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Anatomy Flashcards

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?

A

Common iliac artery and vein

Sacral nerves plexus

24
Q

Define ‘moulding’

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
Q

What is the ‘station’ referring to/

A

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
Q

When should the foetal head be lying transverse?

A

When it is at the pelvic inlet

27
Q

When should the foetal head rotate and flex?

A

As it descends through the pelvic cavity

28
Q

When should the foetal head be occipitoanterior?

A

At the pelvic outlet

Neck should be extended

29
Q

What occurs once the head has been delivered?

A

Further rotation to allow for the shoulders to be delivered

30
Q

List the layers f the anterolateral abdominal wall:

A 
Skin
Superficial fascia
REctus sheath 
External oblique
internal oblique
Transversus Abdominus
Rectus Abdominus
31
Q

Where does the external oblique attach?

A

Lower parts of ribs 5-11
Iliac crest
Pubic tubercle

32
Q

What is the linea alba?

A

Midline aponeurosis - interdigitation of fibres

33
Q

At what point does the muscle become aponeurosis/

A

Mid clavicular line

34
Q

What ribs do the internal obliques attach to?

A

Ribs 10-12

35
Q

What divides the segments of the rectus Abdominus?

A

Tendinous intersections

36
Q

Where does the linea alba lie?

A

Runs from xiphoid process to pubic symphysis

37
Q

What do the 7th-11th intercostal nerves become?

A

The thoracoabdominal nerves

38
Q

What vessel supplies arterial blood to anterolateral abdominal wall?

A

Superior epigastric arteries
(branch of internal thoracic)
Inferior epigastric arteries (branch of external iliac)

39
Q

What does the musculophrenic artery come off and what does it supply?

A

Branch of internal thoracic artery

Sits on diaphragm and sends smaller branches to supply diaphragm

40
Q

What three layers are stitched after a Lower-segment caesarean section?

A

Uterine wall
Rectus sheath
Skin

41
Q

Why are there increased risks of wound complications with a laparotomy?

A

Minimal blood supply to this region

42
Q

Where are incisions made for a laparoscopic procedure?

A

Sub-umbilical (may be the only one)

Lateral port - must avoid inferior epigastric artery

43
Q

Where does the inferior epigastric artery emerge?

A

Medial to the deep inguinal ring

44
Q

Which type of inguinal hernia perforates hasselbach’s triangle?

A

Direct

45
Q

What must you watch for when performing a hysterectomy?

A

The ureter.

It lies inferior to the artery and will vermiculate when touched

46
Q

What two ways can a hysterectomy be performed?

A

Vaginally

Abdominally

47
Q

What are the three components of the pelvic floor?

A

Pelvic Diaphragm
Muscles of the perineal pouches
Perineal Membrane

48
Q

The levator ani and coccygeus make up what?

A

Pelvic Diaphragm

49
Q

List the three components of the levator ani

A

Puborectalis
Pubococcygeus
Iliococcygeus

50
Q

What is contained in the deep perineal pouch (male and female)

A 
Urethra
Vagina/Bulbourethral glands 
Neurovascular bundle 
Ischioanal fat pads
Smooth muscles
51
Q

What is the name of the tough deep fascia which closes the urogenital triangle and provides support to the pelvic organs?

A

Perineal Membrane

52
Q

Define vaginal prolapse:

A

Herniation of the urethra, bladder, rectum or rectouterine pouch through supporting fascia.
Presents as lump in vaginal wall

53
Q

Define uterine prolapse:

A

Descent of the uterus, graded in three stages.

54
Q

What are some signs/symptoms of uterine prolapse?

A

Urinary incontinence
Dragging sensation
Feeling a lump

55
Q

What is the term for the method of suturing the sacrospinous ligament to repair cervical descent?

A

Sacrospinous fixation

done vaginally

56
Q

How is incontinence surgery approached?

A

Trans-obturator i.e. through the obturator canal

57
Q

What arteries in the pelvic wall do NOT arise from the internal iliac artery?

A

Gonadal artery
(arises from abdominal aorta)
Superior Rectal Artery (arises from IMA)

Reproduction (19 decks)

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