar
Lateral sacral
Superior gluteal

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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) ```

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