Lecture Exam 4 Flashcards
1
Q
What is the most posterior organ in the abdomen?
A
The Kidney (p.145)
2
Q
What are the functions of the kidneys?
A
Remove water, salts and products of protein metabolism from the blood (p.145)
3
Q
What does retroperitoneal mean?
A
It means that the given organ lies posterior to the peritoneum and are only covered by peritoneum on their ANT. surface (p.145)
4
Q
Where is the kidney located relative to a given vertebral level?
A
TV12 to LV3 (p.145)
5
Q
Where is the right kidney located relative to the left kidney?
A
The R. kidney is slightly lower than the L. kidney due to the large size of the R. lobe of the liver (p.145)
6
Q
The hilum of the kidney transmits what structures? (4 items)
A
- The renal vein (anteriorly)
- The renal artery (b/w renal v. and ureter)
- Ureter (posteriorly)
- Autonomic and sensory nerves
(p. 145)
7
Q
The kidneys lie where relative to the vertebral column?
A
Lateral to the vertebral column w/n the para-vertebral grooves (p.145)
8
Q
Strain of the psoas major is sometimes mistaken for kidney pain. Why?
A
B/C the kidneys lie ant. to the psoas major muscle (p.145)
9
Q
The hilum of the kidney is located where on the organ?
A
On the medial surface of the organ (p.145)
10
Q
The renal pedicle is known collectively as?
A
The structures which enter the hilum are known collectively by this term (p.145)
11
Q
The inner portion of the kidney known as the renal medulla contains approximately how many renal pyramids?
A
8-12 (p.146)
12
Q
How many minor calices are present in the kidney?
A
8-12, 1 for ea pyramid. (p.146)
13
Q
The renal pyramid terminates in an apex known as?
A
The renal papilla. (p.146)
14
Q
How many major calices are present in a kidney and where do they empty in to?
A
2-3 major channels which the minor calices empty in to. The major calices empty into the renal pelvis. (p.146)
15
Q
Which renal v. is longer, the right or left?
A
The left is longer and has many tributaries. (p.146)
16
Q
In the situation of an anatomical nutcracker, what structures may be compressed between the aorta and sup. mesenteric artery?
A
The left renal v. and the 3rd or inferior part of the duodenum. (p.146)
17
Q
The kidney receives its innervation mainly from what nerve of the renal plexus?
A
The least splanchnic n. (t12). (p.147)
18
Q
What purpose does fat around the kidney have?
A
Functions in protection, insulation, and support. (p.147)
19
Q
List the layers covering the kidney from innermost to outermost. (4 layers)
A
Renal capsule
perinephric fat
renal fascia
paranephric fat (p.147)
20
Q
A membranous layer of extraperitoneal tissue which splits to enclose the kidney is called?
A
The renal fascia. (p.147)
21
Q
What does it mean if an organ is extraperitoneal?
A
It means that the organ lies in a portion of the pelvis and abdomen which is not within the peritoneum (p.147)
22
Q
Renal calculi are composed primarily of?
A
Calcium oxalate, calcium phosphate, and uric acid. (p.147)
23
Q
What artery supplies the pelvic portion of the ureter?
A
The superior vesical A. (p.148)
24
Q
What retroperitoneal structure descends on the psoas major muscle?
A
The ureter. (p.148)
25
The upper part of the ureter lies in the ____ and the lower part lies in the ___.
abdomen; pelvis (p.148)
26
What are the three sites in which kidney stones can become lodged?
The ureteropelvic junction, the pelvic brim, and where the ureter enters the wall of the bladder (p.148)
27
What five arteries supply the ureter?
renal a., gonadal a., aorta, common iliac a., superior vesical a, (p.148)
28
The renal plexus and the hypogastric plexus supply innervation to what structure in the abdomen and pelvis?
the ureter (p.148)
29
The suprarenal gland consists of two parts that secrete two different hormones. Name the parts are their corresponding hormones.
Medulla - Secretes epinephrine and norepinephrine
Cortex - Secretes corticosteroids
(p.148)
30
What retroperitoneal organ lies on the superomedial aspect of the kidney?
The suprarenal gland. (p.148)
31
What three arteries supply the suprarenal gland?
Superior suprarenal artery from the inferior phrenic A.
Middle suprarenal artery from the aorta
Inferior suprarenal artery from the renal A.
(p.149)
32
How does the drainage of the right suprarenal vein differ from the left suprarenal vein?
R. suprarenal v. drains directly into the inferior vena cava.
L. suprarenal v. drains into the left renal v.
(p.149)
33
What is unique about the innervation of the suprarenal gland?
The suprarenal gland relative to its size has the largest autonomic nerve supply of any organ because of the fight or flight response and the need for rapid response to environmental stimuli via the hormones it releases
(p.149)
34
Suprarenal innervation is?
Primarily sympathetic from the celiac plexus and the thoracic splanchnic nerves
(p.149)
35
Pain from the kidney or suprarenal gland is often referred to what region?
The paralumbar region, or flank.
Remember from the loin to the groin
(p.149)
36
Kidney infection is more common in males or females and why?
Females because of the short urethra.
| p.149
37
This part of the abdominal diaphragm originates from the upper three lumbar vertebrae and splits to surround the esophagus.
Right Crus.
Weakness of the right crus is cause for a hiatal hernia.
(p.150)
38
What ligament forms the border of the aortic hiatus?
The median arcuate ligament. (p.150)
39
The medial arcuate ligament connects the body of LV1 to the TVP of LV1 and passes over what two structures?
Psoas major and the sympathetic trunk
| p.150
40
A positive psoas sign is indicative/suggests?
Appendicitis
| p.150
41
The psoas minor muscle is present in approximately what percentage of people?
60%
| p.150
42
Name the functions of the iliacus muscle. (2 of them)
Flexes the thigh and tilts the pelvis forward
| p.150
43
What muscle associated with the abdominal diaphragm functions in forced expiration and coughing?
The quadratus lumborum muscle.
| p.151
44
The lumbar plexus is formed by what nerve rootlets?
The anterior primary rami of L1 2 3 and PART of L4
| p.151
45
This nerve of the lumbar plexus accompanies the spermatic cord in males and round ligament of the uterus in females through the inguinal canal.
The ilioinguinal n.
| p.151
46
The iliacus muscle is the landmark used to find what nerve?
The lateral cutaneous nerve of the thigh (L2,3)
| p.151
47
Which two nerves of the lumbar plexus are common to the L1 APR and exclusive to it?
The iliohypogastric and ilioinguinal nerves.
| P.151
48
What nerve supplies the cremaster muscle?
The Genital branch of the genitofemoral n.
| p.151
49
What is the largest branch of the lumbar plexus?
The femoral n. (L234) Supplies the muscles and skin of the thigh.
(p.151)
50
The sacral plexus is formed from the?
Anterior primary rami of L4-S4.
| p.151
51
The abdominal aorta is a ___ structure whereas the thoracic aorta is biased towards the ___.
Midline; left
| p.152
52
The abdominal aorta passes through what before it descends anterior to the vertebral bodies?
Aortic hiatus
| p.152
53
At what point does the abdominal aorta bifurcate into the right and left common iliac arteries?
Anterior to LV4
| p.152
54
The right and left common iliac arteries bifurcate into?
The external and internal common ilia arteries.
| p.152
55
These arteries are synonymous with the posterior intercostal arteries.
```
Lumbar arteries (there are 4 pairs of them)
(p.152)
```
56
Name the branches of the abdominal aorta.
```
Come, Celiac Trunk
See, Superior mesenteric a.
It, Inferior mesenteric a.
In, Inferior phrenic a.
My, Middle suprarenal a.
Race, Renal a.
Go, Gonadal (testicular or ovarian) a.
Low, Lumbar a.'s (4 pairs)
Man, Median Sacral a.
(p.152)
```
57
Why are the ilia laterally flared?
To support abdominal structures and prevent them from falling out the bottom of the pelvis
(p.153)
58
Protection of the pelvic viscera occurs exclusively within which portion of the pelvis?
The true pelvis
| p.153
59
The pelvic cavity projects where relative to the abdominal cavity?
Posteriorly
| p.153
60
What two structures of the pelvis lie in the same vertical plane when the pelvis is in anatomical position?
The ASIS and the upper margin of the pubic symphysis
| p.153
61
The tip of the coccyx and the upper margin of the pubic symphysis lie in the same ____.
Horizontal plane
| p.153
62
The pelvis is formed by what four bones?
Left Hip Bone, Right hip bone, sacrum, and the coccyx
| p.153
63
Name the specific borders of the Pelvic inlet. (5)
Sacral promontory, sacral alae, arcuate line, pecten pubis, and pubic crest.
(p.154)
64
What is the difference between the pelvic brim and the pelvic inlet?
The pelvic inlet is like walking through a door, the pelvic brim (linea terminalis) is like a door frame.
(p.154)
65
What stucture of the pelvis divides the pelvis into a true and false pelvis?
The pelvic brim, True pelvis below it and false pelvis above it
(p.154)
66
Name the two functions of the false pelvis.
1. to serve as an attachment site for muscles 2. To support abdominal viscera
(p. 154)
67
The lower part of the GI tract, urinary bladder, lower part of the ureter, and internal reproductive organs are all contained in the?
True or lesser pelvis
| p.154
68
The boundaries of the pelvic outlet are?
Pubic symphysis, Ischiopubic rami, ischial tuberosities, sacrotuberous ligament, and the tip of the coccyx
(p.154)
69
What fills the pelvic outlet?
The perineum
| p.154
70
The pubic arch is formed by the?
Pubic symphysis, ischiopubic rami, and ischial tuberosities
| p.154
71
What type of pelvis is present in some males, 20% of females and characterized by a long a-p diameter and a short transverse diameter?
Anthropoid pelvis
| p.155
72
What is the ideal pelvis for childbirth?
Gynecoid pelvis
| p.155
73
This type of pelvis is rare in males and present in 2% of females.
```
Platypelloid pelvis
(p.155)
```
74
The male pelvic inlet is usually heart shaped whereas the female pelvic inlet is usually___.
Oval shaped
| p.155
75
The subpubic angle is larger in males or females?
Females
| p.155
76
This joint is the least mobile synovial joint in the body.
The Sacroiliac joint
| p.155
77
The pubic symphysis is a fibrocartilaginous joint and contains?
An interpubic disc.
| p.155
78
This joint contains an intervertebral disc and is often fused.
Sacrococcygeal joint.
| p.155
79
What hormone causes the joints of the pelvis to become more lax during pregnancy?
Relaxin
| p.156
80
Both ligaments of the pelvis extend from the sacrum and coccyx. Where do each of them go?
Sacrotuberous lig- ischial tuberosity
Sacrospinous lig- ischial spine
(p.156)
81
The greater and lesser sciatic foramen each open up where relative to the pelvic floor?
Greater sciatic foramen opens up above the pelvic floor
Lesser sciatic foramen opens up below the pelvic floor
(p.156)
82
What structures are common to/ pass through both the lesser and greater sciatic foramina?
The pudendal nerve, internal pudendal vessels, and the nerve to the obturator internus pass through both the greater and lesser sciatic foramina. (P.156)
83
Almost all structures transmitted by the greater sciatic foramen lie on top of what muscle?
The piriformis muscle. (P.156)
84
What sciatic foramen transmits the tendon of the Obturator Internus muscle?
The lesser sciatic foramen. (P.156)
85
What are the intrapelvic causes of sciatica?
Piriformis syndrome, Compression by the fetal head during pregnancy, and pelvic tumors. (P.157)
86
The lateral wall of the pelvis is covered primarily by ____ and the lateral portion of the posterior wall of the pelvis is covered by ___.
Obturator internus muscle and Obturator fascia; Piriformis muscle and Coccygeus muscle
(P.157)
87
The bony framework of the posterior wall of the pelvis is comprised by?
The sacrum and coccyx.
| P.157
88
The bony framework of the lateral wall of the pelvis is comprised by?
The portion of the hip bone which lies below the pelvic brim.
(P.157)
89
What structures give support to the abdominal and pelvic viscera?
Peritoneum (above) and the pelvic diaphragm (below). (P.157)
90
The ____ is the lowest point in the peritoneum in males whereas the ____ is the lowest point in the peritoneum in females.
Retrovesical pouch; Rectouterine pouch
| P.158
91
The ____ is the major support structure support structure for the pelvic viscera which consists of the coccygeus and the levator ani.
Pelvic Diaphragm
| P.158
92
This opening within the pelvic diaphragm is present in both sexes.
The anal aperture.
| P.158
93
What does the urogenital Hiatus transmit in males and females?
The urogenital hiatus transmits the urethra in males and the urethra and vagina in females. (P.158)
94
If someone is performing kegal exercises, they are utilizing what muscle?
The levator ani. (P.158)
95
What condition may occur in two of the peritoneum pouches?
Ascites may occur in the rectovesical pouch and the rectouterine pouch.
(P.158)
96
What parts of the levator ani function in micturition?
The puboprostaticus in males and pubovaginalis in females. Specifically they stop the flow of urine.
(P.159)
97
What division of the levator ani relaxes during defecation and also aids in parturition by directing the fetal head?
Puborectalis muscle.
| P.159
98
At approximately ____ vertebral level the abdominal aorta bifurcates in to the left and right common iliac artery.
LV4
| P.160
99
What structures does the external iliac artery supply in the pelvis?
None.
| P.160
100
This artery is crossed anteriorly by the ureter at the pelvic brim.
The internal Iliac artery.
| P.160
101
What branch of the Internal Iliac artery supplies the psoas major and quadratus lumborum muscles?
The lumbar branch of the iliolumbar artery which is a branch of the posterior trunk of the internal iliac.
(P.160)
102
Between the lumboscral trunk and the 1st sacral nerve we would expect to find what?
The superior gluteal artery.
| P.160
103
Between the 1st and 2nd, or 2nd and 3rd sacral nerves we would expect to find what?
The inferior gluteal artery.
| P.160
104
What arteries exit the pelvis through the greater sciatic foramen?
Superior gluteal, inferior gluteal, and internal pudendal arteries.
(P.161)
105
What would we expect to find exiting the pelvis between the piriformis and coccygeus muscles?
Internal pudendal artery.
| P.161
106
What artery in the female specimen is synonymous with the ductus deferens in males?
The uterine artery.
| P.161
107
What other branch comes directly off of the abdominal aorta besides the left and right common iliac arteries?
The gonadal artery
| P.161
108
This artery arises from behind the bifurcation of the abdominal aorta.
The median sacral artery. (Unpaired) (p.161)
109
The superior rectal artery is a branch from the?
Inferior mesenteric artery.
| P.161
110
Most structures from the pelvis drain into the ____ system except the Rectum and anal canal which have some ____ drainage.
Caval system; portal
| P.162
111
The inferior vena cava is comprised of the union of the?
The left and right common iliac veins.
| P.162
112
Which portion of the sacral plexus enters the pelvis through the anterior sacral foramina?
Anterior primary rami of s1-s4.
| P.162
113
What muscles prevent the pelvis from slumping to the unsupported side during gait?
The ant. Gluteal muscles.
| P.162
114
What nerve enters the perineum through the lesser sciatic foramen?
The nerve to the obturator internus muscle.
| P.162
115
What large muscle that we typically think of as a powerful hip extender actually is more involved with getting up from a seated position?
The gluteus Maximus.
| P.162
116
What nerve of the sacral plexus plays an integral role in the ability to maintain the integrity of the pelvic floor?
Nerves to levator ani and coccygeus muscles (s3 s4)
| P.163
117
What nerve is thought to play a role in sexual dysfunction?
The pudendal nerve (s2-4)
| P.163
118
What nerve roots comprise the coccygeal plexus?
The ventral primary rami of S4, 5 and the coccygeal nerve.
| P.163
119
What joins together in front of the coccyx to form the ganglion impar?
The left and right sympathetic trunks.
| P.163
120
How do sympathetic fibers reach the pelvis?
1 of 2 ways. 1, the downward continuation of the sympathetic trunk and 2, the downward continuation of the aortic plexus as the superior hypogastric plexus.
(P.163)
121
The aortic plexus becomes the superior hypogastric plexus after passing what landmark?
The bifurcation of the abdominal aorta into the right and left common iliac arteries.
(P.164)
122
Does the superior hypogastric plexus typically contain any parasympathetic fibers?
Not usually.
| P.164
123
What connects the superior hypogastric plexus to the inferior hypogastric plexus?
The left and right hypogastric nerves.
| P.164
124
The union of the hypogastric, pelvic splanchnic, and sacral splanchnic nerves is known as the?
Left and right Inferior hypogastric plexuses.
| P.164
125
The inferior hypogastric plexuses give rise to subsidiary plexuses which do what?
Supply the pelvic viscera.
| P.164
126
The Rectum is part of the ______ between _____ and anal canal.
Large intestine, sigmoid colon
| P.164
127
T/F. The rectum is part of the colon.
FALSE
| P.164
128
What rectal structure would we expect to find immediately above the pelvic diaphragm?
The rectal ampulla. (P.164)
129
How many rectal folds are found within the rectum?
There are three within the rectum. (p.165)
130
What forms the outer layer of the rectum?
The taeniae coli are spread out to form a more complete outer layer of the rectum. The Rectum has no mesentary, omental appendices, or haustra.
(p.165)
131
Is the rectum retroperitoneal?
The upper and middle third of the rectum is retroperitoneal. The lower third is entirely subperineal.
(p.165)
132
What are the boundaries of the anal canal?
The anal canal is the portion of the large intestine between the pelvic diaphragm and the anus.
(p.165)
133
What are the anal columns comprised of?
5-10 longitudinal folds of mucosa located in the upper half of the the anal canal. Each contains a small branch of the superior rectal artery and a small tributary of the superior rectal vein.
(p.165)
134
Anal valves connect?
The lower end of the anal columns.
| p.165
135
What is contained within the anal sinuses?
The anal sinuses contain mucous glands.
136
The pectinate line of the anal canal is the termination of what embryological development?
Termination of the hindgut.
| p.165
137
This muscular layer of the anal canal is under involuntary control and comprised of smooth muscle located below the pelvic diaphragm?
The internal anal sphincter.
| p.165
138
What part of the external anal sphincter is most superficial of the three parts?
The subcutaneous part.
| p.166
139
What is the function of the external anal sphincter?
To close the anal orifice. Note, contraction can be increased voluntarily.
(p.166)
140
What four arteries supply the Rectum and the anal canal?
The superior rectal, middle rectal, inferior rectal, and median sacral arteries.
(p.166)
141
Internal hemorrhoids are varicosities of the?
Superior rectal vein.
| p.166
142
What kind of hemmorrhoids are generally painless?
Internal Hemorrhoids.
| p.166
143
Varicosities of the ___ vein are associated with external hemorrhoids.
The inferior rectal veins.
| p.166
144
What morbid underlying condition is a cause for both internal and external hemorrhoids?
Portal hypertension.
| p.166
145
The pectinate line divides?
The anal canal into an upper two thirds and a lower one third.
(p.167)
146
The epithelium of the anal canal differs above and below the pectinate line. Explain.
Above the pectinate line the cells are columnar or cuboidal, below the pectinate line the epithelium is stratified or squamous.
(p.167)
147
How does the sigmoid column empty its contents and where does it empty to?
Through mass peristaltic movements, into the rectum.
| p.167
148
What muscle relaxes during defecation, therefore decreasing the angle of the perineal flexure?
The puborectalis muscle.
| p.167
149
During defecation, what opens the internal anal sphincter?
The increase in intra-abdominal pressure.
| p.167
150
Which anal sphincter is relaxed under voluntary control?
The external anal sphincter.
| p.167
151
How does bladder position differ between males and females?
The bladder is slightly lower in females than males.
| p.168
152
Where is the urinary bladder located?
The urinary bladder is located below the peritoneum.
| p.168
153
When the bladder is empty it lies where?
When the bladder is empty it lies entirely within the pelvis and rests against the pubis and the adjacent pelvic floor.
(p.168)
154
As the urinary bladder fills, its position changes how?
As the urinary bladder fills with urine, it rises into the abdomen and may reach as high as the umbilicus.
(p.168)
155
Where do the ureters meet the bladder?
As the ureters travel subperitoneally along the lateral wall of the pelvis, the ureters enter or meet the bladder at the fundus of the bladder.
(p.168)
156
What is the purpose of the retropubic fat pad?
It functions as a shock absorber to cushion the bladder when empty from ramming up against the pubis.
(p.168)
157
Why do females have to urinate frequently during pregnancy?
Frequent urination during pregnancy is a result of the position of the uterus over the bladder. When the uterus enlarges with pregnancy it puts pressure on the bladder therefore stimulating the urge to urinate.
(p.168)
158
What holds the bladder in place?
The puboprostatic or pubovesical ligament and the lateral ligament of the bladder.
(p.169)
159
What function does the detrusor muscle have?
It is a smooth muscle that drains the bladder. (p.169)
160
What prevents the reflux of semen into the bladder and the reflux of urine into the ureters and kidney?
The internal urethral sphincter. (p.169)
161
In what orientation do the ureters travel?
The ureters travel obliquely through the bladder wall in an inferomedial direction.
(p.169)
162
Blood supply to the urinary bladder is via the?
Superior and inferior visical arteries and the vaginal artery.
(p.169)
163
Prostatic and vesical plexuses are extensions of?
The inferior hypogastric plexus.
| p.170
164
What initiates the micturition reflex?
Bladder fullness.
| p.170
165
Bedwetting if formally known as?
Enuresis
| p.170
166
Activation of parasympathetic fibers from the pelvic splanchnic nerves (S234) causes contraction of _____ in both sexes and relaxation of the ______ in males only.
detrusor muscle; internal urethral sphincter
| p.170
167
The external urethral sphincter is under voluntary or involuntary control?
Voluntary control
| p.170
168
The ductus deferens carries sperm from ____ to ____.
From the testis to the ejaculatory duct.
| p.170
169
Where does the ductus deferens begin?
At the tail of the epididymis.
| p.170
170
The ductus deferens cross over what structure as it descends posterior to the bladder, medial to the seminal vesicle?
The ureter.
| p.171
171
The ductus deferens receives its innervation from the?
Superior and inferior hypogastric plexus
| p.171
172
The seminal vesicles are located where relative to the bladder?
Against the fundus of the bladder.
| p.171
173
The lower ends of the _____ become narrow and form ducts which join the ductus deferens to form the ejaculatory ducts.
Seminal vesicles
| p.171
174
What is the purpose of the alkaline secretion of the seminal vesicles in semen?
To neutralize the acidity of the vagina which is harmful to sperm.
(p.171)
175
Innervation of the seminal vesicles is via?
The inferior hypogastric plexus.
| p.171
176
The ejaculatory duct is formed by?
The union of the ductus deferens and the duct of the seminal vesicle.
(p.171)
177
The two ejaculatory ducts open into the____?
Seminal colliculus within the prostatic urethra.
| p.171
178
Blood supply to the ductus deferens, seminal vesicle, and the ejaculatory duct is via?
The artery to the ductus deferens, the inferior vesical artery, and the middle rectal artery. The inferior vesical artery is noted to be the most important.
(p.171)
179
How does the bladder differ in position between males and females?
The bladder is higher in males than in females.
| p.172
180
The prostate gland is composed of what kinds of tissue?
Smooth muscle, glandular tissue, and fibrous tissue.
| p.172
181
What is the function of the prostate?
To produce semen.
| p.172
182
Describe the relative position of the prostate gland in the pelvis.
It sits below the bladder, surrounds the urethra, posterior to the pubic symphysis, and immediately anterior to the rectal ampulla, in which the gland can be palpated through.
(p.172)
183
What part of the prostate contains no glandular tissue?
The part that lies anterior to the urethra, the isthmus.
| p.172
184
The two ejaculatory ducts, and the prostatic utricle open onto what structure within the prostatic urethra?
Seminal colliculus.
| p.172
185
The prostatic utricle is synonymous with what structure in females?
The uterus.
| p.172
186
What structure within the prostatic urethra receives the ducts of the prostate gland?
Prostatic sinus.
| p.172
187
The prostate receives its innervation from the?
Prostatic plexus and the inferior hypogastric plexus.
| p.172
188
Difficulty with micturition in men over 40 is a common symptom of?
Prostatic hypertrophy via compression of the urethra.
| p.173
189
Prostatic cancer can metastasize through?
Blood and lymph.
| p.173
190
How might prostate cancer spread to the vertebral column and pelvis?
Via connections between the prostatic and sacral venous plexus
(p.173)
191
Chronic inflammation of the prostate or prostate cancer may refer to pain?
The sacrum.
| p.173
192
What function do the ovaries have?
The ovaries produce oocytes after puberty and also have an endocrine function.
(p.174)
193
What hormones do the ovaries secrete?
Estrogen, progesterone, and relaxin.
| p.174
194
Describe the relative position of the ovary.
The ovary is located on the posterior aspect of the broad ligament on the lateral wall of the true pelvis. The ovaries lie within the ovarian fossa.
(p.174)
195
What are the boundaries of the ovarian fossa?
The obliterated umbilical artery anteriorly, and the ureter and internal iliac vessels posteriorly.
(p.174)
196
T/F. The ovary is covered in peritoneum.
False. The ovary is not covered by peritoneum.
| p.174
197
The oocyte is expelled from the ovary into what before entering the uterine tube?
The peritoneal cavity.
| p.174
198
The ligament of the ovary attaches the ovary to?
The body of the uterus.
| p.174
199
______ extends from the ovary to the pelvic brim and contains the ovarian vessels.
The Suspensory ligament of ovary.
| p.174
200
The ovaries receive their blood supply from?
The ovarian artery (from the abdominal aorta) and the ovarian branch of the uterine artery.
(p.174)
201
The ovary receives innervation from the?
Ovarian plexus.
| p.174
202
The uterine tubes extend from the _____ near the ovary to the ______.
peritoneal cavity, cavity of the uterus
| p.174
203
The uterine tubes transport oocytes from the ____ to the ____.
Ovary, uterus
| p.175
204
The passage of an oocyte takes approximately how much time?
3-4 days.
| p.175
205
T/F. Sperm are transported in the opposite direction compared to the transport of an oocyte.
True. The uterine tubes transport sperm from the uterus towards the ovary.
(p.175)
206
What are the two most common sites of fertilization?
1. Ampulla of the uterine tube.
2. Infundibulum of the uterine tube.
(p. 175)
207
The opening of the uterine tube near the ovary is called the?
Abdominal ostium.
| p.175
208
What is the narrowest external part of the uterine tube nearest the uterus called?
The isthmus.
| p.175
209
The longest and widest part of the uterine tube is called the ?
The ampulla.
| p.175
210
T/F. There is a gap between the abdominal ostium and the ovary. They are not connected.
True.
| p.175
211
When an oocyte is discharged from the ovary, what catches the oocyte?
The fimbriae.
| p.175
212
Why is there a double source of blood to the female reproductive structures?
So that there is always a back up source of blood should something happen to one arterial source during parturition.
(p.175)
213
Fertilization takes place in what structure?
The uterine tubes. Most commonly the ampulla followed by the infundibulum.
(p.175)
214
When tissue that normally lines the uterus grows outside of the uterus it is known as?
Endometriosis. (Endometrial cells line the uterus)
| p.176
215
The development of the fetus at some site other than the uterine cavity is known as?
An ectopic pregnancy.
| p.176
216
The most common type of ectopic pregnancy is known as?
Tubal ectopic pregnancy.
| p.176
217
Abdominal ectopic pregnancy is the development of the fetus in the?
The Rectouterine pouch.
| p.176
218
After menopause, what happens to the uterus?
There is an increase in fibrous tissue and cyst development.
| p.176
219
Embedding of the fertilized oocyte and fetal development usually occur in the?
The uterus.
| p.176
220
The birth canal is formed by the?
The cavities of the uterus and the vagina.
| p.176
221
The walls of the uterus are thick and muscular and the utuerus is shaped like a pear in what type of woman?
The nulliparous woman. (one with no children)
| p.176
222
The normal position of the uterus is?
Anteverted and anteflexed.
| p.176
223
The position of the uterus can change depending on?
The fullness of the bladder because it sits on top of it.
| p.176
224
Severe menstrual cramps, painful parturition, and increased risk of uterine prolapse are all associated with?
Retroversion of the uterus.
| p.176
225
The fundus of the uterus is located where relative to the uterine tubes?
Superior to the entrance of the uterine tubes.
| p.176
226
This part of the uterus is located inferior to the fundus and superior to the isthmus.
The body of the uterus.
| p.176
227
Anteversion is when the lower end of the uterus forms an approximate right angle with what structure?
The vagina.
| p.176
228
Anteflexion is when the uterus is bent downward the the junction of the?
Body of the uterus and the cervix.
| p.176
229
The isthmus of the uterus is also known as the?
The internal os.
| p.177
230
The cervix of the uterus has two parts. Name them.
The supravaginal part (the portion above the vagina) and the vaginal part (the portion within the vagina).
(p.177)
231
The opening of the cervical canal into the vagina is known as the?
The external os.
| p.177
232
The ____ extends from the internal os (isthmus) to the external os.
The cervical canal.
| p.177
233
The broad ligament is composed of?
A double layer of peritoneum.
| p.177
234
The broad ligament encloses what structures?
The uterine tubes.
| p.177
235
The round ligament of the uterus attaches?
The uterus below and anterior to the entrance of the uterine tubes.
(p.177)
236
What ligament terminates in the labia majora and passes through the inguinal canal?
The round ligament of the uterus.
| p.177
237
This ligament is a thickening of pelvis fascia which passes laterally from the cervix to merge with the upper fascia of the pelvic diaphragm.
The transverse cervical Ligament.
| p.177
238
When the uterus enlarges it can cause traction on what ligament?
The uterosacral ligament which passes backward from the cervix in the rectouterine fold to attach to the sacrum.
(p.177)
239
What structure is always in danger during a hysterectomy?
The ureter.
| p.177
240
What structures support the uterus?
The pelvic diaphragm, broad ligament, bladder, and the pubocervical ligament, transverse cervical ligament, and the uterosacral ligament.
(p.178)
241
Blood supply to the uterus is via the?
Uterine A. from the internal Iliac A. and the ovarian artery from the abdominal aorta.
(p.178)
242
Which lymph nodes of the uterus are most important for cervical cancer?
The internal iliac nodes which drain the cervix.
| p.178
243
The uterus is innervated via the uterovaginal plexus but responds primarily to?
Hormonal signals.
| p.178
244
The vaginal cavity communicates with the cervical canal above via the _____ and the vestibule below via the _____.
External os, vaginal orifice
| p.178
245
The fornix of the vagina is a recess between?
The cervix and the wall of the vagina.
| P.178
246
Why are vaginal fornices identified?
They are used in case histories during gynecological exams to report areas of lesion.
(p.178.)
247
The superior expanded portion of the vagina below the cervix is called?
The vaginal vault.
| p.179
248
What structures support the vagina?
The levator ani, perineal body, perineal membrane, and the pubocervical lig., transverse cervical lig., and the uterosacral lig.
(p.179)
249
The vaginal A. is from the internal iliac A. but sometimes has a common trunk with the?
Uterine A.
| p.179
250
The vagina has lymphatic drainage via the ___ nodes.
The internal iliac nodes which drain the upper 3/4 and the superficial inguinal nodes with drain the lower 1/4.
(p.179)
251
T/F. The vagina is highly sensitive.
False. The vagina has little sensation except in the lowermost part.
(p.179)
252
Bulging of the bladder into the anterior wall of the vagina is known as?
Cystocele. May cause difficulty in micturition.
| p.179
253
Bulging of the rectum into the posterior wall of the vagina is known as?
Rectocele. May cause difficulty in defecation.
| p.179
254
What muscle is crucial in maintaining pelvic floor integrity?
The purborectalis muscle. It is a subdivision or part of the levator ani and also helps to guide the fetal head during parturition in women.
(p.180)
255
In uterine prolapse, the uterus slips down into the vagina and descends to an abdominally low level in the pelvis. What may protrude externally through the vaginal orifice in this happens?
The cervix.
| (p.180)
256
What are the risk factors of uterine prolapse?
Multiple births and a Retroverted uterus.
| p.180
257
Pain from a retroverted uterus, inflammation of the uterine lining, or traction on the uterosacral ligament may refer pain to the?
Sacrum.
| p.180
258
Severe menstrual cramps may be related to?
L1 or L2 subluxations.
| p.180
259
Visceral causes of Sacral pain in males may come from?
Prostatitis in younger males and prostate cancer in older males.
(p.180)
260
The perineum shares the same boundaries as the?
The pelvic outlet.
| p.180
261
In anatomical position, the _____ triangle of the perineum lies in the horizontal plane whereas the ____ triangle of the perineum is tilted slightly upward.
urogenital, anal
| p.180
262
The crus of the penis and the clitoris and the bulb of the penis and vestibule in both sexes are formed by?
Cavernous erectile tissue
| p.181
263
Name the boundaries of the urogenital triangle.
Pubic symphysis, Ischial tuberosities, and the ischiopubic rami.
(p.181)
264
The superficial perineal fascia contains the?
Fatty layer of superficial fascia and the deep layer of membranous fascia.
(p.181)
265
What layer of fascia is continuous with the dartos layer of the scrotum and with scarpa's fascia?
Colles fascia or the membranous layer of the superficial perineal fascia.
(p.181)
266
What layer of fascia deeply invests the muscles of the superficial perineal pouch?
The deep perineal fascia.
| p.181
267
The deep perineal fascia is fused anteriorly with?
The suspensory ligament of the penis or clitoris.
| p.181
268
The superficial perineal pouch lies between what?
The superficial perineal fascia and the perineal membrane.
| p.181
269
What artery and nerve are contained within the superficial perineal pouch?
The internal pudendal artery and the pudendal nerve.
| p.181
270
The perineal body is composed of what type of tissue?
Fibromuscluar.
| p.182
271
The perineal body is an important site for?
Muscle attachment.
| p.182
272
What muscles attach to the perineal body?
Bulbospongious, superficial transverse perineal, deep transverse perineal, levator ani, and sphincter ani externus
(p.182)
273
What is the function of the ischiocavernousus muscle?
It impedes venous return by compressing the crus of the penis or clitoris thereby maintaining erection.
(p.182)
274
What is an episiotomy?
It is an incision from the posterior vaginal wall to the perineal body which is done to prevent damage to the perineum during parturition.
(p.182)
275
In males, what does the bulbospongiosus muscle do?
It impedes venous return to help maintain an erection, compresses the bulb of the penis and constricts the corpus spongiosum to empty the urethra at the end of micturition and during ejaculation.
(p.182)
276
In females, what does the bulbospongiosus muscle do?
It maintains erection of the clitoris by impeding venous return and constricts the vaginal orifice.
(p.183.)
277
The greater vestibular glands are homologous to what in males?
The bulbourethral gland in males.
| p.183
278
Located in the superficial perineal pouch posterior to the bulb of the vestibule we would find?
The greater vestibular glands.
| p.183
279
Parasympathetic activation of S234 causes dilation of what arteries?
Helicine arteries within the corpora cavernosa.
| p.183
280
What muscles maintain erection?
The ischiocavernosus and the bulbospongiosus.
| p.183
281
Between the perineal membrane and the inferior fascia of the pelvic diaphragm we find?
The deep perineal pouch.
| p.183
282
What structures are common to the superficial and deep perineal pouches?
The internal pudendal artery and the pudendal nerve.
| p.183
283
Which perineal pouch containes part of the urethra?
The deep perineal pouch.
| p.183
284
Female urinary incontinence following parturtion may be caused by?
Damage to the external urethral sphincter.
| p.184
285
What structure invests the anterior part of the prostatic urethra with the isthmus of the prostate?
The superior part of the external urethral sphincter muscle.
| p.184
286
The true anatomical sphincter in males is the?
Inferior part of the External urethral sphincter muscle.
| p.184
287
Which part of the external urethral sphincter muscle encircles both the urethra and the vagina?
The sphincter of the urethrovaginalis.
| p.184
288
The ducts of the ___ travel downward through the perineal membrane into the bulb of the penis to empty into the spongy urethra.
Bulbourethral glands.
| p.184
289
The bulbourethral glands in males are synonymous with what in females?
The greater vestibular glands.
| p.184
290
Although the bulbourethral glands are synonymous with the greater vestibular glands they differ in their location. Name their respective pouches.
The greater vestibular glands in females are located in the superficial perineal pouch whereas the bulbourethral glands in males are located in the deep perineal pouch.
(p.184)
291
T/F. The anal triangle is identical in both sexes containing the anal canal, external anal sphincter, and the ischioanal fossa.
True.
| p.185
292
The lateral wall of the ischioanal fossa is formed by?
Obturator fascia.
| p.185
293
What is contained within the ischioanal fossa?
Fat that fxns to support the anal canal, pudendal canal, inferior rectal nerve and vessels, and the perineal branch of the posterior cutaneous nerve of the thigh.
(p.185)
294
What prevents rectal prolapse and allows distension of the anal canal?
Fat in the ischioanal fossa.
| p.185
295
How can infection spread from the anal region to the urogenital triangle?
Via the anterior recesses of the ischioanal fossa.
| p.185
296
What connects the external anal sphincter to coccyx?
The anococcygeal ligament.
| p.185
297
The pudendal canal lies on the lateral surface of the ischioanal fossa; therefore, the fossa is formed by?
Obturator fascia.
| p.185
298
The internal pudendal artery and the pudendal nerve are transmitted by what in the anal triangle?
The pudendal canal.
| p.185
