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MBBS II ERS > ERS anat > Flashcards

ERS anat Flashcards

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1
Q

List the organs located in the true pelvic cavity? What supports the organs?

A 
Urinary bladder 
Rectum 
Anal canal 
Female and male reproductive organs 
Nerves, vessels and lymphatics

Pelvic Diaphragm (PD)

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2
Q

List the main general nerve, blood supply of true pelvic cavity?

A 
Nerve = hypogastric plexus 
Blood = internal iliac a.
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3
Q

Peritoneal position, shape and mucosal folds of the rectum?

A

Retroperitoneal

Ampulla = widest and most distendible

3 transverse folds = Valve of Houston: 1 on right, 2 on left

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4
Q

Muscle the maintains continence in the rectum?

A

Rectal sling = Puborectalis muscle

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5
Q

Structures anterior and posterior to rectum?

A

Anterior = Rectovesical pouch (male)/ Rectouterine pouch (female)

Posterior = Sacrum, sacral nerves, LN

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6
Q

Blood supply + veins of rectum (3)

A

Superior rectal artery (Inf. mesenteric a.)&raquo_space; Inferior mesenteric vein

Middle rectal artery (internal iliac a.)&raquo_space; Internal iliac v.

Inferior rectal artery (Internal pudendal a.)&raquo_space; Internal iliac vein

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7
Q

Lymph and nerve supply of rectum?

A

Lymph: Preaortic, Pararectal, Inferior mesenteric LN

Nerve: Inferior hypogastric plexus

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8
Q

Examination techniques of rectum?

A

Digital rectal exam
Proctosigmoidoscopy
Colonoscopy

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9
Q

Spread of rectal cancer routes (3)

A 
Posterior = sacral plexus (pain!)
Anterior = direct invasion, bladder, prostate, uterus/ vagina 
Lymph = to liver
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10
Q

Anal canal: Compare mucosa lining, blood supply and vein of Upper and Lower anal canal?

A

Upper:

  • Columnar epi.
  • Superior rectal a (inf. mesenteric a.)
  • Superior rectal vein (inf. mesenteric v.)

Lower:

  • Stratified squamous epi.
  • Inferior rectal a.(pudendal a.)
  • Inferior rectal v.(internal iliac v)
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11
Q

Anal canal: Upper and Lower parts’ Nerve and LN?

A

Upper anal:

  • Hypogastric plexus (ANS)
  • Pararectal nodes

Lower half:

  • Inf. rectal nerve (pudendal nerve, somatic)
  • Superficial inguinal nodes
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12
Q

Internal and External anal sphincter nerve supply + MUSCLE name ?

A

Internal = SPHINCTER ANI = circular smooth muscle
= Inf. hypogastric plexus

External = SPHINCTER ANI EXTERNUS
= Perineal branch of S4 nerve + Inferior rectal nerve (pudendal n.)

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13
Q

Clinical outcome of torn Pelvic diaphragm in female? Outcome of torn Urogenital Diaphragm

A

PD = Prolapse of pelvic visecrea through perineum

UD = urinary incontinence

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14
Q

3 parts of male urethra?

A

Prostatic urethra: most dilatable, ejaculatory duct

Membranous urethra: within Urogential diaphragm, sphincter = UD

Spongy urethra: longest, ends at Fossa Navicularis

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15
Q

Part of male urethra most prone to damage? Which part has bulbourethral gland?

A

Membranous urethra: most prone to damage: fixed and narrow

Urogenial diaphragm contains bulbourethal/ greater vestibular gland

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16
Q

Location of prostate and tissue type? Lobes?

A

Below bladder, Above perineal membrane

Fibromuscular connective tissue

5 lobes: 2 lateral, 1 posterior, 1 median, 1 anterior

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17
Q

Lobes of prostate prone to malignancy?

A

Posterior lobe = Malignancy, prostatic carcinoma (BATSON PLEXUS TO SPINE)

Median lobe = BPH

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18
Q

Secretion of Prostate? Lobes in relation of ejaculatory duct?

A

Citric acid
Acid phosphatase

Ejac. duct = between psoteiror and median lobes

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19
Q

Blood supply and vein + Lymph + nerve of prostate?

A

Blood supply: Inferior vesical a. + Middle rectal a.
Vein: Prostatic plexus > Interional iliac vein

Lymph: Internal iliac LN
Nerve: Inferior hypogastic plexus

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20
Q

Area below Pelvic diaphragm? Artery and nerve supply?

A

Perineum
= House external genitalia
Divided into superficial and deep perineal space/ pouches

Internal pudenal artery
Pudendal nerve

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21
Q

List the muscles of the pelvic diaphragm.

A

From medial to lateral:

1) Levator ani muscles:
- Puborectalis (rectal sling)
- Pubococcygeus
- Iliococygeus
2) Coccygeus muscle

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22
Q

Clinical significance of Coccygeus muscle? Nerve supply and action?

A

Detroyed perineal body/ PD = prolapse of bladder, uterus/ vagina, rectum

Nerve = Sacral nerves (4,5) + pudendal nerve

Action = Support pelvic viscera + sphincter for anarectal junction and vagina

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23
Q

4 parts of uterus and natural position?*

A

Fundus, Cornu, Body, Cervix

Anteverted + Anteflexed

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24
Q

Primary and secondary support for uterus?

A

Primary = PD + UD

Secondary:
1) Broad ligament = peritoneum fold, gives rise to mesosalphinx + mesovarium for fallopian tube + ovaries

2) Pelvic Fasciae Condensation: 
Connective tissue from pelvic wall and floor: 
- Uterosacral lig. 
- Pubocrvical lig. 
- Transverse cervical lig.
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25
Blood supply + vein + LN + nerve supply of uterus.
Blood supply = Uterine a. (internal iliac a.) Vein = Uterine venous plexus > internal iliac v. LN: External and internal iliac + Sacral LN Nerve = Inf. hypogastric plexus
26
Position of uterine artery and Ureter? Clinical significance?
Uterine artery = ABOVE ureter Hysterectomy = accidental ligation of ureter
27
4 parts of fallopian tube + support?
Isthmus, ampulla, infundibulum, fimbriae Broad ligament enclosing the tube
28
Blood supply for Fallopian tube?
Ovarian and uterine arteries
29
Clinical significance of Fallopian tube?
Common site for ectopic pregnancy Pelvic inflammatory disease
30
3 supports for Ovaries + LN + nerve supply?
``` Mesovarium from broad ligament Suspensory ligament (w/ vessels) Proper Ligament of Ovary (from uterine body) ``` LN = Paraaortic LN Nerve = Aortic plexus
31
Blood supply of ovaries.
Artery = Ovarian + Uterine arteries Vein: - Left ovary = Left renal - Right ovary = IVC
32
Explain the referred pain from ovary disease.
Ovary close to Obturator nerve Referred pain to medial thigh and knee
33
Name of 2 spaces in vagina + list supports.
2 spaces = Anterior + posterior Fornix ``` Upper = PD + Pelvic viscera Middle = UD Lower = Perineal body ```
34
Blood supply + vein for vagina.
``` Upper = Uterine + Internal iliac Middle = Middle rectal Lower = Internal pudendal arteries ``` Vaginal venous plexus > Internal iliac vein
35
LN and nerve for Vagina.
LN: - Upper + middle = Internal and External iliac LN - Lower = Internal iliac LN + Superficial inguinal LN Nerve: Upper = Uterovaginal plexus (Inf. Hypogastric plexus) Lower = Pudendal Nerve
36
Nerve supply of vagina.
``` Upper = uterovaginal plexus Lower = pudendal nerve ```
37
Explain the spread of bacteria causing PID from the vagina.
Posterior fornix = close to uterine pouch If superior wall is punctures during D&C procedure, bacteria spread through to pelvic cavity and peritoneum
38
What divides the perineum into 2 triangles?
Line across Ischial tuberosity Divide into Anal and Urogenital triangles
39
Content of anal triangle?
Anal canal Ischiorectal fossa Anoccocygeal body/ ligament
40
Location and clinical significance of ischiorectal fossa?
Lateral to anal canal Adipose tissue with poor B/V supply = prone to infection + abscess
41
Content of ischiorectal fossa?
Internal pudendal vessels Pudendal nerve External anal sphincter External anal venous plexus
42
Male urogenital triangle divisions?
Deep perineal pouch = Urogenital diaphragm (muscles) Superficial perineal pouch = below UD = external genitalia
43
Content of Deep perineal pouch in male urogenital triangle? Boundaries?
Superficial and inferior fascia of UD ``` Content: MBDISD Membranous urethra Bulbourethral glands Internal pudendal vessels Dorsal nerves of penis Deep transverse perineal muscle Sphincter urethrae ```
44
2 layers of the superficial perineal pouch of male urogenital triangle?
Fatty layer: Dartos muscle (scrotum) from Campers fascia (abdomen) Membranous layer: Colles' fascia (scrotum) from Scarpa's fascia (abdomen)
45
Content of superficial perineal pouch of male urogenital triangle?
Bulbospongiosus + Ischiocavernosus muscles Superficial transverse perineal muscle Deep perineal branch of pudendal nerve + Internal pudendal vessels
46
2 parts of the penis?
- Root = Crura and bulb - Body Crura (lateral) >> 2 corpus cavernosum Bulb (medial, attached to UD) >> corpus spongiosum + glan penis
47
Blood supply of penis?
Internal Pudendal artery: branches: - Deep artery = corpus cavernosum - Dorsal artery = corpus cavernosum, skin - Artery to bulb of penis = erectile tissue + bulbourethral gland) - Urethral artery = spongy urethra (+Inferior rectal a. + Perineal a.)
48
Vein drain of penis
Internal Pudendal vein > internal iliac vein Deep dorsal vein >> prostatic plexus Superficial dorsal vein >> Femoral vein
49
Lymphatics of penis
Scrotum + superficial penis >> superficial inguinal nodes Deep penis >> internal iliac nodes + deep inguinal LN
50
Nerve supply of penis?
Pudendal nerve S2-S4 Branches: Inferior rectal n. + Perineal n. + Dorsal nerve of penis
51
List all parts of the female external genitalia
Libia majora + Minora Mons pubis Vesticular fossa Clitoris ( crura = 2x corpus cavernosa + body = glans) Vaginal orifice + hymen
52
Content of the deep perineal pouch of female urogenital triangle?
Same as Male DPP: Urethra, Sphincter urethrae, Internal pudendal vessels, Deep transverse perineal muscle Different: Paraurethral glands + greater vestibular glands Dorsal nerve of clitoris
53
Content of superficial perineal pouch in female urogenital triangle?
Bulbospongiosus + Ischiocavernosus Superficial transverse perineal muscle Clitoris Greater vestibular gland Bulb of vestible Perineal nerve + internal pudenal vessels
54
Muscles attached to perineal body in female?
External anal sphincter + superficial transverse perineal muscle + bulbospongiosum
55
Blood supply of female superficial perineal pouch?
Internal Pudendal artery ``` Branches: Posterior labial Deep artery of clitoris Dorsal artery of clitoris Perinal a. Urethral a. Artery of Bulb of vestibule ```
56
Vein drain of female SPP? LN drain?
Internal pudendal > internal iliac vein Superficial inguinal LN
57
Nerve supply of female SPP?
Pudendal nerve Branches: Inferior rectal, perineal, Dorsal nerve of clitoris
58
4 causes of hemorrhoids?
Chronic constipation Portal hypertension Rectal tumour Pregnancy
59
Rupture of membranous urethra clinical sequaelae?
Urine leaks into SPP Penile superficial fascia is continuous with abdomin fascia >>> urine to anterior abdominal wall
60
Tract ducts of breast?
15-20 lobes separated by fibrous septa/ suspensory ligament > lactiferous duct > ampulla > nipple
61
Blood supply for breasts?
``` Axillary artery + internal thoracic artery + Intercostal artery + Lateral thoracic a. + thoracoacromial a. ```
62
LN drainage of breast?
Medial quadrant = Internal mammary chain/ Internal thoracic LN Lateral quadrant = Anterior Axillary LN > Central LN > Apical LN > Subclavian trunk > thoracic duct/ Right lymphatic duct

MBBS II ERS (37 decks)

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