Flashcards in endo anatomy Deck (66):
what are the borders of the pelvic cavity?
Superior: pelvic brim and peritoneum
Anterior: pubic bones
Posterior: sacrum and piriformis muscle
Lateral: ischium, obturator internus muscle and fascia
Inferior: muscular pelvic diaphragm (pubococcygeus, puborectalis, iliococcygeus, (ischio)coccygeus); pelvic outlet
what structures are considered subperitoneal?
Both Sexes: Ureters; Urinary bladder; Urethra; Rectum
Males: Vas deferens, Prostate, Seminal vesicles, Prostatic urethra
Females: Uterus and Uterine (Fallopian) tubes, Ovaries, Vagina
what are the borders of the pelvic inlet? (pelvic brim)
Linea terminalis (3 parts)
Sup. pubic symphysis
Separates the true and false pelvis
true below false above
pelvic outlet boundaries?
Inf. Pubic symphysis
what is the inferior border of the greater sciatic foramen and the posterior medial border?
the sacrospinous ligament in inferior border sacrotuberous ligament forms posterior medial border
what is the inferior border of the lesser sciatic foramen?
what is the superior posterior part of the SI joint? what is the anterior part of the SI joint
superior posterior is classified as sydesmosis while the anterior portion is synovial
what ligament is most important in preventing excessive nutation of the the sacraum
the sacrospinous ligament
what type of cartilage is in the pubic symphisis
what fibers does relaxin act on?
during pregnancy relaxin acts on collagen fibers of pubic ligaments to relax them
where does fluid pool when you have acites in the abdominal cavity for males?
In males, the rectovesical pouch is the most inferior space for fluids to collect in the peritoneal cavity
where does fluid pool in females when you have ascites of the abdominal cavity?
In females, the rectouterine pouch is the most inferior space for fluids to collect in the peritoneal cavity
The lateral ligament of the bladder contains what vessels?
Contains superior vesical a. & v.
Cardinal/ transverse cervical lig.
containing uterine a. & v.
(Rectovesical septum in males
containing inferior vesical a. & v.)
containing internal iliac a. & v.
Lateral lig. of rectum
containing middle rectal a. & v. & rectal n plexus
contents of the deep perineal pouch M and F
M:Anterior extension of ischioanal fat pads, external urethral sphincter, part of urethra, bulbourethral glands, Dorsal n. of the penis
Internal pudendal a.
Deep transverse perineal m.
F:Anterior extension of ischioanal fat pads, sphincter urethrae muscle, part of urethra, Dorsal n. of the clitoris
Internal pudendal a.
Deep transverse perineal m.
contents of the superficial perineal pouch M and F
borders are in between perineal membrane and colles fascia (superficial perineal fascia)
M:Crus of the penis, Ischiocavnosus muscle, Bulb of the penis, Bulbospongiosus m., Proximal part of spongy urethra
F: crus of the clitoris, Ischiocavnosus muscle, Bulb of the vestibule, Bulbospongiosus m.,Greater vestibular glands
the perineal body serves as an insertion point for which muscles?
common insertion for bulbospongiosus m., superficial & deep transverse perineal m., & external anal sphincter
how would an infection spread from one deep pineal pouch laterally to the other deep perineal pouch?
The deep perineal pouch is NOT continuous bilaterally due to presence of the perineal body and external genitalia
However: The ischioanal fossae DO communicate via
the deep postanal space
In males the urethra traveling through the penis is imbedded into what muscle layer?
corpus spongiosum (bulb of the penis)
what muscle forms the crus of the penis?
what forms the glans of the clitoris?
what forms the body of the clitoris?
what fascia makes up the suspensory ligament of the penis?
deep urogenital fascia
what are the borders of the Ischioanal fossa and contents?
Levator ani with superior and inferior fascia
Obturator internus and obturator fascia
contents: Pudendal (Alcock’s) canal with internal pudendal a. & v.; pudendal n.
A patient has problems with their anorectal flexure this is most likely do to the disfunction of what muscle?
the anorectal flexure is maintained by the puborectalus muscle which helps control bowel movements
a patient has pain above the pectinate line this would be classified as what kind of pain?
visceral pain dull
pain below the pectinate line would be classified as what kind of pain?
somatic pain sharp
The internal venous plexus lies above or below the pectinate line?
the external venous plexus lies above or below the pectinate line
how doe the epithelium change at the anocutaneous line?
epithelium goes from stratified squamous above to keratinized skin cells below
branches of the posterior division of the internal iliac A.
1ST branch is iliolumbar A, then lateral sacral A, then superior gluteal A
branches of the anterior division of the internal iliac a.
Umbilical A. which gives off superior vesicle A, then Obturator A., then uterine A and vaginal A (females only), inferior vesicle A, middle rectal A, internal pudendal A, inferior gluteal A.
the iliolumbar A anastomoses with what A?
deep circumflex iliac A
Uterine A anastomoses with what a?
A. of the ductus defrons anastomoses with what A?
middle/inferior rectal a anastomose with what
superior rectal A
inferior gluteal A anastomoses with?
deep femoral branches
lateral sacral a anastomoses with?
median sacral A
internal pudendal A branches and route
gives off inferior rectal A, then the perineal A which travels inferior (superficial) to the perineal membrane in the superficial perineal pouch and terminates as the posterior scrotal a, the internal pudendal artery then travels deep (superior) to the perineal membrane in the deep perineal pouch where it pierces the membrane to give off the dorsal A of the penis and deep artery of the penis in males and the dorsal clitoral and deep clitoral a in femals,
external pudendal A is a branch of? and terminates as?
branches off of femoral A and terminates as the anterior scrotal A
superior rectal vein drainage path?
drains into IMV which drains into the splenic v which drains into portal v.
middle and inferior rectal v drainage path?
internal iliac v then common iliac then IVC
where are there portal caval anastomoses?
the internal and external rectal venous plexuses
internal hemorrhoids pathology?
result from dilated veins of the internal rectal venous plexus not painful because visceral pain above the pectineal line, can prolapse through anal sphincter
external hemorrhoids pathology?
dilated veins of external rectal venous plexus, typically painful because somatic pain below pectineal line
most superior node of the deep inguinal nodes is called?
node of cloquet
lymph drainage from the Common iliac nodes; gonads
Females: ovaries; uterine tube; part of uterus near uterine tube Males: testis; epididymis drains where?
Superior-most rectum & sigmoid colon lymph drainage
Inferior Mesenteric nodes
Posteroinferior structures: Inferior rectum; inferior vagina [F] lymph drainage
Internal and External iliac lymph nodes drain where
common iliac node
Inferior pelvic structures (base of bladder; inferior pelvic ureter; urethra; inferior rectum)
Females: superior vagina; cervix; inferior uterus
Males: prostate and prostatic urethra, seminal vesicles
internal iliac nodes
Inguinal nodes; Anterosuperior pelvic structures (superior bladder, sup. pelvic ureter, sup. uterus [F]) lymph drainage
external iliac nodes
Glans clitoris and glans penis [M]; distal spongy urethra [M] lymph drainage
Lower limb; superficial structures of perineum including skin, external genitalia and inferior anal canal lymph drainage
superficial inguinal nodes
IMPORTANT what exits the greater sciatic foramen below piriformis
Inf. gluteal n., a., v.
- Sciatic n.
- Pudendal n.
- Int. pudendal a,v
- Post. fem. cut. n
- N. to obturator int.
- N. to quad. femoris
IMPORTANT what exits the greater sciatic foramen above the pirformis
Sup. gluteal n., a., & v.
what exits the lesser sciatic foramen?
obteratur internus muscle
what exits the obturator foramen?
Obturator N. and A
route of the pudendal n into the perinium and chord levels?
the pudendal N S2-S4 goes from the sacral plexus through the greater sciatic foramen then loops into the lesser sciatic foramen and enters the perinium
branches of the pudendal N.
first branch is the inferior anal N, then it gives off deep and superficial perineal n, the superficial perineal n becomes the posterior scrotal n, and finally gives off dorsal n of the penis
where is the deep perineal N located
in the superficial perineal pouch
what nerve provides sensory innervation to the skin between the anus and coccyx
the anal coccygeal n from the coccygeal plexus
what measurement has the smallest diameter adn is most concerning regarding the birth canal?
the interspinous diameter around 10 cm
pelvic inlet is transversely wide while pelvic outlet is a-p wide