Anki Pelvis and perinium Flashcards
(132 cards)
1
Q
When we are sit on the ground, the only bony point that touches the ground is the […].
A
When we are sit on the ground, the only bony point that touches the ground is the ischial tuberosity.
2
Q
Sacral hiatus clinical importance:
A
Anaesthetic injections for an epidural go into the sacral hiatus.
3
Q
Coccyx injury resulting pain and discomfort is called:
A
Coccydynia
4
Q
What is the sacral promontory?
A
It is the most superior surface on the body of the first sacral vertebra, which projects into the pelvic inlet.
5
Q
Anatomical position of pelvic bone, and its significance:
A
ASIS and pubic tubercle lie on the same vertical plane. This makes the pelvic organs tilted slightly such that they are not directly in the line of gravity (prevents prolapse).
6
Q
Pelvic inlet vs outlet:
A
Inlet: Anteriorly: Pubic symphysisPosteriorly: Sacral promontory and ala of sacrumLaterally: Arcuate (iliopectineal) lines Outlet: Anteriorly: Pubic symphysisPosteriorly: CoccyxAnterolaterally: Ischiopubic ramusPosterolaterally: Sacrotuberous ligament
7
Q
Male vs female pelvis:
A
Male: Bones are heavier and thicker.Pelvic cavity is narrow and deep.Pelvic inlet is heart-shaped and smaller.Subpubic angle narrower.Coccyx is more curved (inverted).Ischial spine projects more medially. Sacrum is narrow, long, straight. Female: Bones are lighter and thinner.Pelvic cavity is wide and shallow.Pelvic inlet is oval. Subpubic angle wider.Coccyx is straighter (everted).Ischial spine p
8
Q
The pelvic diaphragm separates the […] from the […].
A
The pelvic diaphragm separates the pelvis from the perineum.
9
Q
What muscles form the pelvic floor? What are its two hiatuses?
A
Formed by the levator ani and coccygeus muscles. The muscles contain a urogenital hiatus and an anal/rectal hiatus.
10
Q
The levator ani is made up of:
A
Puborectalis, pubococcygeus, iliococcygeus muscles.
11
Q
The pelvic floor muscles are innervated by:
A
Perineal branches of S4, and the pudendal nerve (S2-S4).
12
Q
Importance of pelvic floor muscles:
A
Support pelvic viscera.Resists rise in intra-abdominal and pelvic pressure (from coughing, constipation, weightlifting etc.).Sphincter action to maintain urinary and fecal continence.
13
Q
Anatomical spaces in pelvic cavity (men and women):
A
Men: Rectovesical pouch. Women: Vesicouterine and rectouterine/rectovaginal pouch.
14
Q
Bladder wall contains a smooth muscle called:
A
Detrusor muscle
15
Q
The bladder […] if there is something blocking exit of urine. It can […] all the way until the superior surface is behind the […]. In that case, a […] can help remove the urine. […] is not pierced if bladder is large enough.
A
The bladder enlarges if there is something blocking exit of urine. It can enlarge all the way until the superior surface is behind the abdominal wall. In that case, a suprapubic catheter can help remove the urine. Peritoneum is not pierced if bladder is large enough.
16
Q
Relations of the bladder (men and women):
A
Men Posterior (top to bottom): Ureters, vas deferens, seminal vesicle, rectovesical pouch. Women Posterior (top to bottom): Uterus, cervix, vagina. Superior: Peritoneum, vesicouterine pouch, coils of small intestine, uterus (only if bladder is empty).
17
Q
The trigone is a [1] and [shape] region bordered by: […], […], and […]. Why is it [1]?
A
The trigone is a smooth and triangular region bordered by: Right ureteric orifice, left ureteric orifice, and internal urethral orifice. Why is it smooth? Trigone is of mesodermal origin, whilst rest of bladder is of endodermal origin.Mucosal layer of trigone is firmly attached to the muscular layer, preventing folds.
18
Q
Function of internal urethral sphincter (and special function in men):
A
Maintains urinary continence. In males, prevents seminal fluid from entering bladder during ejaculation.
19
Q
Venous drainage of the bladder: Drain into the […] veins. A [1] is formed at the base of the bladder.In female: [1] communicates with veins within the […].In male: [1] communicates with […] and […] vein.
A
Venous drainage of the bladder: Drain into the internal iliac veins. A vesical plexus is formed at the base of the bladder.In female: Vesical plexus communicates with veins within the broad ligament.In male: Vesical plexus communicates with prostatic plexus and middle rectal vein.
20
Q
Lymph drainage of the bladder:
A
Mainly drains into internal iliac nodes, and some into the external iliac nodes.
21
Q
Mechanism of emptying of bladder:
A
Stretch receptors (visceral afferent) carry signal along pelvic splanchnic nerve to sacral spinal segments of the spinal cord, which send signal up to pontine micturition centre (PMC) and cerebral cortex. If want to urinate, PMC fires signals down to sacral pre-ganglionic neurons, which travel along pelvic splanchnic nerve, synapsing with post-ganglionic neurons to cause detrusor muscles to contra
22
Q
[Female counterpart]/[…] glands are homologous to prostate gland.
A
Paraurethral/Skene glands are homologous to prostate gland.
23
Q
Accessory glands of the male reproductive system:
A
Seminal vesicles, prostate, bulbourethral glands.
24
Q
Rectal examination (process and differentiating results):
A
Finger in rectum to feel for posterior surface of prostate. Benign: Prostate feels smooth on the posterior surface. Malignant: Prostate feels lobulated, irregular, and solid.
25
Significance of this area?
Significance of this area? Toggle Masks RemarksBenign prostatic hyperplasia
26
What is this area prone to?
What is this area prone to? Toggle Masks RemarksProstatic cancer
27
Structure of prostatic part of urethra (and what opens into what):
Central urethral crest, and prostatic sinuses are adjacent to either side. Ejaculatory ducts open into the urethral crest. Prostatic gland ducts open into the prostatic sinuses.
28
The ejaculatory duct is formed by the union between the [...] and the [...].
The ejaculatory duct is formed by the union between the ampulla of the vas deferens and the duct of the seminal vesicle.
29
Prostate cancer and metastasis clinical anatomy:
Connections between the prostatic venous plexus and vertebral veins exist. When coughing/sneezing and abdominal straining, there can be reverse flow of blood from prostatic plexus to the vertebral veins. Therefore, there is frequent skeletal metastases in the lower vertebral column and pelvic bones of patients with prostate cancer. The cancer can further spread to the skull.
30
The majority of women have an [...] and [...] uterus. Those that have a [...] and [...] suffer symptoms such as:
The majority of women have an anteverted and anteflexed uterus. Those that have a retroverted and retroflexed uterus suffer symptoms such as: Dysmenorrhea (painful menstruation), dyspareunia (painful coitus), infertility, backache, uterine prolapse.
31
Cardinal ligament: Formed by [...] at the [...] of broad ligaments.It extends between [...] and [...] walls.Major [...] to the uterus. [...] artery runs within it.
Cardinal ligament: Formed by thick connective tissue at the base of broad ligaments.It extends between cervix and lateral pelvic walls.Major support to the uterus. Uterine artery runs within it.
32
The ovaries descend from the [...] region into the [...]. The [...] ligament connects the [...] to the [...]. The [...] ligament originates from the where the [...], and attaches to the [...], passing through the [...]. Both ligaments are derivatives of the [...].
The ovaries descend from the lumbar region into the pelvis. The ovarian ligament connects the ovary to the side of the uterus. The round ligament originates from the where the uterine tubes enter the uterus, and attaches to the labia majora, passing through the inguinal canal. Both ligaments are derivatives of the gubernaculum.
33
Broad ligament of uterus: Made of [...]. Consists of meso[...], meso[...], meso[...]. Plays a [...] in support of uterus.The upper lateral part of the broad ligament contains [...] vessels, which are enclosed by the [...].Between the [...], [...] vessels are present, [...], [...] ligament, epoophoron, paraoophoron.
Broad ligament of uterus: Made of double fold of peritoneum. Consists of mesosalpinx, mesovarium, mesometrium. Plays a tiny role in support of uterus.The upper lateral part of the broad ligament contains ovarian vessels, which are enclosed by the suspensory ligament of the ovary.Between the layers of the peritoneum/broad ligament, uterine vessels are present, lymphatics, round ligament, epoophoron
34
Implantation site in uterus is usually in the [...] and [...] wall of the uterus in the [...] plane.
Implantation site in uterus is usually in the upper and posterior wall of the uterus in the midsagittal plane.
35
Clinical significance of opening of uterine tube:
The uterine tubes open into the peritoneal cavity. Therefore, infection from uterus/uterine tubes can lead to peritonitis.
36
What is a hysterosalpingogram (HSG)?
Injection at cervix, then see if there is leakage at each side of the fallopian tube. Normal: There is leakage. Abnormal: Blockage.
37
Blood supply to the uterus (artery and vein):
Supplied by ovarian and uterine arteries, which anatomose. Ovarian is branch of abdominal aorta, whilst uterine is branch of internal iliac, providing path for collateral circulation. Venous plexuses drain into internal iliac veins.
38
Innervation of uterus:
Via inferior hypogastric plexus. Sympathetic: Uterine contraction and vasoconstriction, for childbirth. Parasympathetic: Vasodilation, inhibits uterine contraction for continuation of pregnancy.
39
[...] nerves and [...] nerves unite to form the inferior hypogastric/ pelvic plexus.
Hypogastric nerves and pelvic splanchnic nerves unite to form the inferior hypogastric/ pelvic plexus.
40
What is the significance of the pelvic pain line?
The pelvic pain line is formed by the inferior peritoneum and the organs it touches. Pain above pelvic pain line: Carried by sympathetic nerve (visceral pain follows sympathetic nerves). Pain below pelvic pain line: Carried by parasympathetic (pelvic splanchnic) nerve.
41
Cystocele vs rectocele:
Bladder bulging into vaginal wall is cystocele. Incomplete urination as urine can get stuck at the prolapsed pouch. Rectum bulging ito vaginal wall is rectocele.
42
The rectum starts from [vertebral level], and is where the [...] of the large intestine [...]. Rectum has no [...], [...], and [...].
The rectum starts from S3, and is where the features of the large intestine disappear. Rectum has no taenia coli, haustra, and appendices epiploicae/fatty tags.
43
The rectum contains [...] folds formed by extension of [...], [...], and [...] fibres. As a result, these folds are [...]. The [...] is the lower part of the rectum, resting on the [...], which is where [...] is stored.
The rectum contains transverse folds formed by extension of mucosa, submucosa, and circular fibres. As a result, these folds are permanent. The ampulla is the lower part of the rectum, resting on the pelvic floor, which is where faeces is stored.
44
Peritoneal reflection of rectum:
Upper 1/3: Covered by peritoneum Middle 1/3: Only anterior covered by peritoneum Lower 1/3: Not covered by peritoneum
45
Blood supply of rectum (artery and vein):
Supplied by superior rectal (branch of IMA), middle rectal (branch of internal iliac), inferior rectal arteries (branch of internal pudendal). Drained by superior rectal, middle rectal, inferior rectal veins. Form portosystemic anatomoses (superior rectal goes into portal system, the rest go into IVC).
46
Innervation of the bladder: Parasympathetic: [Spinal roots], [...] nerve and [...] plexus. This [...] the detrusor muscles and [...] the internal urethral sphincter. Sympathetic: [Spinal roots], [...] plexus. [...] detrusor contraction, and [...] urethral sphincter.The external urethral sphincter is innervated by the [...] nerve.
Innervation of the bladder: Parasympathetic: S2-S4, Pelvic splanchnic nerve and inferior hypogastric plexus. This contracts the detrusor muscles and relaxes the internal urethral sphincter. Sympathetic: T11-L2, superior hypogastric plexus. Inhibits detrusor contraction, and contracts urethral sphincter.The external urethral sphincter is innervated by the pudendal nerve.
47
What is the tendinous arch in the pelvis? Where is it?
It is a thickening of the fascia of the obturator internus muscle, which lies lateral to the levator ani muscles.
48
Collateral circulation if internal iliac artery is ligated:
Middle rectal (from internal iliac) and superior rectal artery (from IMA). Iliolumbar (from internal iliac) and last lumbar artery (from aorta). Lateral sacral (from internal iliac) and median sacral artery (from aorta).
49
The perineum is viewed in the [...] position.
The perineum is viewed in the lithotomy position.
50
A visible line or ridge of tissue that extends from anus through perineum to scrotum is called a [...].
A visible line or ridge of tissue that extends from anus through perineum to scrotum is called a raphe.
51
When the peritoneum evaginates during testicular development, it forms the [...]. The leftover peritoneum surrounding the testes upon completing development is called [...]. The testes must descend into the [...] because the [...].
When the peritoneum evaginates during testicular development, it forms the processus vaginalis. The leftover peritoneum surrounding the testes upon completing development is called tunica vaginalis. The testes must descend into the scrotum because the process of spermatogenesis requires a temperature lower than body temperature.
52
Covering of the testis/spermatic cord (from superficial to deep):
SkinDartos muscle (continuation of Camper's fascia)Colles' fascia (continuation of Scarpa's fascia)External spermatic fascia (continuation of external oblique)Cremaster muscle and fascia (continuation of internal oblique)Internal spermatic fascia (continuation of transversalis fascia)Tunica vaginalis (parietal)CavityTunica vaginalis (visceral)Testes
53
Cremaster muscle details:
Skeletal muscle supplied by genital branch of genitofemoral nerve.
54
Hydrocele (what is it, types, causes, clinical anatomy):
A hydrocele is a collection of fluid inside the scrotum, surrounding the testes. The fluid is collected between the parietal and visceral layers of the tunica vaginalis. There is: Non-communicating type: Processus vaginalis is closed off. Caused by trauma, inflammation, infection.Communicating type: Processus vaginalis not closed off. Fluid from peritoneum will flow downward.
55
What are the primary arterial sources of the pelvis and perineum respectively?
Pelvis: Internal iliac artery. Perineum: Internal pudendal artery.
56
The internal pudendal artery travels along with the [...], exits the [...], and then enters the [...], supplying the [...] of the perineum, and structures in [...] and [...] regions.
The internal pudendal artery travels along with the pudendal nerve, exits the greater sciatic foramen, and then enters the internal sciatic foramen, supplying the skin of the perineum, and structures in anal and urogenital regions.
57
Most lymph vessels of the perineum drain into the [...]. The lymph vessels of the penis and clitoris drain into the [...]. Only the [organ] does not drain into the [...]; it drains into the [...] instead, following [...] vessels.
Most lymph vessels of the perineum drain into the superficial inguinal nodes. The lymph vessels of the penis and clitoris drain into the deep inguinal nodes. Only the testes does not drain into the inguinal nodes; it drains into the para-aortic nodes instead, following testicular vessels.
58
When doing surgery in the perineum, other than blocking the pudendal, what other nerves should be anesthesised?
Ilioinguinal and genitofemoral, posterior femoral cutaneous nerve, coccygeal and last sacral nerves.
59
What is the landmark to look for when performing a pudendal nerve block? What are some uses?
Ischial spine. Analgesia for second stage of labour.Repair of an episiotomy or perineal laceration.Outlet instrument delivery.Minor surgeries of lower vagina and perineum.
60
Urogenital and anal triangle borders:
Urogenital triangle: Pubic symphysis, and imaginary line between ischial tuberosities. For male and female, contents are different due to external genitalia. Anal triangle: Coccyx and imaginary line between sacrotuberous ligaments. For male and female, contents are same.
61
Where is the junction between the rectum and the anal canal (gross anatomy)?
At the pelvic floor.
62
The upper 1/2 of the anal canal is lined by [...], derived from [...]; the lower 1/2 of the anal canal is lined by [...], derived from [...].
The upper 1/2 of the anal canal is lined by mucosal layer, derived from endoderm; the lower 1/2 of the anal canal is lined by skin, derived from ectoderm.
63
Internal anal sphincter is formed by [...] of [...]. It is [...] relative to external anal sphincter. External anal sphincter, innervated by [...] is made of three parts: [...][...]: In line with [...].[...]: Continuous with [...] muscle.
Internal anal sphincter is formed by thickening of circular layer of muscles. It is weak relative to external anal sphincter. External anal sphincter, innervated by inferior rectal (pudendal) nerve is made of three parts: SubcutaneousSuperficial: In line with raphe.Deep: Continuous with puborectalis muscle.
64
Lymphatic drainage of anal canal (above vs below pectinate line):
Above pectinate: Lymphatics drain into the inferior mesenteric nodes. Below pectinate: Lymphatics drain into the superficial inguinal nodes.
65
Innervation of anal canal (above vs below pectinate line):
Above pectinate: Inferior hypogastric plexus. Sensitive to stretch only. Below pectinate: Pudendal nerve, somatic nerve supply. Sensitive to pain, temperature, touch, pressure.
66
Paraurethral/Skene glands are homologous to [male counterpart] gland.
Paraurethral/Skene glands are homologous to prostate gland.
67
Hemorrhoids (AKA [...]) are [...] in the wall of the [...] or [...].
Hemorrhoids (AKA piles) are swollen veins in the wall of the rectum or anus.
68
Anal cushions details (and clinical significance):
Rich submucosal venous plexus, largest in the 3, 7, 11 o'clock positions. The cushions help to seal the anal canal to maintain continence of flatus and fluid. Abnormal enlargement of these cushions is called internal hemorrhoids.
69
External hemorrhoids:
Caused by dilated blood vessels that have become so large that they protrude. Blood may clot inside the protruding vessel, forming a hard lump which can be painful.
70
Defecation process: When [...] of the rectum is distended, [...] nerve endings are triggered. [...] muscle contracts, increasing [...] pressure.Coordinated reflex causes [...] of descending and sigmoid colon, and rectum.Finally, the [...] relax, and faeces is defecated.
Defecation process: When ampulla of the rectum is distended, sensory nerve endings are triggered. Abdominal wall muscle contracts, increasing intra-abdominal pressure.Coordinated reflex causes emptying of descending and sigmoid colon, and rectum.Finally, the sphincters relax, and faeces is defecated.
71
Borders of ischiorectal/ ischioanal fossa:
Laterally: Obturator internus, pudendal canal Medially: Levator ani and anal canal Base: Skin Apex: Where levator ani meets obturator internus.
72
Contents of pudendal canal:
Pudendal vessels and pudendal nerve
73
The left and right ischiorectal fossa communicate [...]. They are [...]-shaped, filled with [...], and provides [...] for anal canal to expand into during defecation.
The left and right ischiorectal fossa communicate posteriorly. They are wedge-shaped, filled with fat, and provides dead space for anal canal to expand into during defecation.
74
Ischiorectal abscess clinical anatomy:
Abscess is a collection of pus. SInce ischiorectal fossa is mainly fat, an abscess can spread through the ischiorectal fossa through the posterior communication. As it accumulates, tension increases, and it takes the path of least resistance, opening on the surface of the skin, or the anal canal.
75
The urogenital diaphragm is a double layered [...] sheet that fills the [...] triangle. The bottom layer is [...], and is called the [...]. This is where [...] are attached. The space between the two layers is called the [...].
The urogenital diaphragm is a double layered tough fibrous tissue sheet that fills the urogenital triangle. The bottom layer is thicker, and is called the perineal membrane. This is where external genitalia are attached. The space between the two layers is called the deep perineal pouch.
76
[Male counterpart] glands are homologous to Bartholin's glands.
Bulbourethral glands are homologous to Bartholin's glands.
77
Bulbourethral glands are homologous to [female counterpart] glands.
Bulbourethral glands are homologous to Bartholin's glands.
78
Bulbourethral glands are found in the [...]. What is its function?
Bulbourethral glands are found in the deep perineal pouch. What is its function? Produces pre-ejaculatory fluids during sexual arousal.
79
Contents of deep perineal pouch (males and females):
Male: Bulbourethral gland.Membranous urethra.External urethral sphincter.Deep transverse perineal muscles.Internal pudendal vessels.Dorsal nerve of penis. Female: Urethra.Part of vagina.External urethral sphincter.Deep transverse perineal muscles.Two additional muscles: Sphincter urethrovaginalis, compressor urethrae.Internal pudendal vessels.Dorsal nerve of clitoris.
80
Superficial perineal space is formed between [...] and [...].
Superficial perineal space is formed between Colles' fascia and inferior layer of urogenital diaphragm / perineal membrane.
81
Superficial perineal space is [...] to the deep perineal pouch, and contains [...], muscles, and nerves.
Superficial perineal space is inferior to the deep perineal pouch, and contains root of penis, muscles, and nerves.
82
The penis has three parts: [1], [2], and [3]. [1] contains [number] erectile tissues, one [...], two [...].[2] contains [number] cylinders of erectile tissue. [...], which is continuation of [...]; and [...], which is continuation of [...]. [3] gets it shape from [...] of [...].
The penis has three parts: Root, body, and glans. [1] contains three erectile tissues, one bulb, two crura.[2] contains three cylinders of erectile tissue. Corpora cavernosa, which is continuation of crura; and corpus spongiosum, which is continuation of bulb. [3] gets it shape from expansion of corpus spongiosum.
83
Foreskin is also known as [...]. It is the skin covering the [...] of the penis. The inability to retract it is called [...]. The surgical removal of the foreskin is called [...].
Foreskin is also known as prepuce. It is the skin covering the glans of the penis. The inability to retract it is called phimosis. The surgical removal of the foreskin is called circumcision.
84
All corpora are firmly anchored to the perineal membrane by the [...], which is a [...] tissue.
All corpora are firmly anchored to the perineal membrane by the tunica albuginea, which is a tough fibrous tissue.
85
Penile musculature (2, innervation, and functions):
Ischiocavernosus: Spirals over the corpora cavernosa to aid in support and movement of erect penis. Bulbospongiosus: Spirals over the corpus spongiosum to help in emptying the last few drops of urine in the urethra, and to assist in expulsion of semen. Both are skeletal muscles innervated by the pudendal nerve.
86
Mechanism of erection and ejaculation:
When stimulated, parasympathetic fibres are simulated, it relaxes the smooth muscles to dilate the arteries.Cavernous spaces are filled with blood.Blood compresses veins against the tunica albuginea.This prevents backflow of blood, causing pooling of blood which causes an erection. During ejaculation, internal urethral sphincter (sympathetic) contracts to prevent semen from flowing into the bladde
87
Penis is homologous to [female counterpart].
Penis is homologous to clitoris.
88
[Male counterpart] is homologous to clitoris.
Penis is homologous to clitoris.
89
The clitoris is formed where the [...] meet [...]ly.
The clitoris is formed where the labia minora meet anteriorly.
90
The [...] is a [...] structure located in the [...] of the perineum, at the junction between the urogenital and anal triangles. It helps to strengthen the [...]. What is it between in males vs females?
The perineal body is a fibro-muscular structure located in the midline of the perineum, at the junction between the urogenital and anal triangles. It helps to strengthen the pelvic floor. What is it between in males vs females? In males: Between the bulb of the penis and the anus. In females: Between the posterior limit of the vulvar orifice and the anus.
91
What is an episiotomy? What structures are cut?
An episiotomy is the surgical incision of the perineum on the infero-posterior vaginal wall. It prevents multiple tears during childbirth. This enlarges the vagina to allow for easier passage of the baby. Structures cut are: SkinSubcutaneous fatSuperficial and deep transverse perineal muscles.BulbospongiosumPart of levator aniPart of posterior vaginal wall
92
Rupture of the perineal body may lead to:
Uterine, rectal and even bladder prolapse. This is because there is a wider gap between the free edges of the levator ani muscle.
93
The narrowest part of the urethra is the [...].
The narrowest part of the urethra is the external urethral orifice.
94
Rupture of the spongy urethra:
Urine can be collected in the: Rupture in the superficial perineal pouchScrotumAround penis (but not glans)Even up to the anterior abdominal wall
95
Rupture of the membranous urethra:
Rupture in the deep perineal pouch.Blood and urine collect in the retroperitoneal spaces.
96
What is the fornix?
Upper end of the vagina is expanded and receives the cervix, which is projected into the vagina. The fornix is space between.
97
The posterior fornix is covered in [...], and is anterior to the [...] pouch.
The posterior fornix is covered in peritoneum, and is anterior to the rectouterine pouch.
98
Lymph drainage of the vagina:
Upper 4/5: Iliac nodes Lower 1/5: Superficial inguinal nodes
99
Innervation of vagina:
Upper 4/5: Inferior hypogastric plexus, sensitive only to stretch. Lower 1/5: Pudendal nerve, somatic innervation, sensitive to touch and temperature.
100
What is the adnexa? How is it examined?
Adnexa refers to the area that includes the ovaries, fallopian tubes, and ligaments supporting them. It is examined bimanually.
101
Parts of the uterine tube:
Infundibulum, ampulla, isthmus, intra-mural.
102
Lymphatic drainage of the uterus:
Paraaortic nodes, internal iliac nodes, external iliac nodes, sacral nodes, inguinal nodes.
103
Anatomical division of the prostate:
Five lobes: Anterior lobe, median lobe, posterior lobe, right lateral lobe, left lateral lobe.
104
Prostate blood supply (artery and vein):
Artery: Branches of internal iliac artery: Inferior vesical, middle rectal, internal pudendal. Vein: Veins form prostatic plexus, which drain into internal iliac veins.
105
What causes the anal columns?
Inferior rectal veins bulging into it
106
Lymphatic drainage of the ovaries:
Para-aortic nodes
107
Where do the majority of ectopic pregnancies occur?
Fallopian tubes
108
What is endometriosis?
It is a disease characterised by the presence of tissue resembling the endometrium outside the uterus. These endometrial tissues are affected by hormonal changes during the menstrual cycle, which leads to inflammation and pain.
109
What is the most common benign tumour in women of childbearing age?
Uterine fibroids (Leiomyoma). Smooth muscle fibres whorl and are embedded in the fibrous stroma.
110
[...] is the portion of the cervix that projects into the vagina. [...] is the more proximal portion of the cervix.
Ectocervix is the portion of the cervix that projects into the vagina. Endocervix is the more proximal portion of the cervix.
111
What is the normal pH of the vagina? How is it maintained?
It is normally acidic (pH 4.2). It is maintained by oestrogen, which causes glycogen to be made and stored in the epithelial cells. Lactobacilli break down the glycogen, producing lactic acid which maintains the pH.
112
Where are the Bartholin glands found? What is their function?
In the superficial perineal space. They secrete a lubricating fluid during sexual arousal.
113
What causes Bartholin cysts?
It occurs when the ducts fo the Bartholin's glands are blocked. This can occur due to chronic inflammation, which can cause pus or thick mucous to get retained and obstruct the duct.
114
Labia majora is homologous to [male counterpart].
Labia majora is homologous to scrotum.
115
[Female counterpart] is homologous to scrotum.
Labia majora is homologous to scrotum.
116
What is an undescended testicle called? What problems can result and how is it treated?
Cryptorchidism. An undescending testicle increases risk of infertility, testicular cancer, hernia, testicular torsion. The treatment is cryptorchidopexy/ orchidopexy.
117
What blood vessel helps in preserving function of the testes? How does it work?
The pampiniform plexus, which is a network of many small veins. The plexus plays a role in temperature regulation by acting as a heat exchanger, cooling blood from adjacent arteries into the veins.
118
What is a varicocele (and symptoms)?
Varicoceles are swollen and enlarged veins in the scrotum. It occurs due to defective valves that allow blood to flow backward, causing blood to pool. Symptoms vary from dull to sharp discomfort. It worsens with standing or physical exertion, and is relieved by lying down. It worsens over time.
119
The epididymis is a long [...] tube, lies in the scrotum at the [...] and [...] side of the testes. It consists of a [...], [...], and [...].
The epididymis is a long coiled tube, lies in the scrotum at the superior and posterolateral side of the testes. It consists of a head, body, and tail.
120
Functions of head, body, tail of epididymis:
Head: Receives spermatozoa from testis via efferent ductules. Body: Site of maturation of spermatozoa, developing motility. Tail: Storage of sperm until ejaculation.
121
The seminal vesicles are [...] glands, located between [...] and [...]. They secrete [...] ([...] of sperm cells) and [...] ([...] mucus of cervix and aids in [...] of sperm).
The seminal vesicles are paired glands, located between fundus of bladder (posteroinferior) and rectum. They secrete fructose (major energy source of sperm cells) and prostaglandins (softens mucus of cervix and aids in movement of sperm).
122
What is the function of PSA? What is its relevance?
Prostate specific antigen (PSA) is a protease that liquefies semen, allowing sperm to swim freely. Small amounts of PSA leaks into the prostatic vasculature. Elevated levels of PSA indicate abnormal glandular mucosa, which could be due to benign prostatic hyperplasia, prostate cancer, or inflammation.
123
Where does ejaculatory duct open into?
Prostatic urethra
124
The [...] muscle forms a sling from the pubic bone to the anal canal.
The puborectalis muscle forms a sling from the pubic bone to the anal canal.
125
What is the vestibule (anatomy)?
It is the area between the labia minora, containing the openings of vagina and urethra.
126
What crosses the pelvic brim?
Common iliac arteries and veins, ureter, gonadal arteries.
127
Narrowest vs widest part of male urethra:
Narrowest: Membranous urethra Widest: Prostatic urethra
128
Male vs female length of urethra:
Male: 20-30cm Female: 3-4cm
129
Branches of pudendal nerve:
Perineal, inferior rectal/anal, dorsal nerve of penis/clitoris.
130
Kidneys lie near [...]th ribs.
Kidneys lie near 11-12th ribs.
131
Contents of the spermatic cord:
3 arteries: Testicular artery, cremasteric artery, artery to vas deferens. 3 veins: Testicular vein, cremasteric vein, deferential vein. (3) nerves: Genital branch of genitofemoral nerve (cremasteric nerve), autonomic nerve plexus. 3 others: Vas deferens, pampiniform plexus, lymphatics. Rule of 3.
132
Unlike the penis, the clitoris does not have a [...].
Unlike the penis, the clitoris does not have a corpus spongiosum.
