Common Pelvic Viscera, Innervation and Vasculature

Question 1

The pelvic cavity is a region encased within the __ __, or bony pelvis

Answer 1

pelvic girdle

Question 2

What bones make up the pelvic girdle?

Answer 2

ilium, ischium, pubis, and sacrum

Question 3

What does the pelvic cavity contain?

Answer 3

terminal parts of ureters, urinary bladder, rectum, pelvic genital organs, and part of sigmoid colon and ileum

Question 4

The greater (true) and lesser (false) pelvis are separated by the __ __

Answer 4

pelvic inlet

Question 5

The pelvic inlet is formed by what?

Answer 5

the sacral promontory & ala, and the line terminals of each hip bone

Question 6

What do the greater and lesser pelvis contain?

Answer 6

greater (true) : abdominal contents

lesser (false) : pelvic viscera

Question 7

This lies over pelvic structures so they are not covered on all sides; serves as a conduit for arteries, veins, lymphatic vessels, nerves; forms folds, fuss & ligaments over some structures

Answer 7

peritoneum

Question 8

This type of pelvic fascia is situated between peritoneum and muscular pelvic walls & floor

Answer 8

membranous

Question 9

This type of pelvic fascia is situated between membranous fascial layers

Answer 9

endopelvic

Question 10

This potential space in the pelvic cavity is between the pubic symphysis and bladder

Answer 10

prevesical space

Question 11

This potential space in the pelvic cavity is between the sacrum and rectum

Answer 11

retrorectal space

Question 12

Condensed endopelvic fascia forms what?

Answer 12

ligaments of hypogastric sheath

Question 13

Parietal membranous fascia condenses to form what?

Answer 13

pubovesical ligaments (female) or puboprostatic ligaments (male)

Question 14

The rectovesical septum separates what?

Answer 14

the rectum from the prostate and seminal vesicles

Question 15

Name the following structure:
retroperitoneal; muscular tubes comprised of smooth muscle and transitional epithelium; peristalsis pushes urine toward the bladder; richly supplied by several sets of blood vessels and nerves; enter the bladder wall obliquely

Answer 15

ureters

Question 16

In regards to ureters, what are the 3 places where urinary calculi catch

Answer 16

steric junction of renal pelvis, crossing of the external iliac artery and pelvic brim, vesicoureteric junction

Question 17

The ureter in the female runs medially to the __ artery and is then crossed by it. Relationship is described as “water under the bridge”

Answer 17

uterine

Question 18

The ureter in the male crosses posterolaterally to the ___ ____ on its way to the bladder

Answer 18

ductus deferns

Question 19

The urinary bladder is located in the ____ space, inferior to the peritoneum and posterior to the pubic symphysis

Answer 19

retropubic

Question 20

The walls of the bladder are primarily made up of which muscle?

Answer 20

detrusor muscle

Question 21

The inside of the bladder is lined by transitional epithelium that form ___ when empty

Answer 21

rugae

Question 22

The ___ is an internal smooth thickened area defined by 2 urethra orifices and the urethra

Answer 22

trigone

Question 23

What sympathetics stimulate internal urethral sphincter to contract?

Answer 23

T11- L2

Question 24

Parasympathetics are motor to the ___ muscle and also inhibit internal urethral sphincter in males

Answer 24

detrusor

Question 25

The arteries that supply the superior bladder are called the ___ ___ aa and come from where?

Answer 25

superior vesical; internal iliac

Question 26

The arteries that supply the inferior/posterior bladder are called what?

Answer 26

male: inferior vesical aa female: vaginal or inferior rectal aa

Question 27

The urethra in the female begins where?

Answer 27

internal urethral orifice note: no internal urethral sphincter in females

Question 28

The female urethra passes through which 3 things?

Answer 28

pelvic diaphragm, external urethral sphincter, and perineal membrane

Question 29

True or false? | The urethra is much longer in females

Answer 29

False; shorter note: short length allows for bacteria form the external environment to be introduced into the bladder - reason why UTI's are more common in females

Question 30

The rectum is found between what two junctions?

Answer 30

the rectosigmoid and anorectal junctions

Question 31

The lumbar splanchnic nerves, hypogastric plexuses, and pelvic splanchnic nerves all innervate what?

Answer 31

rectum

Question 32

The sharp posteroinferior angle at the tip of the coccyx bone where gut perforates pelvic diaphragm is called what?

Answer 32

anorectal flexure

Question 33

The angle in the anorectal flexure is created by this muscle as it forms a "sling" at the anorectal junction

Answer 33

puborectalis muscle

Question 34

The anorectal flexure serves as an important mechanism for ___ ___ due to tons of puborectalis muscle during rectal state, or its active contraction during peristaltic contractions if defecation is not to occur

Answer 34

fecal continence

Question 35

In regards to the anal canal, the pectinate line divers what?

Answer 35

upper 2/3 from lower 1/3 anal canal

Question 36

In terms of development, the superior 2/3 of the anal canal comes from endoderm, mesoderm, or ectoderm?

Answer 36

endoderm

Question 37

In terms of development, the lower 1/3 of the anal canal comes from endoderm, mesoderm, or ectoderm?

Answer 37

ectoderm

Question 38

What are the arteries of pelvis?

Answer 38

common iliac a, external iliac a, internal iliac a

Question 39

Name the three posterior branches off of the internal iliac a

Answer 39

superior gluteal a, iliolumbar a, lateral sacral a

Question 40

Name the anterior branches off of the internal iliac a

Answer 40

obturator a, umbilical a, internal pudendal a, supeior vescial aa, uterine a, vaginal a, middle rectal a, inferior gluteal a

Question 41

The inferior gluteal a usually leaves the pelvis between __ and __ of the sacral plexus

Answer 41

S2; S3

Question 42

This artery (anterior branch of internal iliac a) almost always exists the pelvis near the ischial spine

Answer 42

internal pudendal a

Question 43

What are the differences in the internal iliac a between males and females?

Answer 43

males have an inferior vesicle a, females have vaginal aa; males do not have a uterine a

Question 44

The following is another type of pelvic artery found found in females: arise from aorta cross anterior to the ureter, over bifurcation of common iliac aa run in the suspensory ligament

Answer 44

ovarian aa

Question 45

Name the following pelvic artery: | arises form posterior aorta at bifurcation into common iliac aa

Answer 45

median sacral a

Question 46

Name the following pelvic artery: | anatomies with the deep circumflex iliac aa off of external iliac aa

Answer 46

iliolumbar aa

Question 47

Veins of the pelvic drain into what?

Answer 47

internal iliac veins

Question 48

The superior rectal vv empty into what?

Answer 48

the inferior mesenteric vein, which in turn empties into the portal vein

Question 49

The middle rectal vv empty into what?

Answer 49

the inferior vena cava

Question 50

The inferior rectal vv empty into what?

Answer 50

the internal pudendal veins which eventually drain to the internal iliac

Question 51

The condition involving prolapsed rectal mucosa containing veins of the internal rectal plexus is called what?

Answer 51

internal hemorrhoids note: associated with visceral nerves

Question 52

The condition involving clots in veins of the external rectal venous plexus is called what?

Answer 52

external hemorrhoids note: associated with somatic nerves

Question 53

True or False | External hemorrhoids are painless, while internal hemorrhoids are excruciating

Answer 53

false; internal hemorrhoids are painless, external hemorrhoids are very painful

Question 54

What are the branches of the pudendal nerve in males?

Answer 54

inferior rectal n, perineal n, and dorsal n of penis

Question 55

What is formed by the bowl-shaped pelvic diaphragm, which includes the coccygeus & levator ani muscle group? (LAM)

Answer 55

pelvic floor

Question 56

The diaphragm attaches to a thickening in the obturator fascia, known as the ___ ___ of levator Dani, which covers the obturator interns muscle overlying the lateral pelvic wall

Answer 56

tendinous arch

Question 57

The anterior gap in the medial borders of the LAM that allow for passage of the urethra, and vagina in females is called what?

Answer 57

urogenital hiatus

Question 58

The pelvic floor is mostly tonically contracted which resists what?

Answer 58

increases in intra-abdominal pressure, supports abdominopelvic viscera, assists in maintaining urinary and fecal continence

Question 59

What is the pelvic floor innervated by?

Answer 59

levator ani n, inferior rectal n, and coccygeal plexus

Question 60

The leavtor ani n arises from which sacral rami?

Answer 60

S4 mostly and S3

Question 61

True or false? | The levator ani n can sometimes be injured during vaginal birth

Answer 61

true

Question 62

Disruption of the levator ani n can lead to what type of dysfunction in the pelvic floor?

Answer 62

urinary incontinence and prolapse of pelvic viscera

Question 63

What is the inferior part of vagina innervated by?

Answer 63

somatic branches from the internal pudendal n

Question 64

What are the middle and superior parts of the vagina and uterus innervated by?

Answer 64

visceral nn. from uterovaginal plexus, by sympathetics from lumbar splanchnic, and by parasympathetics from S2-4

Question 65

The pelvic pain line follows the peritoneum. Pain from viscera above the line follows ___. Pain from viscera below the line follows ___.

Answer 65

sympathetics; parasympathetics