Fields- anatomy of male pelvis and perineum Flashcards
(129 cards)
1
Q
3 bones of pelvis
A
pubis
ischium
ilium
2
Q
covered by the pectineal ligament and crossed by the femoral v, a, n, medial to lateral
A
pectineal line
3
Q
how nerves and arteries leave the pelvis and enter the perineum
A
greater and lesser sciatic foramen
4
Q
a full bladder will extend into ____ pelvis
A
false
5
Q
b/t the iliopectineal line and the pelvic diaphragm
A
true pelvis
5
Q
prevents organs from spilling out to the feet
A
pelvic diaphragm
6
Q
posterior boundary of true pelvis
A
sacrum, coccyx, piriformis m.
7
Q
floor of the true pelvis
A
pelvic diaphragm
8
Q
anterior boundary of true pelvis
A
pubic bone
9
Q
lateral boundary of true pelvis
A
obturator internus m
10
Q
main innervation of the pelvic diaphragm
A
somatic innervation (skeletal muscle)
11
Q
innervation of coccygeus/ischiococcygeus of pelvic diaphragm
A
S4-S5 (somatic)
12
Q
innervation of levator ani of pelvic diaphragm
A
S3-S4 (somatic)
13
Q
supports male pelvic organs and helps prevent urinary and fecal incontinence
A
pelvic diaphragm
14
Q
strengthened by Kegel exercise to prevent urinary and fecal incontinence
A
Levator Ani
15
Q
fascia of the obturator internus muscle from which the iliococcygeus m. takes its origin
A
Arcus Tendineous
16
Q
3 parts of pubococcygeus muscle
A
puboprostate
puborectalis
pubococcygeus
17
Q
connects to ischial spine
A
coccygeus muscle
18
Q
The physician’s diagnosis is injury to the nerves supplying the pelvic diaphragm. What are the muscles and their innervation?
A
Levator Ani: S3, S4
Coccygeus: S4, S5
19
Q
transports sperm from testis to penis
A
vas deferens
20
Q
Where the duct of the seminal vesicle joins the vas dererens.
It empties into the prostate gland
A
Ejaculatory Duct
21
Q
passes behind the ureters
A
vas deferens
22
Q
where sperm is stored until smooth m. contractions force it out
A
ampulla (vas deferens)
23
Q
will secrete bicarbonate to increase the pH so sperm can still function in acidic environment of vagina
A
prostate gland
24
bone is white on CT or MRI
CT
25
arrows
seminal vesicle
26
MRI (?)
seminal vesicle
27
secretion from seminal vesicle that causes lubrication of vagina
mucoid material
28
seminal vesicle secretion that provides nutrients for the sperm
fructose
29
seminal vesicle secretion that enhances sperm migration
prostaglandins
30
seminal vesicle secretion that activates sperm motility
calcium
31
seminal vesicle secretion that is fibrinogen-like clotting protein that coagulates semen when acted on by clotting enzyme secreted by the prostate gland. Causes the semen to stick to the
cervical and vaginal wall.
Prosemenogelin
32
what separates median and posterior lobes of prostate gland
ejaculatory duct
33
what separates anterior lobe from median and posterior lobes
prostatic urethra
34
small bump along prostatic urethra
verumontanum
35
opening in verumontanum
prostatic utricle
36
prostate gland secretion that neutralizes the acid in the vagina
bicarbonate and phosphate
37
prostatic gland secretion that acts on prosemenogelin and coagulates semen
clotting enzyme
38
prostate gland secretion that liquifies coagulated semen
serine protease
39
prostate gland secretion that is nutrient for the sperm
citrate
40
prostate gland secretion that prevents premature capacitation and acromosome reaction of the sperm
spermine
41
secretes mucus and acts as a buffer
cowper's gland/bulbourethral gland
42
most of the composition of semen
seminal fluid
43
pelvic floor fascia; adheres to prostate posteriorly
aka rectovesical septum
Denonvillier fascia
44
b/t rectum and bladder and prostate gland
rectovesical septum (Denonvillier fascia)
45
b/t rectum and bladder in peritoneum
rectovesicular pouch
46
______following a prostectomy.
The rectum bulges into the space vacated
by the prostate gland & bladder.
This prevents proper filling of the bladder.
Rectocele
47
Frequently associated with prostatectomy, which can result in postoperative deficiency of the Denonvillier fascia
Rectocele
48
bilateral drooping of bladder wall
saddle bag sign
49
A deficiency of _____ can lead to posteriolateral drooping of the bladder wall
Denonvillier fascia
50
supplies pelvis and perineum
internal iliac a
51
bottom R arrow
vesicular, prostatic, and seminal vesicle a.
52
where does the caudal portion of prostate drain
sacral lymph nodes to aortic all the way up
53
where does the lateral portion of prostate drain
internal iliac lymph nodes to common iliac to aortic and up
54
where does cranial portion of prostate drain
external iliac to common iliac to aortic and up
55
where do the seminal vesicle and vas deferens drain
internal iliac to common iliac to aortic and up
56
most common lobe for BPH
median
57
restricts prostatic urethra (bladder wont empty properly)
BPH
58
most common lobe for prostate cancer
posterior
59
bladder won't empyt well, urine can back up and damage kidneys due to this
prostatitis
60
how to treat prostatitis if it doesnt get better on its own
antibiotics
61
releases PSA (prostate specific antigen) into blood
prostate gland
62
high levels of _____ can be associated with cancer or prostatitis or other things
PSA
63
Symptoms:
Infertility (low semen volume).
Hematospermia (blood in the semen).
Pain when urinating or ejaculating.
Pain in the perineum (groin & anal regions), lower abdomen or back.
Rx: antibiotics
seminal vesiculitis
64
during this exam, can palpate an enlarged prostate gland or inflamed seminal vesicle
digital rectal exam
65
cause bladder obstruction in males that can
manifest along a spectrum of severity, ranging from disease
incompatible with postnatal life to conditions that have such minimal
impact that they may not manifest until later in life.
posterior urethral valve (PUV)
66
This involves taking a piece of tissue from the intestinal tract and adding it to the bladder tissue. This has two intended consequences. One is an increase in bladder volume. And the proportion of the bladder that participates in contractions is reduced, resulting in a decrease in bladder pressure during urination.
bladder augmentation
67
The appendix is used to connect the umbilicus to the urinary bladder. The appendix blood supply is preserved.
Mitrofanoff appendicovesicostomy
68
D.
69
pelvic organ mesenteric structures
superior bladder
upper 1/2 of rectum
70
mesenteric structures of pelvic organs referred pain by _____
sympathetics (L1, L2)
71
retroperitoneal structures of pelvic organs
lower 1/2 rectum
anus
bladder
SV
prostate
72
retroperitoneal structures of pelvic organs referred pain by _____
pelvic splanchnics (S2-S4)(parasympathetics)
73
The ______ cell bodies are located in the dorsal root ganglion at spinal cord levels of the lateral horns L1 & L2 (sympathetic) and S2-S4 (parasympathetic)
GVA
74
lumbar splanchnics (preganglionic) synapse where
inferior hypogastric plexus
75
sacral splanchnics (preganglionic) synapse where
inferior hypogastric plexus
76
Important with regards to visceral (referred) pain to dermatomes L1 & L2
sympathetic lumbar and sacral splanchnic nerves
77
____ nerves travel to pelvic organs from inferior hypogastric plexus
postganglionic sympathetic nerves
78
enter pelvic organs where they synapse in enteric ganglia
parasympathetics (pelvic splanchnic nerves)
79
Except for the _______., parasympathetics do not synapse in the inferior hypogastric plexus
cavernous n.
80
C and D
81
area below pelvic diaphragm
perineum
82
_____ consists of:
sphincter urethra m. (skeletal muscle)
covered superiorly and inferiorly
by deep fascia of the sphincter urethra m. fascia
UG diaphragm
83
basically is what external genitalia is attaching to
UG diaphragm
84
urogenital triangle anterior boundary
pubic bone
85
urogenital triangle floor boundary
skin
86
urogenital triangle roof boundary
perineal membrane
87
urogenital triangle posterior wall boundary
perineal body
88
urogenital triangle later wall boundary
ischiopubic ramus
89
contents of urogenital triangle
scrotum
crus of penis
bulb of penis
internal pudendal a branches and pudendal n.
90
anal triangle anterior wall
perineal body
91
anal triangle lateral wall
obturator internus m
92
anal triangle medial wall
levator ani m.
93
anal triangle posterior wall
coccyx
94
contents of anal triangle
external anal sphincter m
obturator internus m
levator ani m
internal pudendal a branches and pudendal n branches
95
MRI or CT
CT
96
UG Diaphragm – sphincter urethra (skeletal muscle) covered superiorly and inferiorly
by deep fascia of the sphincter urethra fascia
deep pouch of urogenital triangle
97
provides foundation for external genitalia
inferior fascia of UG diaphragm
98
contents of superficial pouch of UG triangle
scrotum
shaft (crus and bulb)
99
muscle that covers crus of penis
ischiocavernosus m
100
muscle that covers bulb of penis
bulbospongiosus m
101
crus of penis aka
corpus cavernosum
102
bulb of penis aka
corpus spongiosum
103
blood filled structures of penis
"corpus"
104
roof of superficial pouch and floor of deep pouch
perineal membrane
105
contents of deep pouch of UG triangle
membranous urethra
Cowper's gland (bulbourethral gland)
sphincter urethra m
deep transverse perineal m
deep dorsal a and nerve
106
Prostate gland with _____ urethra
prostatic
107
urogenital diaphragm with the ______ urethra
membranous
108
corpus spongiosum with the ______ urethra
spongy penile
109
deep pouch of UG triangle 2 main components
UG diaphragm
bulbourethral glands
(membranous urethra)
110
superficial pouch main contents
bulb and crus of penis
(penile/spongy urethra)
111
in male bulbourethral gland is found where
deep pouch
112
in females, homologous gland to bulbourethral gland in males is found where
superficial pouch
113
______ leaves the pelvis through greater sciatic foramen and enters perineum through lesser sciatic foramen
pudendal a. and n.
114
3 branches of internal pudendal a. that supplies male perineum
inferior rectal a
perineal a
dorsal a
115
somatic innervation of the perineum
pudendal n. (S2-S4)
116
branch of pudendal n. that carries motor to external anal sphincter & sensory to the anal area. In the anal triangle
Inferior rectal n
117
branch of pudendal n. that motor to all skeletal muscles of UG triangle & sensory to the posterior scrotum. In the superficial pouch.
perineal n.
118
branch of pudendal n. that carries pure sensory to the glans penis.
In the deep pouch.
Dorsal n.
119
Painful sitting
Genital pain
Perineal pain
Pain during intercourse.
Erectile dysfunction.
Difficulty achieving orgasm.
Bladder and bowel dysfunction.
Feeling of urgency to use the toilet
pudendal n. neuralgia
120
Nerve entrapment between the sacrospinous and sacro-tuberous ligaments. Inflammation of the piriformis or obturator internus
possible causes of pudendal n/ neuralgia
121
drainage for testes and epididymis
aortic to lumbar and up
122
penis and scrotum drainage
superficial or deep inguinal to external iliac to common iliac to aortic and up
123
PREGANGLIONIC SYMPATHETIC
Sacral Splanchnic nerves (L1-L2) innervation to perineum exit the paravertebral ganglia and synapse in the _________
inferior hypogastric plexus
124
PREGANGLIONIC PARASYMPATHETIC
Pelvic Splanchnic nerves (S2-S4) travel to the inferior hypogastric plexus where they _______ and travel to the perineum
via the cavernous n.
synapse
125
Postganglionic parasympathetics to the perineum. Cell bodies are
in the inferior hypogastric plexus.
cavernous n.
126
parasympathetics role of penis
excitement and plateau (erection)
127
sympathetics role of penis
orgasm (ejaculation)
128
C. and D.
