endo anatomy

Question 1

what are the borders of the pelvic cavity?

Answer 1

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

Question 2

what structures are considered subperitoneal?

Answer 2

Both Sexes: Ureters; Urinary bladder; Urethra; Rectum
Males: Vas deferens, Prostate, Seminal vesicles, Prostatic urethra
Females: Uterus and Uterine (Fallopian) tubes, Ovaries, Vagina

Question 3

what are the borders of the pelvic inlet? (pelvic brim)

Answer 3

Boundaries:
Sacral promontory
Sacral alae
Linea terminalis (3 parts)
Sup. pubic symphysis

Separates the true and false pelvis
true below false above

Question 4

pelvic outlet boundaries?

Answer 4

Boundaries:
Inf. Pubic symphysis
Ischiopubic rami
Ischial tuberosities
Sacrotuberous ligs.
Coccyx

Question 5

what is the inferior border of the greater sciatic foramen and the posterior medial border?

Answer 5

the sacrospinous ligament in inferior border sacrotuberous ligament forms posterior medial border

Question 6

what is the inferior border of the lesser sciatic foramen?

Answer 6

sacrotuberous ligament

Question 7

what is the superior posterior part of the SI joint? what is the anterior part of the SI joint

Answer 7

superior posterior is classified as sydesmosis while the anterior portion is synovial

Question 8

what ligament is most important in preventing excessive nutation of the the sacraum

Answer 8

the sacrospinous ligament

Question 9

what type of cartilage is in the pubic symphisis

Answer 9

fibrocartilidge

Question 10

what fibers does relaxin act on?

Answer 10

during pregnancy relaxin acts on collagen fibers of pubic ligaments to relax them

Question 11

where does fluid pool when you have acites in the abdominal cavity for males?

Answer 11

In males, the rectovesical pouch is the most inferior space for fluids to collect in the peritoneal cavity

Question 12

where does fluid pool in females when you have ascites of the abdominal cavity?

Answer 12

In females, the rectouterine pouch is the most inferior space for fluids to collect in the peritoneal cavity

Question 13

The lateral ligament of the bladder contains what vessels?

Answer 13

Contains superior vesical a. & v.

Question 14

Cardinal/ transverse cervical lig.

Answer 14

containing uterine a. & v.
(Rectovesical septum in males
containing inferior vesical a. & v.)

Question 15

Hypogastric sheath

Answer 15

containing internal iliac a. & v.

Question 16

Lateral lig. of rectum

Answer 16

containing middle rectal a. & v. & rectal n plexus

Question 17

contents of the deep perineal pouch M and F

Answer 17

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.

Question 18

contents of the superficial perineal pouch M and F

Answer 18

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
Clitoris

Question 19

the perineal body serves as an insertion point for which muscles?

Answer 19

common insertion for bulbospongiosus m., superficial & deep transverse perineal m., & external anal sphincter

Question 20

how would an infection spread from one deep pineal pouch laterally to the other deep perineal pouch?

Answer 20

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

Question 21

In males the urethra traveling through the penis is imbedded into what muscle layer?

Answer 21

corpus spongiosum (bulb of the penis)

Question 22

what muscle forms the crus of the penis?

Answer 22

corpus cavernosum

Question 23

what forms the glans of the clitoris?

Answer 23

corpus spongiosum

Question 24

what forms the body of the clitoris?

Answer 24

corpus cavernosum

Question 25

what fascia makes up the suspensory ligament of the penis?

Answer 25

deep urogenital fascia

Question 26

what are the borders of the Ischioanal fossa and contents?

Answer 26

Levator ani with superior and inferior fascia Obturator internus and obturator fascia Superficial fascia contents: Pudendal (Alcock’s) canal with internal pudendal a. & v.; pudendal n.

Question 27

A patient has problems with their anorectal flexure this is most likely do to the disfunction of what muscle?

Answer 27

the anorectal flexure is maintained by the puborectalus muscle which helps control bowel movements

Question 28

a patient has pain above the pectinate line this would be classified as what kind of pain?

Answer 28

visceral pain dull

Question 29

pain below the pectinate line would be classified as what kind of pain?

Answer 29

somatic pain sharp

Question 30

The internal venous plexus lies above or below the pectinate line?

Answer 30

above

Question 31

the external venous plexus lies above or below the pectinate line

Answer 31

below

Question 32

how doe the epithelium change at the anocutaneous line?

Answer 32

epithelium goes from stratified squamous above to keratinized skin cells below

Question 33

branches of the posterior division of the internal iliac A.

Answer 33

1ST branch is iliolumbar A, then lateral sacral A, then superior gluteal A

Question 34

branches of the anterior division of the internal iliac a.

Answer 34

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.

Question 35

the iliolumbar A anastomoses with what A?

Answer 35

deep circumflex iliac A

Question 36

Uterine A anastomoses with what a?

Answer 36

ovarian A

Question 37

A. of the ductus defrons anastomoses with what A?

Answer 37

testicular A

Question 38

middle/inferior rectal a anastomose with what

Answer 38

superior rectal A

Question 39

inferior gluteal A anastomoses with?

Answer 39

deep femoral branches

Question 40

lateral sacral a anastomoses with?

Answer 40

median sacral A

Question 41

internal pudendal A branches and route

Answer 41

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,

Question 42

external pudendal A is a branch of? and terminates as?

Answer 42

branches off of femoral A and terminates as the anterior scrotal A

Question 43

superior rectal vein drainage path?

Answer 43

drains into IMV which drains into the splenic v which drains into portal v.

Question 44

middle and inferior rectal v drainage path?

Answer 44

internal iliac v then common iliac then IVC

Question 45

where are there portal caval anastomoses?

Answer 45

the internal and external rectal venous plexuses

Question 46

internal hemorrhoids pathology?

Answer 46

result from dilated veins of the internal rectal venous plexus not painful because visceral pain above the pectineal line, can prolapse through anal sphincter

Question 47

external hemorrhoids pathology?

Answer 47

dilated veins of external rectal venous plexus, typically painful because somatic pain below pectineal line

Question 48

most superior node of the deep inguinal nodes is called?

Answer 48

node of cloquet

Question 49

lymph drainage from the Common iliac nodes; gonads | Females: ovaries; uterine tube; part of uterus near uterine tube Males: testis; epididymis drains where?

Answer 49

lumbar nodes

Question 50

Superior-most rectum & sigmoid colon lymph drainage

Answer 50

Inferior Mesenteric nodes

Question 51

Posteroinferior structures: Inferior rectum; inferior vagina [F] lymph drainage

Answer 51

sacral nodes

Question 52

Internal and External iliac lymph nodes drain where

Answer 52

common iliac node

Question 53

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 lymph drainage

Answer 53

internal iliac nodes

Question 54

Inguinal nodes; Anterosuperior pelvic structures (superior bladder, sup. pelvic ureter, sup. uterus [F]) lymph drainage

Answer 54

external iliac nodes

Question 55

Glans clitoris and glans penis [M]; distal spongy urethra [M] lymph drainage

Answer 55

deep inguinal

Question 56

Lower limb; superficial structures of perineum including skin, external genitalia and inferior anal canal lymph drainage

Answer 56

superficial inguinal nodes

Question 57

IMPORTANT what exits the greater sciatic foramen below piriformis

Answer 57

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

Question 58

IMPORTANT what exits the greater sciatic foramen above the pirformis

Answer 58

Sup. gluteal n., a., & v.

Question 59

what exits the lesser sciatic foramen?

Answer 59

obteratur internus muscle

Question 60

what exits the obturator foramen?

Answer 60

Obturator N. and A

Question 61

route of the pudendal n into the perinium and chord levels?

Answer 61

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

Question 62

branches of the pudendal N.

Answer 62

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

Question 63

where is the deep perineal N located

Answer 63

in the superficial perineal pouch

Question 64

what nerve provides sensory innervation to the skin between the anus and coccyx

Answer 64

the anal coccygeal n from the coccygeal plexus

Question 65

what measurement has the smallest diameter adn is most concerning regarding the birth canal?

Answer 65

the interspinous diameter around 10 cm | pelvic inlet is transversely wide while pelvic outlet is a-p wide

Question 66

what passes through the urogenital hiatus?

Answer 66

deep dorsal vein of penis/clitoris