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AANATOMY > Male pelvis > Flashcards

Male pelvis Flashcards

(88 cards)

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1
Q

What is the sacral promonotory and ala of the sacrum?

A
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2
Q

What is the arcuate line (OF THE ILIUM)?

(Not same as the arcuate line of the rectus sheath)

A
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3
Q

What is the pecten pubis also called?

Where is it located?

A

AKA Pectineal line

Ridge on the superior ramus of the pubic bone

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4
Q

Describe the location of the pubic crest.

What attaches here?

A

Medial to the pubic tubercle

Gives attachment to:

rectus abdominis

external oblique muscle

pyramidalis muscle.

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5
Q

What are the boundaries of the pelvic outlet

A

Anterior -> pubic symphysis

Anterolaterally -> pubic rami

Posteriolaterally -> sacrotubeorus ligaments

Posteriorly -> coccyx

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6
Q

Which parts of the pelvis are termed the true and false pelvis?

A

True below inlet

False above inlet

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7
Q

How do the greater and lesser pelvis (pelvis major and minor) differ in male and female?

A

Greater pelvis:

  • Female: Shallow
  • Male: Deep

Lesser Pelvis:

  • Female: Wide and Shallow
  • Male: Narrow and Deep
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8
Q

What is the shape of the pelvic inlet and outlet like in men and women?

A

Pelvic inlet:

  • Female: Oval and rounded
  • Male: heart shaped

Pelvic outlet:

  • Female: Comparatively large
  • Male: comparatively small
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9
Q

How does the subpubic angle differ between males and females?

A

Female: Obtuse

Male: Acute

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10
Q

How do the obturator foramens differ between men and women?

A

Females -> oval

Male -> round

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11
Q

How does the acetabulum differ in men and women?

A

Females -> small

Men -> large

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12
Q

What type of joints are the sacroiliac and pubic symphysis joints?

A

Sacroiliac joint -> synovial plane

Pubic symphysis -> secondary cartilaginous

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13
Q

What are the walls of the pelvic cavity?

A
  • Antero-inferior wall
    • (formed by the bodies and rami of the pubic bones and the pubic symphysis)
  • Two lateral walls
  • Posterior wall
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14
Q

Which muscle occupies the lateral pelvic wall?

A

Obturator internus

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15
Q

Which muscle is present on the posterior wall of the pelvis?

A

Piriformis

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16
Q

Which nerve network lies on the muscle forming the posterior wall of the pelvis?

A

Sciatic

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17
Q

What forms the pelvis floor?

A

Levator ani + ischiococcygeus

Levator ani = puborectalis, pubococcygeus, iliococcygeus

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18
Q

What is a raphe?

A

A groove in an organ or tissue

Marks the line where two halves fused in the embryo

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19
Q

What are the perineal and anococcygeal bodies?

A

Pernieal body -> firbomuscular mass that lies in the middle of the pernieal membarne that maintains the integrity of the pelvic floor

Anococygeal mass -> musculotendinous mass that lies between the coccyx and the anal canal

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20
Q

What is the function of the pelvic diaphragm/ floor

A
  • Support of abdominopelvic viscera
  • Resistance to increases in intra-abdominal pressure
  • Urinary and fecal continence
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21
Q

What is the innervation of the pelvic diaphragm/ floor?

A

PUDENDAL NERVE

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22
Q

Damage to the pelvic floor during childbirth is common and potentially damaging.

Why?

A

Weakening of levator ani and pelvic fascia

This alters position of the neck of the bladder and urethra

Can cause urinary stress incontinence

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23
Q

What is an episiotomy and why does it minimise damage during childbirth?

A

Enlarges vaginal opening by cutting into muscular area between vagina and anus (perineum)

Usually medio-laterally

Reduces…

Excessive tearing of pelvic floor

Spread of tears

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24
Q

Name 3 parts of the alimentary system that are present in the pelvis

A

Rectum

Anal canal

Transverse colon

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25
Branches of the right and left internal iliac artery distribute blood to most of the pelvic organs, perineum and gluteal region except what?
Gonads (testes and ovaries) Upper part of rectum
26
The venous drainage of the pelvis structures consists of which 5 different veins?
Internal iliac veins Superior rectal veins Median sacral vein Gonadal veins Internal vertebral venous plexus
27
Which part(s) of the rectum drain into the portal and systemic circulation?
Superior = portal Middle and inferior = systemic
28
The veins along the sides and base of the prostate join to form the prostatic venous plexus. With which venous plexus does the prostatic venous plexus communicate on its posterior side?
This drains into the internal vertebral venous plexus. Cancer commonly spreads through this route from prostate to vertebral bodies
29
Which nerve supplies skin at the root of the penis in the male and the labia in the female?
Ilioinguinal nerve
30
What nerve root does the ilioinguinal nerve originate from?
L1
31
The ilioinguinal nerve enters the inguinal ring where?
Superficial inguinal ring
32
What is the nerve root of the genitofemoral nerve?
L1-L2 (genitofemoral nerve lies on the illiopsoas
33
The genitofemoral nerve enters the inguinal canal where?
Deep inguinal ring
34
What structures in the male are supplied by the genital branch of the genito-femoral nerve?
Anterior scrotum and cremaster muscle
35
What is the clinical significance of the loss of the genital branch of the genitofemoral nerve?
Cremaster reflex lost -\> no temperature control of testes
36
What plexus does the pudendal nerve arise from?
Sacral plexus
37
What two muscles in the reproductive organs does the pudendal nerve supply?
Bulbospongiosus and ischiocavernosus muscles
38
From which segmental level(s) does the pudendal nerve arise?
S2-S4
39
How does the pudendal nerve travel from pelvis to perineum? (why is it important to know this?)
Via the gluteal region This arrangement is essential to understand in bilateral pudendal nerve block for pain relief during childbirth
40
What bony landmark do you look for when performing a pudendal nerve block during labour?
Ischial spine
41
Sympathetic fibres from L1-L2 travel via what plexus to supply the vas deferens, seminal vesicles, prostate and epididymis in the male?
Hypogastric plexus
42
What nerves supply sympahethic and parasympathetic innervation to the female genital tract?
Sympathetic -\> pelvic and ovarian plexus Parasympathetic -\> pelvic splanchnic nerves (S2, S3 and S4)
43
What innervates erectile tissue in both male and female?
Parasympathetic fibres from S2, S3 and S4 via the hypogastric plexus
44
What forms erectile tissues?
Tissues with numerous vascular spaces that may become engorged with blood
45
Name the 4 primary node groups in the pelvis
Common iliac lymph nodes External iliac lymph nodes Internal iliac lymph nodes Sacral lymph nodes
46
The external iliac lymph nodes drain what?
Inguinal lymph nodes Adductor region of thigh Superior part of the anterior and middle pelvic organs
47
The internal lymph nodes drain what?
Gluteal region Deep perineum Inferior pelvic viscera
48
What do the sacral lymph nodes drain?
Rectum Posterior wall of pelvis (posteroinferior pelvic viscera)
49
What do the common iliac lymph nodes drain?
external & internal iliac LNs Sacral LNs
50
What 3 categories can the reproductive organs be grouped into?
1. Gonads: * Testes or ovaries * Where gametes or sex cells are produced * Site for the production of important sex hormones 2. External genitalia 3. Internal genitalia * Tube system for conveying gametes * Accessory glands which support the gametes and lubricate the copulatory organs
51
What is included in the male internal reproductive organs?
Testis Vas deferens Seminal glands Prostate Epididymis Bulbourethral glands
52
In the male the gonads are located outside the abdominopelvic cavity, but remain intimately connected to the structures located there. What purpose does this serve?
Temperature regulation
53
What are the main contents of the spermatic cord?
Vas deferens Pampiniform plexus Cremaster muscle Testicular artery Genitofemoral nerves Lymphatics
54
The ovoid testes are suspended in the scrotum by what?
Spermatic cords
55
What is the tough outer fibrous layer of the testis?
Tunica albuginea
56
The tunica vaginalis is a peritoneal sac covering the testis. What are the two layers of the tunica vaginalis?
Parietal and visceral
57
What material is present between the two layers of tunica vaginalis?
Fluid lubricating layers
58
Increase in blood between the two layers of tunica vaginalis is called what?
Haematocoele
59
What vertebral level fo the testicular arteries arise from the abdominal aorta?
L2
60
Name two important structures the testicular arteries pass near the pelvic brim before they travel through the inguinal canal
Ureters Inferior parts of the external iliac arteries
61
What is the term used for the 8-12 anastomosing veins associated with the testis?
Pampiniform Venous Plexus
62
What is the function of the pampiniform venous plexus?
Venous return and temperature regulation of testes
63
Into which vein does the right and left testicular vein drain?
Right = IVC Left = Left renal vein
64
Which two lymph node groups recieve lymph from the testis?
Right and left lumbar Para-aortic lymph nodes
65
Describe the route of the vas deferens
arises from the tail of the epididymis traverses the inguinal canal enters the pelvis by crossing over the external iliac vessels. Terminates by joining the duct of the seminal gland to form the ejaculatory duct
66
WHat secretions are produced by the seminal vesicles?
65-75% of seminal fluid Thick alkaline fluid (Rest produced by prostate)
67
What is the clinical significance of drainage from the prostatic venous plexus?
Gives passage to parasympathetic fibres which give rise to the cavernous nerves that convey the fibres that cause penile erection
68
What are the Bulbourethral (Cowper's) Glands?
These are small, paired structures located in the urogenital diaphragm which empty into the penile/ spongy urethra. They produce mucus like secretions which enter the urethra during sexual arousal, contributing less than 1% of semen
69
What is the lymphatic drainage of the prostate?
Internal iliac and sacral nodes
70
What is the lymphatic drainage of the seminal vesicle?
External iliac
71
What is the lymphatic drainage of the scrotum?
Superficial inguinal
72
What is the lymphatic drainage of the penis?
Superficial and deep inguinal
73
What are the histological features of the testes (seminiferous tubules)?
Convoluted tubules sectioned in various planes. 4-8 layers of cells. Spermatozoa in the lumen. Leydig cells in the interstitial spaces between tubules
74
What are the histological features of the prostate?
Serous aveloi with infolding epithelium. Trabeculae of muscular stroma Amorphous eosinophilic masses, called corpora amylacea, in the elveoli in older men
75
What are the histological features of the seminal vesicle?
No sperms in the lumen Highly recessed and irregular lumen forming crypts and cavities giving a honey combed appearances Well developed muscular externa
76
What are the histological features of the ductus deferens?
Lumen Stellate in shape A thick walled muscular tube Epithelial lining and its supporting lamina propria are thrown into longitudinal folds
77
What imaging is this and what is it showing
USS Shows the testes (right) and epididymis
78
What is this imaging and what is it showing
USS of testes Yes there is a mass in it but who gives a fuck
79
What imaging is this and what are the arrows pointing to
MRI Green **-\> Bladder** Orange **-\> seminal vescile** Blue **-\> anal canal**
80
What image is this and what is the arrow pointing to
MRI ## Footnote **Prostate**
81
What is the function of the crmaster and dartos muscles?
Thermoregulation of the testes
82
What is this and label 1, 2 & 3
Speramtic cord 1- Internal spermatic fascia 2- cremaster muscle 3- External spermatic fascia
83
What is number 8
Tunica albuginea
84
Why is the left testicular cancer more dangerous than the right?
As the left testicual (gonadal) vein drains into the left renal vein, so the cancer can spread to the kidenys more easily
85
What are the fluids secreted by the prostate, seminal vesciles and bulbourethral galnds
**Prostate -\>** liquid rich in citric acid and proteolytic enzymes (lquifies coagulated semen) **Seminal vesicle -\>** thicc alkaline fluid that contains fructose, prostaglandins, fibrinogen and Vit. C **Bulbourethral glands -\>** Mucous like secretions during sexual arousal (pre-cum) **What prostatic fluid contains** Fructose Vit. C Fibrinogen Prostaglandins
86
What are the sympathetic (L1-L2) and parasymapthetic (S2-S4) responses for sexual activivity in a man (erection, emission, ejaculation, emission)
**Erection** -\> parasympathetic **Emission** -\> sympahetic **Ejaculation** -\> paraympathetic & sympathetic **Remission** -\> sympathetic For ejaculation: Parasympathetic -\> contraction of external uertheral sphincter Symaphetic - contraction of internal urethral sphincter
87
What does the inguinal canal contain
Ilio-ingunial nerves Inguninal LN Spermatic cord **Spermatic cord contains** Genito-femoral nerve Testicular artery Vas deferens Panpiniform plexus Cremaster muscle
88
How do the gonadal arteries travel
Retroperitoneally

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