Final Review

Question 1

What type of tissue covers the perimetrium of the uterus?

Answer 1

serosa

Question 2

What part of the broad L of the uterus does the round L of the uterus pass through?

Answer 2

mesometrium

Question 3

What are the glands in the female perineum called?

Answer 3

greater vestibular glands: posterior to bulbs of vestibule

lesser vestibular glands: secrete mucus btw external urethral orifice and vaginal orifice

Question 4

What is the level of the ilioinguinal nerve?

What relevant branch comes from it?

Answer 4

L1

anterior scrotal/labial N

Question 5

What is the spinal level of genitofemoral N?

What relevant branch comes from it?

Answer 5

L1-L2

genital branch –> to scrotum/labia

Question 6

What levels make up obturator N?

Answer 6

L2-4

Question 7

What spinal levels make up the lumbosacral trunk?

Answer 7

L4-5

Question 8

What spinal levels make up posterior femoral cutaneous N?

What relevant branch arises from it?

Answer 8

S1-3

perineal branch to scrotum/labia

Question 9

What muscles does the deep perineal n innervate?

Answer 9

deep transverse perineal

superficial transverse perineal

ischiocavernosus

bulbospongeosus

Question 10

What are the branches of the coccygeal plexus?

Answer 10

anococcygeal N

nerve to levator Ani (S4)

nerve to coccygeus m (S4, 5)

Question 11

How does pain run in the pelvis?

Answer 11

with parasympathetic pelvic splanchnics –> ventral rami of sacras spinal nerves –> dorsal root and dorsal root ganglion –> synapse in dorsal horn of spinal cord

Question 12

What is the intermesenteric plexus and what does it form/supply?

Answer 12

mixed S and PS

input from superior mesenteric and aortic plexuses

forms periarterial plexus –> follows gonadal As –> ovarian plexus

feeds S into Inferior mesenteric and superior hypogastric

Question 13

What is the superior hypogastric plexus and what does it produce/innervate?

Answer 13

ONLY sympathetic

input from lumbar splanchnic Ns

produces ureteric plexus and testicular plexus

sends hypogastric Ns to Inf hypogastric plexus

Question 14

Where can you see the hypogastric Ns?

Answer 14

Can see it superior and anterior to anterior sacral rami

feeds lateral to medial to inf hypogastric plexus

Question 15

What parasympathetically innervates the descending and sigmoid colon?

Answer 15

inferior hypogastric plexus

Question 16

What nerves are only parasympathetic?

Answer 16

cavernous Ns

from uterovaginal plexus or prostatic plexus –> work to produce erections

Question 17

What are the branches of the prostatic plexus?

Answer 17

cavernous Ns (only PS)

Nerves of the ductus deferens

Nerves of the ejaculatory ducts

Nerves of the seminal vesicles

Question 18

How do visceral sensory fibers from the uterus, cervix, and vagina travel?

Answer 18

from fundus and body of Uterus: w/ sympathetic fibers of uterovaginal plexus

From cervis and upper vagina: w/ Parasympathetics

Question 19

What branches of the femoral A are relevant?

Answer 19

superficial and deep external pudendal A –> anterior scrotal/labial A

Question 20

What is the internal rectal venous plexus?

Answer 20

superior most anastomosis of the superior, middle, and inferior rectal Vs

Question 21

What is the external rectal venous plexus?

Answer 21

inferior most anastomosis of the superior, middle, and inferior Rectal Vs

Question 22

What N innervates the external urethral sphincter M?

What muscles are associated w/ it and are also innervated by the same nerve?

Answer 22

dorsal N of clitoris/penis

compressor urethrae m

urethrovaginal sphincter M

Question 23

What N innervates the external anal sphincter m?

Answer 23

inferior rectal N

Question 24

What are the small muscles branching from pubococcygeus?

Answer 24

levator prostatae

pubovaginalis

puboperinealis

puboanalis

Question 25

What nerves innervate the levator ani ms?

Answer 25

n to levator ani M (S4) inferior rectal N branches of coccygeal plexus

Question 26

What nerve innervates coccygeus M?

Answer 26

ner to the coccygeus (S4,5, branches of coccygeal plexus)

Question 27

What is the interureteric fold?

Answer 27

superior limit of the trigone

Question 28

What is vesical fascia?

Answer 28

loose connective tissue surrounding the detrusor M

Question 29

What are the contents of the spermatic cord?

Answer 29

ductus deferens testicular A A of ductus deferens cremasteric A Pampiniform plexus of veins genital branch of genitofemoral N

Question 30

What are mural granulosa cells?

Answer 30

become highly steroidogenic remain in the ovary after ovulation to differentiate into the corpus luteum

Question 31

What causes the breakdown of the follicle wall to release an egg during ovulation?

Answer 31

before ovulation, follicle presses against wall of ovary to form bulge = stigma LH surge --\> inflammatory cytokines and hydrolytic enzymes from theca and granulosa cells --\> breakwon follicle wall, tunica albuginea, etc

Question 32

What produces angiogenic factors to increase blood supply to a corpus luteum?

Answer 32

granulosa cells

Question 33

What happens to thecal cells after follicular atresia?

Answer 33

thecal cells persist and repopulate the cellular stroma of the ovary have LH receptors and ability to produce androgens collectively called the interstitial gland of the ovary

Question 34

What is the diagonal conjugate diameter?

Answer 34

from inferior edge of pubic symphysis to sacral promontory

Question 35

What structure is often damaged in anterior-posterior crush injuries of the pelvis?

Answer 35

urinary bladder

Question 36

Where is the pudendal canal located in the ischiorectal fossa?

Answer 36

lateral wall contains pudenal N and internal pudendal A

Question 37

What lobes are commonly involved in BPH?

Answer 37

middle lobes (central zone)

Question 38

Which pelvic floor muscle is likely to tear during childbirth if the perineum tears?

Answer 38

pubococcygeus

Question 39

What is a good landmark to find the left ureter?

Answer 39

anterior to left common iliac A

Question 40

What ligaments provide direct support to the uterus?

Answer 40

cardinal ligament uterosacral ligament

Question 41

What is the most typical position for the uterus?

Answer 41

anteflexed and anteverted

Question 42

What is contained in the pubocervical L?

Answer 42

superior vesicle artery and vein

Question 43

What is contained in the male urogenital diaphragm?

Answer 43

membranous urethra bulbourethral glands deep transverse perineal m external urethral sphincter

Question 44

What is contained in the female urogenital diaphragm?

Answer 44

deep tranverse perineal m external urethral sphincter m compressor urethrae m sphincter urethrovaginalis m bulb of the vestibule greater vestibular glands

Question 45

What secretes estradiol in the developing follicle?

Answer 45

theca interna

Question 46

How many days after ovulation does the corpus albicans begin to form?

Answer 46

14

Question 47

What are the 3 layers from out to in that the sperm needs to get through to get to the oocyte?

Answer 47

corona radiata zona pellucida plasma membrane

Question 48

What are the 3 steps of capacitation?

Answer 48

1. uterine and fallopian tubes wash away inhibitory factors from sperm 2. membrane becomes permeable to Ca --\> tail more powerful and ready to release stuff 3. activated sperm

Question 49

When do sperm express ZP-3 receptors?

Answer 49

only after capacitation

Question 50

What are the 3 glycoproteins in the zona pellucida and what do they do?

Answer 50

ZP-1 = crosslinker ZP-2 = blocks polyspermy ZP-3 = initiates acrosome rxn (then falls off)

Question 51

What occurs to sperm immediately after it enters the egg?

Answer 51

nucleoli merge and sperm DNA condenses

Question 52

What are the steps of the cortical Rxn

Answer 52

1. ZP-2 --\> ZPf --\> inhibits entrance of sperm 2. ca released --\> granules also released and egg completes meiosis II 3. Egg activated - sperm DNA condenses, male and femal pronuclei fuse

Question 53

What are the autocrine growth factor functions of hCG?

Answer 53

stimulates trophoblast growth and development stimulates placental growth

Question 54

What cells can secrete prolactin?

Answer 54

decidual cells

Question 55

What are the most high risk strains of HPV?

Answer 55

16 and 18