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Anatomy Flashcards

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1
Q

What muscle acts to divide the pelvis from the perineum?

A

The levator ani
Above - pelvis
Below - Perineum

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2
Q

What nerve fibres are found in the pelvis?

A

Sympathetic
Parasympathetic
Visceral Afferent

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3
Q

What nerve fibres are found in the perineum?

A

Somatic motor

Somatic Sensory

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4
Q

How is uterine cramping/contraction pain sensation carried?

A

Hormonally

para/sympathetic

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5
Q

The superior aspects of pelvic organs have visceral afferents which enter the spinal cord at what level?

A

T11-12

Felt as suprapubic pain

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6
Q

Where does visceral afferents from the inferior aspects of pelvic organs, enter the spinal cord?

A

S2, 3, 4

Felt as perineum pain

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7
Q

What three methods of anaesthesia are important in Obs/Gynae proceedures

A

Spinal
Epidural
Pudendal nerve block

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8
Q

At what spinal level does the subarachnoid space end?

A

S2

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9
Q

Where is spinal anaesthetic injected?

A

L3-4 region

Anaesthetises the cauda equina

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10
Q

List the structures that the needle passes through when giving a spinal anaesthetic?

A 
Supraspinous ligament
Interspinous ligament
Ligamentum flavum
Epidural space
Dura mater
Arachnoid mater
Finally reaches sub-arachnoid space
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11
Q

What physiological effect does spinal anaesthesia cause and what must you be aware of?

A

Vasodilation

Risk of hypotension

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12
Q

When is a pudendal nerve block used?

A

Episiotomy incision
Forceps use
Perineal stitching (post-op)

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13
Q

Where does the pudendal nerve exit the pelvis?

A

Greater sciatic foramen

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14
Q

What does the pudendal nerve pass posteriorly to?

A

The sacrospinous ligament

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15
Q

Where does the pudendal nerve re-enter the pelvis/perineum?

A

Lesser Sciatic Foramen

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16
Q

What components travel in the pudendal canal?

A

Pudendal nerve
Pudendal artery
Pudendal vein
(and the nerve to the obturator internus)

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17
Q

What can be used as a landmark for pudendal nerve blocks?

A

Ischial spine

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18
Q

What can occur if the pudendal nerve branches are stretched during labour?

A

Weakened pelvic floor muscles

Faecal incontinence

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19
Q

Where does the inguinal ligament attach?

A

Between the ASIS and the pubic tubercle

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20
Q

What type of joint is the pubic symphysis?

A

Secondary cartilaginous

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21
Q

When can you palpate the ischial spines?

A

On vaginal examination

Positions 4 and 8 o’clock

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22
Q

What two ligaments form the greater and lesser sciatic foraminae?

A

Sacrotuberous

Sacrospinous

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23
Q

What important vessels do we worry about when the pelvis suffers extreme trauma?

Study These Flashcards
A

Common iliac artery and vein

Sacral nerves plexus

24
Q

Define ‘moulding’

Study These Flashcards
A

This is the process where one bone moves over another to allow the head to pass through during labour
Fontanelles and sutures allow for this

25
What is the 'station' referring to/
This is the distance of the foetal head from the ischial spines. Negative numbers means head is above spines, positive means it's below the spines
26
When should the foetal head be lying transverse?
When it is at the pelvic inlet
27
When should the foetal head rotate and flex?
As it descends through the pelvic cavity
28
When should the foetal head be occipitoanterior?
At the pelvic outlet | Neck should be extended
29
What occurs once the head has been delivered?
Further rotation to allow for the shoulders to be delivered
30
List the layers f the anterolateral abdominal wall:
``` Skin Superficial fascia REctus sheath External oblique internal oblique Transversus Abdominus Rectus Abdominus ```
31
Where does the external oblique attach?
Lower parts of ribs 5-11 Iliac crest Pubic tubercle
32
What is the linea alba?
Midline aponeurosis - interdigitation of fibres
33
At what point does the muscle become aponeurosis/
Mid clavicular line
34
What ribs do the internal obliques attach to?
Ribs 10-12
35
What divides the segments of the rectus Abdominus?
Tendinous intersections
36
Where does the linea alba lie?
Runs from xiphoid process to pubic symphysis
37
What do the 7th-11th intercostal nerves become?
The thoracoabdominal nerves
38
What vessel supplies arterial blood to anterolateral abdominal wall?
Superior epigastric arteries (branch of internal thoracic) Inferior epigastric arteries (branch of external iliac)
39
What does the musculophrenic artery come off and what does it supply?
Branch of internal thoracic artery | Sits on diaphragm and sends smaller branches to supply diaphragm
40
What three layers are stitched after a Lower-segment caesarean section?
Uterine wall Rectus sheath Skin
41
Why are there increased risks of wound complications with a laparotomy?
Minimal blood supply to this region
42
Where are incisions made for a laparoscopic procedure?
Sub-umbilical (may be the only one) | Lateral port - must avoid inferior epigastric artery
43
Where does the inferior epigastric artery emerge?
Medial to the deep inguinal ring
44
Which type of inguinal hernia perforates hasselbach's triangle?
Direct
45
What must you watch for when performing a hysterectomy?
The ureter. | It lies inferior to the artery and will vermiculate when touched
46
What two ways can a hysterectomy be performed?
Vaginally | Abdominally
47
What are the three components of the pelvic floor?
Pelvic Diaphragm Muscles of the perineal pouches Perineal Membrane
48
The levator ani and coccygeus make up what?
Pelvic Diaphragm
49
List the three components of the levator ani
Puborectalis Pubococcygeus Iliococcygeus
50
What is contained in the deep perineal pouch (male and female)
``` Urethra Vagina/Bulbourethral glands Neurovascular bundle Ischioanal fat pads Smooth muscles ```
51
What is the name of the tough deep fascia which closes the urogenital triangle and provides support to the pelvic organs?
Perineal Membrane
52
Define vaginal prolapse:
Herniation of the urethra, bladder, rectum or rectouterine pouch through supporting fascia. Presents as lump in vaginal wall
53
Define uterine prolapse:
Descent of the uterus, graded in three stages.
54
What are some signs/symptoms of uterine prolapse?
Urinary incontinence Dragging sensation Feeling a lump
55
What is the term for the method of suturing the sacrospinous ligament to repair cervical descent?
Sacrospinous fixation | done vaginally
56
How is incontinence surgery approached?
Trans-obturator i.e. through the obturator canal
57
What arteries in the pelvic wall do NOT arise from the internal iliac artery?
Gonadal artery (arises from abdominal aorta) Superior Rectal Artery (arises from IMA)

Reproduction (19 decks)

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