Male Pelvis Flashcards
(63 cards)
Where is the pelvic viscera relative to the pelvic pain line?
Inferior to it (pelvic pain line runs along inferior border of peritoneum)
What happens to the pelvic fascia when they penetrate the pelvic floor and what is this called?
The parietal and visceral pelvic fascia become continuous and thick, forming the tendinous arch
What is the anterior aspect of the tendinous arch of pelvic fascia called in males and females respectively?
Puboprostatic ligament (males), pubovesical ligament (females)
Two potential spaces of the male pelvis
Rectropubic and rectrorectal
Name the three leaflets of the hypogastric sheath, including alternate names and where each attaches
Anteriormost (Lateral ligament of the bladder) - attaches to bladder. Posteriormost (presacral fascia) - attaches to rectum, Middle lamina (rectovesical septum in males runs btwn bladder and rectum, transverse (cardinal) ligament in females, attaches to cervix of uterus)
Where are the ureters relative to the ductus deferens in males?
Posterolateral to ductus deferens
List the arteries that send branches to supply the ureter
Renal artery, Gonadal artery, Aorta, Common Iliac, Internal Iliac, Superior Vesical, Uterine (f), Middle Rectal, Vaginal (f), Inferior Vesical (m)
Where does the ureter get its innervation from?
Adjacent autonomic plexuses
Is the course of the ureter mostly superior or inferior to the pelvic pain line?
Superior
What does the bladder rest on?
Anteriorly on the pubic bone and symphysis, posteriorly on the prostate (male) or vagina (female)
What holds the neck of the bladder in place?
Lateral ligament of bladder and tendinous arch of pelvic fascia
List the four surface and four parts of the bladder
Surfaces - Superior, 2 inferolateral, and posterior. Parts - Apex, fundus, body, neck
What three points create the triangular-shaped trigone of the bladder?
The two ureteric orafices (superior) and the internal urethral orifice (inferior)
Uvula of the bladder
Elevated ridge along the wall of the inferior bladder, in the trigone region
Where is the detrusor muscle and what is the orientation of its fibers?
Muscle of the bladder, fibers are scattered in orientation, no particular pattern
What feature of the bladder is present in one sex but not the other, which sex is it present in, and what does it do?
The involuntary internal urethral sphincter is present only in males, it prevents reflux of semen into the bladder
Arterial supply to the bladder
Superior vesical aa, Inferior vesical aa (m), Vaginal aa (f), Obturator aa, Inferior Gluteal aa
Venous drainage for the bladder
Vesical venous plexuses (m/f), also prostatic venous plexuses (m), drain to internal iliac vein (m/f)
What system innervates the detrusor muscles?
Parasympathetic (this tells you to go to the bathroom)
Where do visceral afferent fibers leaving the bladder go?
Fibers from superior portion of bladder follow sympathetic fibers retrogradely, fibers from inferior portion follow parasympathetic fibers retrogradely (remember pelvic pain line)
Which nervous system helps you not go to the bathroom and which system helps you go to the bathroom?
Parasympathetic - go to bathroom, Sympathetic - not now
How long are the male and female urethrae?
Male - 18-22 cm, Female - 4 cm
4 parts of the male urethra and the lengths of each
Intramural (preprostatic) (1-1.5 cm), Prostatic (4 cm), Intermediate (less than 1 cm), Spongy (15-16 cm)
What are the widest/most distensible and shortest/least distensible parts of the male urethra?
Prostatic is widest and most distensible, Intermediate is shortest and least distensible
