Lower Limb And Pelvis Flashcards by Victoria Carr

Arterial supply of uterus

Ovarian artery from L2- supplies ovaries
Uterine artery from internal iliac- supplies uterine tube
Vaginal artery from internal iliac- supplies middle uterine tube
Internal pudendal form internal iliac- supplies cervix

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Ovaries

Broad ligament is anterior- posterior to ovaries 
Arterial supply form L2 aorta 
Ovarian vein into IVC on the right 
Ovarian vein into renal vein on left
Nerve- aortic plexus
Suspensory ligament- carries vessels 
Ligament of ovary

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Position of uterus

Bladder empty- uterus antiflexion

Bladder fill- uterus anteversion

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Uterus ligaments

2 forwards- pubocervical
2 backwards- sacralcervical
2 to both sides- transversecervical

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Uterus arterial supply

Ovarian artery- suspensory ligament
Uterine artery- broad ligament
Suspensory ligament- ovarian artery, vein
Broad ligament- uterine artery form internal iliac

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Uterus; broad ligament

Over Fallopian tube- mesosalpinx
Over ovaries- mesovarium 
Over uterus- mesometrium
Broad ligament drain to external iliac lymph
Uterus-  internal iliac

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Rectum arterial supply

Superior rectal (inferior mesenteric)- portal vein
Middle rectal (internal iliac)- internal iliac vein
Inferior rectal (internal pudendal)- internal pudendal vein

Lymph: pararectal- inferior mesenteric- internal iliac
Nerve: inferior hypogastric plexus

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Rectum

Transverse folds
Rectal ampulla (stool stored)
Anorectal junction

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Bladder

2 superior vesicle artery
1 inferior vesicle artery/vaginal

Drainage of bladder and urethra- internal iliac lymph

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Sphincters

Sphincter vesicae- internal, involuntary, neck of trigone

Sphincter urethrae- external, voluntary,

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Clitoris

Crus- clitoris
Pudendal nerve and internal pudendal artery and vein
Pudendal n- dorsal nerve of the clitoris
Pudendal n- perineal n

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Nerves of penis

Pudendal nerve- inferior rectal, superficial and deep perineal nerve
Perineal- scrotal branches
Dorsal of penis- deep perineal pouch

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Male urethra

Pre-prostatic
Prostatic
Membranous
Penile (spongy)

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Penis

Corpus cavernosum (extension of Crura)
Corpus spongiosum (extension of bulb)
Urethra through corpus spongiosum

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Perineal body

Urogenital diaphragm attaches to this

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Non-erectile Muscles

Ischiocavernosus- around the side

Bulbospogiousus- labia or bulb

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Erectile tissue muscles

Ischiocavrnosus- crura

Bulbospongiosus- bulb of penis/ bulb of vestibule

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Superficial perineal pouch

Males- ischiocavenosus, bulbospongiosus, superficial transverse perineal
Females- urethra, vagina, clitoris, penis
Urethra and vagina also in deep pouch

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Deep perineal pouch

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Urethra
Sphincter urethrae
Deep transverse perineal muscles
Internal pudendal vessels and branches

Female also: vagina, dorsal nerves of clitoris
Males also: membranous urethra, dorsal nerves of penis, bulbourethral glands, penile arteries

Urogenital triangle

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Ischial tuberosities - pubic symphysis
Urogenital diaphragm- sphincter urethrae sandwiched between superficial and inferior fascia- membranous
Fuses together anteriorly but not to bone
Space for blood vessels
Superior Layer of fascia
Sphincter urethrae- deep perineal pouch
Inferior layer of fascia

Eternal anal sphincter

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Attaches to Perineal body
Closes anus with puborectalis
Nerve- inferior recal of pudendal (S2-4)
Has 3 parts; deep, superficial, subcutaneous
Artery- superior rectal - inferior mesenteric
Lymph- above pectinate line- internal iliac
Below pectinate line- superficial inguinal

Anal canal

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Internal anal sphincter- involuntary
External anal sphincter- voluntary
Anal columns- contains terminal branches of superior rectal
Rectum pierces pelvic floor- becomes anal canal

Ischioanal (rectal) fossa

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Walls- is hail tuberosity and rectum
Roof- levator ani
Floor- skin
Contents- branches of pudendal nerve, internal pudendal artery and vein, adipose tissue

Anal triangle

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Ischial tuberosity- coccyx= anal triangle

Ischial tuberosity- pubic symphysis= urogenital triangle

Prostate glands

Under bladder Secretes enzymes and acid Ejaculatory duct- meets urethra inside Arterial- internal pudendal, middle rectal, inferior vesicle Veins- deep dorsal of penis- plexus- internal iliac Ligament and muscle hold it in place- levator ani, pubo-prostatic ligament Lymph- testis- testicular, skin- superficial inguinal node

Seminal vesicles

``` Ejaculatory duct (vas deferens joins here) Arterial supply- inferior vesicle and prostate artery ```

Vas deferens

Through inguinal canal- over the bladder- seminal vesicles= ejaculatory duct- urethra

Posterior division of internal iliac

1st- iliolumbar 2nd- lateral sacral 3rd- superior gluteal

Anterior division of internal iliac

``` 1st- umbillical- superior vesicle x2 2nd-obturator 3rd- inferior vesicle/uterine 4th- middle rectal 5th- inferior gluteal 6th- internal pudendal Inferior vesicle- prostatic Uterine- vaginal ```

Vessels

L4 aorta divides- common iliac Common iliac- internal and external iliac Pelvis- internal Internal iliac divides- anterior and posterior divisions

Pudendal nerve

``` S2-4 Levator ani External anal and urethral sphincter Bulbospongiosus Ishiocavrnosus Transverse perineal Muscle Through greater and lesser sciatic notch ```

Levator ani

Nerve S4 and pudendal

Coocygeus

S4, 5

Sacral plexus

``` Superior gluteal L4, 5, S1 Inferior gluteal L5, S1, 2 Sciatic L4, 5, S1, 2 Pudendal S4-4 Nerve to obturator internus L5, S1 Nerve to piriformis S1-2 ```

Levator ani

Pubococcygeus Iliococcygeus- attaches to fascia of obturator internus Pubococcygues-puborectile (sling), levator prostate, pubovaginalis Innervation- pudendal and nerve to levator ani

Coccygeus

Ischial spine and sacrospinous ligament- attaches to Flexes coccyx Direct branch from sacral plexus S4-5

Pelvic diaphragm

Levator ani and coccygeus (pelvic floor) Prevents prolapse Levator ani is the roof of anal triangle

Psoas

Attach to T12-L4 of bodies and intervertebral discs Flexes hip, bends trunk laterally, raises trunk from supinate position L2-4 anterior rami

Iliacus

Iliacus and Psoas- iliospoas Iliospsoas joins lesser trochanter of femur Flexes hip Femoral nerve

Ligament in pelvic wall

Sacrotaberous and sacrospinous ligament form greater and sciatic notch Posterior sacroiliac ligament Anterior sacroiliac ligament Pubic symphysis= fibrocartilage

Contents of the femoral triangle

Lateral to medial NAVL | Femoral nerve, artery, vein

Deep fascia of the lower limb

Fascia latae thickens to form iliotibial tract

Cutaneous nerves- anterior

Anterior cutaneous branches of femoral L2-4

Superficial inguinal lymph nodes

``` Horizontal group- Medial: drain to anterior abdominal wall Lateral: drain to posterior abdominal wall Vertical group- Drain to superficial lower limb ```

Superficial vein

Great/long saphenous- medial, joins femoral vein Short saphenous- plantar, posterior leg through roof of popliteal fossa, popliteal vein Superficial epigastric- joins femoral, anterior thigh Circumflex iliac- joins femoral Accessory saphenous- joins femoral, going down

Femoral, obturator and sciatic nerves

Femoral L2,3,4- anterior thigh Obturator L2,3,4- medial thigh Sciatic L4,5,S1-3- posterior thigh

Pelvis- lower limb transition

Sciatic and gluteal nerve, artery, vein via great sciatic notch Femoral nerve and vessels via sublingual space Obturator nerve and vessels via obturator canal

Lower Limb And Pelvis Flashcards

(47 cards)